STRESS AND STRESS-RELATED HORMONES DURING IN-VITRO FERTILIZATION TREATMENT

Whether stress and infertility are linked as cause or consequence is u nclear, and there is no consensus on the most appropriate methods for measuring stress in infertile women. To address this question, we meas ured changes in biochemical and questionnaire-based assessments of str ess in infertile women. Median baseline, follicular phase and pre-oper ative serum prolactin (229, 311 and 457 mIU/I) cortisol (278, 369 and 496 nmol/l) and state anxiety score (38, 40 and 49) respectively all i ncreased during stimulated in-vitro fertilization (IVF) treatment. The re was no such increase in a control group having similar laparoscopic surgery unrelated to infertility, or in women having unstimulated IVF without laparoscopy, suggesting that anxiety levels are greatest in s timulated IVF, increase as a result of the treatment, and are adequate ly reflected by state anxiety scores, Baseline serum prolactin in unst imulated IVF (384 mIU/l) was significantly higher than control (177 mI U/l), although this was not reflected in serum cortisol or state anxie ty score. Trait anxiety was constant within and between groups, sugges ting that stress is not contributing greatly to the infertility. Women who achieved a pregnancy had similar state anxiety scores to those wh o failed, suggesting that the degree of anxiety observed during IVF tr eatment is unlikely to influence the chance of pregnancy. There was a trend towards lower trait anxiety in women who became pregnant, but th e numbers were small.