ALTERED RESPONSES TO STRESS IN WOMEN UNDERGOING IN-VITRO FERTILIZATION AND RECIPIENTS OF OOCYTE DONATION

Clinical impressions suggest the presence of considerable anxiety and depression in infertile couples. We utilized a psychological stress te st to assess adaptations to provoked stress to improve the psychologic al profile of infertile women. A psychological stress test was adminis tered to four groups: normal menstruating females (controls, n = 13); oocyte donors (n = 13); recipients of oocyte donation (n = 7); and wom en undergoing standard in-vitro fertilization (IVF; mean age 38.0 year s; n = 8). The psychological stress test consisted of three active cop ing tasks: (i) serial subtraction, (ii) Stroop colour test, (iii) spee ch task and (iv) one passive coping task, the cold-presser test. Haemo dynamic responses (HD) were monitored before, during and after the psy chological stress test, and serum samples were drawn for catecholamine s and cortisol. Baseline blood pressures were similar among groups. Th e psychological stress test elicited different biophysical responses i n controls compared with the other groups (P < 0.001). Oocyte donors h ad different speech task responses from baseline, although these and t he other parameters of the psychological stress test were not differen t from either the recipient or IVF groups. Blood pressure responses fr om baseline were blunted in both recipients and standard IVF patients following provoked stress. Baseline cortisol and norepinephrine were s imilar among all groups, yet provoked stress elicited a significant in crease in controls (142.0 +/- 25.2%, P < 0.001) compared with oocyte d onors (17.1 +/- 19.7%), recipients and standard IVF patients (mean -15 .5 +/- 17.3% respectively). Norepinephrine responses were apparently g reater in controls (60.1 +/- 13.1%) compared with oocyte donors (41.8 +/- 27%) and recipient and IVF groups combined (21.7 +/- 12.4%) but th is result was not significant. These data suggest that infertile women have blunted biophysical and biochemical reactions to provoked behavi oural stressors. Oocyte donors demonstrate blunted passive coping resp onses similar to those of infertile women, yet still respond to active coping stressors in a manner similar to that of normal controls. Our data suggest that infertility therapy combined with the anticipation o f success or failure results in blunted patterns of response to passiv e coping stressors. However, blunted active coping responses are uniqu e to infertile women,