STRESS AND ANXIETY DO NOT RESULT IN PREGNANCY WASTAGE

The association between stress and reproductive outcome is unclear. In -vitro fertilization (IVF) is psychologically stressful and has been s hown to alter psychological markers such as cortisol, prolactin and pr ogesterone, This study was designed to assess prospectively psychologi cal and physiological markers of stress and to determine if they are r elated to pregnancy outcome. Forty patients were recruited from Northw estern Medical Faculty Foundation (Chicago, Illinois, USA) having obta ined an initial positive beta-human chorionic gonadotrophin (HCG) conc entration 13 days after IVF with uterine embryo transfer. Patients und erwent psychological and hormonal testing on three separate occasions (13, 20 and 27 days after embryo transfer) early in pregnancy. All sub jects were followed to delivery. An adverse outcome was defined as a m iscarriage before or after cardiac activity (including vanishing twin) or a loss before 20 weeks gestation. There was no difference in age, duration of infertility, diagnosis between patients experiencing an ad verse pregnancy outcome (n = 18) and those that did not (n = 22), All patients were found to have high stress levels although this did not d ifferentiate between groups of patients, There was no difference in ho rmonal markers of stress between patients. In conclusion, there is lit tle association between psychological scores and physiological stress hormone concentrations. Also, it does not appear that high levels of a nxiety and stress result in an adverse pregnancy outcome.