Immunological changes and stress are associated with different implantation rates in patients undergoing in vitro fertilization-embryo transfer

Objective: To evaluate the possible correlation between immunological chang es and implantation rates in patients who undergo in vitro fertilization-em bryo transfer (IVF-ET). Design: Controlled clinical study. Setting: University hospital. Patient(s): Forty infertile women undergoing IVF-ET. Intervention(s): Stroop Color Word (CW) test, State-Trait Anxiety Inventory (STAI) test, blood sampling. Main Outcome Measure(s): Heart rate and systolic and diastolic blood pressu re responses to Stroop CW; circulating T, B, T-helper (CD4), and T-suppress or (CD8) lymphocytes. Result(s): The total number of T lymphocytes increased significantly during superovulation, resulting in significantly higher levels in subjects achie ving embryo implantation than in those showing a failure of implantation. A n opposite trend was observed for the activated T cells. The number of T-he lper lymphocytes and the T-helper/T-suppressor ratio showed a significant i ncrease from baseline to the time of pick-up only in patients with implanta tion. Conclusion(s): A prolonged condition of stress, which causes a decreased ab ility to adapt and a transitory anxious state, is associated with high amou nts of activated T cells in the peripheral blood. Such a condition, in turn , is associated with a reduced implantation rate in women undergoing IVF-ET . (C) 2001 by American Society for Reproductive Medicine.