The effect of anxiety and depression on the outcome of in-vitro fertilization

BACKGROUND: The study aim was to clarify the role of anxiety and depression on the outcome in assisted reproductive treatment. Previous studies on thi s topic have shown contradicting results, which may have been caused by pop ulation characteristics, the design of the study, or small sample sizes. ME THODS: In a multicentre prospective study, 291 out of 359 (81%) consecutive ly invited women agreed to participate. Before down-regulation by means of gonadotrophin-releasing hormone (GnRH) analogues in a long IVF protocol, pa tients were asked to complete the Dutch version of the State and Trait Anxi ety Inventory to measure anxiety, and the Dutch version of the Beck Depress ion Inventory (BDI) to measure depression. Multiple logistic regression ana lysis was used to analyse known predictors of pregnancy and psychological f actors and their relationship with treatment outcome. RESULTS: A significan t relationship was shown between baseline psychological factors and the pro bability to become pregnant after IVF/intracytoplasmic sperm injection (ICS I) treatment, controlling for other factors, State anxiety had a slightly s tronger correlation (P = 0.01) with treatment outcome than depression (P = 0.03), CONCLUSIONS: Pre-existing psychological factors are independently re lated to treatment outcome in IVF/ICSI, and should therefore be taken into account in patient counselling, Psychological factors may be improved by in tervention, whereas demographic and gynaecological factors cannot, Future s tudies should be directed towards underlying mechanisms involved and the ro le of evidence-based distress reduction in order to improve treatment resul ts.