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Hum. Reprod. Advance Access originally published online on January 28, 2009
Human Reproduction 2009 24(5):1092-1098; doi:10.1093/humrep/den491
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© The Author 2009. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Anxiety and depression have no influence on the cancellation and pregnancy rates of a first IVF or ICSI treatment

A.M.E. Lintsen1,5, C.M. Verhaak2, M.J.C. Eijkemans3, J.M.J. Smeenk1,4 and D.D.M. Braat1

1 Department of Obstetrics and Gynaecology, Radboud University Nijmegen Medical Centre, 6500 HB Nijmegen, The Netherlands 2 Department of Medical Psychology, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands 3 Department of Public Health, Erasmus MC, University Medical Center, Dr Molewaterplein 50, PO Box 2040, 3000 CA Rotterdam, The Netherlands 4 Department of Gynaecology and Obstetrics, St Elisabeth Hospital, Hilvarenbeekse Weg 60 5022 GC Tilburg, The Netherlands

5 Correspondence address. Tel: +31-24-3619573; Fax: +31-24-3668597; E-mail: a.lintsen{at}obgyn.umcn.nl

BACKGROUND: After many years of research, the impact of psychological distress on the IVF treatment outcome is still unclear. This study aimed to determine the influences of anxiety and depression before and during IVF or ICSI treatment on the cancellation and pregnancy rates of inductees.

METHODS: In a multicentre prospective cohort study, we assessed anxiety and depression at baseline and the procedural anxiety level one day before oocyte retrieval, with the short versions of the State Anxiety Inventory (STAI) and the Beck Depression Inventory-Primary Care (BDI-PC). The effect of baseline anxiety and depression on the cancellation and pregnancy rates of 783 women in their first IVF or ICSI treatment was evaluated. We also determined if a change in anxiety from the start of treatment until just before oocyte retrieval affects the pregnancy rate. The predictive value of distress was assessed while controlling for several factors in subfertility treatment.

RESULTS: Neither baseline nor procedural anxiety, nor depression affected the ongoing pregnancy rates, with odds ratios (ORs) of 1.04 (95% CI 0.82–1.33), 0.96 (95% CI 0.77–1.20) and 0.85 (95% CI 0.65–1.10), respectively. Neither did the anxiety gain score affect the pregnancy rate, OR 1.08 (95% CI 0.83–1.41). A cancellation of treatment could not be predicted by either anxiety or depression, OR 1.16 (95% CI 0.83–1.63) and 0.85 (95% CI 0.59–1.22), respectively.

CONCLUSIONS: Inductees in IVF treatment can be reassured that anxiety and depression levels before and during treatment have no significant influence on the cancellation and pregnancy rates.

Key words: anxiety/depression/distress/IVF/pregnancy rate

Submitted on October 31, 2008; resubmitted on December 8, 2008; accepted on December 10, 2008.


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