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Hum. Reprod. Advance Access originally published online on May 22, 2009
Human Reproduction 2009 24(9):2173-2182; doi:10.1093/humrep/dep185
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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

Stressful life events are associated with a poor in-vitro fertilization (IVF) outcome: a prospective study

S.M.S. Ebbesen1,3, R. Zachariae1, M.Y. Mehlsen1, D. Thomsen1, A. Højgaard2, L. Ottosen2, T. Petersen2 and H.J. Ingerslev2

1 Department of Psychology, University of Aarhus, Jens Chr. Skous vej 4, 8000 Aarhus, Denmark 2 The Fertility Clinic, Aarhus University Hospital, 8200 Aarhus, Denmark

3 Correspondence address. E-mail: signese{at}psy.au.dk

BACKGROUND: There is preliminary evidence to suggest an impact of stress on chances of achieving a pregnancy with in-vitro fertilization (IVF). The majority of the available research has focused on stress related to infertility and going through IVF-treatment, and it is still unclear whether non-fertility-related, naturally occurring stressors may influence IVF pregnancy chances. Our aim was to explore the association between IVF-outcome and negative, i.e. stressful, life-events during the previous 12 months.

METHODS: Prior to IVF, 809 women (mean age: 31.2 years) completed the List of Recent Events (LRE) and questionnaires measuring perceived stress and depressive symptoms.

RESULTS: Women who became pregnant reported fewer non-fertility-related negative life-events prior to IVF (Mean: 2.5; SD: 2.5) than women who did not obtain a pregnancy (Mean: 3.0; SD: 3.0) (t(465.28) = 2.390, P = 0.017). Logistic regression analyses revealed that the number of negative life-events remained a significant predictor of pregnancy (OR: 0.889; P = 0.02), when controlling for age, total number of life-events, perceived stress within the previous month, depressive symptoms, and relevant medical factors related to the patient or treatment procedure, including duration of infertility, number of oocytes retrieved and infertility etiology. Mediation analyses indicated that the association between negative life events and IVF pregnancy was partly mediated by the number of oocytes harvested during oocyte retrieval.

CONCLUSION: A large number of life-events perceived as having a negative impact on quality of life may indicate chronic stress, and the results of our study indicate that stress may reduce the chances of a successful outcome following IVF, possibly through psychobiological mechanisms affecting medical end-points such as oocyte retrieval outcome.

Key words: infertility/stress/negative life events/IVF/treatment outcome

Submitted on December 30, 2008; resubmitted on April 17, 2009; accepted on April 21, 2009.


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