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Hum. Reprod. Advance Access published online on January 21, 2005
Human Reproduction, doi:10.1093/humrep/deh739
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Human Reproduction © European Society of Human Reproduction and Embryology 2005; all rights reserved
Received May 25, 2004
Revised September 10, 2004
Accepted December 14, 2004

Article

Stress and outcome success in IVF: the role of self-reports and endocrine variables

J.M.J. Smeenk 1*, C.M. Verhaak 2, A.J.J.M. Vingerhoets 3, C.G.J. Sweep 4, J.M.W.M. Merkus 1, S.J. Willemsen 4, A. van Minnen 5, H. Straatman 6, and D.D.M. Braat 1

1 Departments of Obstetrics and Gynaecology, University Medical Center Nijmegen, PO Box 9101, NL-6500 HB Nijmegen, The Netherlands
2 Department ofMedical Psychology, University Medical Center Nijmegen, PO Box 9101, NL-6500 HB Nijmegen, The Netherlands
3 Department of Clinical Health Psychology, Tilburg University, PO Box 90153, NL-5000 LE Tilburg, The Netherlands
4 Department ofChemical Endocrinology, University Medical Center Nijmegen, PO Box 9101, NL-6500 HB Nijmegen, The Netherlands
5 Department of Clinical Psychology, Radboud University Nijmegen Medical Center, PO Box 9104, NL-6500 HE Nijmegen, The Netherlands
6 Department ofEpidemiology and Biostatistics, Radboud University Nijmegen Medical Center, PO Box 9101, NL-6500 HB Nijmegen, The Netherlands

* To whom correspondence should be addressed.
J.M.J. Smeenk, E-mail: j.smeenk{at}obgyn.umcn.nl


  Abstract

BACKGROUND: The aim of this study was to examine the associations between urinary levels of the stress hormones adrenaline, noradrenaline and cortisol during treatment with self reported stress, in order to investigate the mechanism for the previously observed negative association of anxiety and depression with the outcome of IVF/ICSI. METHODS: In a multicentre prospective cohort study, women entering their first cycle of IVF/ICSI treatment were asked to participate. From each participant nocturnal urine samples were collected; pre-treatment, before oocyte retrieval and before embryo-transfer (ET), to assess hormonal concentrations. Additionally, two questionnaires were administered before the start of the treatment to measure anxiety and depression. RESULTS: 168 women completed the questionnaires and collected at least two urine specimens. A significant positive correlation between urinary adrenaline concentrations at baseline and ET and the scores on depression at baseline were found. In women with successful treatment, lower concentrations of adrenaline at oocyte retrieval and lower concentrations of adrenaline and noradrenaline at ET, compared with unsuccessful women, were found. CONCLUSIONS: The significant positive association of adrenaline concentration with pregnancy and with depression suggested that this adrenal hormone could be one of the links in the complex relationship between psychosocial stress and outcome after IVF/ICSI.

Keywords: anxiety; catecholamines; cortisol; depression; in vitro fertilization.
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