An increased vulnerability to stress is associated with a poor outcome of in vitro fertilization-embryo transfer treatment

Objective: To evaluate the association between the vulnerability to stress and the treatment outcome of couples undergoing IVF-ET. Design: Controlled, prospective clinical study. Setting: The Assisted Reproduction Unit of the Department of Obstetrics and Gynecology, University of Modena. Patient(s): Forty-nine infertile women consecutively admitted to standard superovulation treatment. Mean age was 33.9 years, duration of infertility was 6.3 years. Reasons for assisted reproduction were mechanical factor in 22 cases, sperm problem in 9 cases, and endocrine disorder in 6 cases. In 12 cases, infertility was unexplained. More than 55% already had an IVF-ET attempt. Intervention(s): The day of oocyte pick-up, subjects were submitted to Stroop Color and Word test, a task measuring the ability to cope with a cognitive stressor, involving attentional and sympathoadrenal systems. Systolic (SEP) and diastolic blood pressure, as well as heart rate (HR) were measured at baseline, during the test, and 10 minutes after the end of testing. Main Outcome Measure(s): The evidence of a biochemical pregnancy (beta-hCG value 12 days after ET) define the success and failure groups. Result(s): Sixteen women (33%) had a biochemical pregnancy, 12 also had ultrasound evidence. Eight gave birth to healthy infants. Age, education, causes, and duration of infertility were similar in the success and failure groups. The latter were more involved in a job outside home than the former. Moreover, they had a lower number of both fertilized oocytes and transferred embryos. In response to the Stroop test, every subject reported an increase of cardiovascular parameters. However, women becoming pregnant showed a lower response of both SEP and HR than women who failed. Conclusion(s): Both a major cardiovascular vulnerability to stress and working outside home are associated to a poor outcome of IVF-ET treatment.