Stress and outcome success in IVF: the role of self-reports and endocrine variables.
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.
Smeenk
J M J
JM
Department of Obstetrics and Gynaecology, Radboud University Nijmegen Medical Center, PO Box 9101, NL-6500 HB Nijmegen, The Netherlands. j.smeenk@obgyn.umcn.nl
Verhaak
C M
CM
Vingerhoets
A J J M
AJ
Sweep
C G J
CG
Merkus
J M W M
JM
Willemsen
S J
SJ
van Minnen
A
A
Straatman
H
H
Braat
D D M
DD
D000328:Adult; D001007:Anxiety / Q000097:blood / Q000150:complications / Q000503:physiopathology; D003863:Depression / Q000097:blood / Q000150:complications / Q000503:physiopathology; D004837:Epinephrine / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro / Q000523:psychology*; D006728:Hormones / Q000097:blood*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007247:Infertility, Female / Q000503:physiopathology* / Q000523:psychology* / Q000628:therapy; D009490:Neurosecretory Systems / Q000503:physiopathology; D009638:Norepinephrine / Q000097:blood; D011446:Prospective Studies; D020554:Sperm Injections, Intracytoplasmic / Q000523:psychology; D013312:Stress, Physiological / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D006728:Hormones; D006854:Hydrocortisone; D009638:Norepinephrine; D004837:Epinephrine