title: Baseline psychological stress and ovarian norepinephrine levels negatively affect the outcome of in vitro fertilisation.
abstract: OBJECTIVE
  We determined the effect of baseline psychological stress and norepinephrine (NE) levels in the follicular fluid on the outcome of in vitro fertilisation (IVF).
  
  
  METHODS
  One hundred seven women with tubal factor infertility were evaluated before and during their first IVF treatment. On the first day of down-regulation, their psychological state was measured using the Zung Self-rating Anxiety (SAS) and Depression Scales (SDS), and defined as baseline psychological stress. On oocyte retrieval day, NE levels in the follicular fluid and peripheral plasma were measured by high-performance liquid chromatography.
  
  
  RESULTS
  On the first day of down-regulation, nearly 10% of the women with tubal factor infertility reported that they were experiencing both anxiety and depression. This baseline psychological stress was lower in pregnant (3.7%) than in non-pregnant women (15.7%, p<0.05). On oocyte retrieval day, the NE levels in follicular fluid were almost twice the amount seen in peripheral plasma, but did not differ in pregnant and non-pregnant women (p>0.05). NE levels in follicular fluid were negatively associated with the percentage of good quality embryos (r= -0.62, p<0.05).
  
  
  CONCLUSIONS
  Baseline psychological stress (both anxiety and depression) may negatively influence the clinical pregnancy rate of IVF treatment in women with tubal factor infertility. Furthermore, follicular NE levels are negatively associated with the percentage of good quality embryos.
authors.affiliation: Reproductive Medical Center of West China 2nd Hospital, Sichuan University, Ren Min Nan Lu, City of Chengdu, Sichuan, 610041, People's Republic of China.
authors.forename: Xiao-Hong
authors.initials: XH
authors.lastname: Li
authors.forename: Yu-Gen
authors.initials: YG
authors.lastname: Ma
authors.forename: Li-Hong
authors.initials: LH
authors.lastname: Geng
authors.forename: Lang
authors.initials: L
authors.lastname: Qin
authors.forename: Han
authors.initials: H
authors.lastname: Hu
authors.forename: Shang-Wei
authors.initials: SW
authors.lastname: Li
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods* / Q000523:psychology; D015571:Follicular Fluid / Q000378:metabolism*; D006801:Humans; D009638:Norepinephrine / Q000378:metabolism*; D011247:Pregnancy; D013315:Stress, Psychological / Q000378:metabolism / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D009638:Norepinephrine