title: Pituitary-adrenal and sympathetic nervous system responses to psychiatric disorders in women undergoing in vitro fertilization treatment.
abstract: OBJECTIVE
  To evaluate whether psychological variables as well as changes in hypothalamus-pituitary-adrenal (HPA) axis and sympathetic nervous system (SNS) at baseline and in response to a psychosocial stressor affect the chance of achieving pregnancy in women undergoing a first in vitro fertilization (IVF) cycle.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Private IVF center.
  
  
  METHODS
  264 women undergoing IVF or intracytoplasmic sperm injection (ICSI) treatment.
  
  
  METHODS
  Oocyte retrieval after ovarian stimulation.
  
  
  METHODS
  Standardized psychological questionnaires to assess anxiety and depression, and norepinephrine and cortisol in serum or follicular fluid measured by specific assays.
  
  
  RESULTS
  Only a trend increase was found in psychological scores during treatment, which did not affect the ongoing pregnancy rates. On the oocyte retrieval day, a statistically significant increase in norepinephrine and cortisol concentrations was found. Lower concentrations of norepinephrine and cortisol, both in serum and follicular fluid, were found in women whose treatments were successful. Concentrations of steroid in serum before treatment and in follicular fluid were positively associated with the State Anxiety scores.
  
  
  CONCLUSIONS
  Norepinephrine and cortisol concentrations may negatively influence the clinical pregnancy rate in IVF treatment. These biological stress markers could be one of the links in the complex relationship between psychosocial stress and outcome after IVF-ICSI.
authors: Department of Reproductive Medicine, First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, People's Republic of China.
authors: Yuan
authors: Y
authors: An
authors: Zhuoran
authors: Z
authors: Wang
authors: Hongping
authors: H
authors: Ji
authors: Yajuan
authors: Y
authors: Zhang
authors: Kun
authors: K
authors: Wu
mesh_terms: D000328:Adult; D001007:Anxiety / Q000209:etiology / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D002681:China; D003863:Depression / Q000209:etiology / Q000503:physiopathology; D005260:Female; D005307:Fertilization in Vitro / Q000523:psychology*; D015571:Follicular Fluid / Q000378:metabolism; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007030:Hypothalamo-Hypophyseal System / Q000378:metabolism / Q000503:physiopathology*; D007246:Infertility / Q000097:blood / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D016014:Linear Models; D009638:Norepinephrine / Q000097:blood; D054315:Oocyte Retrieval / Q000523:psychology*; D010062:Ovulation Induction / Q000523:psychology*; D010913:Pituitary-Adrenal System / Q000378:metabolism / Q000503:physiopathology*; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D013315:Stress, Psychological / Q000209:etiology* / Q000503:physiopathology; D011795:Surveys and Questionnaires; D013564:Sympathetic Nervous System / Q000378:metabolism / Q000503:physiopathology*; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D006854:Hydrocortisone; D009638:Norepinephrine