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Fertility Treatment Success Not Prevented by Emotional Distress


A new study reports emotional distress in women undergoing IVF (invitro fertilization) or other assisted reproduction therapy will not prevent the treatment from working.

Professor Jacky Boivin from the Cardiff Fertility Studies Research Group and colleagues have published their findings in the February 23, 2011 issue of the British Medical Journal.

Infertility affects up to 15% of women of childbearing age. Over half of these individuals will seek medical advice in the hope of becoming a parent.

It is a commonly held belief that emotional distress (for example stress and tension) is a factor in not getting pregnant naturally or lack of success with fertility treatment. This view is largely based on anecdotal evidence and fertility myths such as 'don't think about it and you'll get pregnant'.

Most doctors are skeptical that stress affects fertility, but note the lack of evidence on this issue. Boivin and colleagues investigated links between the success of fertility treatment and stress by undertaking a large scale review (meta-analysis) of related research.

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Two authors independently assessed the studies for eligibility and quality (using criteria adapted from the Newcastle-Ottawa quality scale) and extracted data.

Fourteen studies with 3,583 infertile women undergoing a cycle of fertility treatment were included in the review. The women were assessed before fertility treatment for anxiety, stress, and depression. The authors then compared data for women who achieved pregnancy and those who did not.

The researchers found pretreatment emotional distress was not associated with treatment outcome after a cycle of assisted reproductive technology (standardized mean difference −0.04, 95% confidence interval −0.11 to 0.03 (fixed effects model); heterogeneity I²=14%, P=0.30).

Subgroup analyses according to previous experience of assisted reproductive technology, composition of the not pregnant group, and timing of the emotional assessment were not significant.

Professor Boivin therefore argues that "these findings should reassure women that emotional distress caused by fertility problems or other life events co-occurring with treatment will not compromise their chance of becoming pregnant".

Emotional distress in infertile women and failure of assisted reproductive technologies: meta-analysis of prospective psychosocial studies; Boivin J, Griffiths E, Venetis CA; BMJ 2011; 342:d223 doi: 10.1136/bmj.d223 (Published 23 February 2011)