Stress: does it affect IVF outcomes?

09 Apr Stress: does it affect IVF outcomes?

Stress and IVF. We’re always told the two don’t mix. Clinics say take it easy, before and after your treatment. Friends keep a respectful distance. But the truth is, stress and anxiety don’t seem to affect IVF outcomes that much. But read on.

A study in into emotional stress and infertility said as much. It gathered data from 14 separate studies, which followed over 3,500 women having fertility treatment. It concluded that the distress that women naturally feel before IVF treatment, as well as stress from other aspects of their life, doesn’t impact on their pregnancy chances.

But other studies beg to differ. A later study into stress and IVF found that lower stress levels the day before egg retrieval led to higher pregnancy rates. But this study was very small, and so we can’t give it too much weight in comparison to larger studies.

A bigger trial took place in 2019. Looking at physiological and psychological stress during IVF, it found that stress doesn’t negatively affect IVF outcomes. Cortisol samples were taken on egg retrieval and embryo transfer day. The highest stress levels were, unsurprisingly, on egg retrieval day. Stress levels dropped by embryo transfer day, though first-time IVF patients were more stressed. But it didn’t matter. In fact, even when follicle cortisol levels were high, it didn’t affect things.

But then there’s the genetic argument. A recent study into stress and infertility suggested blocking the gene that controls the stress hormone. It argued that this may counteract the longer-term negative consequences of stress, potentially improving female fertility.

Studies into stress and infertility are rarely conclusive. Percentages are often smaller than you think. Most of us cope with low levels of stress well, although excessive stress is unpleasant and can sometimes lead to physical illness.

Yet there are many arguments in favour of fostering a sense of psychological wellbeing during IVF and other fertility treatments. Stress also comes in many forms, including childhood stress, short-term stress and more complex stress. Measuring the effect of stress is hard. People react to stress in different ways.

In terms of male fertility, we know that stress can affect sperm concentration, morphology and volume. But this can be corrected by ICSI in an IVF cycle. It’s certainly the case that sperm samples from the same patient can vary widely. Stress may play a part.

Our best advice to prospective IVF patients? Rest when you can. Eat a balanced diet (both partners). Take moderate daily exercise. Limit everyday stress – the easiest form of stress to control. And seek fertility counselling for more ingrained stress you may think you have from past events.

Stress can be anticipated, managed and overcome. Whether you’re blessed with a baby or not, it’s possible to emerge from IVF with your head held high. Keep a positive outlook if you can – it could make all the difference.