The focus of this research database is on how stress affects women's health,

and options for treatment using mind-body therapies. 

If you are not a health care professional, see new "Medical Glossary" below.  

To obtain full summaries of the articles, see "How to Get Abstracts" below. 

A survey of members of the American Fertility Society, with a 47% response rate, revealed that most did not psychologically screen infertility patients prior to being accepted into their programs. Four "red flags" were significantly endorsed for treatment rejection: substance abuse, physical abuse, severe marital strife, and coercion of one spouse by another.

1993 J Psychosom Obstet Gynaecol 14 Suppl;37-44

Leiblum, S. R. and Williams, E.

10587818 JA

IVF patients showed a variety of coping patterns depending on gender, education, stressors, and levels of depression, anxiety and overall psychopathology. The most common pattern overall was fatalism, and the most common for men was problem-solving.

1999 Int J Psychiatry Med 29;2:251-60

Sonawalla, S., Parikh, R., and Parikh, F.

69% of recipients of frozen-thawed embryos donated by other infertile couples vs. 47% of the donors, felt that the child should be informed about the manner of conception. 29% of recipients and 42% of donors thought the child should receive identifying information concerning the donor couple--considerations of knowing genetic origin, and also knowing full-blood genetic siblings.

2001 Hum Reprod 16;6:1120-8

Soderstrom-Anttila, V., Foudila, T., Ripatti, U. R., and Siegberg, R.

9539279 JA

More than 90% of Swedish women of different fertility subgroups were in favor of oocyte donation, although the majority wanted both donor and recipient to remain anonymous.

1998 Acta Obstet Gynecol Scand 77;3:317-21

Westlander, G., Janson, P. O., Tagnfors, U., and Bergh, C.

1586034 JA

In 1995 payment for ovum donors was $2500 with 39% identifying financial motivation as an important factor. In 1998 payment was $5000, and 68% identified financial motivation. With money a dominant factor in a young, inexperienced population, greater attention needs to be made to informed consent.

2001 Gynecol Obstet Invest 52;2:89-92

Lindheim, S. R., Chase, J., and Sauer, M. V.

10756602 JA

[Article in German] Per abstract, subjects rated the pain of transvaginal oocyte retrieval similar to that of surgery, bone fracture or delivery. Younger women and those with a history of dysmenorrhea perceived pain more strongly, and these patients may especially benefit from medication or anesthesia.

2000 Zentralbl Gynakol 122;3:169-74

Wicke, V., Weigert, M., Danninger, B., Fuchs, R., Stangl, S., Deixler, B., Leitl, E., and Feichtinger, W.

11206432 JA

Although Taiwanese IVF mothers rated themselves higher in protectiveness toward their children than non-IVF mothers, teachers blinded to condition rated IVF mothers as displaying greater warmth but not overprotective.

2001 Dev Psychol 37;1:37-48

Hahn, C. S. and DiPietro, J. A.

10080360 R,T

Thorough review of research on stresses involved in IVF, from baseline state, through the process, and after successful and unsuccessful results.

1999 Soc Sci Med 48;5:575-89

Eugster, A. and Vingerhoets, A. J.

7921010 JA

Women experienced greater stress than men from IVF procedures, and both men and women agreed the most stressful times were negative outcomes and waiting for results.

1994 J Psychosom Obstet Gynaecol 15;2:85-92

Laffont, I. and Edelmann, R. J.

11204620 JA

Of infertile Chinese couples, wives experienced significantly more stress from infertility tests and treatments than their husbands.

2001 Arch Androl 46;1:67-71

Lee, T. Y., Sun, G. H., and Chao, S. C.

11532476 JA

Women who were depressed prior to their first IVF cycle were less likely to become pregnant.

2001 Fertil Steril 76;3:525-31

Verhaak, C. M., Smeenk, J. M., Eugster, A., van Minnen, A., Kremer, J. A., and Kraaimaat, F. W.

11438324 JA

IVF patients who had increased activated T cells and increased cardiovascular reactivity, both signs of stress, had significantly decreased implantation rates.

2001 Fertil Steril 76;1:85-91

Gallinelli, A., Roncaglia, R., Matteo, M. L., Ciaccio, I., Volpe, A., and Facchinetti, F.

10696958 JA

22 Swedish women entering IVF treatment had significantly higher levels of suspicion, guilt and hostility than fertile controls. They also had higher levels of prolactin and cortisol than controls, but these levels did not differ between those who became pregnant and those who didn't.

2000 Acta Obstet Gynecol Scand 79;2:113-8

Csemiczky, G., Landgren, B. M., and Collins, A.

11569423 JA

[Article in Czech] Per abstract, of 66 IVF couples, women who were more depressed and anxious were significantly less likely to achieve pregnancy.

2001 Ceska Gynekol 66;4:264-9

Koryntova, D., Sibrtova, K., Klouckova, E., Cepicky, P., Rezabek, K., and Zivny, J.

11591398 JA

Baseline stress levels significantly inversely correlated with number of oocytes fertilized and embryos transferred, as well as rate of live birth delivery.

2001 Fertil Steril 76;4:675-87

Klonoff-Cohen, H., Chu, E., Natarajan, L., and Sieber, W.

9949886 JA

Increased risks for depression in 281 German IVF couples were unsuccessful treatment outcome, repeated treatment cycles, low socioeconomic status, foreign nationality, and for women, lack of partner support.

1999 Andrologia 31;1:27-35

Beutel, M., Kupfer, J., Kirchmeyer, P., Kehde, S., Kohn, F. M., Schroeder-Printzen, I., Gips, H., Herrero, H. J., and Weidner, W.

Sperm of men who showed a higher cardiovascular response to stress, indicating decreased stress coping ability, were less likely to have fertilized oocytes even though sperm count, motility and capacitation were similar to the more successful group.

2000 Psychother Psychosom 69;5:275-9

Tarabusi, M., Matteo, M. L., Volpe, A., and Facchinetti, F.

10221709 JA

This study replicated other findings that the quality of semen significantly decreased from a pre-IVF sampling period to the time of egg retrieval. Since the spermatogenic cycle is approximately 70 days, and the time interval of the study was 30-45 days, it was felt that accumulated stress during the weeks in-between sequentially affected spermatogenesis. The men felt significantly stressed on egg retrieval day that they produce a specimen. It was noted that men were very uncomfortable talking about stress, and attempted to minimize or mask any stress effects. Future studies may want to measure cortisol, etc. for evaluation.

1999 Hum Reprod 14;3:753-8

Clarke, R. N., Klock, S. C., Geoghegan, A., and Travassos, D. E.

2226921 JA

After a failed first cycle, both partners showed significant increases in anxiety and depressive symptoms. Women without children were particularly vulnerable to the stress of failure.

1990 Fertil Steril 54;5:879-86

Newton, C. R., Hearn, M. T., and Yuzpe, A. A.

8350290 JA

"Veteran" IVF patients were significantly more depressed than first timers, but not more anxious. Depressed veterans were significantly less likely to have successful IVF outcomes in the first 6 cycles, were more likely to drop out of IVF, and less likely to become pregnant during the following year.

1993 J Psychosom Res 37;5:481-91

Thiering, P., Beaurepaire, J., Jones, M., Saunders, D., and Tennant, C.

11157838 JA

2-3 years after IVF, most women were glad they had tried it Those women in whom the results were unsuccessful did not have any increased subsequent marital or mood problems, but did have a decrease in life satisfaction. Women agreed that the most stressful time was after implantation prior to pregnancy test.

2001 Hum Reprod 16;2:374-83

Hammarberg, K., Astbury, J., and Baker, H.

11062855 JA

Infertile women were significantly more anxious and depressed than fertile women, both qualities of which significantly increased even more if IVF failed. After three years of infertility, there was a trend to decreasing psychological distress.

2000 J Assist Reprod Genet 17;8:445-8

Kee, B. S., Jung, B. J., and Lee, S. H.

10394525 CT

By law, Austrian physicians must offer psychological counseling to IVF patients, unless refused. In this study of 1156 patients, those who underwent counseling (which included psychotherapy, hypnotherapy and relaxation exercises) had a 56.4% pregnancy rate, those who refused 44.3%, those who were planning to but didn't 41.9%, and those who did not comment on the questionnaire 39.0%. [Statistical analysis not given.]

1999 J Assist Reprod Genet 16;6:302-5

Poehl, M., Bichler, K., Wicke, V., Dorner, V., and Feichtinger, W.

11554198 JA

Being sexually active during the IVF treatment period was positively associated with likelihood of conception and adaptive coping strategies.

2001 J Sex Marital Ther 27;5:389-94

Bar-Hava, M., Azam, F., Yovel, I., Lessing, J. B., Amit, A., Abramov, L., Militscher, I., and Chen, J.

11584476 JA

In this double blind study of Korean infertility patients and American, Canadian and Australian prayer groups, IVF patients who were prayed for had significantly higher implantation and pregnancy rates (50% vs. 26% p=.0013).

2001 J Reprod Med 46;9:781-7

Cha, K. Y., Wirth, D. P., and Lobo, R. A.

10899502 CT

Patients in an IVF support group met twice a week in the early morning to coincide with blood draws and procedures. They felt the group helped to decrease stress, and the social support was highly valued, with strong bonds forming quickly. They did not want more information, or to learn relaxation techniques such as guided imagery, but wanted to share their similar situations. Themes were isolation, comparing notes about procedures, the impact of infertility on their marriages, feelings of inadequacy and jealousy of fertile couples, coping with family insensitivity, sadness during the holidays, questioning of faith and anger at God, ethical and moral issues of what they were doing, and alternate procedures. "Men frequently adopted the job of tracking technical details such as dosages of medication...seemed to be a gender-typical way they could both participate in the process and gain some sense of control over it...they felt they had to remain calm and rational because their wives 'seemed so out of control'."

2000 Fertil Steril 74;1:87-93

McNaughton-Cassill, M. E., Bostwick, J. M., Vanscoy, S. E., Arthur, N. J., Hickman, T. N., Robinson, R. D., Neal, G. S., and Bostwick, M.

9197445 JA

Women facing IVF who coped well with their situation were more likely to have good personality disposition, a high level of self-esteem, be satisfied with their job and relationship with their husband, and be willing to consider adoption if necessary.

1997 Acta Obstet Gynecol Scand 76;5:431-7

Bringhenti, F., Martinelli, F., Ardenti, R., and La Sala, G. B.

9130064 JA

"The ART (assisted reproductive technology) experience appears to have a profound psychological affect on participants." Psychological counseling can help patients with the intense demands of treatment, complex ethical decisions about number of eggs to implant or use of donor gametes, and cope with disappointment of failed outcome. Even if they do not take advantage of counseling services, patients reported being less stressed knowing they are available.

1997 J Assist Reprod Genet 14;4:186-8

Greenfeld, D. A.

9130063 JA

This author feels that since so much emphasis is placed on counseling for infertility patients, but only about 20% make use of this counseling, that the other 80% are being neglected. He surmises they are finding ways to cope on their own, but notes that in one study the number one thing IVF patients had wanted was a booklet of information about the psychological aspects of infertility and its treatment. This psychosocial information would be of benefit to all.

1997 J Assist Reprod Genet 14;4:184-6

Boivin, J.

8671350 JA

This article looked at less obvious impacts of IVF to better prepare patients and those who care for them. Women noted significant tiredness due to treatment medications, and increasing physical discomfort, culminating at time of egg retrieval such that 20% of women had to curtail activities. There was a surge of optimism with successful embryo transfer that might need to be tempered with realism. Women made extensive use of social support during the waiting period after transfer, and those who do not have such support may need clinic staff to help fulfil this need.

1996 Hum Reprod 11;4:903-7

Boivin, J. and Takefman, J. E.

7577516 JA

In the time period between implantation and pregnancy test, IVF couples felt very anxious and isolated. They would liked to have had an advice sheet pertinent to this waiting time, and contact with the IVF team and a specified nurse responsible for their care.

1995 Nurs Stand 10;2:31-4

Goacher, L.

11209535 JA

After implantation and before pregnancy test, was the IVF stage in which patients scored the highest on hostility, depression and anxiety (p<.001). Psychological counseling could be targeted to this time period.

2000 J Assist Reprod Genet 17;10:553-6

Yong, P., Martin, C., and Thong, J.