Stress relief may improve IVF success

NEW YORK Thu May 5, 2011 10:23pm BST

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NEW YORK (Reuters Health) - Enrolling in a stress-management class might help women undergoing in vitro fertilization (IVF) get pregnant, according to a new study.

The finding is in line with other recent work suggesting that stress relief might up the success rate for women who have trouble conceiving.

One previous study, for instance, found that entertainment by a professional medical clown just after embryos were implanted was helpful (see Reuters Health story of January 12, 2011).

"Women who are in infertility treatment do report huge amounts of stress," Courtney Lynch, the head of reproductive epidemiology at The Ohio State University, told Reuters Health.

"One of the reasons IVF is not as effective as we'd like it to be is that some couples don't make it to cycle 2 and cycle 3 because they're so stressed out," added Lynch, who was not involved in the current research.

While evidence has been mounting that high stress is linked with infertility, especially in women getting fertility treatment, Lynch described it as "a chicken and egg problem."

"We don't know if the infertility caused the stress or the stress caused the infertility," she said.

In the current study, Alice Domar of Boston IVF and colleagues recruited 143 women who were about to undergo their first cycle of fertility treatment, and randomly assigned about half of them to a mind-body course intended to curb stress levels. The rest got a gift certificate to a spa.

The mind-body course consisted of 10 weekly classes during which women received talk therapy focused on changing negative thinking and training in relaxation and healthy behavior.

Scientists then followed the women through two cycles of IVF. A total of 97 women -- 46 in the stress-management group and 51 in the control group -- completed at least one cycle.

After the first IVF cycle, 43 percent of women in both groups became pregnant -- but before the start of that cycle, less than half of women in the stress-management group had attended their first class.

The results were different for the second cycle, when most women taking stress-management classes had gone to at least five sessions. Then, 52 percent of women taking the course got pregnant, versus 20 percent of women in the comparison group.

That finding "should give women a lot of hope," Domar told Reuters Health.

Lynch said that chronic stress may cause changes in hormones that interfere with the development of eggs, making them slower to release. It may also interfere with the immune system in a way that increases the chance a woman's body will reject an embryo.

According to Domar, it makes sense that lots of stress can make it harder to conceive. After all, when our ancestors were overwhelmed by the difficulties of finding food and surviving harsh conditions, it probably wasn't the best time to add a baby to the family.

Lynch, who has worked with Domar, said that researchers' current focus is on finding the best program to reduce stress that is also convenient and inexpensive.

Already with fertility treatment, "you have to go to the physician's office many, many times," Lynch said. "What we're trying to do is find an effective at-home intervention. I would hope that we could come out with a book or a video or even a computer program that folks could access to do this."

Domar said the stress-relieving program in this study cost about $500 per woman.

Dr. Brian Cooper, of Mid-Iowa Fertility, said that this type of stress-management program is "a great option" -- for some patients.

"There's no one magic bullet for everyone," Cooper, who did not participate in the research, told Reuters Health. "Everyone finds their own way to de-stress."

The best way to reduce stress should be a topic for every IVF patient and her doctor to discuss together, he added.

For some, Cooper said, it might be moderate exercise, yoga, or support groups.

"Sometimes a nice, tropical vacation is what some people need," he added.

SOURCE: bit.ly/jzpSjs Fertility and Sterility, online April 15, 2011.

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