Stress in couples undergoing assisted reproductive technology
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GYNECOLOGIC ENDOCRINOLOGY AND REPRODUCTIVE MEDICINE
Stress in couples undergoing assisted reproductive technology Gorkem Tuncay1 · Sedat Yıldız2 · Abdullah Karaer1 · Ismail Reyhani3 · Tuba Özgöcer4 · Cihat Ucar5 · Umran Karabulut1 · Süheyla Unal3 Received: 8 January 2020 / Accepted: 11 April 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose To determine the associations between pre-treatment self-reported stress level, salivary cortisol levels, and clinical pregnancy outcome in couples undergoing assisted reproductive technology treatment (ART). Study design Seventy-five couples (150 patients) undergoing ART treatment were enrolled in this study. Psychological variables were assessed using the Perceived Stress Scale, Beck Anxiety Inventory, State–Trait Anxiety Inventory, and Beck Depression Inventory. Salivary cortisol levels were obtained from each couple prior to commencing gonadotropin treatment at several times (upon waking and at 15, 30, and 60 min after waking). Results There was no statistically significant association between the self-reported stress levels and the ART treatment outcome in couples. Women with a successful outcome after ART treatment had higher median salivary cortisol levels than women who had an unsuccessful result [24.7 (19.9–63.1) vs. 20.7 (10.4–30.4), respectively]. There was no statistically significant difference in the median salivary cortisol levels of men in relation to ART treatment outcome. Salivary cortisol levels of the couples were not correlated. Conclusions Women who had higher median salivary cortisol levels in the pre-treatment period had a higher clinical pregnancy rate. This result suggests that moderately increased activity of the hypothalamic–pituitary–adrenal axis during ART treatment might be associated with successful conception. Keywords Assisted reproductive technology · Salivary cortisol · Psychology · Stress
Introduction Infertility as an important determinant of the course of one’s life and often gives rise to unpredicted stressors and depressors in couples [1]. Infertile couples may experience negative changes in their family relationships and social interactions. * Abdullah Karaer [email protected]; [email protected] 1
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, School of Medicine, Inonu University, Malatya, Turkey
2
Department of Physiology, School of Medicine, Inonu University, Malatya, Turkey
3
Department of Psychiatry, School of Medicine, Inonu University, Malatya, Turkey
4
Department of Physiology, School of Medicine, Harran University, Şanlıurfa, Turkey
5
Department of Physiology, School of Medicine, Adıyaman University, Adıyaman, Turkey
Assisted reproduction technology (ART), such as in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI), is an additional stress, being physically rigorous, emotionally difficult, and financially costly [2]. The glucocorticoid cortisol, a biological concomitant of stress, plays a major
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