Publikation
Treatment-related psychological stress in different in vitro fertilization therapies with and without gonadotropin stimulation
Wissenschaftlicher Artikel/Review - 16.12.2017
Hämmerli Keller Katja, Alder Gilliane, Loewer Lennard, Fäh Monika, Rohner Susanne, von Wolff Michael
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Introduction
Infertility treatments such as in vitro fertilization (IVF) impose substantial distress. However, the specific role of individual contributory factors remains unclear. We therefore compared treatment-related psychological stress in IVF treatments with (cIVF) and without (NC-IVF) gonadotropin stimulation, as cIVF includes potentially stressful factors such as ovarian stimulation, anesthesia, embryo selection and cryopreservation, whereas NC-IVF does not.
Material and methods
Women were offered to have cIVF or NC-IVF. Validated psychological questionnaires filled in online before, during and after completed treatment cycle(s) at home were used to analyze psychological distress and treatment-related satisfaction and quality of life. To avoid different pregnancy rates in the two treatment groups, one cIVF was compared with three NC-IVF therapies, resulting in the same cumulative pregnancy rate.
Results
Data from 57 NC-IVF and 62 cIVF patients were evaluated. NC-IVF resulted in a similar overall clinical pregnancy rate than one cIVF. NC-IVF patients had a significantly lower level of depression (CES-D, 13.4 vs. 15.7, p < 0.05) and a higher satisfaction with the treatment (Treatment FertiQoL, 67.9 vs. 62.9, p < 0.05) compared with cIVF patients. The level of psychological distress increased during c-IVF treatment and decreased during NC-IVF treatment. In contrast, during NC-IVF treatment there was a significant increase in satisfaction with the treatment, whereas satisfaction with treatment in the cIVF patients decreased.
Conclusions
Factors other than just pregnancy rate seem to have an impact on psychological stress in IVF treatment. Due to reduced psychological stress in NC-IVF, this treatment could be especially considered in psychologically stressed women.
Key Message
Natural cycle IVF induces less psychological stress than conventional IVF with gonadotropin stimulation, indicating that other factors such as ovarian stimulation, anesthesia, embryo selection and cryopreservation might also contribute to the induction of psychological stress.