Stress and Anxiety Scores in First and Repeat IVF Cycles: A Pilot Study

The role of stress in reproduction, particularly during treatment for infertility, has been of considerable interest; however, few studies have objectively measured stress and anxiety over the course of the IVF cycle or compared the experience of first-time and repeat patients. This prospective coho...

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Vydáno v:	PloS one Ročník 8; číslo 5; s. e63743
Hlavní autoři:	Turner, Kathy, Reynolds-May, Margaret F., Zitek, Emily M., Tisdale, Rebecca L., Carlisle, Allison B., Westphal, Lynn M.
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	United States Public Library of Science 23.05.2013 Public Library of Science (PLoS)
Témata:	Acupuncture Adult Anxiety Anxiety - epidemiology Anxiety - etiology Care and treatment Clinical trials Comparative analysis Embryo transfer Embryos Female Fertilization in vitro Fertilization in Vitro - psychology Gynecology Humans In vitro fertilization Infertility Infertility, Female - therapy Medicine Obstetrics Oocyte Retrieval Patients Pilot Projects Pregnancy Pregnancy Rate Prospective Studies Questionnaires Reproductive technologies Retrieval Social and Behavioral Sciences Stress Stress (Psychology) Stress, Psychological - epidemiology Stress, Psychological - etiology Stresses Studies Surveys and Questionnaires Treatment Outcome Womens health United States > US California
ISSN:	1932-6203, 1932-6203
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Abstract	The role of stress in reproduction, particularly during treatment for infertility, has been of considerable interest; however, few studies have objectively measured stress and anxiety over the course of the IVF cycle or compared the experience of first-time and repeat patients. This prospective cohort pilot study enrolled 44 women undergoing IVF at a university-based clinic to complete the State-Trait Anxiety Inventory (STAI), Perceived Stress Scale (PSS) and Infertility Self-Efficacy Scale (ISES) at three time points prior to ovarian stimulation (T1), one day prior to oocyte retrieval (T2), and 5-7 days post embryo transfer (T3). Mean STAI State scores were significantly elevated at all three time points (p<0.01). STAI State and PSS mean values did not change over time and did not differ in first-time vs. repeat patients. Self-efficacy (ISES) scores declined over time, with a greater decline for repeat patients. Of the 36 women who completed a cycle, 15 achieved clinical pregnancy. Using logistic regression modeling, all scores at T2 were correlated with pregnancy outcome with lower scores on the STAI State and PSS and higher scores on the ISES associated with higher pregnancy rates. Stress and anxiety levels remained elevated across all cycles. Women with lower stress and anxiety levels on the day prior to oocyte retrieval had a higher pregnancy rate. These results emphasize the need to investigate stress reduction modalities throughout the IVF cycle.
AbstractList	Background The role of stress in reproduction, particularly during treatment for infertility, has been of considerable interest; however, few studies have objectively measured stress and anxiety over the course of the IVF cycle or compared the experience of first-time and repeat patients. Methods This prospective cohort pilot study enrolled 44 women undergoing IVF at a university-based clinic to complete the State-Trait Anxiety Inventory (STAI), Perceived Stress Scale (PSS) and Infertility Self-Efficacy Scale (ISES) at three time points prior to ovarian stimulation (T1), one day prior to oocyte retrieval (T2), and 5–7 days post embryo transfer (T3). Results Mean STAI State scores were significantly elevated at all three time points (p<0.01). STAI State and PSS mean values did not change over time and did not differ in first-time vs. repeat patients. Self-efficacy (ISES) scores declined over time, with a greater decline for repeat patients. Of the 36 women who completed a cycle, 15 achieved clinical pregnancy. Using logistic regression modeling, all scores at T2 were correlated with pregnancy outcome with lower scores on the STAI State and PSS and higher scores on the ISES associated with higher pregnancy rates. Conclusions Stress and anxiety levels remained elevated across all cycles. Women with lower stress and anxiety levels on the day prior to oocyte retrieval had a higher pregnancy rate. These results emphasize the need to investigate stress reduction modalities throughout the IVF cycle. The role of stress in reproduction, particularly during treatment for infertility, has been of considerable interest; however, few studies have objectively measured stress and anxiety over the course of the IVF cycle or compared the experience of first-time and repeat patients.BACKGROUNDThe role of stress in reproduction, particularly during treatment for infertility, has been of considerable interest; however, few studies have objectively measured stress and anxiety over the course of the IVF cycle or compared the experience of first-time and repeat patients.This prospective cohort pilot study enrolled 44 women undergoing IVF at a university-based clinic to complete the State-Trait Anxiety Inventory (STAI), Perceived Stress Scale (PSS) and Infertility Self-Efficacy Scale (ISES) at three time points prior to ovarian stimulation (T1), one day prior to oocyte retrieval (T2), and 5-7 days post embryo transfer (T3).METHODSThis prospective cohort pilot study enrolled 44 women undergoing IVF at a university-based clinic to complete the State-Trait Anxiety Inventory (STAI), Perceived Stress Scale (PSS) and Infertility Self-Efficacy Scale (ISES) at three time points prior to ovarian stimulation (T1), one day prior to oocyte retrieval (T2), and 5-7 days post embryo transfer (T3).Mean STAI State scores were significantly elevated at all three time points (p<0.01). STAI State and PSS mean values did not change over time and did not differ in first-time vs. repeat patients. Self-efficacy (ISES) scores declined over time, with a greater decline for repeat patients. Of the 36 women who completed a cycle, 15 achieved clinical pregnancy. Using logistic regression modeling, all scores at T2 were correlated with pregnancy outcome with lower scores on the STAI State and PSS and higher scores on the ISES associated with higher pregnancy rates.RESULTSMean STAI State scores were significantly elevated at all three time points (p<0.01). STAI State and PSS mean values did not change over time and did not differ in first-time vs. repeat patients. Self-efficacy (ISES) scores declined over time, with a greater decline for repeat patients. Of the 36 women who completed a cycle, 15 achieved clinical pregnancy. Using logistic regression modeling, all scores at T2 were correlated with pregnancy outcome with lower scores on the STAI State and PSS and higher scores on the ISES associated with higher pregnancy rates.Stress and anxiety levels remained elevated across all cycles. Women with lower stress and anxiety levels on the day prior to oocyte retrieval had a higher pregnancy rate. These results emphasize the need to investigate stress reduction modalities throughout the IVF cycle.CONCLUSIONSStress and anxiety levels remained elevated across all cycles. Women with lower stress and anxiety levels on the day prior to oocyte retrieval had a higher pregnancy rate. These results emphasize the need to investigate stress reduction modalities throughout the IVF cycle. The role of stress in reproduction, particularly during treatment for infertility, has been of considerable interest; however, few studies have objectively measured stress and anxiety over the course of the IVF cycle or compared the experience of first-time and repeat patients. This prospective cohort pilot study enrolled 44 women undergoing IVF at a university-based clinic to complete the State-Trait Anxiety Inventory (STAI), Perceived Stress Scale (PSS) and Infertility Self-Efficacy Scale (ISES) at three time points prior to ovarian stimulation (T1), one day prior to oocyte retrieval (T2), and 5-7 days post embryo transfer (T3). Mean STAI State scores were significantly elevated at all three time points (p<0.01). STAI State and PSS mean values did not change over time and did not differ in first-time vs. repeat patients. Self-efficacy (ISES) scores declined over time, with a greater decline for repeat patients. Of the 36 women who completed a cycle, 15 achieved clinical pregnancy. Using logistic regression modeling, all scores at T2 were correlated with pregnancy outcome with lower scores on the STAI State and PSS and higher scores on the ISES associated with higher pregnancy rates. Stress and anxiety levels remained elevated across all cycles. Women with lower stress and anxiety levels on the day prior to oocyte retrieval had a higher pregnancy rate. These results emphasize the need to investigate stress reduction modalities throughout the IVF cycle. The role of stress in reproduction, particularly during treatment for infertility, has been of considerable interest; however, few studies have objectively measured stress and anxiety over the course of the IVF cycle or compared the experience of first-time and repeat patients. This prospective cohort pilot study enrolled 44 women undergoing IVF at a university-based clinic to complete the State-Trait Anxiety Inventory (STAI), Perceived Stress Scale (PSS) and Infertility Self-Efficacy Scale (ISES) at three time points prior to ovarian stimulation (T1), one day prior to oocyte retrieval (T2), and 5-7 days post embryo transfer (T3). Mean STAI State scores were significantly elevated at all three time points (p<0.01). STAI State and PSS mean values did not change over time and did not differ in first-time vs. repeat patients. Self-efficacy (ISES) scores declined over time, with a greater decline for repeat patients. Of the 36 women who completed a cycle, 15 achieved clinical pregnancy. Using logistic regression modeling, all scores at T2 were correlated with pregnancy outcome with lower scores on the STAI State and PSS and higher scores on the ISES associated with higher pregnancy rates. Stress and anxiety levels remained elevated across all cycles. Women with lower stress and anxiety levels on the day prior to oocyte retrieval had a higher pregnancy rate. These results emphasize the need to investigate stress reduction modalities throughout the IVF cycle. Background The role of stress in reproduction, particularly during treatment for infertility, has been of considerable interest; however, few studies have objectively measured stress and anxiety over the course of the IVF cycle or compared the experience of first-time and repeat patients. Methods This prospective cohort pilot study enrolled 44 women undergoing IVF at a university-based clinic to complete the State-Trait Anxiety Inventory (STAI), Perceived Stress Scale (PSS) and Infertility Self-Efficacy Scale (ISES) at three time points prior to ovarian stimulation (T1), one day prior to oocyte retrieval (T2), and 5–7 days post embryo transfer (T3). Results Mean STAI State scores were significantly elevated at all three time points (p<0.01). STAI State and PSS mean values did not change over time and did not differ in first-time vs. repeat patients. Self-efficacy (ISES) scores declined over time, with a greater decline for repeat patients. Of the 36 women who completed a cycle, 15 achieved clinical pregnancy. Using logistic regression modeling, all scores at T2 were correlated with pregnancy outcome with lower scores on the STAI State and PSS and higher scores on the ISES associated with higher pregnancy rates. Conclusions Stress and anxiety levels remained elevated across all cycles. Women with lower stress and anxiety levels on the day prior to oocyte retrieval had a higher pregnancy rate. These results emphasize the need to investigate stress reduction modalities throughout the IVF cycle.
Audience	Academic
Author	Zitek, Emily M. Westphal, Lynn M. Reynolds-May, Margaret F. Tisdale, Rebecca L. Turner, Kathy Carlisle, Allison B.
AuthorAffiliation	1 Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California, United States of America 3 Department of Psychology, Stanford University, Stanford, California, United States of America Tehran University of Medical Sciences, Islamic Republic of Iran 2 Department of Psychiatry, Stanford University School of Medicine, Stanford, California, United States of America
AuthorAffiliation_xml	– name: Tehran University of Medical Sciences, Islamic Republic of Iran – name: 3 Department of Psychology, Stanford University, Stanford, California, United States of America – name: 2 Department of Psychiatry, Stanford University School of Medicine, Stanford, California, United States of America – name: 1 Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California, United States of America
Author_xml	– sequence: 1 givenname: Kathy surname: Turner fullname: Turner, Kathy – sequence: 2 givenname: Margaret F. surname: Reynolds-May fullname: Reynolds-May, Margaret F. – sequence: 3 givenname: Emily M. surname: Zitek fullname: Zitek, Emily M. – sequence: 4 givenname: Rebecca L. surname: Tisdale fullname: Tisdale, Rebecca L. – sequence: 5 givenname: Allison B. surname: Carlisle fullname: Carlisle, Allison B. – sequence: 6 givenname: Lynn M. surname: Westphal fullname: Westphal, Lynn M.
BackLink	https://www.ncbi.nlm.nih.gov/pubmed/23717472$$D View this record in MEDLINE/PubMed
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Copyright	COPYRIGHT 2013 Public Library of Science 2013 Turner et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: https://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. 2013 Turner et al 2013 Turner et al
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License	This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. Creative Commons Attribution License
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Notes	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 Competing Interests: The authors have declared that no competing interests exist. Conceived and designed the experiments: KT MFR-M LMW. Performed the experiments: KT MFR-M RLT ABC. Analyzed the data: KT MFR-M EMZ RLT ABC LMW. Contributed reagents/materials/analysis tools: KT MFR-M EMZ RLT ABC LMW. Wrote the paper: KT MFR-M LMW.
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Snippet	The role of stress in reproduction, particularly during treatment for infertility, has been of considerable interest; however, few studies have objectively... Background The role of stress in reproduction, particularly during treatment for infertility, has been of considerable interest; however, few studies have... BACKGROUND: The role of stress in reproduction, particularly during treatment for infertility, has been of considerable interest; however, few studies have... Background The role of stress in reproduction, particularly during treatment for infertility, has been of considerable interest; however, few studies have...
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SubjectTerms	Acupuncture Adult Anxiety Anxiety - epidemiology Anxiety - etiology Care and treatment Clinical trials Comparative analysis Embryo transfer Embryos Female Fertilization in vitro Fertilization in Vitro - psychology Gynecology Humans In vitro fertilization Infertility Infertility, Female - therapy Medicine Obstetrics Oocyte Retrieval Patients Pilot Projects Pregnancy Pregnancy Rate Prospective Studies Questionnaires Reproductive technologies Retrieval Social and Behavioral Sciences Stress Stress (Psychology) Stress, Psychological - epidemiology Stress, Psychological - etiology Stresses Studies Surveys and Questionnaires Treatment Outcome Womens health
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Title	Stress and Anxiety Scores in First and Repeat IVF Cycles: A Pilot Study
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