The implications of stress on women who try to conceive with assisted reproductive technology.

Updated: Sep 26, 2020

Couples worldwide are seeking treatment for infertility in growing numbers. Both infertility and its treatment are stressful experiences that generate considerable emotional distress. Some speculation exists that women's distress is associated with poorer likelihood of pregnancy via assisted reproductive technology (ART) and plausible psycho-biological mechanisms bolster this association.

Many people connect being female with the ability to conceive and bear a child. Thus, infertility can leave a woman feeling different, defective, or out of step with her peers. Infertility can also disrupt a woman's life goals and result in loneliness, powerlessness, and stigmatization. Additionally, infertile women may experience grief, anger, sadness, bodily disparagement, lack of femininity, shame, or self-blame.

Assisted reproductive technology (ART) has become an increasingly common treatment for infertility. About half of all infertile women in developed or developing countries will seek such treatment. The most common types of ART are in-vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). Although ART can be life-changing for some women in helping them conceive a child, the process is often physically demanding and may entail frequent blood tests, ultrasounds, daily hormone injections, and surgery.


Infertility treatment is also expensive, the average cost of an IVF cycle in the U.S. ranges between $10,000 to $15,000. Furthermore, such expensive treatments do not guarantee success. In Europe, for example, the reported pregnancy rate for IVF is 34.5%.

Research has shown that all the treatment stages can be distressing. Before treatment, a woman may be coping with the chronic stressor of being infertile and, in some cases, she may be considering ART as her last chance to have a biological child. Before treatment, some women experience fear, uncertainty, and emotional, religious, or moral dilemmas about the treatment itself. Additionally, waiting for a pregnancy result, receiving a negative pregnancy test result, waiting to hear about fertilization, and the wait between IVF treatment attempts are extremely stressful time points once the treatment has begun.

The impact of distress on reproductive outcomes might also occur through health behaviours. There is compelling evidence that people under high stress take poorer care of themselves and are more likely to engage in health-impairing behaviours such as smoking and other substance use.

In conclusion, a number of plausible psycho-biological pathways are implicated in the possibility that a woman's distress affects her fertility or can impede the success of infertility treatment. Evidence suggests as well that there is a direct association between an infertile woman's distress and her reduced likelihood of pregnancy with ART, including ICSI and IVF.

Source: Just relax and you'll get pregnant? Meta-analysis examining women's emotional distress and the outcome of assisted reproductive technology.
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