The association between stress and reproductive outcome is unclear. In-vitro fertilization (IVF) is psychologically stressful and has been shown to alter psychological markers such as cortisol, prolactin and progesterone, This study was designed to assess prospectively psychological and physiological markers of stress and to determine if they are related to pregnancy outcome. Forty patients were recruited from Northwestern Medical Faculty Foundation (Chicago, Illinois, USA) having obtained an initial positive beta-human chorionic gonadotrophin (HCG) concentration 13 days after IVF with uterine embryo transfer. Patients underwent psychological and hormonal testing on three separate occasions (13, 20 and 27 days after embryo transfer) early in pregnancy. All subjects were followed to delivery. An adverse outcome was defined as a miscarriage before or after cardiac activity (including vanishing twin) or a loss before 20 weeks gestation. There was no difference in age, duration of infertility, diagnosis between patients experiencing an adverse pregnancy outcome (n = 18) and those that did not (n = 22), All patients were found to have high stress levels although this did not differentiate between groups of patients, There was no difference in hormonal markers of stress between patients. In conclusion, there is little association between psychological scores and physiological stress hormone concentrations. Also, it does not appear that high levels of anxiety and stress result in an adverse pregnancy outcome.
