Emotionally expressive coping reduces pregnancy rates in patients undergoing in vitro fertilization

Objective: To examine the effects of coping and of infertility-specific and nonspecific stress on pregnancy outcomes after IVF treatment. Design: Cross-sectional design controlling for potential confounding variables. Psychosocial measures were assessed on the day of embryo transfer. Setting: Fertility clinic in Greece. Patient(s): Three hundred forty-two women. Intervention(s): None. Main Outcome Measure(s): A clinically recognized pregnancy or a biochemical pregnancy. Result(s): Of 342 women participating in the study, 79 became pregnant, representing a success rate of 23.3%. There were no statistically significant differences between women who became pregnant and those who did not in terms of duration of infertility, causes of infertility, previous IVF cycles, and infertility-specific or nonspecific stress. The only factor that was significantly associated with pregnancy outcome was emotionally expressive coping (adjusted odds ratio, 1.272; 95% confidence interval, 1.06-1.52). Women who coped by expressing their emotions were less likely to get pregnant than were women who did not. Conclusion(s): The link between psychological processes and reproductive outcomes of IVF treatment is less likely to be identified through the assessment of stress but rather is likely to be identified through the assessment of the strategies that people use to deal with stress. Emotionally expressive coping may be a risk factor for reduced pregnancy rates in women undergoing IVF.