COPING, INEFFECTIVENESS OF COPING AND THE PSYCHOENDOCRINOLOGICAL STRESS RESPONSES DURING INVITRO FERTILIZATION

The psychoendocrinological stress responses during in-vitro fertilization (IVF) and embryo transfer (ET) were investigated in 40 women as a function of a 'coping-ineffectiveness of coping' construct. The results demonstrate an important dissociation between emotional and endocrine stress responses and the existence of relatively independent dimensions of arousal (emotional, prolactin, cortisol). The emotional stress response, i.e. state anxiety levels, are for 34-59% predicted by chronic ineffectiveness of coping, and this both before (anticipation) and after (recovery) the stress of oocyte retrieval (OR) and embryo transfer. The effect of anticipatory stress, i.e. in the follicular phase and before oocyte retrieval or embryo transfer, on prolactin and cortisol release is more important in women with a high chronic ineffectiveness of coping while the effect of oocyte retrieval itself is more important in women who are effective copers. Other prolactin concentrations, i.e. after OR or ET, are for 14-26% predicted by low palliative coping and high avoiding. Other cortisol concentrations, i.e. after OR or ET, are for 13-19% predicted by comforting ideas. The advantages of this 'coping-ineffectiveness of coping' construct are weighed against the 'effectiveness of defenses' construct described by Wolff et al. Psychosom Med 1964; 26:406-413. It is suggested that these personality dependent stress responses are important for conception rates in spontaneous cycles as well as in stimulated cycles.