The Effect of Stress, Anxiety and Depression on In Vitro Fertilization Outcome in Kazakhstani Public Clinical Setting: A Cross-Sectional Study

Although it is clear that infertility leads to heightened stress for patients, the impact of depressed mood and anxiety on treatment outcome is inconsistently reported. The aim of this study was to evaluate the effect of stress, depression and anxiety on in vitro fertilization (IVF) outcomes in Kazakhstani public assisted reproductive technology (ART) clinics. The prospective cohort study was performed between June 2019 and September 2020 using questionnaires to assess psychological stress, depressed mood and anxiety in women referred to IVF clinics in two public clinical centers in Kazakhstan, Nur-Sultan and Aktobe. Our study sample comprised 142 women with the average age of 33.9 ± 4.9 years, and infertility duration 6.0 ± 3.5 years. More than half of respondents had Center for Epidemiological Studies Depression Scale (CES-D) scores higher than 16, indicating their risk of developing clinical depression. Ninety-one percent of women from Aktobe city were at risk for clinical depression (p < 0.001). Aktobe city respondents had higher stress subscale scores and anxiety scale scores (p < 0.001) than Nur-Sultan respondents. Statistical analysis showed that IVF outcome was not significantly associated with depression and stress, while the higher anxiety scale scores were negatively associated with clinical pregnancy after IVF.

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Impact of COVID-19 Pandemic on COMPI Fertility Problem Stress Scale and the State-Trait Anxiety Scale in Patients Undergoing IVF/ICSI

Gynecology Obstetrics and Reproductive Medicine ◽

10.21613/gorm.2021.1187 ◽

2021 ◽

pp. 1-7

Author(s):

Arzu Yurci ◽

Saban Karayagiz

Keyword(s):

In Vitro Fertilization ◽

Trait Anxiety ◽

Correlation Coefficients ◽

Anxiety Scale ◽

Lower State ◽

Cross Sectional ◽

Vitro Fertilization ◽

Stress Scale ◽

Fertility Problem

OBJECTIVE: This study aimed to investigate the effect of the COVID-19 outbreak on infertile couples dealing with stress and anxiety during in vitro fertilization treatment. STUDY DESIGN: 252 infertile patients who applied for in vitro fertilization treatment were included in this cross-sectional study. Data were collected via four data collection tools including socio-demographic form, COVID-19 Inventory (COVID-I), COMPI fertility problem stress scale (COMPI-FPSS), and state-trait anxiety scale. Data analysis was conducted by SPSS statistical software included statistical analysis such as averages, standard deviations, correlation, regression, and t-test. RESULTS: Both negative and weak correlations were found between COMPI fertility problem stress scale and subscales of state-trait anxiety scale as well as the total score of state-trait anxiety scale. In terms of socio-demographic characteristics of the participants and their responses in state-trait anxiety scale and ISS forms, the correlation coefficients were also so low. The results also showed that public officials, health professionals, and educators showed lower state-trait anxiety scale (stress-related anxiety) scores. CONCLUSION: During the COVID-19 pandemic, there was an increase in spontaneous pregnancy expectations. Although participants were mostly stressed because of the COVID-19 outbreak, they didn’t change their in vitro fertilization treatment plans during the outbreak.

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Resilience, Perceived Stress, and Depressed Mood in Women Under in Vitro Fertilization Treatment

Reproductive Sciences ◽

10.1007/s43032-021-00685-1 ◽

2021 ◽

Author(s):

Carmen Fernandez-Ferrera ◽

David Llaneza-Suarez ◽

Daniel Fernandez-Garcia ◽

Vanesa Castañon ◽

Cristina Llaneza-Suarez ◽

...

Keyword(s):

Protective Effect ◽

Perceived Stress ◽

Depressed Mood ◽

Sleep Disturbances ◽

Depression Scale ◽

Short Version ◽

Cross Sectional ◽

Vitro Fertilization ◽

Infertile Women

AbstractIt has been suggested that women who display higher resilience levels may have less psychological distress during IVF. The aim of this study was to evaluate how infertile women deal with perceived stress, depressed mood, and sleep disturbances at the first IVF attempt and after one or more negative IVF outcomes depending on their level of resilience. An observational, cross-sectional study was carried out in a sample of 207 infertile women undergoing IVF procedures. The participants completed the short version of the Connor-Davidson Resilience Scale (CD-RISC), the short version of the European Spanish Version of Perceived Stress Scale (PSS-10), the Center of Epidemiologic Studies Depression Scale (CESD-10), and the Jenkins Sleep Scale (JSS). The relationship between CD-RISC scores ranked according to percentiles and mean PSS-10 scores revealed that women with strong resilience had lower perceived stress. After splitting the sample according to CD-RISC percentiles, differences were observed only at the first IVF attempt and the observed protective effect of high resilience scores appears to disappear following a negative IVF outcome. Women with high resilience are less likely to suffer from perceived stress or depressed mood during their first IVF attempt, this protective effect appears to be lost after a negative outcome.

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Tryptophan catabolism to serotonin and kynurenine in women undergoing in-vitro fertilization

Physiological Research ◽

10.33549/physiolres.934435 ◽

2020 ◽

pp. 1113-1124

Author(s):

J Bódis ◽

E Sulyok ◽

M Koppán ◽

Á Várnagy ◽

V Prémusz ◽

...

Keyword(s):

In Vitro Fertilization ◽

Serum Levels ◽

Ovarian Hyperstimulation ◽

Cross Sectional ◽

Vitro Fertilization ◽

Tryptophan Catabolism ◽

Paired Serum ◽

Relationship Of ◽

The Impact

This cross-sectional clinical study was designed to explore the impact of tryptophan-kynurenine and tryptophan-serotonin (5 HT) pathways on reproductive performance during in vitro fertilization (IVF). Paired serum and follicular fluid (FF) samples were obtained from 64 consecutive IVF patients. The analysis was done by using LC-MS/MS. Ovarian hyperstimulation resulted in decreased serum tryptophan (p<0.004), 5-HT (p<0.049) and kynurenine (p<0.001). FF levels of tryptophan (R=0.245, p<0.051), kynurenine (R=0.556, p<0.001) and 5-HT (R=0.523, p<0.001) were positively related to their respective serum levels. Clinical pregnancy was associated with higher serum 5-HT (p<0.045) and FF 5-HT (p<0.020) and lower kynurenine to 5-HT ratio (p<0.024). Chemical pregnancy was also positively related to FF 5-HT (R=0.362, p<0.024). Moreover, there was a direct relationship of the number of mature oocytes to the FF 5-HT (R=0.363, p<0.020) but it was inversely related to FF tryptophan to 5-HT and FF kynurenine to 5-HT ratios (R=-0.389, p<0.016 and R=-0.337, p<0.036, respectively). Multivariate logistic regression revealed that the number of mature oocytes was significantly influenced by FF 5-HT (β=0.473, p<0.001). In IVF patients ovarian hyperstimulation results in a reduction of the availability of tryptophan to catabolic pathways to kynurenine and 5-HT. Outcome measures improved significantly when 5-HT predominated over kynurenine.

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Individualized embryo selection strategy developed by stacking machine learning model for better in vitro fertilization outcomes: an application study

Reproductive Biology and Endocrinology ◽

10.1186/s12958-021-00734-z ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Qingsong Xi ◽

Qiyu Yang ◽

Meng Wang ◽

Bo Huang ◽

Bo Zhang ◽

...

Keyword(s):

Machine Learning ◽

In Vitro Fertilization ◽

Endometrial Thickness ◽

Learning System ◽

Embryo Selection ◽

Selection Strategy ◽

Application Study ◽

Vitro Fertilization ◽

The Impact

Abstract Background To minimize the rate of in vitro fertilization (IVF)- associated multiple-embryo gestation, significant efforts have been made. Previous studies related to machine learning in IVF mainly focused on selecting the top-quality embryos to improve outcomes, however, in patients with sub-optimal prognosis or with medium- or inferior-quality embryos, the selection between SET and DET could be perplexing. Methods This was an application study including 9211 patients with 10,076 embryos treated during 2016 to 2018, in Tongji Hospital, Wuhan, China. A hierarchical model was established using the machine learning system XGBoost, to learn embryo implantation potential and the impact of double embryos transfer (DET) simultaneously. The performance of the model was evaluated with the AUC of the ROC curve. Multiple regression analyses were also conducted on the 19 selected features to demonstrate the differences between feature importance for prediction and statistical relationship with outcomes. Results For a single embryo transfer (SET) pregnancy, the following variables remained significant: age, attempts at IVF, estradiol level on hCG day, and endometrial thickness. For DET pregnancy, age, attempts at IVF, endometrial thickness, and the newly added P1 + P2 remained significant. For DET twin risk, age, attempts at IVF, 2PN/ MII, and P1 × P2 remained significant. The algorithm was repeated 30 times, and averaged AUC of 0.7945, 0.8385, and 0.7229 were achieved for SET pregnancy, DET pregnancy, and DET twin risk, respectively. The trend of predictive and observed rates both in pregnancy and twin risk was basically identical. XGBoost outperformed the other two algorithms: logistic regression and classification and regression tree. Conclusion Artificial intelligence based on determinant-weighting analysis could offer an individualized embryo selection strategy for any given patient, and predict clinical pregnancy rate and twin risk, therefore optimizing clinical outcomes.

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The impact of in vitro fertilization on the risk of recurrence in fertility-sparing management of endometrial atypical hyperplasia and grade 1 adenocarcinoma with chlormadinone acetate

Reproductive BioMedicine Online ◽

10.1016/j.rbmo.2021.06.007 ◽

2021 ◽

Author(s):

M. Vaugon ◽

M. Peigné ◽

J. Phelippeau ◽

C. Gonthier ◽

M. Koskas

Keyword(s):

In Vitro Fertilization ◽

Atypical Hyperplasia ◽

Vitro Fertilization ◽

Risk Of Recurrence ◽

Chlormadinone Acetate ◽

Fertility Sparing ◽

The Impact

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Expression of mRNAs for Pro-and Anti-Apoptotic Factors in Granulosa Cells and Follicular Fluid of Women Undergoing in Vitro Fertilization. A Pilot Study

10.21203/rs.3.rs-330029/v1 ◽

2021 ◽

Author(s):

Jozsef Bodis ◽

Endre Sulyok ◽

Akos Varnagy ◽

Viktória Prémusz ◽

Krisztina Godony ◽

...

Keyword(s):

Gene Expression ◽

In Vitro Fertilization ◽

Mrna Expression ◽

Granulosa Cells ◽

Follicular Fluid ◽

Vitro Fertilization ◽

Expression Levels ◽

The Impact ◽

Apoptotic Factors

Abstract BackgroundThis observational clinical study evaluated the expression levels and predictive values of some apoptosis-related genes in granulosa cells (GCs) and follicular fluid (FF) of women undergoing in vitro fertilization (IVF).Methods GCs and FF were obtained at oocyte retrieval from 31 consecutive patients with heterogeneous infertility diagnosis (age: 34.3±5.8 years, body mass index: 24.02±3.12 kg/m2, duration of infertility: 4.2±2.1 years). mRNA expression of pro-apoptotic (BAX, CASP3, CASP8) and anti-apoptotic (BCL2, AMH, AMHR, FSHR, LHR, CYP19A1) factors was determined by quantitative RT-PCR using ROCHE LightCycler 480. Results No significant difference in GC or FF mRNA expression of pro- and anti-apoptotic factors could be demonstrated between IVF patients with (9 patients) or without (22 patients) clinical pregnancy. Each transcript investigated was detected in FF, but their levels were markedly reduced and independent of those in GCs. The number of retrieved oocytes was positively associated with GC AMHR (r=0.393, p=0.029), but the day of embryo transfer was negatively associated with GC LHR (r=-0.414, p=0.020) and GC FSHR transcripts (r=-0.535, p=0.002). When pregnancy positive group was analysed separately the impact of apoptosis- related gene expressions on some selected measures of IVF success could be observed. Strong positive relationship was found between gene expression levels of pro- and anti-apoptotic factors in GCs.ConclusionOur study provides only marginal evidences for the apoptosis dependence of IVF outcome and suggests that the apoptosis process induces adaptive increases of the anti-apoptotic gene expression to attenuate apoptosis and to protect cell survival.

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