Emotional Stress Lowers Follicular Output Rate (FORT) of Unexplained Infertile or Poor Responder Women unlike Women with Male Infertility without any Prognostic Effect on Cycle Outcomes during Ovulation Induction for In Vitro Fertilization

Abstract

A total of 78 patients have accepted to evaluate and answer questions in the Beck depression questionnaire form at the beginning of their controlled ovarian hyperstimulation procedures. Among these patients; 28 (36%), 27 (34%), and 23 (30%) of them were accepted for in vitro fertilization and embryo transfer (IVF-ET) treatment due to male factor, explained infertility and poor ovarian reserve respectively. Based on the Beck depression scale; 9 (12%) patients had mild depression, 31 (39%) patients had moderate depression and 38 (49%) patients had severe depression. IVF-ET cycle outcomes of these three groups of depression levels are statistically similar. A significant negative correlation between Beck depression scores a Follicular Output Rate (FORT) ratios, but not for metaphase II (MII) oocyte numbers, has been detected among unexplained infertile and poor ovarian reserve groups. A significant relationship between increasing Beck depression scores and lower FORT ratios have also been detected for unexplained infertile and poor ovarian reserve groups.  FORT ratio which is achieved during the controlled ovarian hyperstimulation (COH) process of IVF-ET procedures seems to be lowered by emotional stress among unexplained or poor responder infertile women despite lack of a clinical effect on other cycle outcomes. Further studies investigating the effect of emotional stress itself and interventions to relieve this stress on IVF-ET cycle outcomes are needed to clarify this uncertainty.