The impact of infertility-related stress, physiological stress and some fertility indices on clinical pregnancy in women undergoing in vitro fertilization

Despite numerous studies on the impact of stress on post-in vitro fertilization (IVF) clinical outcomes are contradictory and researchers recommend the need for further studies. Therefore, the purpose of the present study was to investigate the impact of infertility-related stress, measuring salivary cortisol as a biological marker, and non-invasive sampling and measuring some fertility indices, including the number of suctioned follicles and Anti-Müllerian hormone (AMH), on the post- IVF clinical pregnancy results. The present study is a prospective longitudinal study conducted on 115 women with primary infertility who were undergoing IVF treatment at the Infertility Center of Zeinbiyeh Hospital, Shiraz. The studied subjects were selected by simple and convenience sampling during the years 2021 to 2022. The data collection tool included a two-part questionnaire including demographic characteristics and fertility problem inventory (FPI), and measurement of salivary cortisol concentration and some fertility indices. Data were analyzed using SPSS software. t-test, Mann-Whitney, Chi-square and logistic regression statistical tests were used. Among 115 participants, 45 were in the positive stress group and 70 people were in the negative stress group. Post-IVF pregnancy results were positive and negative in 32% and 68%, respectively. The mean FPI scores in women with positive pregnancy result (152.78 ± 23.38) were lower than women with negative pregnancy result (157.30 ± 33.34), but this difference was not statically significant (P-value = 0.43). There was also no significant difference between the two groups in terms of the mean scores of different dimensions of FPI. The results of multivariate regression showed a significant relationship between the results of IVF with the level of cortisol hormone (p-value = 0.04) and AMH (p-value = 0.04). The results of the chi-square test showed that there was no significant relationship between stress and pregnancy outcome (P-value = 0.176). The results of the present study showed that salivary cortisol levels can affect the fertility problem inventory. Also; infertility-related stress does not affect IVF results.