The psychological impact of mild ovarian stimulation combined with single embryo transfer compared with conventional IVF

Department of Medical Psychology and Psychotherapy, Erasmus Universiteit Rotterdam, Rotterdam, South Holland, Netherlands
Human Reproduction (Impact Factor: 4.57). 04/2006; 21(3):721-7. DOI: 10.1093/humrep/dei395
Source: PubMed


The objective of this study was to assess the psychological implications of mild ovarian stimulation combined with single embryo transfer (SET) during a first IVF cycle.
We conducted a randomized controlled two-centre trial. Three hundred and ninety-one couples were randomized to undergo either mild ovarian stimulation with GnRH antagonist co-treatment and SET (n=199) or conventional GnRH agonist long protocol ovarian stimulation with double embryo transfer (DET) (n=192). Women completed the Hospital Anxiety and Depression Scale, the Hopkins Symptom Checklist and the Subjective Sleep Quality Scale at baseline, on the first day of ovarian stimulation and following embryo transfer. Affect was assessed daily with the Daily Record Keeping Chart from the first day of ovarian stimulation until the day treatment outcome became known.
The conventional IVF group experienced elevated levels of physical and depressive symptoms during pituitary downregulation. At oocyte retrieval, this group experienced more positive affect and less negative affect than the mild IVF group. In the conventional IVF group, cycle cancellation was associated with less positive and more negative affect.
During the first IVF treatment cycle, mild ovarian stimulation and SET does not lead to more psychological complaints than conventional IVF.

Download full-text


Available from: Bart C J M Fauser
  • Source
    • "IVF is usually the final treatment option for infertile couples, and failure will probably mean their remaining childless38. It is therefore not surprising that both patients and men always demonstrate elevated levels of anxiety during IVF treatment3940. In IVF treatment, the state anxiety is caused by the fear of TVOR, or the strain of the emotional moment at ET, which can be measured by the levels of anxiety at a certain time-point41. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The study was to explore whether auricular acupressure (AA) can relieve anxiety during the period from trans-vaginal oocyte retrieval to the embryo transfer in IVF treatment and whether AA can improve the outcomes of IVF. 305 infertile patients with tubal blockage who were referred for IVF were included. The women were randomized into a control group with 102 cases, a Sham-AA group with 102 cases and an AA group with 101 cases. The anxiety levels were rated with Spielberger's State Trait Anxiety Inventory and the Amsterdam Preoperative Anxiety and Information Scale. Data of clinical pregnancy rate (CPR), implantation rate (IR) and live birth rate (LBR) were obtained. The levels of neuropeptide Y (NPY) and transforming growth factor alpha (TGF-alpha) in the follicular fluids were detected with ELISA. After treatment, in AA group, the levels of state anxiety, preoperative anxiety and need-for-information were significantly lower, whereas CPR, IR, LBR and NPY levels in the follicular fluids were markedly higher than Sham-AA group and control group. We concluded that AA could help to reduce anxiety levels associated with IVF and improves the outcomes of IVF partly through increasing the levels of NPY in the follicular fluids.
    Full-text · Article · May 2014 · Scientific Reports
    • "Mild stimulation protocols have fewer symptoms of depression after IVF failure, the drop-out rate is lower and patients go for repeat cycles earlier thus improving their CPR.[383940] However, lower per cycle pregnancy rates and repeated IVF attempts by themselves would increase stress. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Mild stimulation protocols aim to reduce the physical, financial and emotional burden associated with the conventional IVF protocol without compromising the pregnancy rate. Such protocols help to decrease the complications and the discomfort related to the prolonged administration of agonist and large doses of gonadotrophins, by limiting the number of oocytes recruited to no more than eight. The per cycle pregnancy rates are lower though the cumulative pregnancy rate in a year is equivalent. This CPR comes by going through earlier repeat cycles. Whether this reduces the physical, emotional or financial burden remains a matter of debate. There is need to standardize these protocol and do more trials to compare the two effectively. Till such time there is a clear benefit above the conventional protocol it will not be the protocol of choice with most physicians.
    No preview · Article · Mar 2013 · Journal of Human Reproductive Sciences
  • Source
    • "Yet, conventional IVF regimes are not without side effects and risks. One of the risks associated with a conventional IVF protocol is ovarian hyperstimulation syndrome (OHSS), which although rare, is potentially life threatening (approximately one death in 400–500 000 cycles) (de Klerk et al., 2006; Heijnen et al., 2007; Devroey et al., 2009). Further side effects which can occur alongside the down-regulation necessary for conventional treatment protocols include abdominal discomfort, depressed mood, headaches, and lower back pain and muscular pain (de Klerk et al., 2006; Pennings and Ombelet, 2007). "
    [Show abstract] [Hide abstract]
    ABSTRACT: The introduction of mild cycle IVF adds to the repertoire of fertility treatments. However, its place is still novel and is contested within the literature. Women's experiences of mild cycle IVF have received minimal attention. The aim of the study was to explore women's perspectives regarding mild cycle IVF. In this qualitative thematic analysis study, 17 women, and 2 partners were interviewed regarding their perceptions of 'mild' cycle IVF. Data were thematically analysed to identify the key aspects of participants' perceptions. Participants reported that 'mild' cycle IVF offered a number of positive aspects, including the reduction in the intrusion of IVF procedures in women's lives, the short timeframe spent in awaiting the results and the way mild cycle worked with women's natural hormonal cycles. 'Mild' cycle IVF was perceived positively by the participants particularly in terms of timeframes and the impact on their physical and emotional wellbeing.
    Full-text · Article · Nov 2011 · Human Reproduction
Show more