Friday, March 04, 2011

Does Stress Reduce Fertility or cause infertility? New Article

Does stress cause infertility?  IU get asked this question at lieast 2 times per day.  My answer is that it is possible.

But a ew article  on British Medical Journal  suggest that there is no relationship between   stress (as defined buy the clinical trems of anxiety and depression) and outcome of fertility treatments. this article is a meta analisys  which means that the authors put together the data of multiple studies and analised them together.

I would probably argue that the findings are close to the truth. It is very likely that in cases of extreme stress fertility is certainly affected.

In another are  of medicine it is interesting to note that most studies show that attitude towards  a cancer diagnosis does not seem to have an effect on survival.

source : BMJ 2011; 342:d223 doi: 10.1136/bmj.d223 (Published 23 February 2011)

abstract below


Objective To examine whether pretreatment emotional distress in women is associated with achievement of pregnancy after a cycle of assisted reproductive technology.

Design Meta-analysis of prospective psychosocial studies.

Data sources PubMed, Medline, Embase, PsycINFO, PsychNET, ISI Web of Knowledge, and ISI Web of Science were searched for articles published from 1985 to March 2010 (inclusive). We also undertook a hand search of reference lists and contacted 29 authors. Eligible studies were prospective studies reporting a test of the association between pretreatment emotional distress (anxiety or depression) and pregnancy in women undergoing a single cycle of assisted reproductive technology.

Review methods Two authors independently assessed the studies for eligibility and quality (using criteria adapted from the Newcastle-Ottawa quality scale) and extracted data. Authors contributed additional data not included in original publication.

Results Fourteen studies with 3583 infertile women undergoing a cycle of fertility treatment were included in the meta-analysis. The effect size used was the standardised mean difference (adjusted for small sample size) in pretreatment anxiety or depression (priority on anxiety where both measured) between women who achieved a pregnancy (defined as a positive pregnancy test, positive fetal heart scan, or live birth) and those who did not. Pretreatment emotional distress was not associated with treatment outcome after a cycle of assisted reproductive technology (standardised mean difference −0.04, 95% confidence interval −0.11 to 0.03 (fixed effects model); heterogeneity I²=14%, P=0.30). Subgroup analyses according to previous experience of assisted reproductive technology, composition of the not pregnant group, and timing of the emotional assessment were not significant. The effect size did not vary according to study quality, but a significant subgroup analysis on timing of the pregnancy test, a contour enhanced funnel plot, and Egger’s test indicated the presence of moderate publication bias.
Conclusions The findings of this meta-analysis should reassure women and doctors that emotional distress caused by fertility problems or other life events co-occurring with treatment will not compromise the chance of becoming pregnant.

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