The study aimed to examine: (i) the association between perception of infertility controllability and coping strategies; and (ii) the association between perception of infertility controllability and coping strategies to psychological distress, applying multivariate statistical techniques to control for the effects of demographic variables. This cross-sectional study included 137 women with fertility problems undergoing IVF in a public hospital. All participants completed questionnaires that measured fertility-related stress, state anxiety, depressive symptomatology, perception of control and coping strategies. Pearson's correlation coefficients were calculated between all study variables, followed by hierarchical multiple linear regression. Low perception of personal and treatment controllability was associated with frequent use of avoidance coping and high perception of treatment controllability was positively associated with problem-focused coping. Multivariate analysis showed that, when controlling for demographic factors, low perception of personal control and avoidance coping were positively associated with fertility-related stress and state anxiety, and problem-appraisal coping was negatively and significantly associated with fertility-related stress and depressive symptomatology scores. The findings of this study merit the understanding of the role of control perception and coping in psychological stress of infertile women to identify beforehand those women who might be at risk of experiencing high stress and in need of support.

A considerable literature has been accumulated regarding the relation of psychological factors to in-vitro fertilization outcome. However, study findings have been inconsistent, and the association between psychological stress and in-vitro fertilization outcomes is still unclear. The aim of the authors in this study was to examine the relation of infertility-related stress, anxiety, and depressive symptoms to in-vitro fertilization outcome. The sample consisted of 160 women with fertility problems undergoing fertility treatment in a public hospital in Athens, Greece between November 2008 and July 2009. The relation of infertility-related stress, anxiety, and depressive symptoms to in-vitro fertilization outcome was assessed by using hierarchical, sequential logistic regression, while controlling for the effects of relevant biomedical factors. After the embryo transfer, 41 women (26%) had a positive pregnancy outcome. Logistic regression analyses revealed that, controlling for biomedical factors (age, number of oocytes retrieved, and embryos transferred) infertility-specific stress (OR = 0.964, p = .011) and nonspecific anxiety (OR = 0.889, p = .006) were negatively associated with a positive pregnancy outcome after IVF. Psychological stress was negatively associated with in-vitro fertilization outcome, after controlling for biomedical variables. Fertility treatment protocols should consider including counselling interventions to potentially mitigate adverse effects of stress.

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