Saliva cortisol levels and subjective stress are not associated with number of oocytes after controlled ovarian hyperstimulation in patients undergoing in vitro fertilization

Relationship between hair and salivary cortisol and pregnancy in women undergoing IVF

“…The remaining five studies failed to find any significant associations between cortisol and pregnancy outcomes (Lovely et al, 2003;Lewicka et al, 2003;Smeenk et al, 2005;Nouri et al, 2011;Csemiczky et al, 2000). These equivocal findings are in contrast to evidence from animal studies which have shown a more consistent relationship between elevated cortisol levels and impaired reproductive outcomes across a range of species (Dobson and Smith, 1995;Alejandro et al, 2014).…”

“…Second, studies measured cortisol at different stages of treatment. Whilst IVF is a useful clinical model for exploring the effects of stress on reproductive outcomes, over half of the studies (7/12) measured cortisol following gonadotrophin administration (Andersen et al, 1994;Keay et al, 2002;Thurston et al, 2003;Micheal et al, 1999;Lovely et al, 2003;Lewicka et al, 2003;Nouri et al, 2011). Gonadotrophins have profound effects on the HPA axis and, therefore, are likely to have confounded any observed associations between HPA function and pregnancy.…”

Diagnostic usefulness of salivary reproductive hormones: An update

“…There were no statistically significant correlations between Sal-C concentrations, FPI results, and age, number of poor responders, live birth rate, and clinical pregnancy rate (PR). Stress, as measured by Sal-C and the FPI questionnaire, does not negatively impact the effectiveness of ovarian hyper stimulation and is not associated with a reduced number of oocytes 48 . Since correct assessment of luteal function in basal conditions and during therapy requires multiple steroid measurements, and since saliva can be obtained by non-invasive techniques, salivary assays represent an attractive alternative to plasma for monitoring ovarian activity, also during specific treatment 49 .…”

“…Predicting ovulation with data derived from saliva sampling awaits the development of more suitable assays for salivary estradiol (Sal-E2) 34 . Stress, as measured by saliva cortisol (Sal-C) and the Fertility problem inventory, does not negatively impact the effectiveness overstimulation and is not associated with a reduced number of oocytes 35 . Studies suggests that salivary measures represent the biologically active, free fraction of cortisol (C) and greater relative increase insal-C in response to tests that raise the absolute C concentration above the saturation point of Cortisol Binding Globulin (CBG) the strong exponential relationship between C assessed in the two media; and the improved IJBAR (2014) 05 (09) www.ssjournals.com linear correlations when subjects known to have increased Cortisol Binding Protein.…”

The association of physiological cortisol and IVF treatment outcomes: a systematic review

“…In the context of IVF, a growing body of evidence suggests that stress may exert its deleterious effects on IVF treatment outcomes through activation of the HPA axis [6][7][8][9][10][11].This hypothesis is plausible because both physical and emotional stress can cause alterations to the endocrine axis which may, in turn, affect the reproductive system through immunosuppression [12]. However, although a relationship between the HPA axis and reproductive success is possible, the evidence for a cortisol and IVF association appears inconclusive, with a number of studies reporting an association [7,8,11,[13][14][15] and others reporting no association between cortisol levels and IVF treatment outcomes [9,10,[16][17][18]. In addition, there also exists ambiguity within the literature regarding the directionality of a potential cortisol/IVF relationship.…”