Treatment‐related psychological stress in different in vitro fertilization therapies with and without gonadotropin stimulation

Abstract

Factors other than just pregnancy rate seem to have an impact on psychological stress in IVF treatment. Due to reduced psychological stress in NC-IVF, this treatment could be especially considered in psychologically stressed women.

Women Undergoing Hormonal Treatments for Infertility: A Systematic Review on Psychopathology and Newly Diagnosed Mood and Psychotic Disorders

“…In our systematic review, we found that patients receiving ovarian stimulation with GnRH antagonists had increased depressive symptoms compared to patients who did not receive ovarian stimulation (32). One study suggested that treatment with one GnRH agonist, buserelin, had a poorer mood profile than other GnRH agonist (goserelin) 1 week later but showed similar mood changes at the end of the trial (37).…”

“…When focusing on hormonal compounds other than GnRH agonists or antagonists, one recent trial has been developed to study the effect of clomiphene citrate on women under the IVF protocol (39). Moreover, in the study by Haemmerli Keller et al (32), patients under the protocol without gonadotropin stimulation could receive low doses of clomiphene (32). This latter study suggests that the lack of gonadotropin stimulation is associated with fewer changes in mood, as the effect size was very small (g = -0.07).…”

“…Four trials compared GnRH agonists and GnRH antagonists (3,(34)(35)(36), showing a better mood profile (less depressive symptoms) for those hormonal protocols including antagonists in one trial. Two trials compared protocols using either GnRH agonists or GnRH antagonists versus natural cycle protocols that did not use gonadotropin stimulation, reporting a better mood profile in those protocols without gonadotropin stimulation (32,33). Other two studies comparing long and short protocols of GnRH agonists (2) and two GnRH agonists (buserelin and goserelin) (37) did not find significant differences in mood changes between treatment arms.…”

“…Eight trials investigated the effects of hormones used in women undergoing fertility treatments (2,3,(32)(33)(34)(35)(36)(37). All of them evaluated the effect of GnRH antagonists or GnRH agonists on the occurrence of newly diagnosed depressive symptoms in women (Tables 1, 2 and 3).…”

“…Haemmerli-Keller et al (32) carried out a non-randomized trial comparing women undergoing IVF with (cIVF) and without gonadotropin stimulation (NC-IVF) (32). In the cIVF arm (gonadotropin stimulation), human menopausal gonadotropin (HMG) was initiated between days 3 and 5 of the menstrual cycle, and GnRH antagonists were first administered subcutaneously between days 6 and 7 of the menstrual cycle and continued until ovulation induction with urinary human chorionic gonadotropin (hCG).…”