Failed IVF attempts lead to depression and anxiety

Women who are stressed and anxious before in vitro fertilization (IVF) are no less likely to have a baby, new research suggests. But if the treatment fails, it may take a toll on their mental health. In two separate studies in the journal Fertility and Sterility, researchers found women with anxiety or depression symptoms were just as likely as others to become pregnant. One study focused on women undergoing IVF and the other followed women trying to conceive naturally. "Our findings are consistent with the most recent research," said Lauri A. Pasch, a clinical psychologist at the University of California, San Francisco Center for Reproductive Health, and the lead researcher on the IVF study. Based on that body of research, she told Reuters Health, "I think we can safely say to women, ‘Stop worrying about being worried.'" Women should not feel pressured to be a "good IVF patient" who's free of stress, Pasch said. And they should not blame themselves if they feel stressed out and their IVF attempt fails. The other study, from the UK, looked at 339 women who were trying to become pregnant naturally. Overall, 61 percent of them became pregnant over about six months. And the odds of success were not linked to women's mental well-being once the researchers accounted for factors like their age and smoking habits, a team led by Courtney Lynch of the Ohio State University College of Medicine in Columbus reported. WHEN IVF DOESN'T WORK On the other hand, women who try IVF and fail may see their mental health suffer, Pasch and her colleagues found. The researchers followed 202 women undergoing IVF at five San Francisco practices. All of the women were interviewed before their IVF attempt, which included standard questionnaires on depression and anxiety. Overall, the study found, women whose IVF treatment failed were at greater risk of anxiety or depression in the months afterward. Of 103 women with a failed attempt, 60 percent had symptoms of a clinical anxiety disorder - up slightly from 57 percent before their IVF cycles. And 44 percent had clinical depression, which was up from 26 percent before treatment. It's not surprising that many women with a failed IVF attempt would have such symptoms, according to Pasch. But there has actually been little research into how IVF outcomes may affect women's mental health, she said. And although women with a failed try at IVF were at higher risk, even women who became pregnant had substantial rates of depression and anxiety, Pasch's team found. During pregnancy, 30 percent of those women had depression in the "clinical range," while half had clinical-level anxiety. Those rates were close to what they were before IVF. According to Pasch, infertility practices should do more to help women with mental health symptoms - though not because it would be expected to improve their odds of IVF success. "Psychological interventions need to be geared toward helping women feel better, and not toward increasing their chances of pregnancy," Pasch said. Some larger, university-linked infertility centers have on-site services for women who want mental health counseling. But most practices do not, Pasch said. Women can, however, ask their center for a referral to counseling if they need it. Pasch said there are also organizations that offer help, like information on local support groups. Article: 27th June 2012 www.uk.reuters.com

IVF success up by 40% as lab mimics conditions in womb

Doctors have dramatically increased the success of IVF by creating laboratories which mimic conditions found inside the womb. The fertility experts have boosted a woman’s odds of pregnancy by up to 40 per cent simply by keeping lab conditions more similar to those inside a woman’s body.
The success of the technology, developed at Newcastle University, promises to reduce the financial cost of treatment, as well as the emotional heartache of repeatedly failing to become pregnant.

Despite some popular perceptions, IVF is far from fail-safe, with some women undergoing multiple courses costing between £3,000 and £15,000 to try to realise their dream of motherhood.

IVF is a multi-step process that culminates with the embryo being grown in an incubator for several days before being placed into the womb. However many steps, from the actual fertilisation of the egg to checks under the microscope, take place outside the incubator. This can lead to changes in temperature and air quality which can be potentially harmful to the embryo.

To get round this, experts at the Newcastle Fertility Centre created a ‘lab in box’, or a chain of interlinked incubators with in-built microscopes. This allows them to work with and examine the embryo without taking it out of the incubator.

Professor Mary Hebert, who helped draw up the system, said that while the concept is simple, it was difficult to come up with a design that allowed the delicate lab work to be done without taking the embryos out of the incubator.

She added: ‘Our aim was to keep eggs and embryos in conditions similar to those they would experience naturally inside a woman’s body. ‘This led our team to design and develop a system in which it is possible to perform all of the technical procedures while maintaining stable conditions throughout the IVF process.’

As a result, since installing the system in 2007, IVF success rates at the centre have soared. Pregnancy rates at the clinic have gone from between 32 and 35 per cent per session of IVF to 45 per cent – an increase of up to 40 per cent – and hundreds of babies have been born.

The data, published in the journal PLoS ONE applies to women aged 37 and under. A woman aged under 35 has a 32 per cent of giving birth per IVF attempt. The figure falls to 27 per cent in women aged between 35 and 37. Labs in the Netherlands, Canada and Thailand have all installed systems based on the Newcastle design.

Alison Murdoch, professor of reproductive medicine at Newcastle University, said: ‘Growing good embryos is the key to IVF success and everyone, even those with a very small prospect of success, deserves to have the best possible chance.

‘Since installing the technology over 850 babies have been born.’
The Newcastle Fertility Centre mainly does NHS work but some private patients are also treated. Dr Allan Pacey, a fertility expert at Sheffield University, said: ‘Any technical development that can improve the success rate of IVF should be given serious consideration.

‘This is a novel solution to the age-old problem of trying to control the environment in which embryos are grown during IVF. ‘Whilst different units around the world tackle this problem in different ways, we will see whether this development becomes a popular choice now that it has been the subject of scientific evaluation.

Article: 1st March 2012 www.dailymail.co.uk