A paper published by Alice Domar, Ph.D., in Fertility & Sterility (Journal of the American Society for Reproductive Medicine), February 2004, stated that "recent research on the relationship between psychological distress and IVF success indicates that pre-cycle distress is associated with lower pregnancy rates." Dr. Domar cited 15 studies found in the literature from around the world, and ten of these studies "provided statistically significant results to support the theory that distress is associated with lower pregnancy rates. Two of the studies had small numbers of patients but showed a trend toward the same direction. Three showed no relationship."

Dr. Domar also cited a Turkish study by Terzioglu where 60 couples were evaluated. Half of the couples received counseling and support throughout their IVF cycles, whereas the other half received routine medical care. Terzioglu found that "the experimental patients had lower anxiety and depression scores in addition to significantly higher pregnancy rates."

In the same issue of Fertility & Sterility, Catharina Olivius et. al. reported "that 54% of the patients not achieving live birth discontinued the IVF program, despite the treatment being free of charge." She concluded that the "majority of discontinuations were due to psychological stress."

Continued research on the effects of stress and the impact of stress management and psychological support on pregnancy rates is needed. However, there appears to be a solid foundation to support the need for fertility clinics and providers to address the emotional aspects of patient care. Fertility treatment at its best provides excellent medical care as well as comprehensive psychological support and stress management.