The Psychological Effects of Hormonal Treatment on Women Under IVF Treatment: A Comprehensive Review

Authors

  • Sri Raghavi Vasudevan School of Social Sciences and Languages, Vellore Institute of Technology, Tamil Nadu, India
  • Mohanraj Bhuvaneswari School of Social Sciences and Languages, Vellore Institute of Technology, Tamil Nadu, India https://orcid.org/0000-0002-4970-0820

DOI:

https://doi.org/10.55489/njcm.150620243829

Keywords:

Infertility, In Vitro Fertilisation, Psychological Distress, Women

Abstract

This comprehensive review delves into the intricate world of assisted reproductive technologies (ART) and hormonal treatments, exploring their profound psychological effects on women undergoing IVF treatment. The psychological distress of infertility, combined with the demanding nature of ART, has been widely acknowledged, yet a comprehensive examination of the psychological impacts has remained elusive. This study examined the psychological repercussions of hormonal medications used in IVF, addressing the complex interplay of hormones and their effects in each stage of the IVF process. This review followed PRISMA guidelines and included studies from PubMed, Google Scholar, and ScienceDirect. A total of nine papers were collected. The findings of this study identified that depression, anxiety, mood swings, irritability, sleep disturbances, and cognitive changes were the most commonly seen medically induced psychological effects among the IVF patients. This review offers a holistic understanding of the psychological intricacies of IVF treatment, highlighting the imperative need for a more comprehensive approach to address the emotional wellbeing of individuals undergoing fertility procedures.

References

Burgio S, Polizzi C, Buzzaccarini G, Laganà AS, Gullo G, Perricone G, Perino A, Cucinella G, Alesi M. Psychological variables in medically assisted reproduction: a systematic review. Menopause Review/Przegląd Menopauzalny. 2022 Mar 9;21(1):47-63. Doi: https://doi.org/10.5114/pm.2022.114404 PMid:35388278 PMCid:PMC8966420

Toftager M, Sylvest R, Schmidt L, Bogstad J, Løssl K, Prætorius L, Zedeler A, Bryndorf T, Pinborg A. Quality of life and psychosocial and physical well-being among 1,023 women during their first assisted reproductive technology treatment: secondary outcome to a randomized controlled trial comparing gonadotropin-releasing hormone (GnRH) antagonist and GnRH agonist protocols. Fertility and sterility. 2018 Jan 1;109(1):154-64. Doi: https://doi.org/10.1016/j.fertnstert.2017.09.020 PMid:29175067

Mains L, Zimmerman M, Blaine J, Stegmann B, Sparks A, Ansley T, Van Voorhis B. Achievement test performance in children conceived by IVF. Human reproduction. 2010 Oct 1;25(10):2605-11. Doi: https://doi.org/10.1093/humrep/deq218 PMid:20716561

Jirge PR, Patil MM, Gutgutia R, Shah J, Govindarajan M, Roy VS, Kaul-Mahajan N, Sharara FI. Ovarian stimulation in assisted reproductive technology cycles for varied patient profiles: An Indian perspective. Journal of Human Reproductive Sciences. 2022 Apr 1;15(2):112-25. Doi: https://doi.org/10.4103/jhrs.jhrs_59_22 PMid:35928474 PMCid:PMC9345274

Wu L, Sun L, Wang J, Sun Y, Zhang X, Huang Y, Lu YE, Cao F. Psychological distress among women undergoing in vitro fertilization-embryo transfer: A cross-sectional and longitudinal network analysis. Frontiers in Psychology. 2023 Jan 5; 13:1095365. Doi: https://doi.org/10.3389/fpsyg.2022.1095365 PMid:36687877 PMCid:PMC9849569

Holka-Pokorska J, Jarema M, Wichniak A. Clinical determinants of mental disorders occurring during the infertility treatment. Psychiatr Pol. 2015;49(5):965-82. Doi: https://doi.org/10.12740/PP/35958 PMid:26688847

Glatthorn HN, Decherney A. The efficacy of add-ons: selected IVF "add-on" procedures and future directions. Journal of assisted reproduction and genetics. 2022 Mar;39(3):581-9. Doi: https://doi.org/10.1007/s10815-022-02410-6 PMid:35066700 PMCid:PMC8995402

Sze Y, Brunton PJ. Sex, stress and steroids. European Journal of Neuroscience. 2020 Jul;52(1):2487-515. Doi: https://doi.org/10.1111/ejn.14615 PMid:31705553

Bezerra CT, Grande AJ, Galvão VK, Santos DHMD, Atallah ÁN, Silva V. Assessment of the strength of recommendation and quality of evidence: GRADE checklist. A descriptive study. Sao Paulo Med J. 2022 Nov-Dec;140(6):829-836. Doi: https://doi.org/10.1590/1516-3180.2022.0043.r1.07042022

Haemmerli Keller K, Alder G, Loewer L, Faeh M, Rohner S, von Wolff M. Treatment-related psychological stress in different in vitro fertilization therapies with and without gonadotropin stimulation. Acta Obstetricia et Gynecologica Scandinavica. 2018;97(3):269-76. Doi: https://doi.org/10.1111/aogs.13281 PMid:29247514

Mamata D, Ray SK, Pratap K, Firuza P, Birla AR, Manish B. Impact of different controlled ovarian stimulation protocols on the physical and psychological burdens in women undergoing in vitro fertilization/intra cytoplasmic sperm injection. Journal of human reproductive sciences. 2015 Apr 1;8(2):86-92. Doi: https://doi.org/10.4103/0974-1208.158615 PMid:26157299 PMCid:PMC4477455

An Y, Sun Z, Li L, Zhang Y, Ji H. Relationship between psychological stress and reproductive outcome in women undergoing in vitro fertilization treatment: psychological and neurohormonal assessment. J Assist Reprod Genet. 2013 Jan;30(1):35-41. Doi: https://doi.org/10.1007/s10815-012-9904-x PMid:23212833 PMCid:PMC3553357

Bloch M, Azem F, Aharonov I, Ben Avi I, Yagil Y, Schreiber S, et al. GnRH-agonist induced depressive and anxiety symptoms during in vitro fertilization-embryo transfer cycles. Fertil Steril. 2011 Jan;95(1):307-9. Doi: https://doi.org/10.1016/j.fertnstert.2010.07.1073 PMid:20801439

de Klerk C, Heijnen EMEW, Macklon NS, Duivenvoorden HJ, Fauser BCJM, Passchier J, et al. The psychological impact of mild ovarian stimulation combined with single embryo transfer compared with conventional IVF. Hum Reprod. 2006 Mar;21(3):721-7. Doi: https://doi.org/10.1093/humrep/dei395 PMid:16311295

Grigorova M, Sherwin BB, Tulandi T. Effects of treatment with leuprolide acetate depot on working memory and executive functions in young premenopausal women. Psychoneuroendocrinology. 2006;31(8):935-47. Doi: https://doi.org/10.1016/j.psyneuen.2006.05.004 PMid:16831518

Choi SH, Shapiro H, Robinson GE, Irvine J, Neuman J, Rosen B, et al. Psychological side-effects of clomiphene citrate and human menopausal gonadotrophin. J Psychosom Obstet Gynaecol. 2005 Jun;26(2):93-100. Doi: https://doi.org/10.1080/01443610400022983 PMid:16050534

Yong P, Martin C, Thong J. A comparison of psychological functioning in women at different stages of in vitro fertilization treatment using the mean affect adjective check list. J Assist Reprod Genet. 2000 Nov;17(10):553-6.

Sharma A, Shrivastava D, Sharma IV A. Psychological problems related to infertility. Cureus. 2022 Oct 15;14(10). Doi: https://doi.org/10.7759/cureus.30320

Klonoff-Cohen H, Chu E, Natarajan L, Sieber W. A prospective study of stress among women undergoing in vitro fertilization or gamete intrafallopian transfer. Fertil Steril. 2001 Oct;76(4):675-87. Doi: https://doi.org/10.1016/S0015-0282(01)02008-8 PMid:11591398

Shauli N. ELITE IVF - Global IVF Clinic [Internet]. Birth Control Before IVF. 2022 [cited 2023 Nov 1]. Available from: https://www.elite-ivf.com/birth-control-before-ivf/

Edlow AG, Bartz D. Hormonal contraceptive options for women with headache: a review of the evidence. Rev Obstet Gynecol. 2010;3(2):55-65.

Dean J, Kramer KJ, Akbary F, Wade S, Hüttemann M, Berman JM, et al. Norethindrone is superior to combined oral contraceptive pills in short-term delay of menses and onset of breakthrough bleeding: a randomized trial. BMC Womens Health. 2019 May 28;19(1):70. Doi: https://doi.org/10.1186/s12905-019-0766-6 PMid:31138184 PMCid:PMC6537409

The Truth About Norethisterone and IVF | Your IVF Journey [Internet]. 2017 [cited 2023 Nov 1]. Available from: https://yourivfjourney.com/the-truth-about-norethisterone-and-ivf/

Mu E, Kulkarni J. Hormonal contraception and mood disorders. Aust Prescr. 2022 Jun;45(3):75-9. Doi: https://doi.org/10.18773/austprescr.2022.025 PMid:35755988 PMCid:PMC9218393

Johansson T, Vinther Larsen S, Bui M, Ek WE, Karlsson T, Johansson Å. Population-based cohort study of oral contraceptive use and risk of depression. Epidemiol Psychiatr Sci. 2023 Jun 12;32: e39. Doi: https://doi.org/10.1017/S2045796023000525 PMid:37303201 PMCid:PMC10294242

Martell S, Marini C, Kondas CA, Deutch AB. Psychological side effects of hormonal contraception: a disconnect between patients and providers. Contraception and Reproductive Medicine. 2023 Jan 17;8(1):9. Doi: https://doi.org/10.1186/s40834-022-00204-w PMid:36647102 PMCid:PMC9842494

Bosch E, Broer S, Griesinger G, Grynberg M, Humaidan P, Kolibianakis E, Kunicki M, La Marca A, Lainas G, Le Clef N. ESHRE guideline: ovarian stimulation for IVF/ICSI. Human reproduction open. 2020 May 1;2020(2): hoaa009. Doi: https://doi.org/10.1093/hropen/hoaa009 PMid:32395637 PMCid:PMC7203749

Liu S, Liu X, Li H, Liu M, Lv Y, Li Y. Clomiphene citrate priming increases sensitivity during ovarian stimulation in poor ovarian responders undergoing in vitro fertilization treatment: a retrospective cohort study. Human Fertility. 2023 Oct 20;26(5):1080-6. Doi: https://doi.org/10.1080/14647273.2022.2109069 PMid:35950570

Howles CM, Shoham Z. Drugs Used for Ovarian Stimulation: Clomiphene Citrate, Aromatase Inhibitors, Metformin, Gonadotropin-Releasing Hormone Analogues, and Gonadotropins. InTextbook of Assisted Reproductive Techniques 2023 Dec 13 (pp. 419-442). CRC Press.

Bühler KF, Fischer R, Verpillat P, Allignol A, Guedes S, Boutmy E, Bilger W, Richter E, D'Hooghe T. Comparative effectiveness of recombinant human follicle-stimulating hormone alfa (r-hFSH-alfa) versus highly purified urinary human menopausal gonadotropin (hMG HP) in assisted reproductive technology (ART) treatments: a non-interventional study in Germany. Reproductive Biology and Endocrinology. 2021 Jun 16;19(1):90. Doi: https://doi.org/10.1186/s12958-021-00768-3 PMid:34134695 PMCid:PMC8207759

Chapon RD, Genro VK, de Souza CA, Cunha-Filho JS. Randomized controlled trial comparing embryonic quality in rFSH versus hMG in the IVF protocol with GnRH antagonist. JBRA Assisted Reproduction. 2021 Jan;25(1):131. Doi: https://doi.org/10.5935/1518-0557.20200064 PMid:33118716 PMCid:PMC7863090

Kagawa H, Ichigo S, Takagi H, Kawabata I, Matsunami K, Imai A. Psychotic Reaction Associated with Clomiphene Induced Ovulation. BJSTR. 2019 Apr 24;17(3):12793-4. Doi: https://doi.org/10.26717/BJSTR.2019.17.002996

Macklon NS, Stouffer RL, Giudice LC, Fauser BCJM. The science behind 25 years of ovarian stimulation for in vitro fertilization. Endocr Rev. 2006 Apr;27(2):170-207. Doi: https://doi.org/10.1210/er.2005-0015 PMid:16434510

Farquhar C, Marjoribanks J, Brown J, Fauser BCJM, Lethaby A, Mourad S, et al. Management of ovarian stimulation for IVF: narrative review of evidence provided for World Health Organization guidance. Reprod Biomed Online. 2017 Jul;35(1):3-16. Doi: https://doi.org/10.1016/j.rbmo.2017.03.024 PMid:28501428

Castillo JC, Haahr T, Martínez-Moya M, Humaidan P. Gonadotropin-releasing hormone agonist for ovulation trigger-OHSS prevention and use of modified luteal phase support for fresh embryo transfer. Upsala Journal of Medical Sciences. 2020 Apr 2;125(2):131-7. Doi: https://doi.org/10.1080/03009734.2020.1736696 PMid:32366146 PMCid:PMC7721056

Marques P, Skorupskaite K, Rozario KS, Anderson RA, George JT. Physiology of GNRH and gonadotropin secretion. Endotext [internet]. 2022 Jan 5.

Kadoura S, Alhalabi M, Nattouf AH. Conventional GnRH antagonist protocols versus long GnRH agonist protocol in IVF/ICSI cycles of polycystic ovary syndrome women: a systematic review and meta-analysis. Scientific reports. 2022 Mar 15;12(1):4456. Doi: https://doi.org/10.1038/s41598-022-08400-z PMid:35292717 PMCid:PMC8924277

Castillo JC, Haahr T, Martínez-Moya M, Humaidan P. Gonadotropin-releasing hormone agonist for ovulation trigger-OHSS prevention and use of modified luteal phase support for fresh embryo transfer. Upsala Journal of Medical Sciences. 2020 Apr 2;125(2):131-7. Doi: https://doi.org/10.1080/03009734.2020.1736696 PMid:32366146 PMCid:PMC7721056

Lan J, Wu Y, Wu Z, Wu Y, Yang R, Liu Y, Lin H, Jiao X, Zhang Q. Ultra-Long GnRH agonist protocol during IVF/ICSI improves pregnancy outcomes in women with adenomyosis: a retrospective cohort study. Frontiers in endocrinology. 2021 May 31; 12:609771. Doi: https://doi.org/10.3389/fendo.2021.609771 PMid:34135858 PMCid:PMC8202082

Arizona Associates for Reproductive Health [Internet]. Lupron IVF Protocol | Timeline and Side Effects. 2022 [cited 2023 Nov 1]. Available from: https://www.azarh.com/blog/lupron-ivf-protocol.html

Varney NR, Syrop C, Kubu CS, Struchen M, Hahn S, Franzen K. Neuropsychologic dysfunction in women following leuprolide acetate induction of hypoestrogenism. J Assist Reprod Genet. 1993 Jan;10(1):53-7. Doi: https://doi.org/10.1007/BF01204441 PMid:8499680

Newton C, Slota D, Yuzpe AA, Tummon IS. Memory complaints associated with the use of gonadotropin-releasing hormone agonists: a preliminary study. Fertil Steril. 1996 Jun;65(6):1253-5. Doi: https://doi.org/10.1016/S0015-0282(16)58351-4 PMid:8641510

Tapanainen J, Hovatta O, Juntunen K, Martikainen H, Ratsula K, Tulppala M, et al. Subcutaneous goserelin versus intranasal buserelin for pituitary down-regulation in patients undergoing IVF: a randomized comparative study. Hum Reprod. 1993 Dec;8(12):2052-5. Doi: https://doi.org/10.1093/oxfordjournals.humrep.a137980 PMid:8150902

Sabrina. Trigger shot for IVF and its importance in egg quality [Internet]. 2022 [cited 2024 Feb 12]. Available from: https://coastalfertility.com/ivf-trigger-shot/

Ovidrel (Choriogonadotropin Alfa Injection): Side effects, uses, dosage, interactions, warnings [Internet]. RxList; 2022 [cited 2024 Feb 12]. Available from: https://www.rxlist.com/ovidrel-drug.htm

Cui Y, Yu H, Meng F, Liu J, Yang F. Prospective study of pregnancy outcome between perceived stress and stress‐related hormones. Journal of Obstetrics and Gynaecology Research. 2020 Aug;46(8):1355-63. Doi: https://doi.org/10.1111/jog.14278 PMid:32500644

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Published

2024-06-01

How to Cite

1.
Vasudevan SR, Bhuvaneswari M. The Psychological Effects of Hormonal Treatment on Women Under IVF Treatment: A Comprehensive Review. Natl J Community Med [Internet]. 2024 Jun. 1 [cited 2024 Jun. 23];15(06):487-95. Available from: https://njcmindia.com/index.php/file/article/view/3829

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Review Articles