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Stress und artifizielle Reproduktionstechnologien – Gibt es einen Einfluss?

Stress and artificial reproduction technologies—is there an influence?

  • Leitthema
  • Published:
Der Gynäkologe Aims and scope

Zusammenfassung

Hintergrund

Immer wieder wird diskutiert, inwiefern Stress bzw. Stresserleben (akut oder chronisch) sich auf die Ergebnisse (Outcome) von Reproduktionsmedizin (artifizielle Reproduktionstechnologien, ART) auswirkt.

Fragestellung

Gibt es anhand bisheriger wissenschaftlicher Studien Beweise für die Hypothese „Stress hat einen negativen Einfluss auf den Erfolg der ART“?

Material und Methode

Ein Review aktueller Literatur zum möglichen Zusammenhang zwischen Stress und ART-Outcome wurde erstellt.

Ergebnisse

Die meisten aktuellen Studien, insbesondere Metaanalysen, zeigen keinen eindeutigen Zusammenhang zwischen Stress und ART-Outcome. Allerdings verursacht ART bei den Betroffenen Stress, der wiederum mit ein Grund für die hohen Drop-out-Raten bei IVF (In-vitro-Fertilisation) und ICSI (intrazytoplasmatische Spermieninjektion) darstellt. Als medizinisch sinnvoll erachtete Therapien werden dadurch nicht selten vorzeitig beendet, und Paare können nicht von der kumulativen Schwangerschaftsrate profitieren.

Schlussfolgerung

Eine Beratung der Patientinnen bzw. der Paare über die o. g. Ergebnisse sind außerordentlich wichtig, um den Erfolgsdruck und den Stress der Therapie nicht noch zu erhöhen. Psychosoziale Beratungs- und spezifische Therapieangebote sollten aktiv empfohlen und bereitgestellt werden, um Stress und Drop-out-Raten zu reduzieren.

Abstract

Background

Time and again, it is discussed to what extent stress (acute or chronic) has an impact on the results (outcome) of reproductive medicine (artificial reproductive technology, ART).

Objective

Does the current scientific evidence support the hypothesis that stress has a negative impact on the success of ART?

Materials and methods

A review of the current literature was conducted regarding the connection between stress and ART outcome.

Results

Most recent studies, especially meta-analyses, show no clear relationship between stress and the outcome of ART. However, ART itself causes stress in patients, which in turn is a cause for the high drop-out rates during in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) treatments. This means that medically useful therapies are often prematurely terminated, and couples cannot benefit from cumulative pregnancy rates.

Conclusion

In order to reduce the pressure to succeed and prevent placing an additional burden on patients, pre-treatment counseling must include the information that stress has no primary impact on the results of ART. Psychosocial counseling and patient-tailored interventions should be offered to all patients in order to reduce treatment-related stress and high drop-out rates.

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Authors and Affiliations

  1. Facharzt-Zentrum für Kinderwunsch, Pränatale Medizin, Endokrinologie und Osteologie, Amedes, Mönckebergstr. 10, 20095, Hamburg, Deutschland

    Christoph Dorn

  2. Praxis für Gynäkologische Psychosomatik, Hamburg, Deutschland

    Mareike Stiel &  Almut Dorn

Authors
  1. Christoph Dorn
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  2. Mareike Stiel
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  3. Almut Dorn
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Correspondence to Christoph Dorn.

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Interessenkonflikt

C. Dorn, M. Stiel und A. Dorn geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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K. Diedrich, Groß Sarau

B. Sonntag, Hamburg

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Dorn, C., Stiel, M. & Dorn, A. Stress und artifizielle Reproduktionstechnologien – Gibt es einen Einfluss?. Gynäkologe 52, 673–676 (2019). https://doi.org/10.1007/s00129-019-4468-9

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  • DOI: https://doi.org/10.1007/s00129-019-4468-9

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