Stress, anxiety, and depression of both partners in infertile couples are associated with cytokine levels and adverse IVF outcome

Am J Reprod Immunol. 2018 Apr;79(4):e12832. doi: 10.1111/aji.12832. Epub 2018 Mar 12.


Problem: Psychiatric disorders and stress in women have been associated with poor IVF outcome. We hypothesized that both partners in the infertile couples are emotionally affected, and cytokines in both may link psychological to reproductive outcome.

Method of study: Forty-five IVF couples completed questionnaires and visual analog scales for stress and psychiatric disorders and had cytokines measured in serum, semen, cervicovaginal, and follicular fluids. Multivariable analyses, t tests, maximum likelihood estimates, Spearman correlation, and data mining were applied.

Results: Psychopathology was found in 72% of the couples. Female and male stress were associated with stress, anxiety, and depression in the respective partner, and with a lower likelihood of clinical pregnancy and live birth. Lower serum TGF-β and higher cervicovaginal IL-6 and IL-1β were associated with stress. In data decision trees, cytokines in relation to stress and depression in both partners were found indicative of IVF failure.

Conclusion: Infertile couples may benefit from psychiatric evaluation and treatment of both partners.

Keywords: cytokines; in vitro fertilization; infertile couples; psychopathology.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anxiety / immunology
  • Anxiety / psychology*
  • Cytokines / blood
  • Depression / immunology
  • Depression / psychology*
  • Female
  • Fertilization in Vitro / methods*
  • Humans
  • Infertility / immunology
  • Infertility / psychology*
  • Infertility / therapy
  • Inflammation Mediators / blood
  • Male
  • Pregnancy
  • Pregnancy Outcome
  • Sexual Partners
  • Stress, Psychological / immunology
  • Stress, Psychological / psychology*
  • Surveys and Questionnaires


  • Cytokines
  • Inflammation Mediators