Emotional distress in infertile women and failure of assisted reproductive technologies: meta-analysis of prospective…
I keep being told stress is hurting my chances — the best meta-analysis says pretreatment distress doesn't change IVF outcomes, so can we focus on treating my anxiety for its own sake instead of as a fertility intervention?
Well-supported by good-quality research. how we score evidence
Caveat on this rating: The authors themselves report evidence of moderate publication bias (contour-enhanced funnel plot, significant Egger's test, and a significant subgroup analysis on timing of the pregnancy test). Separately, the first author disclosed speaker fees from EMD Serono and Merck and a research grant from Merck Serono in the three years before publication, though the paper itself received no organisational support.
Fourteen prospective studies of 3,583 women undergoing a cycle of assisted reproduction found no association between pretreatment anxiety or depression and whether the cycle worked (standardised mean difference -0.04, 95% CI -0.11 to 0.03). Being distressed before a cycle did not lower the chance of pregnancy — which means the common advice to "just relax" has no evidence behind it, and a failed cycle is not something a woman caused by feeling bad.
Worth asking
I keep being told stress is hurting my chances — the best meta-analysis says pretreatment distress doesn't change IVF outcomes, so can we focus on treating my anxiety for its own sake instead of as a fertility intervention?
What to watch for
Evidence quality tells you whether to trust the finding — not whether the treatment is safe. These are the risks this research reports.
- Fertility & pregnancy risk
Source
Emotional distress in infertile women and failure of assisted reproductive technologies: meta-analysis of prospective psychosocial studies. — Boivin J, Griffiths E, Venetis CA. (2011)
Top-tier peer-reviewed journal
Read the source: https://doi.org/10.1136/bmj.d223
DOI: 10.1136/bmj.d223
How this was scored
- Study design
- Systematic review of observational studies
- Funding
- No external funding
- Published in
- Top-tier peer-reviewed journal
- Sample size
- 3,583
- Preregistered
- No
- Conflicts disclosed
- Yes
- Independent of proponent
- Yes
- Retracted
- No
Read the full scoring rubric, including what it can't tell you.
Published August 19, 2026.
Where we put this study in context
Questions
How strong is the evidence behind this?
Resolv rates this source "strong evidence". Well-supported by good-quality research. It scores 81 out of 100 on our published rubric. One caveat travels with that badge: The authors themselves report evidence of moderate publication bias (contour-enhanced funnel plot, significant Egger's test, and a significant subgroup analysis on timing of the pregnancy test). Separately, the first author disclosed speaker fees from EMD Serono and Merck and a research grant from Merck Serono in the three years before publication, though the paper itself received no organisational support. The score is calculated from recorded facts about the source — study design, funding, publication venue, sample size, preregistration — not typed in by an editor.
What is the source for this?
Emotional distress in infertile women and failure of assisted reproductive technologies: meta-analysis of prospective psychosocial studies. — Boivin J, Griffiths E, Venetis CA. (2011). Published in: Top-tier peer-reviewed journal. DOI: 10.1136/bmj.d223. The full source is linked on this page so you can read it yourself.
Who paid for this research, and does that matter?
Study design: Systematic review of observational studies. Funding: No external funding. The researchers were independent of whoever benefits from the result. Industry sponsorship is one of the most reliably measured biases in medicine, which is why funding carries real weight in the score rather than sitting in a footnote.
Is this medical advice?
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.