Infertility and fertility treatment can come with layers of stress: emotional, physical, and financial. But does that stress actually impact IVF success rates? The short answer is that the evidence is mixed.
In this article, we’ll explore the high-quality studies that find little to no association between patients’ stress and IVF pregnancy rates, along with newer data suggesting that higher preconception stress may be linked to lower odds of live birth in IVF.
What do researchers mean by “stress,” and how is it measured?
“Stress” in IVF is usually measured in two ways:
Self-report questionnaires (for example, the Perceived Stress Scale, depression, and anxiety inventories)
Biological markers such as cortisol or salivary α-amylase.
Each captures different aspects of the stress response and they do not always agree, which partly explains why results across studies can differ.
How Stress Might Affect Reproduction
Stress sets off the body’s built-in “alarm systems,” releasing hormones that can disrupt the normal rhythm of reproductive hormones.
In natural cycles, this is one reason stress has been linked to irregular ovulation or even missed periods.
During IVF, though, the picture looks a little different. Because fertility medications provide the hormones needed to grow eggs, they essentially bypass the brain’s usual signals.
This means the most direct way stress interferes with ovulation is less relevant in an IVF cycle.
Still, stress may play a role in other, more subtle ways, such as by affecting the environment inside the ovaries where eggs develop, by influencing the immune system as it interacts with early embryos, or by shaping lifestyle factors like sleep, nutrition, and treatment adherence.
Does stress lower IVF success? What the Research Says
To understand this question clearly, it helps to separate what the strongest evidence shows overall from what some newer, more specific studies suggest.
What most high-quality studies show
Large meta-analyses and prospective studies have consistently found no clear association between stress measured at the start of an IVF cycle and clinical pregnancy rates after IVF or ICSI.
In other words, across large groups of patients, baseline emotional stress does not reliably predict whether an IVF cycle will work.
This has been confirmed in multiple well-designed reviews, which is why most professional guidance concludes that stress is not a proven cause of IVF failure in a given treatment cycle.
What newer research adds
At the same time, the EARTH Study, a large prospective cohort conducted through Massachusetts General Hospital and Harvard, suggests a more nuanced pattern.
In this study, higher perceived stress measured before conception was associated with a small reduction in the probability of live birth, particularly among patients undergoing IVF.
The study measured stress before patients attempted to conceive and followed outcomes through pregnancy.
Importantly, it did not find that stress affected outcomes once pregnancy was established. Among women who went on to deliver, preconception stress levels were not associated with differences in gestational age or birthweight.
Because stress did not appear to influence outcomes after implantation and pregnancy were established, the researchers concluded that stress was most likely acting earlier in the reproductive process, rather than later in pregnancy.
Specifically, the study suggests that perceived stress may influence IVF outcomes at the level of:
Ovarian function and egg quality
Fertilization or early embryo development
Implantation, when the embryo attaches to the uterine lining
In practical terms, if stress even slightly reduces the chance of live birth in IVF, it likely does so by lowering the odds of achieving pregnancy in the first place, rather than by affecting the health of an ongoing pregnancy.
The Impact of stress at specific IVF stages
A 2024 review looked at studies that measured stress (both short-term stress, like anxiety on retrieval day, and longer-term stress, like chronic distress) at different points in the IVF process. Key findings include 5:
The most consistently affected stage was egg retrieval. Women with higher stress sometimes had fewer eggs retrieved or eggs of lower quality.
Other stages found to be affected by stress, though less consistently across studies, included fertilization, embryo transfer, and the “two-week wait.”
Stress was not consistently found to affect outcomes such as fertilization success, implantation, or pregnancy rates.
The Takeaway
Stress does not ruin IVF, so don’t beat yourself up for feeling anxious or overwhelmed. Reducing stress is valuable for your overall well-being and ability to cope with treatment, not because stress determines whether IVF works.
Stress is common during Infertility Care
Across settings, patients report elevated rates of stress, anxiety, and depressive symptoms during IVF.
A 2024 study found medium/high perceived stress in 88% of respondents and probable depression in 44%, particularly among those actively undergoing treatment and not yet pregnant.
Since we do know that stress is very common during fertility treatment, finding ways to manage it through support, relaxation, or emotional and physical intimacy can make the process feel more manageable.
Managing stress is important for the health of the parent and future chil,d even if the impact on pregnancy rates in IVF is less certain.
How Stress Indirectly Affects IVF Success
Even if stress does not consistently reduce per-cycle success, it can still reduce the chance of eventually taking home a baby by increasing the likelihood of discontinuing treatment before achieving pregnancy.
Researchers have found that the psychological burden of IVF and “treatment fatigue” are among the most commonly cited reasons for stopping care. Financial stress has also been found to loom large.
Since it’s no surprise that lower discontinuation rates are linked to higher cumulative live-birth rates over time, managing stress can be the difference between IVF success and failure.
Evidence-Based Takeaways for Patients
The evidence is not conclusive, and that matters.
Most large, well-designed studies and major reviews have found no clear link between baseline emotional distress and IVF success in a single treatment cycle.
National guidance from the Society for Assisted Reproductive Technology emphasizes that while infertility and IVF are stressful experiences, stress itself has not been proven to reduce IVF effectiveness.
Don’t Blame Yourself
If stress had a strong or reliable impact on IVF outcomes, it would consistently appear across studies. It does not.
Feeling anxious, overwhelmed, or emotionally exhausted during treatment is common and understandable, and it is not a personal failing or a reason IVF does not work.
Why stress is still worth addressing
Some newer prospective research, including the EARTH Study, suggests that higher perceived stress before trying to conceive may be associated with a slightly lower chance of live birth in IVF.
This finding does not establish causation, and it does not mean stress determines outcomes.
If stress has any effect, the evidence suggests it is likely small and indirect, acting early in the process rather than during pregnancy itself.
The practical takeaway: You do not need to eliminate stress to succeed with IVF.
At the same time, caring for your mental health during preconception and treatment is still important, mainly because reducing unnecessary stress supports overall well-being and helps many patients cope with a demanding process.
Supporting yourself emotionally is about your overall well-being, not about responsibility for outcomes.
Get psychological support
Studies show that therapy, counseling, and group or online psychological support can reduce anxiety/depression and improve quality of life during treatment.
In these studies, the direct effects on pregnancy and live birth remain inconsistent, but psychological support can help you stick with the fertility journey for as long as it takes you to take home your baby.
Male partners matter, too
Because the female partner is subject to the majority of the medical intervention, men are often left out of care considerations.
Yet, stress has been found to affect sexual function and the quality of semen. The quality of the relationship is another powerfully supportive factor on the IVF journey, so men’s emotional needs should not be overlooked.
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The Relationship Between Stress and IVF: The Bottom Line
The relationship between stress and IVF is more nuanced, but there is no need for alarm.
What is clear is that stress during fertility treatment is common. Though stress may have a very small impact on medical outcomes, stress can have a large impact on quality of life, emotional health, and the ability to continue treatment over time.
Because IVF often requires more than one attempt, staying supported and able to persist with care can meaningfully influence long-term success.
For this reason, addressing stress should be viewed as part of compassionate, whole-person fertility care, not as a requirement for success and never as a source of self-blame.
Supportive services, emotional connection, and practical resources can make the IVF process more sustainable and protect overall well-being while you work toward your goal of bringing home a baby.
