Evidence map›Paper›PMID 42498851›Full record

ArticleJournal of assisted reproduction and genetics2026

Association of daily perceived stress with fertility outcomes in natural and controlled ovarian stimulation cycles: a feasibility study.

Harmonie Strohl, Nguyen Do, Howon Ryu, Olumayowa Dayo, Emily Ho, Jacey Hu, Alexander Kauffman, Ina Stelzer, Ariel Lang, Kellie Church and 2 more

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In one paragraph

Article in Journal of assisted reproduction and genetics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Harmonie StrohlSchool of Medicine, University of California, La Jolla, San Diego, USA. hstrohl@health.ucsd.edu.
Nguyen DoSchool of Medicine, University of California, La Jolla, San Diego, USA. ntd005@health.ucsd.edu.
Howon RyuHerbert Wertheim School of Public Health and Human Longevity Science, University of California, La Jolla, San Diego, USA.
Olumayowa DayoDepartment of Obstetrics, Gynecology, and Reproductive Sciences, University of California, La Jolla, San Diego, USA.
Emily HoObstetrics and Gynecology Institute, Cleveland Clinic Foundation, Cleveland, USA.
Jacey HuDepartment of Obstetrics, Gynecology, and Reproductive Sciences, University of California, La Jolla, San Diego, USA.
Alexander KauffmanDepartment of Obstetrics, Gynecology, and Reproductive Sciences, University of California, La Jolla, San Diego, USA.
Ina StelzerDepartment of Obstetrics, Gynecology, and Reproductive Sciences, University of California, La Jolla, San Diego, USA.
Ariel LangDepartment of Psychiatry, University of California, La Jolla, San Diego, USA.
Kellie ChurchDepartment of Obstetrics, Gynecology, and Reproductive Sciences, University of California, La Jolla, San Diego, USA.
Jingjing ZouHerbert Wertheim School of Public Health and Human Longevity Science, University of California, La Jolla, San Diego, USA.
Irene SuDepartment of Obstetrics, Gynecology, and Reproductive Sciences, University of California, La Jolla, San Diego, USA. hisu@health.ucsd.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeFemales with infertility perceive stress, but most studies rely on single assessments. We examined the feasibility of repeated ecological momentary assessment (EMA) during IVF and whether stress trajectories across two cycles were associated with reproductive and IVF outcomes.

methodsIn a prospective cohort at a single academic center, 26 females (18-42 years) undergoing IVF with luteal estradiol priming were recruited; 25 completed follow-up. Perceived stress was assessed via text-message EMA three times daily during a priming month and the subsequent controlled ovarian stimulation (COS) cycle. Primary outcomes were ovulation in the priming cycle and a composite poor COS outcome (cycle cancellation, < 4 oocytes retrieved, no blastocyst, or no euploid blastocyst). Functional principal components analysis characterized stress trajectories, and regression models tested associations with outcomes.

resultsMean age was 36 (SD 3.6); 64% were White and 24% Hispanic. All participants ovulated during priming. Two stress patterns explained 96% of follicular-phase variability. The dominant pattern (early decline then plateau) was not associated with outcomes. A second pattern (peak around cycle day 6 with subsequent rise) was associated with lower peak LH (b - 2.85, 95% CI - 4.60 to - 1.06; adjusted p = 0.004). Ten participants (40%) met the composite poor COS outcome, which was not associated with either stress pattern. Stress levels were similar between priming and COS.

conclusionEMA is feasible during IVF. In patients reporting mild-to-moderate stress, perceived stress was stable and not associated with key IVF outcomes, though specific trajectories may modestly relate to hypothalamic-pituitary-ovarian-axis function.

Indexed as

Ecologic momentary assessmentInfertilityIn vitro fertilizationLuteinizing hormoneOvulationPerceived stress

Identifiers

PMID42498851

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.