IN VITRO FERTILISATION AND STRESS

IN VITRO FERTILISATION AND STRESS.

Renato COCCHI, a neurologist and a medical psychologist.

Summary

In the in vitro fertilization (IVF) process there are several operational steps where the action of the not-psychological, but hormonal-metabolic, physical-surgical and physical-thermal stress is fully unknown. In facts we could not exclude the stress symptoms presence, though not identified as such, in the ovarian hyperstimulation syndrome (OHSS), that has the task to produce more oocytes.

It is possible that oocytes, sperms and embryonic stem cells, all alive but ill functioning, go into the in vitro fertilization process, with some negative outcomes, even in the long run.

Key words: In vitro fertilization (IVF), oocyte, sperm, ovarian hyperstimulation syndrome (OHSS), stress, reaction, ill functioning.

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In the current Italian discussion (2005) waiting for the abrogating referendum on the in vitro fertilisation law, nobody spoke about the relationship between in vitro fertilization and not-psychological stress.

Since I am dealing on over 25 years about stress of aspecific reactions (www.stress-cocchi.net) I allow me to attract the attention on this gap.

Hypotheses.

In the operational sequence and in the following of the in vitro fertilization there are some steps potentially sensitive to stress.

1. Among the symptoms of the OHSS for the oocyte production, with "moderate" hormonal stimulation, there are even nausea, vomit and diarrhea (Brinsden and coll., 1995; Olivennes et al., 2005). These are aspecific symptoms of stress, even found in other morbid conditions, either in the woman (in the premenstrual syndrome (Cocchi, 1998)) either in the man (in some atypical depression).

If this is the result, it is possible that the internal metabolic stress by hormonal excess, over to act on the woman, somehow modifies even some oocytes, and, by now, we do not know what follow.

2. The collecting of an embryonic cell (as for an example, for the pre-graft diagnosis) surely determines a physical-surgical stress either in the same cell, and in the remaining cells of the embryo. To this stress the cell / the cells withdraw or frozen could to react with possible genetics answers stress, inherent in the DNA.

In fact, the ability of reacting to stress has always even a genetic component. It is exactly an answer of stress, the progressive death of single cells (apoptosis) of an organ or tissue, in certain metabolic conditions, as for an example: To internal oxidative stress (Inoue et al., 2004). The interested cells do not die all together, but they are extinguishing one at a time. This fact points up that, being equal the stress eliciting cause, the deferred death should be due to different cellular resistance to the stress.

There would not be the cortisole and adrenergic answer to stress because the relative effector organs were not still formed.

3. The cool is one of the more powerful stress producing, used in laboratory experiments, for research on stress, and it is dealing with temperatures that turn about to zero C degrees.

What occurs in the oocytes, in the sperms and in the embryoes all frozen to at least -196 C degrees in liquid nitrogen, by now it is a well kown fact.

Very much fail and malformations from in vitro fertilization can have this origin (CDCP, 1997). We have not only the alive and health cell or the died cell, but even the cell that lives and it is bad functioning, then ill.

4. What happens then eventually as for the undergone stress (some effects could be seen after years or decades) in the graft of stem cells, alive but potentially ill functioning, cut out from frozen embryos, is an other field where any scientific knowledge misses ( Wennerholm and Bergh, 2000). Has the morbid and short live of Dolly, the famous sheep cloned in Scotland, an explanation of this type?

Conclusions.

About relationships between stress and in vitro fertilization by now there is, and not recognized as such, the stress symptom presence in the ovarian hyperstimulation syndrome. Other critical steps of the whole process, as potentially sensitive to stress and to its followings, are fully unknown.

The many wizard apprentices (and among them, even some Nobel prizes) do wonder that commit since them perjury when they guarantee as safe practices on which, for what concerns stress, they have much partial, if null information.

References.

Brinsden PR, Wada I, Tan SL, Balen A, Jacobs HS. Diagnosis, prevention and management of ovarian hyperstimulation syndrome. Br J Obstet Gynaecol 1995;102:767-

CDCP (Centers for Disease Control and Prevention. US Department of Health and Human Services). Assisted Reproductive Technology Success Rates. National Summary and Fertility Clinic Reports 1997;1-23.

Cocchi R. Pre-menstrual syndrome as the paradigm of an internal biochemical stress. Presented at the 2rd World Congress on Stress, Melbourne 1998 <www.stress-cocchi.net/Speculation3-it.htm>

Inoue M, Sato EF, Nishikawa M, Hiramoto K, Kashiwagi A, Utsumi K. Free radical theory of apoptosis and metamorphosis. Redox Rep. 2004,9:237-47.

Olivennes F, Gerris J, Delvigne A, Nygren K. Ovarian Hyperstimulation Syndrome. Short Management Guidelines. ESHRE - European Society for Human Reproduction & Embryology, 2005.

Wennerholm U, Bergh C. Obstetric outcome and follow-up of children born after in vitro fertilization (IVF). Hum Fertil 2000;3:52-64.

Author's address: Renato Cocchi, via Rabbeno, 3

42100 Reggio Emilia

renatococchi@libero.it

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