Association of basal reproduction hormone status with the outcomes of controlled ovarian hyperstimulation: The moderating effect of psychological factors.

PURPOSE: This study aimed to investigate whether psychological factors moderate the association between baseline reproductive hormone levels and oocyte retrieval outcomes in women undergoing in vitro fertilization.

METHOD: We conducted a cohort study involving 1,379 infertile women recruited from the Reproductive Center of the First Affiliated Hospital of Anhui Medical University from April 2017 to December 2020. Psychological status was assessed using validated scales, and baseline hormone levels were measured on the 2nd or 3rd day of menstruation. Oocyte retrieval outcomes, including total antral follicle count (measured after ovarian stimulation), retrieved oocytes, and metaphase II oocytes, were evaluated postovarian stimulation. Structural equation modeling was applied to assess the moderating effects.

RESULTS

A total of 703 women who completed their first controlled ovarian hyperstimulation cycles were included in the final analysis. Psychological factors significantly moderated the relationship between baseline follicle-stimulating hormone levels and oocyte retrieval outcomes based on the manifest variable models, especially for stress, suggesting that stress exacerbates the adverse effects of high baseline follicle-stimulating hormone levels on ovarian response, although these infertile women have underwent controlled ovarian hyperstimulation. Meanwhile, higher levels of psychological scores still amplified the negative impact of abnormal baseline reproductive hormone levels on the total antral follicle count, retrieved oocytes, and metaphase II oocytes based on the latent variable models.

CONCLUSION

Psychological factors, especially stress, play a significant moderating role in the relationship between baseline hormone levels and oocyte retrieval outcomes. These findings highlight the importance of psychological interventions to improve in vitro fertilization outcomes. (PsycInfo Database Record (c) 2026 APA, all rights reserved).