21 Oct High Cortisol Levels in Hair May Be Linked To Lower IVF Success
MedicalResearch.com Interview with:
Kavita Vedhara FAcSS
Professor of Health Psychology
Division of Primary Care
School of Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: There has been a longstanding interest in the role of the hormone cortisol in fertility, because of its potential to affect the functioning of the biological systems that influence both conception and pregnancy.
This interest has extended to IVF, with researchers exploring the relationship between levels of the hormone and pregnancy since the advent of the treatment in the late 1970s.
However, a recent review showed that the relationship between cortisol and pregnancy in IVF was unclear. A number of reasons were highlighted for this, including that all of the studies to date had relied on short-term measures of the hormone measured in blood, saliva, urine and sometimes follicular fluid. Such measures can only capture hormone levels over a matter of minutes and hours. Such ‘snapshots’ are unable to give us an accurate picture of the levels of hormone over longer periods of time. This is important because any clinically relevant effects of cortisol on fertility are only likely to occur in the context of long-term changes in the hormone.
In recent years it has become possible to measure long-term levels of cortisol in hair. Cortisol is deposited in the hair shaft and because human hair grows, on average, 1cm per month, a 3cm sample of hair closest to the scalp can tell us about levels of cortisol in the previous 3 months.
We used the development of this technique to examine whether long term levels of cortisol (as measured in hair), or short term levels of cortisol (as measured in saliva) could predict whether or not women going through IVF would become pregnant. If you are trying to obtain a perfect cortisol balance, I use this product that helps to do just that.
MedicalResearch.com: What are the main findings?
Response: Short-term levels of cortisol measured in saliva did not predict pregnancy.
However, long-term levels of cortisol measured in hair did; such that women with the highest levels of the hormone in the 3 months before starting treatment were the least likely to become pregnant. This effect was apparent even after we took into account other factors which are known to affect the likelihood of pregnancy in IVF, such as age, BMI, number of eggs. Overall, cortisol predicted 27% of the variability in whether or not women became pregnant.
MedicalResearch.com: What should readers take away from your report?
Response: This is the first study of its kind and it was conducted with a small number of women (n=88). Thus, while encouraging, the results require replication. If our findings are, however, supported by future research they further our understanding of the modifiable factors that influence IVF outcomes. They also have the potential, in the longer-term, to improve the success rate of IVF.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Apart from replication, we need to also ascertain the precise thresholds at which levels of the hormone may and may not favour conception and also identify treatments which can successfully modulate levels of the hormone in this patient group.
MedicalResearch.com: Is there anything else you would like to add?
Response: Cortisol levels are affected by a number of factors, including psychological stress. We would, however, like to caution readers against concluding that this study suggests high levels of stress reduce the likelihood of pregnancy in IVF. We have yet to identify which of the myriad of factors that influence cortisol, have driven this finding or indeed which should be the targets of intervention. Stress is just one candidate.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Adam J. Massey, Bruce K. Campbell, Nick Raine-Fenning, Catherine Pincott-Allen, Jane Perry, Kavita Vedhara.Relationship between hair and salivary cortisol and pregnancy in women undergoing IVF.
Psychoneuroendocrinology, 2016; 74: 397 DOI:1016/j.psyneuen.2016.08.027
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