Abstract

I'm under a great deal of stress at work. Will this affect my upcoming IVF cycle?” Patients commonly ask this question in my practice, and Lovely et al ¹ address the subject in this issue of Southern Medical Journal. In their study, Lovely et al measured cortisol and 6-sulfatoxy-melatonin during an in vitro fertilization (IVF) treatment cycle. In addition, study patients completed the State-Trait Anxiety Inventory (STAI) to measure subjective stress. The choice of an appropriate marker for stress is a challenge for any research in this area. Of these three variables, 6-sulfatoxy-melatonin concentrations have not been studied previously in this context. The study of a metabolite of melatonin, and thus an assessment of pineal gland function, is a novel idea. As the authors state, this potentially avoids the influence of endocrine changes associated with IVF on the measurement of stress indicators. Previous studies primarily used the measurement of cortisol and prolactin, which may change with increasing estradiol or other hormones during therapy, as end points.