One cause of elevated levels of catecholamines is stress. Why is it not standard operating procedure to measure levels of epinephrine and norepinepherine in patients undergoing IVF-ET. We now know through recent research that stress does indeed have a deleterious effect on pregnancy outcomes, the extent of which is yet to be determined.
If patients do have elevated catecholamines in the absence of pheochromocytoma, then why not recommend that ALL of these patients be treated with acupuncture and/or biofeedback to lower elevated levels which may help facilitate a + outcome?
As you all know, contributing to a successful outcome takes more than an embryo transfer and certainly more than a proper hormone status and normal s/a; it takes a conglomeration of positive circumstances such as proper intraendometrial perfusion, proper immune status and maternal tolerance, etc. Should we all be taking stress as a mitigator more seriously?