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Discuss this article (0 Comments)The psychology of infertility
by Partners Harvard Medical International on Wednesday, 28 January 2009
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Studies suggest that women undergoing ART are at increased risk for psychological distress, such as anxiety and grief, particularly if therapy fails.
The anxiety of facing IVF has been shown to continue throughout treatment. In fact, nearly 50% of couples that start treatment drop out after the first meeting, and in two large studies, two-thirds dropped out before completing treatment, usually due to psychological distress.
For some women, treatment failure can lead to feelings of shame that they have not done enough or tried hard enough to conceive. It can be hard for them to know when it is time to end the process.
And, once they do move on, they may feel frustrated and betrayed because they invested so many years in something that ultimately disappointed them.
Psychological interventions
It's important that infertile women with symptoms of anxiety, depression, or both receive counselling from a trained mental health professional.
Ideally, this counselling should begin before reproductive therapies are started, as studies suggest that addressing factors such as depression, anxiety, and stress is linked to treatment success.
A recent review of studies suggests that psychotherapy leads to lowered anxiety and depression in infertile women, and may increase conception rates. In other research, interpersonal therapy and cognitive behavioural therapy (CBT) have been shown to help infertile patients who have mild to moderate depression.
One form of such therapy is mind-body therapy, developed in 1987 by Alice Domar, PhD, an assistant professor at Harvard Medical School and executive director of the Domar Center for Mind/Body Health in Massachussets.
Studies of mind-body therapy programs have reported that such programs can help patients reduce tension, anxiety, fatigue, and depression, and re-establish their sense of being in control of their lives.
The 10-session workshops, led by mental health professionals or nurses, teach patients relaxation techniques, stress management, and coping skills; introduce revised lifestyle habits; and offer group support.
One study of 184 women who had been trying to conceive for one to two years, suggested that mind-body programmes might even greatly increase the chances of a successful pregnancy.
But recognising a link between stress and infertility is far from telling a woman, "Just relax and you'll get pregnant," says Professor Domar. Even if stress is a proven contributor to infertility, women should not be made to feel responsible.
If there's any silver lining, it is that the stress of infertility is temporary. At some point, most couples reach a resolution, whether it's conception, adoption, or deciding to remain child-free. A few even find the experience transformative.
This article is provided courtesy of Partners Harvard Medical International.
Infertility and stress
It's well known that infertility creates psychological and emotional distress. But does stress cause infertility? There is some evidence to suggest that it may, but the relationship is complex.
Research focusing on depression suggests that it may play a significant role in infertility. In one study, women with a history of depression were twice as likely as women without depression to have infertility.
Another study of women undergoing IVF treatment showed that those who were depressed before treatment had a 13% pregnancy rate, compared to 29% for women who were not depressed before receiving IVF.
Initially, a third study examining the link between job-strain and pregnancy in women did not find a causal relationship. But when the researchers limited the sample to women with unexplained infertility, job strain was found to predict an unsuccessful pregnancy.
It's well known that infertility creates psychological and emotional distress. But does stress cause infertility? There is some evidence to suggest that it may, but the relationship is complex.
Research focusing on depression suggests that it may play a significant role in infertility. In one study, women with a history of depression were twice as likely as women without depression to have infertility.
Another study of women undergoing IVF treatment showed that those who were depressed before treatment had a 13% pregnancy rate, compared to 29% for women who were not depressed before receiving IVF.
Initially, a third study examining the link between job-strain and pregnancy in women did not find a causal relationship. But when the researchers limited the sample to women with unexplained infertility, job strain was found to predict an unsuccessful pregnancy.
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