The psychosocial aspects of infertility

The psychological burden begins from the moment of diagnosis. Then the couple may experience a sense of loss in relation to life expectations, while repeated existential crises are also reported. According to a study from Denmark, one in a hundred people already had a diagnosis of depression before infertility was diagnosed. Other studies raise the rate of depressive symptoms to 11-15% for women and 5-6% for men at the start of infertility treatment. Decisions about the infertility treatment plan are individualized and are made jointly by the Reproductive Physician and the couple. The couple’s participation in these decisions is more essential when both partners have as little emotional distress as possible.

There has been debate for years about whether high levels of anxiety and depressive symptoms in women undergoing infertility treatment affect the outcome. Two 2011 studies (Boivin and Matthiesen) showed that depressive symptoms do not affect the final outcome of treatment. On the contrary, high levels of anxiety, as one study showed, are associated with reduced clinical pregnancy rates.

Psychological distress also appears to be the most common reason why a couple prematurely discontinues infertility treatment, even in countries like Sweden, where the financial cost of treatment is fully covered by the state: almost 30% of couples discontinue treatment after a failed IVF cycle due to psychological distress.

After the failure of a comprehensive treatment, a significant percentage of individuals experience emotional disorders even five years after the last IVF cycle. Women express dysthymia, anxiety disorders and sadness, while men assume a more supportive role and report a feeling of low satisfaction but not sadness. These symptoms show an exacerbation when the couple reaches the age when their peers have grandchildren. It is worth mentioning here that 1/3 of couples 5 years after failed infertility treatment reported that they experienced benefits in their relationship, which was strengthened after this failure.

Comprehensive care in Medically Assisted Reproduction must provide the infertile couple with access to Mental Health professionals, as is the case in countries such as Iceland, Finland and Sweden. Proper cooperation between the Reproductive Physician and the Mental Health Professional is essential to identify individuals in need of support. It will help the couple to better participate in the planning of the treatment, prevent premature abandonment of it and possibly contribute to its positive outcome.

This article was published in the Kathimerini insert “Love yourself”