Psychological distress and in vitro fertilization outcome

In vitro fertilization failure predicts psychological distress, but not the reverse. Psychological interventions should focus on helping patients cope with treatment as opposed to specifically increasing the chance of pregnancy.

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Authors

Lauri A. Pasch, Ph.D., Steven E. Gregorich, Ph.D., Patricia K. Katz, Ph.D., Susan G. Millstein, Ph.D., Robert D. Nachtigall, M.D., Maria E. Bleil, Ph.D., Nancy E. Adler, Ph.D.

Vol 98, Issue 2 , Pages 459-464

Abstract

Objective:

To examine whether psychological distress predicts IVF treatment outcome as well as whether IVF treatment outcome predicts subsequent psychological distress.

Design:

Prospective cohort study over an 18-month period.

Setting:

Five community and academic fertility practices.

Patient(s):

Two hundred two women who initiated their first IVF cycle.

Intervention(s):

Women completed interviews and questionnaires at baseline and at 4, 10, and 18 months' follow-up.

Main Outcome Measure(s):

IVF cycle outcome and psychological distress.

Result(s):

In a binary logistic model including covariates (woman's age, ethnicity, income, education, parity, duration of infertility, and time interval), pretreatment depression and anxiety were not significant predictors of the outcome of the first IVF cycle. In linear regression models including covariates (woman's age, income, education, parity, duration of infertility, assessment point, time since last treatment cycle, and pre-IVF depression or anxiety), experiencing failed IVF was associated with higher post-IVF depression and anxiety.

Conclusion(s):

IVF failure predicts subsequent psychological distress, but pre-IVF psychological distress does not predict IVF failure. Instead of focusing efforts on psychological interventions specifically aimed at improving the chance of pregnancy, these findings suggest that attention be paid to helping patients prepare for and cope with treatment and treatment failure.

Read the full text at: http://www.fertstert.org/article/S0015-0282(12)00577-8/fulltext


Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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