Abstract
Psychological stress, most commonly manifested by symptoms of anxiety and depression, is a common occurrence in individuals and couples who are struggling with infertility. Sources of stress include a feeling of being out of control, social pressure, the time urgency brought on by the biological clock, and the financial cost of treatment, which is often not covered by insurance. The level of distress reported by infertile women is equivalent to the level of distress reported by women who are facing serious medical issues. In addition to feeling unpleasant, stress is associated with premature treatment termination and possible lower pregnancy rates with the ARTs. Research supports the efficacy of psychological interventions in relieving distress with this patient population as well as potentially increasing pregnancy rates. The most effective interventions include ones which are at least six sessions in length and include instruction in specific stress-reducing skills.
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References
Freeman EW, Boxer AS, Rickels K, Tureck R, Mastoinni L. Psychological evaluation and support in a program of in vitro fertilization and embryo transfer. Fertil Steril. 1985;43:48–53.
Mahlstedt PP, Macduff S, Bemstein J. Emotional factors and the in vitro fertilization and embryo transfer process. J In Vitro Fert Embryo Transf. 1987;4(4): 232–6.
Chen TH, Chang SP, Tsai CF, et al. Prevalence of depressive and anxiety disorders in an assisted reproductive technique clinic. Hum Reprod. 2004; 19(10):2313–8.
Anderson KM, Sharpe M, Rattray A, Irvine DS. Distress and concerns in couples referred to an infertility specialist. J Psychosom Res. 2003;54(4):353–5.
Volgsten H, Skoog Svanberg A, Ekselius L, Lundkvist O, Sundstrom Poromaa I. Prevalence of psychiatric disorders in infertile women and men undergoing in vitro fertilization treatment. Hum Reprod. 2008; 23(9):2056–63.
Domar AD, Zuttermeisiter PC, Friedman R. The psychological impact of infertility: a comparison to women with other medical conditions. J Psychosom Obstet Gynaecol. 1993;14:45–52.
Eugster A, Vingerhoets AJ. Psychological aspects of in vitro fertilization: a review. Soc Sci Med. 1999; 48:575–89.
Benyamini Y, Gozlan M, Kokia E. Variability in the difficulties experienced by women undergoing infertility treatments. Fertil Steril. 2005;83(2):275–83.
Mahajan NN, Turnbull DA, Davies MJ, Jundal UN, Briggs NE, Taplin JE. Adjustment to infertility: the role of intrapersonal and interpersonal resources/vulnerabilities. Hum Reprod. 2009;24(4):906–12.
Sbaragli C, Morgante G, Goracci A, Hofkens T, DeLeo V, Castrogiovanni P. Infertility and psychiatric morbidity. Fertil Steril. 2008;90(6):2107–11.
Freizinger M, Franko DL, Dacey M, Okun B, Domar AD. The prevalence of eating disorders in infertile women. Fertil Steril. 2010;93(1):72–8.
Edelmann RJ, Humphrey M, Owens DJ. The meaning of parenthood and couple’s reactions to male infertility. Br J Med Psychol. 1994;67(Pt 3):291–9.
Daniluk JC. Gender and infertility. In: Leiblum SR, editor. Infertility, psychological issues and counseling strategies. New York: Wiley; 1997. p. 103–35.
Lenzi A, Lonbardo F, Salacone P, Gandini L, Jannini EA. Stress, sexual dysfunctions, and male infertility. J Endocrinol Invest. 2003;26(3 Suppl):72–6.
Peterson BD, Newton CR, Rosen KH. Examining congruence between partners’ perceived infertility-related stress and its relationship to marital adjustment and depression in infertile couples. Fam Process. 2003;42(1):59–70.
Brandes M, van der Steen JO, Bokdam SB, Hamilton CJ, de Bruin JP, Nelen WL, Kremer JA. When and why do subfertile couples discontinue their fertility care? A longitudinal cohort study in a secondary care subfertility population. Hum Reprod. 2009;24: 3127–35.
Van den Broeck U, Holvoet L, Enzlin P, Bakelants E, Demyttenaere K, D’Hooghe T. Reasons for dropout in infertility treatment. Gynecol Obstet Invest. 2009;68: 58–64.
Strauss B, Hepp U, Staeding G, Mettler L. Psychological characteristics of infertile couples: can they predict pregnancy and treatment persistence? J Comm Appl Soc Psychol. 1998;8:289–301.
Verhagen TE, Dumoulin JC, Evers JL, Land JA. What is the most accurate estimate of pregnancy rates in IVF dropouts? Hum Reprod. 2008;23:1793–9.
Daniluk JC. Reconstructing their lives: a longitudinal, qualitative analysis of the transition to biological childlessness for infertile couples. J Couns Devel. 2001;79:439–49.
World Health Organization. Current practices and controversies in assisted reproduction. Report of a meeting on Medical, ethical and social aspects of assisted reproduction, Geneva, Switzerland, 64; 2001
Noorbala AA, Ramazanzadeh F, Malekafzali H, Abedinia N, Forooshani AR, Shariat M, Jafarabadi M. Effects of a psychological intervention on depression in infertile couples. Int J Gynaecol Obstet. 2008; 101(3):251.
Noorbala AA, Ramazanzadeh F, Abedinia N, Bagheri SA, Jafarabadi M. Study of psychiatric disorders among fertile and infertile women and some predisposing factors. J Fam Reprod Health. 2007;1(1): 6–11.
Domar AD, Seibel MM. Emotional aspects of infertility. In: Seibel MM, editor. Infertility: a comprehensive text. Stamford, CT: Appleton & Lange; 1997. p. 29–44.
Menning ECK. Effect of infertility on psychosexual function. Br Med J. 1975;5:295.
Schenker JG, Meirow D, Schenker E. Stress and human reproduction. European Journal of Obstetics &Gynecology and Reproductive Biology. 1992; 45(1):1–8.
Greil A. Not yet pregnant: infertile couples in contemporary America. London: Rutgers University Press; 1991.
Gordon JD, Dimattina M. 100 Questions and answers about infertility. Jones and Bartlett Publishers Inc: Sudbury, MA; 2008. p. 114.
Lampic C, Svanberg AS, Karlström P, Tydén T. Fertility awareness, intentions concerning childbearing, and attitudes towards parenthood among female and male academics. Hum Reprod. 2006;21(2):558–64.
Domar AD, Smith K, Conboy L, Iannone M, Alper M. A prospective investigation into the reasons why insured United States patients drop out of in vitro fertilization treatment. Fertil Steril. 2010;94(4): 1457–9.
Boivin J, Domar AD, Shapiro D, Fauser B, Verhaak CM. Tackling burden in ART: an integrated approach for fertility clinic staff. Hum Reprod. 2012;27(4): 941–50.
Rajkhowa M, McConnell A, Thomas GE. Reasons for discontinuation of IVF treatment: a questionnaire study. Hum Reprod. 2006;21:358.
Boivin J. A review of psychosocial interventions in infertility. Soc Sci Med. 2003;57(12):2325–41.
Ramezanzadeh F, Noorbala AA, Abedinia N, Rahimi Forooshani A, Naghizadeh MM. Psychiatric intervention improved pregnancy rates in infertile couples. Malays J Med Sci. 2011;18(1):16–24.
Hammerli K, Znoj H, Barth J. The efficacy of psychological interventions for infertile patients: a meta-analysis examining mental health and pregnancy rate. Hum Repro. 2009;15(3):279–95.
Domar AD, Clapp D, Slawsby E, Kessel B, Orav J, Freizinger M. The impact of group psychological interventions on distress in infertile women. Health Psychol. 2000;19(6):568–75.
Faramarzi M, Alipor A, Esmaelzadeh S, Kheirkhah F, Poladi K, Pash H. Treatment of depression and anxiety in infertile women: cognitive behavioral therapy versus fluoxetine. J Affect Disord. 2007;108(1): 159–64.
Domar AD, Siebel MM, Benson H. The mind/body program for infertility: a new behavioral treatment approach for women with infertility. Fertil Steril. 1990;53(2):246–9.
Domar AD, Rooney KL, Wiegand B, Orav EJ, Alper MM, Berger BM, Nikolovski J. Impact of a group mind/body intervention on pregnancy rates in IVF patients. Fertil Steril. 2011;95(7):2269–73.
Hosaka T, Matsubayashi H, Sugiyama Y, et al. Effect of psychiatric group intervention on natural-killer cell activity and pregnancy rate. Gen Hosp Psychiatry. 2002;24(5):353–6.
Terzioglu F. Investigation into effectiveness of counseling on assisted reproductive techniques in Turkey. J Psychosom Obstet Gynaecol. 2001; 22(3):133–41.
Louis GMB, et al. Stress reduces conception probabilities across the fertile window: evidence in support of relaxation. Fertil Steril. 2011;95(7):2184–9.
Klonoff-Cohen H, Chu E, Natarajan L, Sieber W. A prospective study of stress among women undergoing in vitro fertilization or gamete intrafallopian transfer. Fertil Steril. 2001;71:675–87.
Boivin J, Griffiths E, Venetis CA. Emotional distress in infertile women and failure of assisted reproductive technologies: meta-analysis of prospective psychosocial studies. BMJ. 2011;342:223.
Domar AD, Backman K, Wiegand B, Friscia D, Orav EJ, Nikolovski J. The relationship between stress and IVF outcome. Paper presented at the annual meeting of ASRM. Denver, CO; 2010
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The authors would like to thank Kristin Rooney for her assistance with this chapter.
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Domar, A., Gross, J. (2012). Stress and ART. In: Ginsburg, E., Racowsky, C. (eds) In Vitro Fertilization. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-9848-4_13
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DOI: https://doi.org/10.1007/978-1-4419-9848-4_13
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