Anxiety, depression, and attachment before and after the first-trimester screening for Down syndrome: comparing couples who undergo ART with those who conceive spontaneously

Abstract

Objectives This study's aim was to describe the emotional status of parents to be before and after the first-trimester combined prenatal screening test.Methods One hundred three couples participated, of which 52 had undergone an in vitro fertilization/intracytoplasmic sperm injection treatment [assisted reproductive technology (ART)] and 51 had conceived spontaneously. Participants completed the state scale of the State-trait Anxiety Inventory, the Edinburgh Depression Scale, and the Maternal and Paternal Antenatal Attachment Questionnaire before the first-trimester combined prenatal screening test at around 12 weeks of gestational age (T1) and just after receiving the results at approximately 14 weeks of gestational age (T2). ResultsWe observed a significant decrease in anxiety and depression symptoms and a significant increase in attachment from T1 to T2. Results showed no differences between groups at either time point, which suggests that ART parents are more similar to than different from parents conceiving spontaneously. Furthermore, given the importance of anxiety during pregnancy, a subsample of women with clinical anxiety was identified. They had significantly higher rates of clinical depression and lower attachment.Conclusions These results indicate that, regardless of whether conception was through ART or spontaneous, clinical anxiety in women over the prenatal testing period is associated with more vulnerability during pregnancy (i.e. clinical depression and less attachment to fetus).

Prenatal attachment in pregnancy following assisted reproductive technology: a literature review

“…Three studies included women who conceived through donor gametes (Fisher, Hammarberg, & Baker, 2008;McMahon et al, 2011;McMahon, Gibson, Allen, & Saunders, 2007) but did not discuss the difference in prenatal attachment between women who conceived with their own eggs and women who conceived with donor eggs. Six studies excluded participants who conceived through donor gametes (Bernstein et al, 1994;Cohen, McMahon, Tennant, Saunders, & Leslie, 2000;Hjelmstedt & Collins, 2008;Hjelmstedt, Widström, & Collins, 2006McMahon, Ungerer, Beaurepaire, Tennant, & Saunders, 1997), and the use of donor gametes in participants was not reported in six studies (Cairo et al, 2012;Chen, Chen, Sung, Kuo, & Wang, 2011;Kuo et al, 2013;Pellerone & Micciche, 2014;Stanton & Golombok, 1993;Udry-Jørgensen et al, 2015).…”

“…Levels of MFA during ART pregnancy have been measured in several studies but the findings are conflicting. In the reviewed studies, MFA in pregnant women who conceived through ART was lower (Pellerone & Micciche, 2014), or higher than (Bernstein et al, 1994;Cairo et al, 2012;Chen et al, 2011;Fisher et al, 2008;McMahon et al, 2011) or similar (Hjelmstedt et al, 2006;McMahon et al, 1997;Stanton & Golombok, 1993;Udry-Jørgensen et al, 2015) compared with that in women who conceived spontaneously. In the study of Bernstein et al (1994), the higher level of attachment was reported only in sub-scale of 'giving of self' (Bernstein et al, 1994).…”

“…In women who conceived through ART, prenatal attachment begins in early pregnancy (Kuo et al, 2013) and increases with progression of the pregnancy (Fisher et al, 2008;Hjelmstedt et al, 2006;Kuo et al, 2013;Udry-Jørgensen et al, 2015). Levels of MFA during ART pregnancy have been measured in several studies but the findings are conflicting.…”

“…In most of the studies, IVF fathers were attached to their unborn child to the same extent as other fathers (Cohen et al, 2000;Hjelmstedt & Collins, 2008;Hjelmstedt et al, 2007;McMahon et al, 1997;Udry-Jørgensen et al, 2015). One study found that the scores for PFA were significantly higher in the IVF group compared to the reference samples (Cairo et al, 2012).…”

“…While the ART women tend to experience parenthood as associated with a high level of general wellbeing, the ART men did not report such positive experiences (Gameiro, Moura-Ramos, Canavarro, & Soares, 2010). However, since the beginning of infertility treatments (ART), research concerning the parentalfetal relationship has predominantly focused on mothers (Kuo et al, 2013;McMahon et al, 2011;Udry-Jørgensen, Darwiche, Germond, Wunder, & Vial, 2015), and research on paternal-fetal attachment (PFA) following ART is scarce and has produced mixed results (Pinto et al, 2017). Some studies showed that ART fathers were highly attached to their fetus/infants compared to other fathers (Cairo et al, 2012;Hjelmstedt & Collins, 2008).…”