Depression and Anxiety in Pathways of Medically Assisted Reproduction: The Role of Infertility Stress Dimensions

Abstract

Background:Depressive and anxious symptoms are common psychological reactions to infertility and Medically Assisted Reproduction (MAR). No study compared depressive and anxious symptoms and infertility stress dimensions across homologous and heterologous MAR, nor explored the specific role of the infertility stress dimensions in the two pathways. Homologous MAR may be associated with higher distress as the couple feel that the responsibility to reproduce and carry on the family line falls on them, and they feel inadequate if they are unable to bear children.Objective:We compared depressive/anxious symptoms and infertility stress dimensions between individuals undergoing homologous and heterologous MAR. We also explored the association between the infertility stress dimensions and depressive/anxious symptoms separately in two MAR pathways.Methods:Two-hundred twenty-six individuals participated [mean age = 39.71 years; 54.45% women]: 118 (52.2%) in homologous and 108 (47.8%) in heterologous MAR. The Fertility Problem Inventory, Beck Depression Inventory-II, and State and Trait Anxiety Inventory-Y form were administered.Results:Individuals in homologous MAR had higher depressive/state-trait anxious symptoms, general infertility stress, and infertility-related sexual concerns than those in heterologous MAR. In homologous MAR, social and sexual concerns were associated with depressive/trait anxious symptoms while gender had no effect. In heterologous MAR, male gender was associated with lower state anxious symptoms while infertility stress dimensions had no effect.Conclusion:Individuals in homologous MAR are a more distressed subgroup which requires a tailored supportive psychological intervention specifically on sexual and social concerns.

Comparison of Depression Severity and Sexual Satisfaction Between Fertile and Infertile Women in Iran: A Population Based Case-Control Study

“…Likewise, a study measured mood distress in infertile couples again which used similar tools used in our study. That showed about 10% of the sample experience clinical symptoms of anxiety and depression (14).The results of our study are consistent with previous studies which shows anxiety and depression are common manifestations among infertile women.…”

“…Studies have reported a great deal of complications such as fatigue, depression, stress, and lack of selfesteem as psychological consequences of infertility among infertile women (11,13,14).…”

“…Sexual satisfaction is also unfavorably affected by infertility due to decreased self-esteem, depression, and anxiety (14). This may let the couple fail to conceive as well and create a defective cycle in which sexual dissatisfaction and infertility may cause each other.…”

Re-examining the Role of Coping Strategies in the Associations Between Infertility-Related Stress Dimensions and State-Anxiety: Implications for Clinical Interventions With Infertile Couples

“…From this perspective, indeed, given the distinct feature of infertility experience, research has identified specific infertility-related stress dimensions characterizing infertility condition, namely, perceived social concerns (i.e., feelings of isolation; perceived alienation; discomfort and stress in spending time with family and/or peers; sensitivity to comments and reminders of infertility), concerns related to need for parenthood (i.e., parenthood as essential step to achieve own identity, and as fundamental life goal), concerns related to rejection of a future without a child (i.e., negative view of a childfree lifestyle; satisfaction and/or happiness as dependent on achieving parenthood), and, finally, concerns about the impact of infertility on the couple relationship (i.e., difficulty in talking about infertility with the partner; reduced intimacy and sexual enjoyment; diminished self-esteem) ( Newton et al, 1999 ; Zurlo et al, 2017 ). These specific infertility-related stress dimensions were widely demonstrated to be significant predictors of infertile patients’ psychological disease ( Lakatos et al, 2017 ; Pozza et al, 2019 ). This fostered the development of further research aiming at identifying protective factors potentially reducing perceived stress and psychological disease among infertile couples ( Donkor and Sandall, 2007 ; Sreshthaputra et al, 2008 ).…”

Perinatal Mood and Anxiety Disorders in Women Undergoing Medically Assisted Reproduction

“…The same applies to the homologous/heterologous dichotomization and to the number of past attempts and treatment cycles. It appears that homologous couples present with more anxious/depressive symptoms and higher stress than heterologous couples [78], but it is unlikely that this could have affected our results. A further strength of our study consists of the simultaneous assessment of partners, which showed that psychopathology in couples is matched.…”