Effects of Self-Esteem on the Associations Between Infertility-Related Stress and Psychological Distress Among Infertile Chinese Women: A Cross-Sectional Study

Abstract

Background Anxiety and depression are the most common psychological causes of distress in infertile women. Our study aimed to evaluate the prevalence of depression and anxiety and investigate the effects of self-esteem on the association of infertility-related stress with depression and anxiety among infertile women. Methods This study was conducted between December 2017 and May 2018. Questionnaires containing Fertility Problem Inventory (FPI), Rosenberg self-esteem scale (RSES) and Hospital Anxiety and Depression Scale (HADS) were distributed among 536 female infertility patients in Shenyang, China. Hierarchical linear regression analyses were used to examine the mediating and moderating role of self-esteem. Baron and Kenny’s technique, asymptotic, and resampling strategies were used to confirm the mediating role of self-esteem on the associations between infertility-related stress with depression and anxiety. Results The prevalence of depression and anxiety was 27.9% and 42.2% among Chinese female infertility patients, respectively. Infertility-related stress was positively associated with depression and anxiety, whereas self-esteem was negatively associated with depression and anxiety. Additionally, the effects of infertility-related stress on depression and anxiety gradually decreased along with an increase in self-esteem. Meanwhile, self-esteem partially mediated the associations between infertility-related stress with depression and anxiety. Conclusion A high prevalence of psychological distress was found among infertile women. Self-esteem mediated and moderated the effects of infertility-related stress on depression and anxiety. Additionally, infertility-related stress and self-esteem were associated with psychological distress, which explained why infertile women had a higher prevalence of depression and anxiety. Therefore, interventions that focus on self-esteem may be effective and should be used as a resource to combat mental health problems.

Sexual Function, Self-Esteem, and Quality of Life in Infertile Couples Undergoing in vitro Fertilization: A Dyadic Approach

“…Self-esteem is an individual’s evaluation of his or her own value. 21 Self-esteem can be used as a mediator variable to alleviate the risk factors caused by infertility. For example, Cui et al found that self-esteem can mediate the effects of infertility, such as stress, depression, and anxiety.…”

“…For example, Cui et al found that self-esteem can mediate the effects of infertility, such as stress, depression, and anxiety. 21 Self-esteem can also act as a mediator to buffer the impact of the physiological indicators of QoL. Treating migraine and tension-type headache in adolescents can lead to an improved QoL as a result of increased self-esteem.…”

Vitamin D level is associated with increased clinical pregnancy rate and live birth rate in Chinese women undergoing IVF/ICSI-ET: a retrospective cohort study

“…Infertility is a disease and social problem. According to the reports 9 , about 10-12% of couples are suffering from infertility worldwide. In China, relevant studies have shown [9][10][11] that the prevalence of infertility greatly varies among different regions, with the prevalence among women of childbearing age ranging from 6.7-25%.…”

“…According to the reports 9 , about 10-12% of couples are suffering from infertility worldwide. In China, relevant studies have shown [9][10][11] that the prevalence of infertility greatly varies among different regions, with the prevalence among women of childbearing age ranging from 6.7-25%. One of the current methods to solve this problem is to conduct IVF for women of childbearing age with con rmed infertility.…”

“…In neonates, it promotes the development of bone, nervous system, and lung 8 . In pregnant women, it attributes to endometrial calcium homeostasis maintenance, immune regulation, it has an anti-in ammatory effect during pregnancy and it reduces the risk of rickets after birth [9][10][11] . Moreover, research by Parikh et al showed that 25(OH)D promotes the production of numerous hormones including estrogen, progesterone, estradiol, and insulin-like growth factor binding protein 1 (IGF-BP-1) 12,13 .…”