How does stress, depression and anxiety affect patients undergoing treatment?

Abstract

Purpose of review: To review latest findings about the impact of fertility care on emotional distress and its effect on treatment outcome. Recent findings: Treatment failure and long agonist protocols are associated with increased emotional distress during treatment. Screening tools can be used to identify men and women at risk of emotional maladjustment at the start of fertility treatment and people unlikely to need emotional support during or after treatment. There are inconclusive results about the association between emotional distress and outcome of fertility treatment. Systematic review of studies evaluating the effect of psychological and educational interventions on anxiety, depression and live birth (or ongoing pregnancy) are uninformative due to clinical heterogeneity and risk of bias. Summary: ART is emotionally demanding, patients likely to adapt more poorly can be identified in advance, and fertility staff could follow good practice guidelines followed to provide them with support during treatment.

Introducing the Hungarian Version of the SCREENIVF Tool into the Clinical Routine Screening of Emotional Maladjustment

“…Reviewing the above study, Boivin also draws our attention [ 22 ] to the fact that the cross-sectional prediction (concurrent validity) of SCREENIVF to the Hospital Anxiety and Depression Scale (HADS) at baseline was better than the prospective prediction to the HADS on day 10 after embryo transfer during the waiting period for the pregnancy test or six weeks after embryo transfer [ 2 ]. In our study, a cross-sectional design was used, and a fertility-specific scale, the FertiQoL, was applied for concurrent validity, which is one of the most frequently used scales to examine psychometric properties of infertility-specific patient-reported outcomes [ 22 ] besides the Fertility Problem Inventory (FPI) [ 66 ] and Copenhagen Multicentre Psychosocial Infertility-fertility Problem Stress Scale (COMPI-FPSS) [ 70 ]. There was already research experience using FertiQoL [ 26 , 30 ], FPI [ 27 , 29 ], and COMPI-FPSS [ 67 ] in the Hungarian sample.…”

“…However, infertility and the perceived lack of control by patients during ART treatment make the situation itself a long-term stressor. The treatment and particularly a failed treatment, could be emotionally and physically demanding [ 18 , 19 , 20 ] and may increase perceived distress, anxiety, and depression [ 21 , 22 ] and decrease quality of life [ 19 , 23 ].…”

ART Innovations: Fostering Women’s Psychophysical Health between Bioethics Precepts and Human Rights

“…For instance, the 2-week time span separating the embryo transfer from the pregnancy test is known to be considerably stressful, and the potential consequences of symptoms on MAP outcome and pregnancy rates has been explored, though no decisive evidence to make such connections has been produced so far; women should therefore be reassured that there is no evidence that psychological or psychiatric conditions caused by or worsened by fertility issues will compromise the possibility of achieving motherhood [13]. Nonetheless, assisted reproduction procedures are without a doubt emotionally demanding, and patients who struggle to adapt must be identified early [14]. Research findings show that women undergoing infertility treatment and MAP procedures are substantially more likely to screen positive for major depressive disorder, anxiety or both [15][16][17].…”

Great expectations of IVF patients: the role of gender, dispositional optimism and shared IVF prognoses

“…In addition, finding out whether receiving a less than average IVF prognosis causes psychological reactions in male and female patients would be of interest as IVF patients had higher levels of distress on days on which they received negative medical feedback (e.g. quantity or quality of oocytes or embryos) (Boivin, 2000, Boivin, 2019.…”