Psychosocial aspects of in vitro fertilization.
ABSTRACT There is growing recognition of the existence of an interaction between the psychosocial status of women and their (in)fertility. This has prompted study of the psychosocial aspects of in vitro fertilization (IVF). Following a literature survey, a psychosocial questionnaire was constructed using existing tests and a specific IVF attitude questionnaire was developed. This questionnaire was completed by 150 new IVF women who were participating in a multicenter study. The newly-developed specific IVF questionnaire appeared to be reliable and valid, although women had a tendency to give socially desirable answers. The results indicate that IVF women feel more anxious (State-Trait Anxiety Index) than a normal population, but do not express more emotional complaints (Hopkins Symptoms Checklist). Comparison of the answers concerning the situation before and after IVF treatment revealed that treatment outcome has no influence on attitude towards IVF. After treatment, the women's state of anxiety was unchanged, while the quality of couples' relationships was enhanced. A possible influence exerted by psychosocial factors on the chances of achieving pregnancy with IVF could not be confirmed. Several methodological aspects of the study are discussed to explain the results.
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ABSTRACT: Emotional and relationship assessments were completed by 144 couples at intake for in-vitro fertilization (IVF) and 6 months after either the identification of pregnancy or the discontinuation of treatment following three unsuccessful cycles. Women also completed emotional assessments at the time of pre-oocyte recovery and post-embryo replacement within each treatment cycle. At intake, women were more anxious than their partners and comparative norms, and were less positive than men about their marital and sexual relationships. Initial emotional assessments were not related to subsequent pregnancy, but at follow-up those who were pregnant were less depressed and more positive about their relationships. Within treatment cycles scores for women were higher after embryo replacement and the failure of pregnancy. First and last treatment cycles were associated with greater anxiety. High levels of confusion and bewilderment found during the initial cycle may indicate the need for better pretreatment information. Services must recognize the presence of high anxiety at intake and provide psychological care for those identified as particularly distressed. Emotional difficulties after failure of IVF treatment can be considered to be iatrogenic effects, and psychological services should be provided to minimize any negative psychological consequences of treatment.Human Reproduction 02/1997; 12(1):183-90. · 4.67 Impact Factor
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ABSTRACT: The distress that couples experience in IVF treatment is well-documented though research exploring factors that might contribute to the distress is scarce and the role of infertility-specific versus more general psychological characteristics in predicting psychological distress remains unexplored. This exploratory study aimed to describe, explore and test a self-constructed conceptual framework designed to understand the relative impact of infertility-specific and general psychological characteristics, in predicting psychological distress. Validated self-report questionnaires that measured the concepts of the encompassing framework (personality characteristics self-criticism and dependency, attachment in the partner relationship, child wish, coping, intrusiveness, infertility-related stress and general psychological distress) were completed by 106 women and 102 men before starting the first IVF/ICSI treatment at a university hospital-based fertility centre. Data were analysed by hierarchical multivariate linear regression analysis and path analysis. The overall conceptual psychological framework explained 55% of the variance in psychological distress. The strongest predictors of psychological distress were general psychological characteristics: passive and active coping, self-criticism and dependency and intrusiveness. A path analysis confirmed the framework and highlighted the mediating role of coping and intrusiveness. In the final analysis, none of the infertility-specific variables significantly predicted psychological distress. The current study of patients starting IVF-treatment demonstrated that general psychological characteristics, specifically active and passive coping, personality characteristics, dependency and self-criticism and intrusiveness, are more important in predicting the variability in psychological distress than infertility-specific concerns. The results raise important questions for infertility counselling. However, the cross-sectional nature of the study only allows for insight into baseline measurement (before starting the first IVF-treatment) and therefore this area of research could benefit from additional longitudinal studies.Human Reproduction 03/2010; 25(6):1471-80. · 4.67 Impact Factor
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ABSTRACT: Purpose This study evaluated the changes in psychological stress during in vitro fertilization and embryo transfer (IVF–ET) and the relationship of such stress to the patients’ background and gender. Methods Sixty couples undergoing IVF–ET were administered the State–Trait Anxiety Inventory-JYZ (STAI) test at six different points during IVF–ET procedures. Anxiety scores at each time point were recorded and analyzed according to gender, fertility status, and duration of treatment. Results The median state anxiety score for women increased following induction until oocyte collection, after which it temporarily declined and then increased again until the pregnancy test. No such changes were noted in men. Scores for women who had undergone a shorter period of IVF treatments were higher while state and trait anxiety in men increased with a prolonged treatment period. Unsuccessful treatment increased the state and trait anxiety of women. Conclusions Psychological stress changed periodically depending on the duration of the patients’ treatment and fertility status also influenced anxiety levels. These findings will prove helpful in guiding psychological therapy and counseling for couples attempting to conceive by in vitro fertilization.Reproductive Medicine and Biology 11(3).