Psychosocial aspects of in vitro fertilization.

International Health Foundation, Brussels, Belgium.
Journal of Psychosomatic Obstetrics & Gynecology (Impact Factor: 1.59). 04/1994; 15(1):35-43. DOI: 10.3109/01674829409025627
Source: PubMed

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: 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.
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    ABSTRACT: Controlled Ovarian Stimulation (COS) is the first step for in vitro fertilization (IVF) treatment, a treatment often described and experienced as stressful to patients and their partners. COS also requires concerted efforts by the patients in administering medication and general compliance to treatment protocols. Little is known about the impacts on patients that may be specific to this important first step in treatment. The absence of a conceptually sound and well-validated measure assessing patient experience and functioning during ovarian stimulation has been an obstacle to understanding the impacts of ovarian stimulation on women pursuing IVF. To address this gap, the Controlled Ovarian Stimulation Impact Measure (COSI) was developed based upon accepted methods for designing patient reported outcome (PRO) measures. The purpose of this study was to psychometrically validate the COSI. 267 patients from three countries (Ireland, United Kingdom, United States) were administered the COSI. Psychometric validation was conducted according to an a priori statistical analysis plan. The final 28-item COSI was found to have robust scale structure with four domains: Interference in Daily Life (Work and Home), Injection Burden, Psychological Health and Compliance Worry. Internal consistency of all domains was adequate (between 0.80 to 0.87) as was test-retest reliability (between 0.72-0.87). All a-priori hypotheses for convergent and known-groups validity tests were met. There is a measurable impact of COS on patient functioning and well-being. The COSI is a well-developed and validated PRO measure of this impact. Future work should include examination of responsiveness and confirmation of concepts in non-western countries.
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