Anxiety among women who have undergone fertility therapy and who are considering multifetal pregnancy reduction: trends and implications

Abstract

Objective: Our primary objective was to evaluate the assumption that women carrying multiple fetuses and who have decided upon multifetal pregnancy reduction (MFPR) have a constant high level of anxiety. Methods: A total of 66 multigestation women considering MFPR were asked to consider how anxious they were when they first started fertility therapy. Using that level of anxiety as a reference point, and using their self-assessments as a vehicle for probing the meaning they attached to their emotional state through time, they then assessed their anxiety level at different points in their pregnancy. Results: Self-reported anxiety across time displayed considerable variation: there was a large drop in anxiety with pregnancy diagnosis. The women's anxiety rose to very high levels with the diagnosis of carrying multiples. Anxiety moderated again on average with consultation, rose sharply during the course of the procedure, and finally dropped to lower levels on average after the procedure was over. Conclusions: We conclude that women with multigestation experience considerable fluctuations in their level of anxiety from the time that they first start fertility therapy until they learn that they are carrying multiple embryos. Their expectations for the future of becoming pregnant seem at last fulfilled (becoming pregnant), become complicated (with multiples), appear salvageable (with consultation), but with a morally complicated resolution (MFPR) that seems at last to have put the pregnancy back on a normal track (post-MFPR). Those working with MFPR patients before, during and after the operation must understand the nature and variability of the anxiety that their patients are confronting, and how they are attempting to construct a safe passage through the moral dilemma associated with the multiple-gestation situation.

• MULTIFETAL PREGNANCY REDUCTION
• ANXIETY
• MULTIPLE FETUSES
• FERTILITY THERAPY