Effect of the previous reproductive outcomes in subfertile women after in vitro fertilization (IVF) and/or intracytoplasmic sperm injection (ICSI) treatments on perinatal anxious and depressive symptomatology

Abstract

Introduction: The present study aims to investigate the effects of previous reproductive outcomes on the levels of depression, anxiety and perceived social support in subfertile women who conceived after in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) treatment.

Methods: A prospective cohort study was developed. Data were collected on subfertile patients who conceived after IVF/ICSI treatment. All demographic and clinical data were recorded. The Edinburgh Postnatal Depression Scale, the State-Trait Anxiety Inventory-Y and the Multidimensional Scale of Perceived Social Support at 22 and 32 weeks of gestation and 15 days after delivery were completed. Data were analyzed comparing patients who conceived at their first IVF/ICSI cycle, after one unsuccessful ARTs cycle, and after multiple unsuccessful IVF/ICSI cycles.

Results: A significant increase in state anxiety and depression scores from 22 gestational weeks of gestation to 15 days after delivery was observed in patients who received multiple unsuccessful IVF/ICSI cycles compared with other groups. No significant difference in perceived social support was detected among groups. The differences in depression and anxiety scores remained consistent after controlling for perceived social support.

Discussion: A history of unsuccessful IVF/ICSI treatments seems to leave women more vulnerable in facing the duties of the new parental role. Such possibility underlies the importance of the availability of a psychological support for these women, even after a successful medical treatment for infertility.

Keywords:

• Anxiety
• depression
• infertility
• pregnancy
• social support
• ART

Acknowledgements

The authors of the study would like to thank all the couples who took part in the research, and all the members of the Reproductive Medicine Center of Reggio Emilia and of the research team, without whose contribution this study would not have existed.

Disclosure statement

The authors report no conflicts of interest.

Current knowledge on this subject

• Many studies have shown that women seeking help for infertility have higher levels of anxiety and depression than women without infertility, and that infertile women may more easily disclose their emotions than men.

• However, most of these investigations focused on the psychological experience of IVF/ICSI procedures, whereas very little is known about women’s emotional experience during and after IVF/ICSI pregnancy.

• Additionally, the very few studies that have assessed the association between infertility and women’s mental health have systematically neglected the role of a history of unsuccessful IVF/ICSI procedures.

What this study adds

• Symptoms of depression and state anxiety significantly increase during the transition to parenthood for women who underwent multiple unsuccessful IVF/ICSI cycles prior to conceiving.

• Women with a history of more unsuccessful IVF/ICSI treatments seem to be more vulnerable in facing the duties of the new parental role.

• From a longitudinal perspective, levels of symptoms of depression and anxiety do not change as a consequence of the extent of perceived social support.