Social consequences for women undergoing fertility treatment

The emotional consequences of fertility treatment are well documented, with approximately up to one fifth of couples reporting elevated levels of anxiety, depression and associated distress. As a result the main focus of interventions has been on providing education to improve knowledge and the reduction of any psychological sequalae in both women and men [1]. Within the biopsychosocial model of research on the ‘social’ element is often overlooked and research into infertility is no exception. Yet, as fertility treatment becomes more widely available across the public and private sectors it is important to consider the social factors that address the wider context on women’s lives not just distress.

In this issue, two papers focus on areas which would not be traditionally addressed in psychologically focussed studies; these include the effects of fertility on women’s working lives and factors which influence women when contemplating egg freezing. In an online survey of 563 women in the UK Payne et al. [2] consider psychological distress but also the impact of combining work and treatment. Given that many women work in full or part-time employment this context is highly relevant. Many women reported that they felt absence for treatment, including the effects of treatment, had adversely affected their work and career trajectory. The need for disclosure also impacted on psychologically distress. It is notable that less than one quarter of participants stated that their employer had a workplace policy. The authors emphasise the need for employers to develop sensitive work policies toward women undergoing infertility treatment in order to maintain physical and psychological wellbeing.

In the second paper, Baldwin et al. [3] explored women’s motivations for engaging in social egg freezing. Interviews with women in the United Kingdom, United States and Norway (n = 31) illuminate the sense of women perceiving that they may ‘run out if time’ if they do not take action to preserve their eggs. This process was underpinned by difficulties in finding a partner (most participants were not in a relationship) and a strong desire to avoid future regret or blame. However, participants did not agree that the choice to freeze their eggs was simply a tactic to delay motherhood. Rather, the decision was a complex one which took into account a range of factors including advancing age, lack of a suitable relationship or within the context of relationship whereby the partners did not want children at this time. Again, links were made to working lives where career trajectories often did not provide the space or support for childbearing. Whilst for some women egg freezing was in response to an underlying medical or fertility reason, most were influenced by their current social contexts. Taken together both papers highlight the need to address the more ‘social’ aspects of women’s lives in research going forward, not just in fertility treatment but also in the management of other conditions.