Impact of infertility and infertility treatments on quality of life and levels of anxiety and depression in women undergoing in vitro fertilization

Abstract

This study aims to evaluate levels of anxiety and depression in women, correlated with infertility per se and with infertility treatments, highlighting predictors of higher levels of distress. Two validated standardized questionnaires, the Hospital Anxiety and Depression Scale (HADS) and the Fertility Quality of Life (FertiQoL), were administered to 89 women both before their first cycle of infertility treatment and again at the end of the ovarian stimulation for in vitro fertilization (IVF). Women's levels of anxiety were significantly higher before the treatment than during the treatment itself. Stratifying the women in three groups based on principal cause of infertility (male infertility, female infertility, or both male and female), we found significantly higher levels of anxiety and general distress in patients under treatment for female infertility. Higher anxiety levels in our sample before the treatment are probably an effect of not knowing what they are expected to do to solve their problem. Moreover, when the cause of infertility is exclusively female, women experience higher levels of anxiety and general distress both before and during the treatment, probably correlated to a sense of guilt. These data help the treating physician to better counsel patients and to provide a more focused psychological support.

摘要

本研究旨在评估女性焦虑和抑郁的水平, 这些水平与不孕症本身及不孕的治疗相关, 突出显示更高水平的痛苦预测因素。两份经过验证的标准化问卷, 即医院焦虑与抑郁量表（HADS）和生活生育质量（FertiQoL）量表, 在89名女性开始不孕症治疗的第一个周期前发放, 并在卵巢刺激以进行体外受精结束时再次填写。女性的焦虑水平在治疗前显著高于治疗期间。根据不孕主要原因（男性不育、女性不孕或双方共同因素）将女性分为三组, 我们发现接受治疗的女性不孕患者的焦虑和总体痛苦水平明显较高。治疗前我们的样本中较高的焦虑水平可能是由于她们不知道应该做些什么来解决她们的问题。而且, 当不孕症的原因完全是女性时, 女性在治疗前和治疗过程中都会出现更高的焦虑和总体痛苦水平, 这可能与内疚感有关。这些数据有助于主治医师更好地为患者提供咨询, 并提供更集中的心理支持。

The Chinese abstracts are translated by Prof. Dr. Xiangyan Ruan and her team: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.

Keywords:

• Infertility
• HADS
• quality of life
• in vitro fertilization
• anxiety
• FertiQoL

Acknowledgements

The authors are grateful to all the staff of the Physiopathology of Human Reproduction Unit, San Martino Hospital, Genova, Italy, especially our nurses.

Disclosure statement

All authors have no conflicts of interest to declare.