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Psychosocial experiences in women facing fertility problems in Belgium, Netherlands and France
– Reported, January 24, 2013
Approximately 10% of all couples wishing to have a child experience fertility problems which do not spontaneously resolve. Most of them, at least in Western countries, seek medical help and many of those with persistent problems receive assisted reproduction treatment. It may be expected that any dificulties couples encounter when attempting to conceive will impose a considerable psychosocial burden on them, and anecdotal evidence indeed supports this view. Descriptive reports suggest that couples with fertility problems undergo various forms of severe psychoemotional distress which may render them susceptible to depression. Such stress may further decrease the likelihood of conception, although evidence in this respect seems conficting.
In contrast to this popular view of infertility as a cause of considerable distress, which derives from descriptive anecdotal reports, most controlled studies using standardized, validated instruments have not in fact confirmed that serious psychological reactions are common in individuals with fertility problems. Although fertility problems are regarded as an impairment of health , these methodologically stronger studies seem to indicate that the associated psycho-emotional burden is less severe than that experienced with other physical diseases.
Further scrutiny of the controlled studies reviewed by and similar, more recent,studies revealed that the psychosocial or well-being assessments among individuals with fertility problems were carried out at the time they were consulting for diagnosis and treatment. Since new hopes may then be kindled and the problems are being shared with professionals, we would expect, but also there is little difference between the scores of those individuals and fertile controls. This has indeed been corroborated by the controlled studies, although the possibility still cannot be excluded that during the periods when these individuals were vainly attempting to conceive, and also the phases prior to consultation, they have experienced more distress than fertile people.
In the present study,it explored the hypothesis that when women facing fertility problems are trying to conceive they experience more negative emotional feelings and negative psychosocial impact than women who eventually conceive spontaneously.
It was noteworthy that women who had undergone earlier unsuccessful IVF treatment did not report higher frequencies of negative emotions before treatment than the other patients, but were more often depressed. The longer period during which they were attempting to get pregnant and the frustration of their failed attempts might have played a role in this respect.
It was reported that women who had undergone more than one IVF cycle, even after successful conception, still had higher anxiety levels than women who conceived after one IVF cycle, which highlights the potential long-term consequences of such frustration.
Although patients might have been expected to attach more weight to the seriousness of infertility than fecund women,precisely because of their fertility problems, this appeared not to be the case. Infertility was fundamentally seen by both patients and controls as a severe life event. This is an important observation and can be considered as a confirmation of the concept that infertility is an impairment of health.
In conclusion, it emerged from the present study that women facing fertility problems may experience a turmoil of negative feelings, in particular at the time when they are attempting to conceive but realize they are not succeeding. The scores of one in four women indicated that they were having psychological problems at the time they sought medical help, notably depression. For professionals involved in the counselling of infertility patients this implies that they should not only focus
on the feelings and experiences of the women concerned at the time of consultation but should also look back with the couple over what they have had to cope with in the recent past. The need for such an approach is clear, combined with awareness of the fact that psychological well-being may deteriorate subsequent to unsuccessful treatment cycles.
CREDITS:
http://humrep.oxfordjournals.org/
Bjo¨rn J.Oddens, Isolde den Tonkelaar and Hugo Nieuwenhuyse
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