Psychological Impact of Sub Fertility on the Couples
Keywords:
Assisted reproduction, Counselling, Infertility, Mental health, Psychosocial factors, Stress.Abstract
Objective: To evaluate the psychological aspect of subfertility and treatment on the couples.
Methodology: This Prospective survey study was carried out in the department of Obstetrics and Gynaecology at a private hospital in Lahore, Pakistan. 40 couples undergoing fertility treatment were enrolled. A Self-report questionnaire included age, level of education, social status, duration of marriage , duration of infertility, causes of infertility, duration of treatment, social stress, effect of infertility on marital relationship, expected likelihood of achieving pregnancy, anticipation of stress during treatment, and emotional reactions to infertility was given to all the participants of the study.
Results: The majority (70%) of women undergoing fertility treatment were of ages 25-34 years. 62.5% couples were married for 1 to 5 years. Majority of couples were educated and belonged to the middle-class family. 55% had been undergoing treatment for 3 years and more. In half, the causes of infertility were known. 67.5% had failed treatment and 32.5% became pregnant with treatment. All the couples experienced emotional trauma with treatment and needed psychological help despite the outcome. 62.5% suffered with depression, 30% anxiety and 7.5% had anger.
Conclusions: Psychological factors play an important role in the infertility. It is important to manage this devastating problem, which has cultural and social impact
References
Larsen U. Research on infertility: Which definition should we use? Fertility and Sterility2005; 83(4): 846-52
Bovine J, Bunting L, Collins JA, Negron KG. International estimates of infertility prevalence and treatment-seeking: potential need and demand for infertility care. Hum Reprod.2007;22(6):1506–12
Van Balen F, Gerrits T. Quality of infertility care in poor-resource areas and the introduction of new reproductive technologies. Hum Reprod. 2011;16 (2):215–19
Deka PK, Sarma S. Psychological aspects of infertility. BJMP 2010;3(3):336
Cooper BC, Gerber JR, McGettrick AL, Johnson JV. Perceived infertility-related stress correlates with in vitro fertilization outcome. Fertil Steril. 2007;88(3):714–17
Faramarzi M, Alipor A, Esmaelzadeh S, Kheirkhah F, Poladi K, Pash H. Treatment of depression and anxiety in infertile women: cognitive behavioural therapy versus fluoxetine. J Affec Disord. 2008;108 (1-2):159–64
Ramezanzadeh F, Aghssa MM, Abedinia N, Zayeri F, Khanafshar N, Shariat M, et al. A survey of relat- ionship between anxiety, depression and duration of infertility. BMC women's health.2004;4(1):9
Wang K, Li J, Zhang JX, Zhang L, Yu J, Jiang P. Psychological characteristics and marital quality of infertile women registered for in vitro fertilization
-intracytoplasmic sperm injection in China. Fertil Steril 2007;87(4):792–98
Inhorn C, Carmeli DB. Assisted Reproductive Technologies and Culture Change. Annual Review of Anthropology , June 2008; 37(1).17796
Dyer SJ, Abrahams N, Mokoena NE, Lombard CJ, van der Spuy ZM. Psychological distress among women suffering from couple infertility in South Africa: a quantitative assessment. Hum Reprod. 2005; 20(7):1938-43
Benyamini Y, Gozlan M, Kokia E. Variability in the difficulties experienced by women undergoing infertility treatments. Fertil Steril. 2005;83(2):275–83
Zorn B, Auger J, Velikonja V, Kolbezen M, Meden- Vrtovec H. Psychological factors in male partners of infertile couples: relationship with semen quality and early miscarriage. Int J Androl. 2008;31(6):557– 64
Pasch LA, Dunkel-Schetter C, Christensen A. Differences between husbands’ and wives’ approach to infertility affect marital communication and adjustment. Fertil Steril.2002; 77(6):1241–47
Campagne DM. Should fertilization treatment start with reducing stress? Hum Reprod 2006;21(7):1651-8
Cousineau TM, Domar AD. Psychological impact of infertility. Best practice and research clinical obstetrics and gynaecology 2007;21(2):293–308
Greil AL. Infertility and psychological distress:a critical review of the literature. Soc Sci Med. 1997; 45(11):1679-704
Williams KE, Marsh WK, Rasgon N. Mood disorders and fertility in women: a critical review of the literature and implications for future research. Hum Reprod Update 2007 Nov-Dec; 13(6):607-
Epub 2007 Sep 25
Pal L, Bevilacqua K, Santoro NF. Chronic psychosocial stressors are detrimental to ovarian reserve: a study of infertile women. J Psychosom Obstet Gynecol 2010; 31(3):130-9
Gameiro S, Boivin J, Dancet E, Klerk CD, Emery M, Lewis-Jones, et al. ESHRE guideline:routine psychosocial care in infertility and medically assisted reproduction—a guide for fertility staff. Hum. Reprod. 2015;30 (11): 2476-85
Drosdzol A, Skrzypulec V. Depression and anxiety among Polish infertile couples–an evaluative prevalence study. Journal of Psychosomatic Obstetrics & Gynaecology 2009; 30(1):11-20
Galhardo A, Cunha M, Pinto-Gouveia J. Psych- ological aspects in couples with infertility. Sexologies. 2011;20(4):224-8
Maroufizadeh S, Ghaheri A, Samani RO. Factors associated with poor quality of life among Iranian infertile women undergoing IVF. Psychol Health Med. 2017;22(2):145-151
Souter VL, Hopton JL, Penney GC, Templeton AA. Survey of psychological health in women with infertility. J Psychosom Obstet Gynaecol. 2002;23 (1):41-9
Lechner L, Bolman C, van Dalen A. Definite involuntary childlessness: associations between coping, social support and psychological distress. Hum Reprod. 2007; 22(1):288-294
Nelson CJ, Shindel AW, Naughton CK, Ohebshalom M, Mulhall JP. Prevalence and predictors of sexual problems, relationship stress, and depression in female partners of infertile couples. The Journal of Sexual Medicine 2008;5(8):1907-14.
Volgsten H, Svanberg AS, Ekselius L, Lundkvist Ö, Poromaa IS. Prevalence of psychiatric disorders in infertile women and men undergoing in vitro fertilization treatment. Human Reproduction. 2008;23(9):2056-63
Chen TH, Chang SP, Tsai CF, Juang KD. Prevalence of depressive and anxiety disorders in an assisted reproductive technique clinic. Hum Reprod 2004; 19(10):2313-18
Brandes M, Van der Steen JO, Bokdam SB, Hamilton CJ, de Bruin JP, Nelen WL, et al. When and why do subfertile couples discontinue their fertility care? A longitudinal cohort study in a secondary care subfertility population. Hum Reprod. 2009; 24(12):3127-35
Olivius C, Friden B, Borg G, Bergh C. Why do couples discontinue in vitro fertilization treatment? A cohort study. Fertil Steril. 2004; 81(2):258-61
Rajkhowa M, McConnell A, Thomas GE. Reasons for discontinuation of IVF treatment: a questio- nnaire study. Hum Reprod. 2006; 21(2):358-63
Dhaliwal LK, Gupta KR, Gopalan S, Kulhara P. Psychological aspects of infertility due to various causes--prospective study. Int J Fertil Womens Med. 2004; 49(1):44-8
Boivin J, Schmidt L. Infertility-related stress in men and women predicts treatment outcome 1 year later. Fertility and sterility 2005;83(6):1745-52.
Huppelschoten AG, van Dongen AJ, Verhaa CM, Smeenk JM, Kremer JA, Nelen WL.Differences in quality of life and emotional status between infertile women and their partners Hum Reprod.2013;28(8): 2168-76
Frederiksen Y, Farver-Vestergaard I, Skovgård NG, Ingerslev HJ, Zachariae R. Efficacy of psychosocial interventions for psychological and pregnancy outcomes in infertile women and men: a systematic review and meta-analysis. BMJ open. 2015;5(1):e 006592
Pakpour AH, Yekaninejad MS, Zeidi IM, Burri A. Prevalence and risk factors of the female sexual dysfunction in a sample of infertile Iranian women. Archives of Gynaecology and obstetrics 2012;286 (6):1589-96
Johnson JA, Tough S. Delayed Child-Bearing, SOGC Committee Opinion, No 271. J Obstet Gynaecol Can 2012;34(1):80–93
Quant HS, Zapantis A, Nihsen M, Bevilacqua K, Jindal S, Pal L. Reproductive implications of psychological distress for couples undergoing IVF. J Assist Reprod Genet. 2013; 30(11):1451–58
Latest UK IVF figures: 2010 and 2011. Human fertilization and embryology authority. Feb 11, 2013.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2017 Shabnum Sibtain, Aaleen Azeez, Ahmad Zunair Wasim, Mujtaba Azeez
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Journal of Bahria University Medical & Dental College is an open access journal and is licensed under CC BY-NC 4.0. which permits unrestricted non commercial use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this license, visit https://creativecommons.org/licenses/by-nc/4.0 
