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By Aristotelis Loufopoulos

Women’s emotional adjustment to IVF

In vitro fertilisation (IVF) is a method of treating infertility, which is time-consuming and invasive, and requires a medication regime that lasts many days, as well as anaesthesia; besides, it has a high rate of failure to achieve pregnancy. All this generates stress and anxiety and has a negative impact on the quality of life of the couple.

Firstly, it should be noted that individuals who end up undergoing IVF treatment have been facing long-standing infertility problems and have undergone a variety of tests and, possibly, treatment regimens for extended periods of time. The difficulty in achieving pregnancy is a particularly stressful factor and a mentally painful affair, which couples have difficulty dealing with. Chronic infertility presents high rates of mental exhaustion, as a result of intense stress and anxiety. Feelings of guilt, shame, fear, anger, and pessimism may lead to depression, they may negatively impact sexual desire, and may lead to social isolation.

Couples with infertility issues have both their own anxiety regarding how the problem will be managed, and they are called upon to deal with a wide range of other concerns, reactions, and pressure from their families and their broader social circle with the negative consequences this creates.

The truly stressful process of IVF is added to this already psychosocially burdened environment the couple has been facing due to chronic infertility. Stress and anxiety levels in these individuals increase with the intensification and duration of the treatment (Doper et al, 2015).

Various factors contribute to the appearance or intensification of the such symptoms. Thus, older women, whose health is already suffering (hypertension, diabetes, etc.), who may be unwed, unemployed or of a low educational, social, and economic level, face a greater risk of suffering such psychological burden. Furthermore, women who have experienced the inability to complete a cycle of IVF or the failure to achieve pregnancy are affected more intensively.

Quality of life, according to the World Health Organisation, is defined as a broad concept impacted in a complicated manner by physical health, mental state, personal beliefs, levels of independence of the individuals involved, and their relationship to their environment and its conditions (social, economic, cultural, safety, etc.). Thus, all the problems related to the physical and mental health of the couple negatively impact their quality of life.

A question that was first posed years ago was whether psychological pressure and its consequences negatively impact fertility or the progress and development of IVF.

While infertility and IVF clearly impact mental health in a significant number of people to some extent, there is no assurance that the opposite is true. The correlation of psychological pressure and associated feelings with reduced fertility and failure of IVF is a long-standing field of scientific dispute.

However, meta-analyses in related research have concluded that stress has no significant statistical impact on IVF outcome (J.Boivin et al 2011, Lin Kong 2019), while, on the contrary, achieving spontaneous conception or pregnancy after IVF significantly reduces any mental burden in most infertile couples.

All research seems to come to the same conclusion. Regardless of the negative or positive impact stress levels have on infertility and IVF treatment, one of the primary goals of health professionals tackling this matter should be the provision of valid information and advice, along with psychological support. Infertility and its treatment are problems for the couple, not for an individual, and they should be treated as such.

There are many ways and many tools to measure the psychological burdens and the quality of life in correlation to infertility and the IVF process, as well as several potential treatments for them. Interventions to reduce and relieve the various clinical symptoms (stress, anxiety, fear, depression, etc.), regardless of whether or not these increase pregnancy rates (Consinean et al 2007, Domar et al 2015, Lin Kong 2019), may be exceptionally beneficial for the emotional balance and harmonious relationship of the couple.

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Aristotelis Loufopoulos

Em. Professor of Obstetrics – Gynaecology, AUTH, FIVI Fertility & IVF Center, European Interbalkan Medical Center

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