Research has shown that the process of assisted reproduction is associated with increased anxiety, depression and stress.
The experience of infertility and its treatments can have a profound and long-lasting impact on the emotional and mental health of hopeful parents. Research undertaken to inform #thetruth campaign highlighted a number of challenges and the mitigating factors that contributed to their experience of emotional distress, anxiety and depression.
While some of these challenges pertained to the nature of infertility itself and its treatment, other factors relating to the delivery of care were identified as having a negative impact on emotional wellbeing at this already vulnerable time.
Ultimately, this contributes to distress and poor mental health outcomes.
Personal experiences of infertility and related treatments
Many women who participated in our research, explained that when undergoing infertility treatment, the process was depersonalised. As a result, patients described feeling treated like just a number.
My experience was that IVF seemed like a commercial business rather than a patient/customer service.
Many expressed receiving a lack of compassion and empathy from health professionals, including GPs and staff in fertility clinics.
Medical professionals were unsympathetic when I said I had mental health problems during IVF. My GP (a woman with children of her own) said, "Well, we can’t all have what we want", when I said I really wanted children.
Having 'blunt' medical professionals discussing my fertility without empathy or compassion made the experience worse.
LGBTIQ couples encountered additional obstacles, noting a lack of understanding and sensitivity among the health professionals who treated them.
Mental health impacts
Research has also shown that the process of assisted reproduction itself is associated with increased anxiety, depression and stress and can impact on self-esteem and confidence.
Stress and IVF
The experience of infertility and IVF has been described by people as being as stressful as any other traumatic life event, including divorce and cancer.
(It’s) stressful, like you don’t have control over your own future anymore, you can’t make any plans because you don’t know what the future holds. Loneliness.
There are a number of stressful aspects for patients and their partners including:
- The experience of infertility prior to treatment
- Dealing with medical staff and unfamiliar clinic environments
- Difficult decisions about treatment options
- Cancelled treatment cycles
- Waiting for pregnancy results
- The grief of treatment failure
- Deciding when to stop treatment
Anxiety and IVF
The relationship between stress, anxiety and infertility and its treatments is complex and no clear picture emerges from the research with regards to cause and effect. What is clear, however, is that infertility and IVF treatment involve multiple psychological, emotional and physiological stressors, or threats. Given this, it is not surprising that studies consistently find men and women undergoing IVF report elevated levels of anxiety.
IVF treatment is comprised of a series of stages, and each must be successfully completed before moving to the next. Men and women going through IVF typically report that their anxiety increases with each stage, with the highest level of anxiety being experienced while waiting for the outcome of treatment.
Hope and anticipation of success typically increases with each passing day but so does the possibility of failure. Successful completion of one stage doesn’t ensure success at the next, and uncertainty and low control is ever-present. Some people find that aspects of the treatment itself are specific anxiety triggers, such as their daily injections and hospital procedures. Other people report side-effects of the hormone treatment can include physical symptoms of anxiety.
Depression and IVF
The process of going through IVF treatment is a psychologically distressing life event. It is costly, often isolating, places stress on both intimate relationships and often friendships and can be traumatic.
For many people embarking on treatment, their struggles with infertility have already left them emotionally vulnerable and depleted. It is not surprising therefore, that most studies examining the association between depression and fertility find a higher prevalence of depressive symptoms in men and women receiving infertility treatment than control groups.
The relationship between infertility and depression is complex, and no clear picture emerges from studies regarding cause and effect. What is apparent, is that men and women undergoing IVF have an increased vulnerability to depressive symptoms.
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