Affective temperaments show stronger impact on infertility treatment success compared to somatic factors, highlighting the role of personality focused interventions

Abstract

Infertility has a multifactorial background, where, besides somatic factors, psychological contributors also play a role in development and outcome. While affective temperaments have been associated with development, course, and outcome as well as treatment success in various somatic conditions, their association with infertility and its treatment has not been investigated so far. The purpose of our retrospective cohort study was to evaluate the influence of affective temperaments on fertility treatment outcomes. Among 578 women who underwent infertility treatment in an Assisted Reproduction Centre in Budapest, Hungary, treatment success, detailed medical history and demographic parameters were recorded, and the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Auto-questionnaire (TEMPS-A) was administered. Possible predictors of assisted reproduction outcome were analysed using multi-variate logistic regression models, followed by a receiver operating curve (ROC) analysis in order to define ideal affective temperament cut-off values for clinical applicability. Aside from age, BMI, and previous miscarriage, cyclothymic scores >4 (OR = 0.51 CI: 0.35–0.74, p < 0.001), depressive scores >9 (OR = 0.59 CI: 0.4–0.87, p = 0.009) and anxious scores >9 (OR = 0.45 CI: 0.31–0.66, p < 0.001) significantly decreased the odds of clinical pregnancy by 49%, 41% and 55%, respectively.Irritable and hyperthymic temperaments, as well as other somatic and socio-economic factors had no effect on infertility treatment outcomes. The results suggest that affective temperaments robustly influence the outcome of the infertility treatment. Thus, screening for affective temperaments may help identify high risk patient groups and offer patient tailored treatment, which may increase the chances of a successful pregnancy and live birth for women undergoing IVF treatment.

Adherence to dietary recommendations mediates the effect of affective temperaments on infertility treatment outcomes

“…The analysis included 308 women (22-46 years of age) who underwent infertility treatment within the last three years and whose treatment plan included both diet and regular physical activity. Since this study is a continuation of our previous study 32 , as a rst step, the main characteristics of this subgroup of 308 patients were compared with the entire population of 578 patients, and no statistically signi cant difference was found between the demographic, anthropometric, psychometric, and medical characteristics of the two groups except for BMI (25.83 ± 5.87 vs. 24.24 ± 4.90 kg/m 2 (W = 103380, p < 0.001)) and diagnosed metabolic disorder (79% vs. 42% (χ 2 = 108, p < 0.001)) which is a natural consequence of the fact that this group includes the patients who need to diet and exercise.…”

“…Of the 578 patients presented in our previous study 32 , 308 had dietary and sports recommendations in their treatment plan, so they were included in this current study. The main characteristics of this subgroup of 308 patients were compared with the entire population of 578 patients using Wilcoxon rank sum tests for continuous variables and Pearson's Chi-squared tests for categorical values.…”

“…Of the 578 patients presented in our previous study 32 , 308 had both diet and sports recommendations in their treatment plan, and thus, were included in this study. Demographic, anthropometric, psychometric, and medical data of all patients were recorded by self-assessment questionnaires or were abstracted from medical records.…”

“…Affective temperaments (depressive, cyclothymic, hyperthymic, irritable, and anxious) represent vulnerability factors towards the development of various psychiatric 17,18 and somatic diseases [19][20][21][22][23][24][25][26][27][28][29][30] and affect the long-term course and treatment outcome of several of these conditions 17,26,28,31 . In a previous study, we reported that affective temperaments also affect infertility treatment success 32 , and we discussed that the necessary next step is to identify the processes and factors through which they exert their in uence, and which may be modi able with psychological interventions and patient-centered, targeted therapy. A growing number of studies suggest that the role of affective temperaments in prognosis and treatment success in somatic illnesses in part may be related to their impact on complying with treatment recommendations because, on the one hand, affective temperaments in uence the degree of adherence 33 , and on the other hand, non-adherence negatively in uences treatment outcome 16 .…”

Adherence to dietary recommendations mediates the effect of affective temperaments on infertility treatment outcomes

“…We chose to investigate this model in part due to its focus on sub-or maladaptive emotional reactions to everyday situations and events which may yield enhanced usefulness when trying to understand barriers of profiting from medical treatment, and also because previously this model has not been investigated in this context. In a previous study, we reported that affective temperaments also affect infertility treatment success 35 , and we discussed that the necessary next step is to identify the processes and factors through which they exert their influence, and which may be modifiable with psychological interventions and patient-centered, targeted therapy. A growing number of studies suggest that the role of affective temperaments in prognosis and treatment success in somatic illnesses in part may be related to their impact on complying with treatment recommendations, on the one hand, because affective temperaments influence the degree of adherence 36 , and on the other hand, because non-adherence negatively influences treatment outcome 16 .…”