Gender differences in emotional reactions to in vitro fertilization treatment: a systematic review

Abstract

Purpose The purposes of this paper are to provide a comprehensive picture of men and women's emotional reactions to infertility treatment, specifically In Vitro Fertilization (IVF) pursued by heterosexual couples, and to identify any differences between the genders. Methods Nonexperimental studies exploring the psychological effects of IVF treatment on infertile couples were included. Six electronic databases were used to conduct a systematic search from the years 2000 to 2014. The references of the articles selected for review and other related systematic reviews were also screened to retrieve additional relevant articles. The quality of the included studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist. Descriptive analysis was adopted to synthesize the results.Results A total of 22 quantitative and 4 qualitative studies were identified and included in this review. Although both men and women experienced psychological distress during the treatment, gender differences existed. Women had elevated anxiety and depression levels prior to the treatment, which became even higher on the day of the oocyte retrieval, pre-and post embryo transfer, and during the waiting period before the pregnancy test. Men of the infertile couples reported elevated depression scores before treatment, which usually increased during the time spent waiting for the outcome of the IVF treatment. Both men and women had lower scores on positive affect before the pregnancy test. A failed IVF cycle had long-term negative psychological consequences for both spouses. Conclusions The results of this review pointed to the need for a couple-based support program, aimed at improving the psychological well-being of couples.

The Partnership and Coping Enhancement Programme for couples undergoing in vitro fertilization treatment: the development of a complex intervention in China

“…The three steps are as follows: (1) identifying evidence by conducting reviews of the relevant literature and carrying out a concept analysis and a qualitative study; (2) identifying/developing a theory-in this case, putting forward a preliminary Endurance with Partnership Conceptual Framework (P-EPCF) for couples undergoing IVF treatment; and (3) modelling the process and outcomes of the PCEP. It should be noted that the literature reviews [1,3,21], the concept analysis [25] and the qualitative study [26] have been published, and that the preliminary Endurance with Partnership Conceptual Framework (P-EPCF) [27] has been developed and is under review for publication. The key findings of these reviews and the studies that contributed to the development of this complex intervention are recaptured and presented in this report.…”

“…Three extensive reviews were conducted to obtain a better understanding of the couples' experiences with infertility [1] and IVF treatment [3] and to examine the effects of established randomized controlled studies of psychosocial interventions on patients/couples undergoing IVF treatment [21]. The findings of the reviews provide some valuable suggestions on developing interventions for couples undergoing IVF treatment.…”

“…For both men and women of infertile couples, support from one's partner was inversely related to stress [1]. The second review found that the periods prior to the pregnancy test and after the IVF failure in the IVF cycle were the most stressful time points for both men and women [3].…”

“…Among infertile couples, the men also reported elevated levels of depression prior to treatment and even higher levels during the 2-week waiting period [3]. An unsuccessful IVF cycle tends to result in long-lasting psychological trauma for both spouses [3].…”

“…A systematic review has indicated that during the IVF cycle, women experience elevated levels of anxiety and depression before the treatment, and that these levels rise on the day of oocyte retrieval, the pre-post embryo transfer, and during the period of waiting for the pregnancy test [3]. Among infertile couples, the men also reported elevated levels of depression prior to treatment and even higher levels during the 2-week waiting period [3].…”