Infertility-related distress and clinical targets for psychotherapy: a qualitative study

Abstract

ObjectivesAn estimated 30%–40% of women attending infertility tertiary care facilities experience clinically significant depression and anxiety. However, current psychological interventions for infertility are only modestly effective in this population. In this study, we aimed to identify the specific psychological components of infertility-related distress to assist in the development of a more targeted and effective therapeutic intervention. To our knowledge, this study is the first of its kind to include the views and opinions of mental health professionals who specialise in the field of infertility and the first to explore therapies currently used by mental health professionals.DesignA qualitative approach using semistructured individual interviews and focus group interviews with women who have experience with infertility and also mental health professionals specialising in the field of infertility. Thematic analysis was used to identify patterns and themes emerging from the data.ParticipantsTwenty-one women (aged 25–41 years) struggling to conceive for ≥12 months and 14 mental health professionals participated in semistructured interviews about the psychological challenges related to infertility.ResultsFive themes, each divided into subthemes, emerged from the data and these were developed into a model of infertility-related distress. These five themes are: (1) anxiety, (2) mood disturbance, (3) threat to self-esteem, identity and purpose, (4) deterioration of the couple and (5) weakened support network. In addition, therapeutic techniques used by mental health professionals were identified.ConclusionsThe results of this study suggest specific clinical targets that future interventions treating infertility-related distress should address.

Fertility-enhancing effect of oil-based contrast agents during hysterosalpingography and the variation of this effect within a 3-year follow-up period in infertile patients

“…The incidence of infertility has been continuously increasing in recent decades, and its prevalence is as high as 13.00-24.58% in women with fertility intentions (3,4). Infertility women suffer from a vast disease burden, including physical distress and emotional devastation, which might cause physiological disorders for infertile women and conflict and emotional break for their families (5)(6)(7)(8). Therefore, finding ways to alleviate the infertility status and enhance fertility is desperate in those patients.…”

Fertility by Design: Integrating IVF, Biopsychosocial Tenets, and Counseling

“…Women going through IVF may experience high levels of emotional distress, including anxiety and depression, along with strains on their relationships and financial hardships (Domar et al, 2018;Fleszar et al, 2023;Njagi et al, 2023). Approximately 40% of women facing infertility meet the criteria for a psychiatric diagnosis, with an increased risk of experiencing suicidal ideation (Chernoff et al, 2020;Dube et al, 2021). However, many women report not discussing psychological stressors associated with infertility with their medical providers, even though the burden of stress is a primary reason cited by women for discontinuing IVF treatment (Domar et al, 2018).…”

“…Women undergoing IVF face unique challenges on biological, psychological, and social levels. As such, using the biopsychosocial model (Engel, 1980) to conceptualize the health and wellness of women with infertility is fitting because it offers a comprehensive understanding and provides implications for intervening in a holistic way (Dube et al, 2021). Given the high rate of infertility within the U.S. and the growing number of people seeking treatment via IVF, the purpose of this article is to explore common experiences of women with infertility from biopsychosocial perspective to provide recommendations for promoting overall health and wellness.…”

The value of motherhood and psychological distress among infertile women: The mediating role of coping strategies

“…Preoccupation with infertility-related thoughts can become obsessive, affecting the daily activities of women who want to become mothers and fail ( 74 ). Moreover, as the years pass and the number of failed treatments increases, the constant thinking about infertility [e.g., about the effectiveness of treatments, causes of infertility, efforts to find ways to avoid explanations to family/friends, uncertainty about the future – who they would be and how would their life will look like if they cannot conceive; ( 76 )] becomes a common coping strategy in infertile couples ( 77 ). Additionally, interacting with potentially stressful stimuli (e.g., seeing a pregnant woman) triggers significantly more intrusive thoughts in females than in males ( 78 ).…”