Infertility treatment and fertility-specific distress: A longitudinal analysis of a population-based sample of U.S. women

Abstract

Because research on infertile women usually uses clinic-based samples of treatment seekers, it is difficult to sort out to what extent distress is the result of the condition of infertility itself and to what extent it is a consequence of the experience of infertility treatment. We use the National Survey of Fertility Barriers, a two-wave national probability sample of U.S. women, to disentangle the effects of infertility and infertility treatment on fertility-specific distress. Using a series of ANOVAs, we examine 266 infertile women who experienced infertility both at Wave 1 and at Wave 2, three years later. We compare eight groups of infertile women based on whether or not they have received treatment and on whether or not they have had a live birth. At Wave 1, infertile women who did not receive treatment and who had no live birth reported lower distress levels than women who received treatment at Wave 1 only, regardless of whether their infertility episode was followed by a live birth. At Wave 2, women who received no treatment have significantly lower fertility-specific distress than women who were treated at Wave 1 or at Waves 1 and 2, regardless of whether there was a subsequent live birth. Furthermore, fertility-specific distress did not increase over time among infertile women who did not receive treatment. The increase in fertility-specific distress was significantly higher for women who received treatment at Wave 2 that was not followed by a live birth than for women who received no treatment or for women who received treatment at Wave 1 only. These patterns suggest that infertility treatment is associated with levels of distress over and above those associated with the state of being infertile in and of itself.

Is infertility really associated with higher levels of mental distress in the female population? Results from the North-Trøndelag Health Study and the Medical Birth Registry of Norway

“…Furthermore, neither items measuring fertilityspecific distress [18,20] nor information about whether the respondent was actively trying to get pregnant, whether she self-identified as infertile, had undergone ART treatment or had adopted a child was included. Finally, levels of anxiety and depressive symptoms were assessed by means of a selfreport instrument.…”

“…However, the association between infertility and symptoms of common mental conditions may be less pronounced in the general female population than in infertility clinic attendees [14], as the less than half of couples [15,16] with infertility who seek medical help are more likely to have a longer duration of infertility, higher levels of distress and higher prevalence of co-morbid somatic conditions than non-help-seeking couples [7,17]. In addition, fertility treatment is associated with levels of distress over and above those associated with the state of being infertile in and of itself [18].…”

Psychologic and sexual dysfunction in primary and secondary infertile male patients

“…For example it has been revealed that during natural disasters like earthquakes, sperm quality activities of seminal plasma superoxide dismutase and arginine decrease, and nitric oxide levels increase in men under stress (7,8). Since psychiatric disorders are more frequently analyzed during infertility investigations, scales specific to infertility process haven't been developed yet (9). In developed countries, it appears to be appropriate to take a detailed history about psychological status of the infertile couple.…”

Infertility and fertility intentions, desires, and outcomes among US women

“…The proportion of women in the US who experience infertility using the ASRM definition is 7% to 15.5% in a given year depending upon specific measurement procedures (Thoma et al 2013). The percentage is substantially higher (51.8%) for women who have met the ASRM criteria at some point throughout their reproductive lifespan (Greil et al 2011a). Little is known about how women who experience infertility (e.g., meet the medical criteria) or identify as having a fertility problem (i.e., with or without meeting the medical criteria) think about their fertility intentions and desires compared to women without infertility experiences.…”