Prospective study of depression and anxiety in female fertility preservation and infertility patients

Abstract

Objective To prospectively assess anxiety, depression, coping, and appraisal in female fertility preservation patients compared to infertile patients. Design Prospective pre- and post-treatment survey. Setting Academic medical center. Patients 47 women with cancer (FP) and 91 age-matched infertile patients. Interventions None. Main Outcome Measures Depression, anxiety, coping, infertility–related stress, appraisal of treatment, and medical outcomes. Results FP patients reported more symptoms of anxiety and depression than infertile patients, but infertile patients’ symptoms worsened over time. 44% of FP and 14% of infertile patients’ scores exceeded the clinical cut-off for depression at pre-treatment. The interval between surveys and medical treatment data did not predict changes in mood symptoms. Coping strategies and infertility-related stress did not differ between groups and avoidant coping predicted higher depression and anxiety scores. Conclusion FP patients reported more anxiety and depression than infertile patients at enrollment in treatment, with more than one third of FP patients reporting clinically significant depressive symptoms. However, infertile patients’ anxiety and depressive symptoms increased across treatment. This increase was not related to time between registration for IVF and oocyte retrieval or the medical aspects of treatment. FP and infertile patients should be provided psychological consultation prior to treatment to identify mood and anxiety symptoms and to refer patients for counseling as needed to prevent worsening of symptoms.

Psychological Counseling of Female Fertility Preservation Patients

“…Due to the retrospective nature of this study it was unclear if full Diagnostic and Statistical Manual IV (DSM-IV) (American Psychiatric Association, 2000) diagnostic criteria for a mood or anxiety disorder were met. The rates of anxiety and depressive symptoms found in this study were consistent with rates of anxiety (13%–32%) and depressive (8%–36%) symptomatology found in other studies of breast and other cancer patients (Carlson et al, 2004; Lawson et al, 2014; Peate et al, 2011; Ruddy et al, 2014; Zabora et al, 2001). It has been noted that the presence of anxiety may be detrimental to the retention of medical information and may influence decision-making in the fertility preservation process (Peate et al, 2011) and depression may prevent patients from seeking medical advice about infertility (Herbert, Lucke, & Dobson, 2010).…”

An Altered Perception of Normal: Understanding Causes for Treatment Delay in Women with Symptomatic Uterine Fibroids

“…Women who engage in avoidance-based coping could potentially worsen the psychological burden that these tumors have on their lives, as avoidance-based coping has been found to increase risk of psychological distress. 18 Thus, the way in which the participants minimize their symptoms and take on this avoidancebased coping style could potentially negatively impact their quality of life.…”

Addressing the needs of fertility treatment patients and their partners: are they informed of and do they receive mental health services?

“…In 1992, Domar et al showed that infertile women seeking fertility treatment had twice the prevalence of depressive symptoms as control subjects and concluded that MHS should be implemented as a routine component of care (2). Since then, many additional studies have revealed high rates of psychologic distress in fertility treatment patients (3)(4)(5)(6). The need for help with the emotional aspects of infertility has been endorsed by professional groups, government authorities, and patients themselves (7)(8)(9)(10).…”