28 June 2012

Failed IVF attempt tied to depression, anxiety

Women who are stressed and anxious before in IVF are no less likely to have a baby, new research suggests. But if the treatment fails, it may take a toll on their mental health.


Women who are stressed and anxious before in vitro fertilisation (IVF) are no less likely to have a baby, new research suggests. But if the treatment fails, it may take a toll on their mental health.

In two separate studies in the journal Fertility and Sterility, researchers found women with anxiety or depression symptoms were just as likely as others to become pregnant.

One study focused on women undergoing IVF and the other followed women trying to conceive naturally.

"Our findings are consistent with the most recent research," said Lauri A Pasch, a clinical psychologist at the University of California, San Francisco Centre for Reproductive Health, and the lead researcher on the IVF study.

Pressure to be good IVF patient

Based on that body of research, she said, "I think we can safely say to women, 'Stop worrying about being worried.'"

Women should not feel pressured to be a "good IVF patient" who's free of stress, Pasch said. And they should not blame themselves if they feel stressed out and their IVF attempt fails.

The other study, from the UK, looked at 339 women who were trying to become pregnant naturally.

Overall, 61% of them became pregnant over about six months. And the odds of success were not linked to women's mental well-being once the researchers accounted for factors like their age and smoking habits, a team led by Courtney Lynch of the Ohio State University College of Medicine in Columbus reported.

When IVF doesn’t work

On the other hand, women who try IVF and fail may see their mental health suffer, Pasch and her colleagues found.

The researchers followed 202 women undergoing IVF at five San Francisco practises. All of the women were interviewed before their IVF attempt, which included standard questionnaires on depression and anxiety.

Overall, the study found, women whose IVF treatment failed were at greater risk of anxiety or depression in the months afterward.

Of 103 women with a failed attempt, 60% had symptoms of a clinical anxiety disorder - up slightly from 57% before their IVF cycles. And 44% had clinical depression, which was up from 26% before treatment.

Help women with mental health symptoms

It's not surprising that many women with a failed IVF attempt would have such symptoms, according to Pasch. But there has actually been little research into how IVF outcomes may affect women's mental health, she said.

And although women with a failed try at IVF were at higher risk, even women who became pregnant had substantial rates of depression and anxiety, Pasch's team found.

During pregnancy, 30% of those women had depression in the "clinical range," while half had clinical-level anxiety. Those rates were close to what they were before IVF.

According to Pasch, infertility practices should do more to help women with mental health symptoms - though not because it would be expected to improve their odds of IVF success.

Ask for counselling

"Psychological interventions need to be geared toward helping women feel better, and not toward increasing their chances of pregnancy," Pasch said.

Some larger, university-linked infertility centres have on-site services for women who want mental health counselling. But most practises do not, Pasch said.

Women can, however, ask their centre for a referral to counselling if they need it. Pasch said there are also organisations that offer help, like information on local support groups.

(Amy Norton, Reuters Health, June 2012) 

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