Infertility tied to mental woes

Depression, anxiety and certain other mental health conditions are more common among infertile couples than those who are able to conceive on their own, a small study suggests.

The findings, say researchers, imply that routine mental health screening could benefit patients being treated for infertility.

While most of the 81 infertile couples in the study did not suffer from any of the psychiatric conditions the researchers assessed, they did have higher rates of certain disorders when compared with 70 fertile couples.

Differences tied to infertility
The biggest difference, the researchers found, was in the diagnosis of "adjustment disorder," particularly among women. Adjustment disorder refers to symptoms of depression and anxiety in response to an identifiable cause - which, in these cases, was most likely patients' infertility.

Among infertile women, 28 percent had an adjustment disorder marked by depression and anxiety, versus 3 percent of fertile women.

In addition, 18 percent of infertile women currently had binge-eating disorder, whereas none of their fertile counterparts did, according to the researchers, led by Dr Chiara Sbaragli of the University of Siena School of Medicine in Italy.

Among men, there was evidence that infertility patients had higher rates of "subclinical" obsessive-compulsive disorder and social phobia - meaning signs and symptoms of these anxiety disorders were there, but not significant enough for a diagnosis.

Causality not shown
According to the researchers, it's not possible to say whether these mental health problems were the result of - or possibly a contributing factor to - patients' infertility.

In the case of adjustment disorders, Sbaragli and her colleagues note, it's likely that patients' symptoms were a response to their fertility problems. However, they add, such symptoms could potentially make it harder for patients to recover from infertility; the effects of depression and anxiety on the nervous system, for instance, could in turn affect their reproductive function.

If larger studies confirm these findings, the researchers say, doctors may want to start routinely screening infertility patients for depression, anxiety disorders and eating disorders, and refer them for help when necessary.

SOURCE: Fertility and Sterility, December 2008.

(Reuters Health, January 2009)

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