Failed IVF attempt tied to depression, anxiety

By Amy Norton

NEW YORK | Wed Jun 27, 2012 12:55pm EDT

NEW YORK (Reuters Health) – Women who are stressed and anxious before in vitro fertilization (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 Center for Reproductive Health, and the lead researcher on the IVF study.

Based on that body of research, she told Reuters Health, “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 percent 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 practices. 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 percent had symptoms of a clinical anxiety disorder – up slightly from 57 percent before their IVF cycles. And 44 percent had clinical depression, which was up from 26 percent before treatment.

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 percent 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.

“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 centers have on-site services for women who want mental health counseling. But most practices do not, Pasch said.

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

Those include the American Fertility Association (www.theafa.org www.theafa.org) and Resolve: The National Infertility Association (www.resolve.org www.resolve.org).

SOURCE: bit.ly/MpROEn and bit.ly/NNkmak Fertility and Sterility, online June 13, 2012.

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