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Emotional Impact in Assisted Reproduction treatments

Assisted reproduction treatments are an alternative full of hope and hope for infertile people and couples who are highly motivated in their goal of being parents.

However, in a situation of difficulty in achieving a successful pregnancy, feelings of discouragement, guilt, exhaustion, social and personal isolation, anxiety and depression appear.

It has been seen that the main negative emotions experienced by women at the time of infertility diagnosis are frustration, helplessness and sadness, feelings that trigger a significant low vitality.

As described in the study by Pasch et al., This emotional impact not only affects the patients, their partners are also affected by the situation. In this study, carried out in 352 women and 274 men, it was observed that 56.5% of women and 32.1% of men had depressive symptoms and that 75.9% of women and 60.6 % of the men reported anxiety symptoms.

Also, both depression and anxiety were higher for women and men who remained infertile compared to those who were successful.

Therefore, it can be affirmed that these feelings greatly affect assisted reproduction treatment and influence pregnancy success rates. In fact, in many cases, patients and couples decide not to go ahead with the treatment and choose to abandon and desist in the desire to be parents.

High levels of stress are associated with an increased risk of infertility

The role of stress during assisted reproduction treatment is fundamental.5,6 It has been seen that women with lower levels of stress and anxiety in the day before oocyte extraction have a higher pregnancy rate.

Likewise, women with higher levels of salivary α-amylase have been shown to have a 29% reduction in fertility compared to women with lower levels. The highest levels of stress, measured by salivary α-amylase , are associated with a longer time to achieve pregnancy and an increased risk of infertility.

Therefore, these results emphasize the need to treat stress and low vitality throughout the IVF cycle in order to improve success rates.

Psychological stress and its relationship with treatment abandonment

The role of stress during assisted reproduction treatment is fundamental.5,6 It has been seen that women with lower levels of stress and anxiety in the day before oocyte extraction have a higher pregnancy rate.

Likewise, women with higher levels of salivary α-amylase have been shown to have a 29% reduction in fertility compared to women with lower levels. The highest levels of stress, measured by salivary α-amylase , are associated with a longer time to achieve pregnancy and an increased risk of infertility.

Therefore, these results emphasize the need to treat stress and low vitality throughout the IVF cycle in order to improve success rates.

Psychological stress and its relationship with treatment abandonment

In a study of 974 couples, a 54% dropout rate from fertility treatment has been reported. Psychological stress being the most decisive factor, since 26% of patients abandon their treatment because of stress.

Other authors have also conducted studies on this topic, and in the case of Rajkhowa et al., 36% of couples abandon assisted reproduction treatment also due to psychological stress.

In a meta-analysis that included 22 studies and in which 21,453 patients from eight countries participated,  it was intended to know why the patients discontinued their fertility treatment, these were:

  • Postponement of treatment (39.18%)
  • Psychological and physical burden (19.07%)
  • Relational and personal problems (16.67%)
  • Treatment refusal (13.23%)
  • Organizational (11.68%) and clinical problems (7.71%)

Postponement of treatment, psychological and physical burden, and relational and personal problems were the most frequently selected reasons for stopping treatment. In addition, it was observed that the psychological burden was common in all the aspects analyzed.

Promote comprehensive treatment to improve success rates

Low vitality is very common during fertility treatment, yet most patients and couples are not referred to mental health services.

In a study of couples undergoing fertility treatments, it was determined to what extent information and psychological support were provided to them by their clinics. Only in 26.7% of the women and 24.1% of the men, did the fertility clinic make information available to them and facilitated contact with the psychology and mental health services.

Patients should be well informed, have the opportunity to address their questions and concerns, and receive advice in deciding whether to continue treatment.

In short, there is a clear need to address the emotional impact throughout this process. It is essential to promote comprehensive biological and emotional treatment in order to improve vital tone. Counseling can help reduce premature discontinuation of treatment and have a decisive influence on the probability of achieving pregnancy and the success of treatments.

It is key to improve the VITAL TONE of patients and offer them all the resources, both accompaniment and supplements, that they need to successfully face the path towards their dream of being parents.

Referencias

Coroleu Lletget, B. Importancia de los aspectos emocionales en los tratamientos de reproducción asistida. 78 (2008). 2. Pasch, L. A. et al. Addressing the needs of fertility treatment patients and their partners: are they informed of and do they receive mental health services? Fertil. Steril. 106, 209-215.e2 (2016). 3. Turner, K. et al. Stress and Anxiety Scores in First and Repeat IVF Cycles: A Pilot Study. PLoS ONE 8, e63743 (2013). 4. Purewal, S., Chapman, S. C. E. & van den Akker, O. B. A. A systematic review and meta-analysis of psychological predictors of successful assisted reproductive technologies. BMC Res. Notes 10, 711 (2017). 5. Lynch, C. D., Sundaram, R., Maisog, J. M., Sweeney, A. M. & Buck Louis, G. M. Preconception stress increases the risk of infertility: results from a couple-based prospective cohort study—the LIFE study. Hum. Reprod. 29, 1067–1075 (2014). 6. Matthiesen, S. M. S., Frederiksen, Y., Ingerslev, H. J. & Zachariae, R. Stress, distress and outcome of assisted reproductive technology (ART): a meta-analysis. Hum. Reprod. 26, 2763–2776 (2011). 7. Olivius, C., Friden, B., Borg, G. & Bergh, C. Why do couples discontinue in vitro fertilization treatment? a cohort study. Fertil. Steril. 81, 258–261 (2004). 8. Rajkhowa, M., Mcconnell, A. & Thomas, G. E. Reasons for discontinuation of IVF treatment: a questionnaire study. Hum. Reprod. 21, 358–363 (2006). 9. Gameiro, S., Boivin, J., Peronace, L. & Verhaak, C. M. Why do patients discontinue fertility treatment? A systematic review of reasons and predictors of discontinuation in fertility treatment. Hum. Reprod. Update 18, 652–669 (2012).
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