Abstract
BackgroundInfertility is often associated with a chronic state of stress which may manifest itself in anxiety-related and depressive symptoms. The aim of our study is to assess the psychological state of women with and without fertility problems, and to investigate the background factors of anxiety-related and depressive symptoms in women struggling with infertility.MethodsOur study was conducted with the participation of 225 (134 primary infertile and 91 fertile) women, recruited in a clinical setting and online. We used the following questionnaires: Spielberger Trait Anxiety Inventory (STAI-T), Shortened Beck Depression Inventory (BDI) and Fertility Problem Inventory (FPI). We also interviewed our subjects on the presence of other sources of stress (the quality of the relationship with their mother, financial and illness-related stress), and we described sociodemographic and fertility-specific characteristics. We tested our hypotheses using independent-samples t-tests (M ± SD) and multiple linear regression modelling (ß).ResultsInfertile women were younger (33.30 ± 4.85 vs. 35.74 ± 5.73, p = .001), but had significantly worse psychological well-being (BDI = 14.94 ± 12.90 vs. 8.95 ± 10.49, p < .0001; STAI-T = 48.76 ± 10.96 vs. 41.18 ± 11.26, p < .0001) than fertile subjects. Depressive symptoms and anxiety in infertile women were associated with age, social concern, sexual concern and maternal relationship stress. Trait anxiety was also associated with financial stress. Our model was able to account for 58% of the variance of depressive symptoms and 62% of the variance of trait anxiety.ConclusionsDepressive and anxiety-related symptoms of infertile women are more prominent than those of fertile females. The measurement of these indicators and the mitigation of underlying distress by adequate psychosocial interventions should be encouraged.
Highlights
Infertility is often associated with a chronic state of stress which may manifest itself in anxiety-related and depressive symptoms
Psychological well-being of fertile and infertile women The mean values (M ± SD) of depressive symptoms (14.94 ± 12.90 vs. 8.95 ± 10.49, p < .001) and anxiety (48.76 ± 10.96 vs. 41.18 ± 11.26, p < .001) were significantly higher in infertile women when compared to fertile controls (Table 1)
We found that depressive symptoms were significantly associated with age (ß = .159, p < .018), Social Concern (FPI-1) (ß = .245, p < .003), Sexual Concern (FPI-2) (ß = .399, p < .001), and Maternal Relationship Stress (ß = .205, p < .002)
Summary
Infertility is often associated with a chronic state of stress which may manifest itself in anxiety-related and depressive symptoms. The aim of our study is to assess the psychological state of women with and without fertility problems, and to investigate the background factors of anxiety-related and depressive symptoms in women struggling with infertility. The primary negative emotional response to both infertility and assisted reproductive treatment (ART) is usually either anxiety (a sense of threat, tension, worry) or depression (a sense of loss, sadness, lack of control) [7]. Based on an overview of 10 years of research, Greil et al stated that infertile women are more likely to experience higher levels of distress than comparison groups [8]. Another review article confirms elevated depression levels in infertile women relative to fertile females [9]. Representative population-based studies found an increased likelihood of anxiety in subfecund women compared to fecund controls [10, 11]
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