Trajectories and predictors of anxiety and depression amongst infertile women during their first IVF/ICSI treatment cycle

Abstract

PurposeThis study aimed to identify anxiety and depression trajectories of infertile women during first IVF treatment cycle and to examine whether the identified trajectories were associated with baseline psychological predictors, namely fertility-related stress, resilience, and illness perception. MethodsA longitudinal prospective study was conducted to assess anxiety and depression using the Chinese version of Self-Rating Anxiety Scale (SAS) and Self-Rating depression Scale (SDS) at four different time points: the day of first IVF/ICSI appointment (baseline/T1), the first day of ovarian stimulation (T2), the one day before oocyte retrieval (T3), and the day of fresh embryo transfer (T4). Final analysis was done on data obtained from 202 infertile women. Latent class growth mixed modeling was carried out to identify anxiety and depression trajectories. Multinomial logistic regressions were conducted to investigate predictors of trajectory membership. ResultsThree different adjustment trajectories were identified amongst infertile women during their first IVF/ICSI treatment cycle. A total of 40.1 and 37.6% of women showed normal levels of anxiety and depression (resilient trajectories), respectively, 45.0 and 43.1% of women had recovery trajectories, and 14.9 and 19.3% of women had chronic anxiety and depression trajectories. Non-resilient trajectories were associated with relatively shorter duration of infertility, higher fertility-related stress, and lower resilience. ConclusionThe results imply that it is possible to identify women in chronic or recovery trajectories on the day of first IVF/ICSI appointment, so that tailored prevention strategies integrated components that attenuate stress appraisal and strengthen resilience should be implemented to target those individuals.