Depression, Anxiety and Stress Among Women Treated Due to Infertility.

Background/

Objectives

Infertility is an important public health problem. It is the source of considerable psychological load, negatively affecting the quality of life, social relations, and psychological health. Stress in infertility plays the role of both a risk factor and a consequence of reproductive disorders, exerting an effect through hormonal, inflammatory and oxidative mechanisms, which may reduce the effectiveness of treatment. The aim of the study is assessment of the frequency of occurrence of depression, anxiety, and stress in infertile women.

Methods

The study included 300 women treated due to infertility, and 50 women in the control group. The evaluation was carried out using an author-constructed socio-demographic questionnaire and the Depression Anxiety Stress Scales-42 (DASS-42) for the measurement of depression, anxiety, and stress. In addition, selected hormones were determined in blood serum.

Results

Hormonal analysis showed significantly higher levels of prolactin (PRL) in women treated due to infertility, especially in the group without the use of assisted reproductive technology (non-ART), whereas higher levels of the follicle-stimulating hormone (FSH), and luteinizing hormone (LH) were noted in the control group. The level of anti-mullerian hormone (AMH) was lower in the therapeutic group, with no differences observed between the methods of treatment, and the levels of thyroid-stimulating hormone (TSH) did not differ between groups. Psychological evaluation according to the DASS-42 showed a significantly higher intensity of depression, anxiety, and stress in patients treated due to infertility, this intensity being the highest in the in vitro fertilization (IVF) group. Weak, but significant, correlations were found between PRL, FSH and LH, and the intensity of the symptoms of depression, anxiety, and stress, and the overall result according to the DASS-42.

Conclusions

Infertile women experienced higher levels of depression, anxiety, and stress, compared to fertile women. The study suggests a relationship between the level of psychological stress in persons treated for infertility, and their hormonal status. The study demonstrates that integration of psychological support and infertility treatment may bring about important benefits for psychological health and the quality of life of patients.