Psychological Disorders among Iranian Infertile Couples Undergoing Assisted Reproductive Technology (ART)
-
Mansoureh KARIMZADEH
,
Nasser SALSABILI
,
Firouzeh AKBARI ASBAGH
,
Robab TEYMOURI
,
Golamreza POURMAND
,
Tahereh SOLEIMANIEH NAEINI
Abstract
Background: Worldwide, infertility affects 10%-15% of couples and most of them seek medical help including Assisted Reproductive Technology (ART) treatments. Undergoing ART treatments create many physical and emotional burdens. This study examined the psychological consequences of infertility in Iranian infertile males and females as well as their spouses, unlike previous studies that examined mainly females with infertility.
Methods: Subjects in this descriptive analytical design were recruited from the IVF Department of Mirza Koochak Khan Hospital and the Rouyesh Infertility Treatment Center of Tehran, Iran between Aug 2014 and Sep 2015. Overall, 256 couples (64% response rate), consisting of 78 infertile male and their spouses and 50 infertile female and their spouses, were included in this research. The psychological disorders were measured by the Persian version of Symptoms Checklist-90-Revised and Cattle Inventory.
Results: Psychological disorders of infertile couples are significantly associated with increasing age, higher education, longer duration of infertility and unemployment (P<0.05). Prevalence of anxiety, depression, hypochondriasis and paranoia in infertile females and spouses of infertile males were significantly higher than husbands of infertile females (P<0.05). Obsession was more sever in infertile females was significantly greater than infertile males (P=0.01). Depression was significantly lower in infertile males than their spouses (P=0.016).
Conclusion: Iranian infertile females and spouses of infertile males experienced more psychological disorders than infertile males and spouses of infertile females. These results may be due to the impact of cultural beliefs and gender roles in Iranian society. Anxiety, depression, obsession, paranoia and hypochondriasis should be addressed before any ART treatments.
World Health Organization (2002). Current practices and controversies in assisted reproduction. Report of meeting on “Medical, Ethical and Social Aspects of Assisted Reproduction. WHO Headquarters Geneva, Switzerland.
Evers JL (2002). Female subfertility. Lancet, 360 (9327): 151-9.
Bonde JPE, Olsen J (2008). Interpreting trends in fecundity over time. BMJ, 336 (7640): 339-40.
Skakkebaek NE, Jørgensen N, Main KM, Rajpert-De Meyts E, Leffers H, Andersson AM, Juul A, Carlsen E, Mortensen GK, Jensen TK, Toppari J (2006). Is human fecundity declining? Int J Androl, 29 (1): 2-11.
Zegers-Hochschild F, Adamson GD, de Mouzon J, Ishihara O, Mansour R, Nygren K, Sullivan E, VanderPoel S (2009). International committee for monitoring assisted reproductive technology (ICMART) and the world health organization (WHO) revised glossary on ART terminology, 2009. Fertil Steril, 92 (5): 1520-4.
Speroff L, Fritz MA (2005). Clinical gynecologic endocrinology and infertility. 7th ed. Lippincott Williams & Wilkins, USA, pp.: 1027-8.
ESHRE Capri Workshop Group (2010). Europe the continent with the lowest fertility. Hum Reprod Update, 16 (6): 590-602.
Parsanezhad ME, Jahromi BN, Zare N, Keramati P, Khalili A, Parsa-Nezhad M (2013). Epidemiology and etiology of infertility in Iran, systematic review and meta-analysis. J Womens’ Health, Issues Care, 2 (6): 1-6.
Schmidt L, Münster K, Helm P (1995). Infertility and the seeking of infertility treatment in a representative population. Br J Obstet Gynaecol, 102 (12): 978-84.
Baldur-Felskov B, Kjaer SK, Albieri V, Steding-Jessen M, Kjaer T, Johansen C, Dalton SO, Jensen A (2013). Psychiatric disorders in women with fertility problems: results from a large Danish register-based cohort study. Hum Reprod, 28 (3): 683-90.
Anonymous (2012). European Society of Human Reproduction and Embryology. The world’s number of IVF and ICSI babies has now reached a calculated total of 5 million. Press release. http://www.meditex-software.com/index.php/en/news/74-the-worlds-number-of-ivf-and-icsi-babies-has-now-reached-a-calculated-total-of-5-million
Inhorn MC (2009). Right to Assisted Reproductive technology: overcoming infertility in low-resource countries. Int J Gynaecol Obstet, 106 (2): 172-4.
Klonoff-Cohen H, Chu E, Natarajan L, Sieber W (2001). A prospective study of stress among women undergoing in vitro fertilization or gamete intrafallopian transfer. Fertil Steril, 76 (4): 675-87.
Cwikel J, Gidron Y, Sheiner E (2004). Psychological interactions with infertility among women. Eur J Obstet Gynecol Reprod Biol, 117 (2): 126-31.
Noorbala AA, Ramezanzadeh F, Abedinia N, Naghizadeh MM (2009). Psychiatric disorders among infertile and fertile women. Soc Psychiatry Psychiatr Epidemiol, 44 (7): 587-91.
Eugster A, Vingerhoets A (1999). Psychological aspects of in vitro fertilization: a review. Soc Sci Med, 48 (5): 575-89.
Kee BS, Jung BJ, Lee SH (2000). A study on psychological strain in IVF patients. J Assist Reprod Genet, 17 (8): 445-8.
Hammarberg K, Astbury J, Baker H (2001). Women's experience of IVF: a follow-up study. Hum Reprod, 16 (2): 374-83.
Lok IH, Lee DT, Cheung LP, Chung WS, Lo WK, Haines CJ (2002). Psychiatric morbidity amongst infertile Chinese women undergoing treatment with assisted reproductive technology and the impact of treatment failure. Gynecol Obstet Invest, 53 (4): 195-9.
Chen TH, Chang SP, Tsai CF, Juang KD (2004). Prevalence of depressive and anxiety disorders in an assisted reproductive technique clinic. Hum Reprod, 19 (10): 2313-8.
Ramezanzadeh F, Aghssa MM, Abedinia N, Zayeri F, Khanafshar N, Shariat M, Jafarabadi M (2004). A survey of relationship between anxiety, depression and duration of infertility. BMC Womens Health, 4 (1): 9.
Khademi A, Alleyassin A, Aghahosseini M, Ramezanzadeh F, Abhari AA (2005). Pretreatment Beck Depression Inventory score is an important predictor for post-treatment score in infertile patients: a before-after study. BMC Psychiatry, 5: 25.
Verhaak CM, Smeenk JM, van Minnen A, Kremer JA, Kraaimaat FW (2005). A longitudinal, prospective study on emotional adjustment before, during and after consecutive fertility treatment cycles. Hum Reprod, 20 (8): 2253-60.
Sbaragli C, Morgante G, Goracci A, Hofkens T, De Leo V, Castrogiovanni P (2008). Infertility and psychiatric morbidity. Fertil Steril, 90 (6): 2107-11.
Volgsten H, Skoog Svanberg A, Ekselius L, Lundkvist O, Sundström Poromaa I (2008). Prevalence of psychiatric disorders in infertile women and men undergoing in vitro fertilization treatment. Hum Reprod, 23 (9): 2056-63.
Volgsten H, Skoog Svanberg A, Ekselius L, Lundkvist O, Sundström Poromaa I (2010). Risk factors for psychiatric disorders in infertile women and men undergoing in vitro fertilization treatment. Fertil Steril, 93 (4): 1088-96.
Drosdzol A, Skrzypulec V (2009). Depression and anxiety among Polish infertile couples--an evaluative prevalence study. J Psychosom Obstet Gynaecol, 30 (1): 11-20.
Johansson M, Adolfsson A, Berg M, Francis J, Hogström L, Janson PO, Sogn J, Hellström AL (2010). Gender perspective on quality of life, comparisons between groups 4–5.5 years after unsuccessful or successful IVF treatment. Acta Obstet Gynecol Scand, 89 (5): 683-91.
Gelbaya TA (2010). Short and long-term risks to women who conceive through in vitro fertilization. Hum Fertil (Camb), 13 (1): 19-27.
Klemetti R, Raitanen J, Sihvo S, Saarni S, Koponen P (2010). Infertility, mental disorders and well-being--a nationwide survey. Acta Obstet Gynecol Scand, 89 (5): 677-82.
Greil AL, Shreffler KM, Schmidt L, McQuillan J (2011). Variation in distress among women with infertility: evidence from a population-based sample. Hum Reprod, 26 (8): 2101-12.
Pasch LA, Gregorich SE, Katz PK, Millstein SG, Nachtigall RD, Bleil ME, Adler NE (2012). Psychological distress and in vitro fertilization outcome. Fertil Steril, 98 (2): 459-64.
Verhaak CM, Smeenk JM, Nahuis MJ, Kremer JA, Braat DD (2007). Long-term psychological adjustment to IVF/ICSI treatment in women. Hum Reprod, 22 (1): 305-8.
Klonoff-Cohen H (2005). Female and male lifestyle habits and IVF: what is known and unknown. Hum Reprod Update, 11 (2): 179-203.
Ebbesen SM, Zachariae R, Mehlsen MY, Thomsen D, Højgaard A, Ottosen L, Petersen T, Ingerslev HJ (2009). Stressful life events are associated with a poor in-vitro fertilization (IVF) outcome: a prospective study. Hum Reprod, 24 (9): 2173-82.
Matthiesen SM, Frederiksen Y, Ingerslev HJ, Zachariae R (2011). Stress, distress and outcome of assisted reproductive technology (ART): a meta-analysis. Hum Reprod, 26 (10): 2763-76
Takaki J, Hibino Y (2014). Family-related opinions and stressful situations associated with psychological distress in women undergoing infertility treatment. Int J Environ Res Public Health, 11 (9): 9068-81.
Greil AL (1997). Infertility and psychological distress: a critical review of the literature. Soc Sci Med, 45 (11): 1679-704.
Milad MP, Klock SC, Moses S, Chatterton R (1998). Stress and anxiety do not result in pregnancy wastage. Hum Reprod, 13 (8): 2296-300.
Lovely LP, Meyer WR, Ekstrom RD, Golden RN (2003). Effect of stress on pregnancy outcome among women undergoing assisted reproduction procedures. South Med J, 96 (6): 548-51.
Anderheim L, Holter H, Bergh C, Möller A (2005). Does psychological stress affect the outcome of in vitro fertilization? Hum Reprod, 20 (10): 2969-75.
de Klerk C, Hunfeld JA, Heijnen EM, Eijkemans MJ, Fauser BC, Passchier J, Macklon NS (2008). Low negative affect prior to treatment is associated with a decreased chance of live birth from a first IVF cycle. Hum Reprod, 23 (1): 112-6.
Gourounti K, Anagnostopoulos F, Potamianos G, Lykeridou K, Schmidt L, Vaslamatzis G (2012). Perception of control, coping and psychological stress of infertile women undergoing IVF. Reprod Biomed Online, 24 (6): 670-9.
Anderson KM, Sharpe M, Rattray A, Irvine DS (2003). Distress and concerns in couples referred to a specialist infertility clinic. J Psychosom Res, 54 (4): 353-5.
Holter H, Anderheim L, Bergh C, Möller A (2006). First IVF treatment--short-term impact on psychological well-being and the marital relationship. Hum Reprod, 21 (12): 3295-302.
Lee TY, Sun GH (2000). Psychosocial response of Chinese infertile husbands and wives. Arch Androl, 45 (3): 143-8.
Monga M, Alexandrescu B, Katz SE, Stein M, Ganiats T (2004). Impact of infertility on quality of life, marital adjustment, and sexual function. Urology, 63 (1): 126-30.
Schneider MG, Forthofer MS (2005). Associations of psychosocial factors with the stress of infertility treatment. Health Soc Work, 30 (3): 183-91.
Slade P, O'Neill C, Simpson AJ, Lashen H (2007). The relationship between perceived stigma, disclosure patterns, support and distress in new attendees at an infertility clinic. Hum Reprod, 22 (8): 2309-17.
Donarelli Z, Kivlighan D, Allegra A, Lo Coco G (2016). How do individual attachment patterns of both members of couples affect their perceived infertility stress? An actor–partner interdependence analysis. Pers Individ Dif, 92: 63-8.
Dembińska AA (2016). Psychological determinants of life satisfaction in women undergoing infertility treatment. Health Psychology Report, 4 (2): 146-58
Hasanpoor-Azghdy SB, Simbar M, Vedadhir A (2014). The emotional-psychological consequences of infertility among infertile women seeking treatment: Results of a qualitative study. Iran J Reprod Med, 12 (2): 131-8.
Derogatis LR, Unger R (2010). Symptom checklist‐90‐revised. Corsini encyclopedia of psychology. John Wiley & Sons Inc, New York.
Alvandi A (1988). Validity and reliability of Cattle inventory for Iranians. Tehran University. Iran.
Wiersema NJ, Drukker AJ, Mai BT, Giang HN, Nguyen TN, Lambalk CB (2006). Consequences of infertility in developing countries: results of a questionnaire and interview survey in the South of Vietnam. J Transl Med, 4: 54.
Inhorn MC (2003). “The worms are weak”: male infertility and patriarchal paradoxes in Egypt. Men Mas, 5 (3): 238-58.
Inhorn MC, Patrizio P (2015). Infertility around the globe: new thinking on gender, reproductive technologies and global movements in the 21st century. Hum Reprod Update, 21 (4): 411-26
Inhorn MC (1994). Interpreting infertility: Medical anthropological perspectives: Introduction. Soc Sci Med, 39 (4): 459-61.
Salsabili N, Karimzadeh M, Ahmadvand MA, Asadi MH, Brati F (2000). A comparative study of Psychological Problem and anxiety levels in between spinal cord injured infertile
couples with normal infertile couples. Iran. Med J Hakim, 3 (3): 207-14.
Karimzadeh M, Salsabili N, Akbariasbagh F, Mehrsai A (2006). The psychological impact of infertility in the male able bodied and spinal cord injured population. Sex Disabil, 24 (4): 185-93.
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| Issue | Vol 46 No 3 (2017) | |
| Section | Original Article(s) | |
| Keywords | ||
| Infertility Psychological disorders Assisted reproductive technology (ART) | ||
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