Multiple small studies have demonstrated a link between infertility and psychological distress, reporting high rates of anxiety and depressive symptoms among women with infertility.  These studies have evaluated psychiatric symptoms or psychological distress; however, less is known about the prevalence of more significant psychiatric disorders in this population.

Data from the largest study to date of women with infertility was recently presented at the annual meeting of ESHRE (European Society of Human Reproduction and Embryology) by Dr. Birgitte Baldur-Felskov.

Danish investigators were able to examine the records of 98,737 Danish women evaluated for infertility between 1973 and 2008.  They found that women who remained childless after their first investigation for infertility had more hospitalizations for psychiatric illness than women who had at least one child following their investigation.  The most common discharge diagnoses were “anxiety, adjustment and obsessive compulsive disorders” followed by “affective disorders including depression.”

In another study (also from Denmark), investigators examine a cohort of 51,221 women with primary or secondary infertility who had been referred to hospitals or private fertility clinics in Denmark between 1973 and 1998.  Each woman was followed from the date of her initial fertility evaluation until 2006.

In this study, they discovered that women who did not have a child after initial fertility evaluation had a greater than twofold risk of suicide (HR: 2.43; 95% CI: 1.38-3.71) than women who had at least one child after evaluation.  Women with secondary infertility, i.e. women who had a child before a fertility evaluation but did not succeed in having another child after evaluation, also had an increased risk for suicide (HR: 1.68; 95% CI, 0.82-3.41), although this finding was not statistically significant.

These two reports extend our understanding of the impact of infertility and its treatment on risk for serious psychiatric illness.  While future studies will help to determine which women are the most vulnerable to illness in this setting, these two large studies highlight the need for adequate screening for psychiatric illness and appropriate interventions in women who are evaluated for infertility.

Ruta Nonacs, MD PhD

Kjaer TK, Jensen A, Dalton SO, et al.  Suicide in Danish women evaluated for fertility problems. Hum Reprod. 2011;26(9):2401-7.

Read more:  Childless Women With Fertility Problems at Higher Risk of Hospitalization for Psychiatric Disorders (Science Daily)