While several studies have demonstrated high levels of psychological distress among women pursuing infertility treatment, few studies have assessed the prevalence of psychiatric illness in populations undergoing infertility treatment using standardized diagnostic instruments. In a recent study from Taipei Veterans General Hospital, a university-affiliated medical center in Taiwan, women attending an assisted reproduction clinic were assessed using the Mini-International Neuropsychiatric Interview (MINI) (Chen 2004) Of the 112 participants, 40.2% met criteria for a psychiatric disorder. The most common diagnosis was generalized anxiety disorder (23.2%), followed by major depressive disorder (17.0%) and dysthymic disorder (9.8%). Participants with a psychiatric disorder did not differ from those without illness in terms of age, education level, income, or years of infertility.
The data from this study indicate that depressive and anxiety disorders were highly prevalent among women visiting an assisted reproduction clinic for treatment. This high prevalence of illness is especially concerning given the data suggesting that women who are undergoing infertility treatment are less likely to be successful if they suffer from depression or anxiety. In a study of 330 women undergoing in vitro fertilization, success rates were markedly lower in women who were depressed at the outset of treatment, as compared to women who were not depressed (Thiering 1993, Demyttenaere 1998). Anxiety also appears to have negative effects. In one study, women who experienced higher levels of anxiety prior to artificial insemination required more cycles to get pregnant (Demyttenaere 1988). In addition, there were higher rates of miscarriage among women with higher levels of anxiety (Demyttenaere 1988).
These studies indicate that there is not only the need screening for psychiatric illness in this population but also the need for support and treatment in patients undergoing infertility treatment.
Demyttenaere K, Nijs P, Steeno O, Koninckx PR, Evers-Kiebooms G. Anxiety and conception rates in donor insemination. J Psychosom Obstet Gynaecol. 1988; 8: 175-181.
Demyttenaere K, Bonte L, Gheldof M, Vervaeke M, Meuleman C, Vanderschuerem D, D’Hooghe T. Coping style and depression level influence outcome in in vitro fertilization. Fertil Steril. 1998; 69: 1026-33.
Thiering P, Beaurepaire J, Jones M, Saunders D and Tennant C. Mood state as a predictor of treatment outcome after in vitro fertilization/embryo transfer technology (IVF/ET). J Psychosom Res 1993; 37: 481-491.