It is common for women experiencing infertility and undergoing fertility treatment to experience significant emotional distress.  Many women, reasoning that their emotional health influences their physical functioning, worry that the stress and anxiety they experience in this context may hinder their ability to become pregnant.

Addressing this concern, a recent meta-analysis analyzed data from 14 studies including a total of 3583 infertile women undergoing a cycle of fertility treatment.  Eligible studies were prospective studies reporting an assessment of the association between pretreatment emotional distress (anxiety or depression) and pregnancy in women undergoing a single cycle of assisted reproductive technology.

Levels of pretreatment anxiety or depression did not differ between women who achieved a pregnancy (defined as a positive pregnancy test, positive fetal heart scan, or a live birth) and those who did not conceive.  Pretreatment emotional distress was not associated with treatment outcome after a single cycle of assisted reproductive technology (ART).

The findings of this meta-analysis are reassuring.  Its findings suggest that while many women experience significant emotional distress when experiencing fertility problems, their chances of conceiving are similar to those women who experience lower levels of distress.  This is great news; however, we need to keep in mind that this population is in need of supports and is vulnerable to depression and anxiety.   Stress influences a couples’ attitude and behavior toward assisted fertility treatment, and it’s the most common reason that couples give for terminating infertility treatment.  In addition, we have data to suggest that, even after a pregnancy is achieved, women undergoing ART are more vulnerable to depression than women who conceive naturally.

Ruta Nonacs, MD PhD

Boivin J, Griffiths E, Venetis CA.  Emotional distress in infertile women and failure of assisted reproductive technologies: meta-analysis of prospective psychosocial studies.  BMJ  2011; 342:d223.

Read more:

Bolvin J.  A review of psychosocial interventions in infertility.  Social Science & Medicine 57 (2003) 2325–2341.  (Full text available)