For women about to undergo in-vitro fertilization or some other method of assisted reproductive therapy, the importance of maintaining a positive outlook could not be any more crucial.
The importance of psychological and psychiatric illness has been well demonstrated in patients with infertility. In self-report questionnaires used to compare women with fertility problems against their normal, fertile cohorts; the women with infertility demonstrated a higher prevalence of negative emotions during periods when they were attempting to conceive. These women also had more changes in the relationships with their partners, as well as decreased sex drive. Other psychological symptoms such as depressed mood, decreased concentration and memory, anxiety, and lower self-esteem were also found among women with fertility problems. About one in four infertile women had test results indicating depression or dysthymia, and among such women who had previously undergone in-vitro fertilization, their wellbeing was more adversely affected by unsuccessful procedures.
For women with infertility who have no identified organic cause of their infertility (e.g. due to endocrine dysfunction, advancing age, or problem with the reproductive system), psychological variables must be taken much more seriously. Women with infertility were found to have a history of depression, and their first depressive episode often occurred prior to being diagnosed with infertility.
Assisted reproductive therapies such as IVF involve the manipulation of hormones, a practice that can have sweeping effects on a woman’s psychological status. Clomiphene citrate, which increases the production of human chorionic gonadotropin, has been linked with the onset or increase of psychotic episodes. Gonadotropin-releasing hormone agonists are associated with increased anxiety and depression.
Women who were able to successfully conceive through IVF demonstrated having greater muscle tension and anxiety than women who conceived through natural means. Postpartum studies of women who delivered a baby conceived through in-vitro fertilization revealed that these mothers had lower self-esteem and self-efficacy as compared to women who conceived naturally. They were also more likely to rate their babies as more difficult to handle and more temperamental than mothers who had a natural course of conception to delivery.
It is vital for women who conceive through IVF to have a strong support system in place not only during IVF cycles and their pregnancy, but also during the postpartum period. This may include any professional help, including psychotherapy, and psychiatric checkups, as well as support groups, family and friends. Infertility and the interventions used to manage it can be stressful, and continuous psychological management has significant benefits for both the mother and her baby.