Depression can prevent fertility treatment

If I were to guess the most common reason that couples do not proceed with or continue in treatment I would guess that it’s the cost. And I would be wrong. Emotional issues are actually the main reason for failing to start or continue treatment. Those issues may be related to fear of failure, repeated failure, stress and anxiety, psychological issues and now you can add depression.

According to a U. S. study reported by Reuters Health infertile women who are depressed are less likely to proceed with fertility treatments. Fertility specialists should consider screening patients for depression, the authors write, to help these patients improve their quality of life and not miss out on the chance of pregnancy.

Of 416 women in the study, 41 percent screened positive for depression, researchers found.

“The relationship between depression and infertility is complex. Many women in our study screened positive for depression,” lead author Dr. Natalie Crawford told Reuters Health in an email.

Dr. Crawford, who is currently medical director of fertility preservation at Austin Fertility Institute in Texas, led the study while she was at the University of North Carolina (UNC) in Chapel Hill.

While she was at UNC, all patients were given questionnaires to screen for depression and providers noticed that many women tested positive.

“We suspected that women who did screen positive for depression were less likely to comply with infertility treatment recommendations,” Dr. Crawford said.

“Our study revealed that women who have a screening test correlating with depression were less likely to proceed with infertility treatments, likely making it harder to achieve the ultimate goal of pregnancy,” Dr. Crawford said.

The research team sent electronic questionnaires to 959 women. The surveys were designed to screen for mental health disorders and patients’ perception of mental health disorders and fertility.

Of the 416 women who answered the questionnaire, more than half had been trying to conceive for more than two years.

Although 41 percent actually tested positive for depression based on their questionnaire responses, 50 percent of the women with infertility said they felt depressed most or all of the time.

Only 36 percent of the women who screened positive for depression went ahead with fertility treatments compared to 64 percent of women who did not have depression, according to the results published January 9 in the journal Human Reproduction.

Dr. Crawford said that if people have friends or family members who are struggling with infertility, it is important to acknowledge their difficulty. “I think simply starting the conversation is the hardest part. Couples who have infertility often report social isolation,” she said. “Thus, supporting friends and family who are suffering can be extremely helpful. Express your feelings clearly.”

Patients might not realize that their avoiding fertility treatment may be, in fact, a sign of the stress infertility is causing them, said Dr. Heather Shapiro, who wasn’t involved in the study.

As a friend or family member of someone undergoing fertility treatment, you are in a good position to be encouraging both to continue in treatment and to deal with the emotional issues as part of that treatment.

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