title: [The emotional burden of artificial insemination: increased anxiety and depression following an unsuccessful treatment].
abstract: OBJECTIVE
  Determination of the emotional burden of the first IVF or ICSI treatment cycle, the effect of the treatment on the marital relationship, and the course of the treatment following a failed and a successful first attempt.
  
  
  METHODS
  Descriptive longitudinal study with repeated measures before and after the first treatment cycle.
  
  
  METHODS
  240 women and 219 men filled in questionnaires both before and after the first treatment cycle in the area of anxiety, depression, and the marital relationship (as measured with the 'Spielberger state trait anxiety inventory' (STAI), the 'Beck depression inventory for primary care' (BDI-PC) and the 'Maudsley marital questionnaire' (MMQ), respectively), as well as their plans for further treatment.
  
  
  RESULTS
  After a first failed treatment cycle, both women and men showed an increase in depression, while women also showed increased anxiety. No differences were found between pre- and post-treatment levels of anxiety and depression after a successful treatment. After the first failed cycle, almost 13% of the women showed clinically relevant forms of depression. There was an increase in dissatisfaction with the sexual relationship in both men and women regardless of the success of the treatment. Before the start of the first treatment cycle, 2% of the couples had no intention to undergo further treatment if the first cycle failed; none of these couples started a new cycle. Ultimately, 18% of the couples refrained from further treatment following a failed first treatment cycle.
  
  
  CONCLUSIONS
  After a failed first treatment cycle the couples showed an increase in depression and one in eight women had a clinically relevant form of depression. More than one out of every 6 couples decided to refrain from further treatment after a failed first cycle.
authors.affiliation: Afd. Medische Psychologie, Universitair Medisch Centrum St Radboud, Postbus 9101, 6500 HB Nijmegen. c.verhaak@cksmps.azn.nl
authors.forename: C M
authors.initials: CM
authors.lastname: Verhaak
authors.forename: J M J
authors.initials: JM
authors.lastname: Smeenk
authors.forename: J A M
authors.initials: JA
authors.lastname: Kremer
authors.forename: D D M
authors.initials: DD
authors.lastname: Braat
authors.forename: F W
authors.initials: FW
authors.lastname: Kraaimaat
mesh_terms: D001007:Anxiety / Q000209:etiology* / Q000523:psychology; D003866:Depressive Disorder / Q000209:etiology* / Q000523:psychology; D005260:Female; D006801:Humans; D007315:Insemination, Artificial / Q000523:psychology*; D008137:Longitudinal Studies; D008297:Male; D008393:Marriage; D011569:Psychiatric Status Rating Scales; D020554:Sperm Injections, Intracytoplasmic / Q000523:psychology; D013315:Stress, Psychological / Q000209:etiology / Q000523:psychology; D011795:Surveys and Questionnaires; D017211:Treatment Failure