A prospective study assessing anxiety, depression and maternal-fetal attachment in women using PGD.
BACKGROUND
PGD has been described in previous cross-sectional and retrospective studies as a stressful experience. No prospective studies of the psychological impact of PGD are currently available.


METHODS
Using a prospective study design, validated measures exploring anxiety and depression were used to assess women using PGD prior to treatment, following embryo transfer, following the pregnancy test result and at 24 weeks of pregnancy. Maternal-fetal attachment was also assessed during pregnancy.


RESULTS
The prospective design revealed the cyclical pathway through PGD for many women, often comprising repeated cycles of ovarian stimulations and IVF and frozen embryo transfers. As predicted, there were significant fluctuations in women's anxiety scores, with increases observed following embryo transfer and pregnancy testing. Women's anxiety scores returned to baseline levels during pregnancy as assessed at 24 weeks gestation. Depression scores did not significantly fluctuate during PGD. Maternal-fetal attachment scores in this sample did not differ from the normative Australian data.


CONCLUSIONS
For some women, the PGD pathway is convoluted and requires multiple IVF cycles and embryo transfers to achieve pregnancy. A subset of women experience significant emotional burden during PGD treatment, and it is these women who require closer attention and support. In this sample, emotional adjustment in pregnancy following PGD appears to be sound.
Sydney Medical School, University of Sydney, Royal North Shore Hospital, St Leonards, Sydney, NSW, Australia. jkaratas@med.usyd.edu.au
J C
JC
Karatas
K
K
Barlow-Stewart
B
B
Meiser
C
C
McMahon
K A
KA
Strong
W
W
Hill
C
C
Roberts
P J
PJ
Kelly
D001007:Anxiety / Q000175:diagnosis*; D003863:Depression / Q000175:diagnosis*; D004624:Embryo Transfer / Q000523:psychology; D005260:Female; D005307:Fertilization in Vitro / Q000523:psychology; D006801:Humans; D033261:Maternal-Fetal Relations / Q000523:psychology*; D011247:Pregnancy; D019836:Preimplantation Diagnosis / Q000523:psychology*