title: The impact of IVF/ICSI on parental well-being and anxiety 1 year after childbirth.
abstract: BACKGROUND
  More couples are delaying childbirth resulting in an increase of age-related subfertility in women. Subfertility and assisted reproductive technology (ART) treatments may affect couples' psychological well-being. The aim of the present study was to investigate whether factors related to IVF/ICSI affect anxiety and mental health in couples 1 year after childbirth.
  
  
  METHODS
  In this cohort study, we included couples with a singleton pregnancy following IVF/ICSI treatment (n=113) and subfertile couples who naturally conceived (NC; n=83). Parental trait anxiety (Dutch version of the Spielberger State-Trait Anxiety Inventory) and mental health (Dutch version of General Health Questionnaire) were assessed 1 year after childbirth. The influence of fertility-related factors was analyzed with logistic regression analyses.
  
  
  RESULTS
  One hundred and ninety-six couples participated, 93% of those eligible. Trait anxiety and mental health were similar in IVF/ICSI and NC groups. However, NC fathers had more often mental health scores in the clinical range (21%) than fathers in the IVF/ICSI group (9%). The risk of having a trait anxiety or mental health score in the clinical range was reduced by the presence of one of the following factors: for females a higher number of IVF/ICSI treatment cycles, and a maternal cause of subfertility, for males having been treated by IVF/ICSI and a longer time to pregnancy.
  
  
  CONCLUSIONS
  The present study indicates (i) that IVF/ICSI treatment is not associated with an increase in clinically relevant Spielberger State-Trait Anxiety Inventory and General Health Questionnaire scores in parents 1 year after childbirth and (ii) a higher number of IVF/ICSI treatment cycles and a longer time to pregnancy were associated with less trait anxiety and better mental health. A limitation of the study is the absence of mental health and trait anxiety data at baseline.
authors.affiliation: Division of Developmental Neurology, Department of Paediatrics, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Jongbloed-Pereboom
authors.forename: K J
authors.initials: KJ
authors.lastname: Middelburg
authors.forename: M J
authors.initials: MJ
authors.lastname: Heineman
authors.forename: A F
authors.initials: AF
authors.lastname: Bos
authors.forename: M L
authors.initials: ML
authors.lastname: Haadsma
authors.forename: M
authors.initials: M
authors.lastname: Hadders-Algra
mesh_terms: D000328:Adult; D001007:Anxiety / Q000175:diagnosis* / Q000523:psychology; D015331:Cohort Studies; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D006304:Health Status; D006801:Humans; D007246:Infertility / Q000523:psychology / Q000628:therapy*; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D010290:Parents; D011247:Pregnancy; D011256:Pregnancy Outcome; D012044:Regression Analysis; D027724:Reproductive Techniques, Assisted; D012306:Risk; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods*; D011795:Surveys and Questionnaires; D061685:Time-to-Pregnancy