Psychological distress and in vitro fertilization outcome.
OBJECTIVE
To examine whether psychological distress predicts IVF treatment outcome as well as whether IVF treatment outcome predicts subsequent psychological distress.


METHODS
Prospective cohort study over an 18-month period.


METHODS
Five community and academic fertility practices.


METHODS
Two hundred two women who initiated their first IVF cycle.


METHODS
Women completed interviews and questionnaires at baseline and at 4, 10, and 18 months' follow-up.


METHODS
IVF cycle outcome and psychological distress.


RESULTS
In a binary logistic model including covariates (woman's age, ethnicity, income, education, parity, duration of infertility, and time interval), pretreatment depression and anxiety were not significant predictors of the outcome of the first IVF cycle. In linear regression models including covariates (woman's age, income, education, parity, duration of infertility, assessment point, time since last treatment cycle, and pre-IVF depression or anxiety), experiencing failed IVF was associated with higher post-IVF depression and anxiety.


CONCLUSIONS
IVF failure predicts subsequent psychological distress, but pre-IVF psychological distress does not predict IVF failure. Instead of focusing efforts on psychological interventions specifically aimed at improving the chance of pregnancy, these findings suggest that attention be paid to helping patients prepare for and cope with treatment and treatment failure.
Department of Psychiatry, University of California, San Francisco, California, USA. lauri.pasch@ucsfmedicalcenter.org
Lauri A
LA
Pasch
Steven E
SE
Gregorich
Patricia K
PK
Katz
Susan G
SG
Millstein
Robert D
RD
Nachtigall
Maria E
ME
Bleil
Nancy E
NE
Adler
D000328:Adult; D015331:Cohort Studies; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods* / Q000523:psychology*; D005500:Follow-Up Studies; D006801:Humans; D007247:Infertility, Female / Q000523:psychology* / Q000628:therapy*; D008137:Longitudinal Studies; D008875:Middle Aged; D011247:Pregnancy; D011446:Prospective Studies; D013315:Stress, Psychological / Q000453:epidemiology / Q000523:psychology*; D011795:Surveys and Questionnaires; D017211:Treatment Failure; D016896:Treatment Outcome; D055815:Young Adult