title: Prospective study of depression and anxiety in female fertility preservation and infertility patients.
abstract: OBJECTIVE
  To prospectively assess anxiety, depression, coping, and appraisal in female fertility preservation (FP) patients compared with infertile patients.
  
  
  METHODS
  Prospective pre- and post-treatment survey.
  
  
  METHODS
  Academic medical center.
  
  
  METHODS
  Forty-seven women with cancer (FP patients) and 91 age-matched infertile patients.
  
  
  METHODS
  None.
  
  
  METHODS
  Depression, anxiety, coping, infertility-related stress, appraisal of treatment, and medical outcomes.
  
  
  RESULTS
  FP patients reported more symptoms of anxiety and depression than infertile patients, but infertile patients' symptoms worsened over time; 44% of FP and 14% of infertile patients' scores exceeded the clinical cutoff for depression before treatment. The interval between surveys and medical treatment data did not predict changes in mood symptoms. Coping strategies and infertility-related stress did not differ between groups, and avoidant coping predicted higher depression and anxiety scores.
  
  
  CONCLUSIONS
  FP patients reported more anxiety and depression than infertile patients at enrollment in treatment, with more than one-third of FP patients reporting clinically significant depressive symptoms. However, infertile patients' anxiety and depressive symptoms increased across treatment. This increase was not related to time between registration for IVF and oocyte retrieval or the medical aspects of treatment. FP and infertile patients should be provided psychologic consultation before treatment to identify mood and anxiety symptoms and to refer patients for counseling as needed to prevent worsening of symptoms.
authors.affiliation: Northwestern University, Chicago, Illinois. Electronic address: alawson@nmff.org.
authors.forename: Angela K
authors.initials: AK
authors.lastname: Lawson
authors.affiliation: Northwestern University, Chicago, Illinois.
authors.forename: Susan C
authors.initials: SC
authors.lastname: Klock
authors.affiliation: Northwestern University, Chicago, Illinois.
authors.forename: Mary Ellen
authors.initials: ME
authors.lastname: Pavone
authors.affiliation: Fertility Centers of Illinois, Orland Park, Illinois.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Hirshfeld-Cytron
authors.affiliation: Northwestern University, Chicago, Illinois.
authors.forename: Kristin N
authors.initials: KN
authors.lastname: Smith
authors.affiliation: Northwestern University, Chicago, Illinois.
authors.forename: Ralph R
authors.initials: RR
authors.lastname: Kazer
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001007:Anxiety / Q000453:epidemiology* / Q000523:psychology*; D015984:Causality; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D059247:Fertility Preservation / Q000523:psychology* / Q000706:statistics & numerical data; D005307:Fertilization in Vitro / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D007087:Illinois / Q000453:epidemiology; D015994:Incidence; D007247:Infertility, Female / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy*; D011247:Pregnancy; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Fertility preservation; IVF; counseling; psychologic