title: Anxiety and depression after failure of assisted reproductive treatment among patients experiencing infertility.
abstract: OBJECTIVE
  To investigate the impact of the number of previous infertility treatment failures on anxiety and depression.
  
  
  METHODS
  In a cross-sectional study, individuals (men and women, but not couples) aged at least 18 years who had a history of infertility and could read and write in Persian were enrolled at the Royan Institute, Tehran, Iran, between November 1, 2013, and February 28, 2014. Participants provided demographic and infertility information and completed the Persian version of the Hospital Anxiety and Depression Scale (HADS).
  
  
  RESULTS
  Overall, 330 patients (122 men, 208 women) were included. Mean scores on the HADS anxiety and depression subscales (HADS-A and HADS-D) were 8.40±4.51 and 5.95±3.54, respectively. In multiple regression analysis, mean HADS-A scores were significantly higher for patients with one treatment failure (9.57±4.58) than for those without a history of treatment (7.79±4.13; P=0.003). HADS-D scores were significantly higher for patients with two failures (6.92±3.69) than for those with no previous treatment (5.59±3.79; P=0.019).
  
  
  CONCLUSIONS
  Patients with infertility have increased depression and anxiety after infertility treatment failure. Counseling or treatment for these potential psychological effects should be considered after infertility treatment failure.
authors.affiliation: Department of Epidemiology and Reproductive Health at Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, Academic Center for Education, Culture and Research (ACECR), Tehran, Iran.
authors.forename: Saman
authors.initials: S
authors.lastname: Maroufizadeh
authors.affiliation: Department of Epidemiology and Reproductive Health at Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, Academic Center for Education, Culture and Research (ACECR), Tehran, Iran.
authors.forename: Elaheh
authors.initials: E
authors.lastname: Karimi
authors.affiliation: Department of Epidemiology and Reproductive Health at Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, Academic Center for Education, Culture and Research (ACECR), Tehran, Iran.
authors.forename: Samira
authors.initials: S
authors.lastname: Vesali
authors.affiliation: Department of Epidemiology and Reproductive Health at Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, Academic Center for Education, Culture and Research (ACECR), Tehran, Iran. Electronic address: samani@royaninstitute.org.
authors.forename: Reza
authors.initials: R
authors.lastname: Omani Samani
mesh_terms: D000328:Adult; D001007:Anxiety / Q000453:epidemiology / Q000209:etiology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D007246:Infertility / Q000523:psychology* / Q000628:therapy; D007492:Iran / Q000453:epidemiology; D008297:Male; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D027724:Reproductive Techniques, Assisted / Q000523:psychology*; D017211:Treatment Failure; D055815:Young Adult
keywords: Anxiety; Assisted reproductive technology; Depression; Failure; Infertility