title: Women show a higher level of anxiety during IVF treatment than men and hold different concerns: a cohort study.
abstract: OBJECTIVE
  The aim of the present study was to determine levels of anxiety during the course of IVF treatment and gender differences in treatment anxiety.
  
  
  METHODS
  This was a prospective cohort study set in a university affiliated, tertiary care IVF program. 119 women and 82 men entering the clinic to undergo IVF treatment filled out questionnaires containing the Spielberger state-trait-anxiety-inventory (STAI) as well as further items on specific stress triggers.
  
  
  RESULTS
  Women and men undergoing IVF have higher levels of anxiety than the average population in Germany. Overall, female patients show significantly higher values (mean ± SD) for state and trait anxiety (47.4 ± 11.0 and 40.1 ± 9.85) than their male partners (41.4 ± 9.66 and 35.3 ± 8.57, p < 0.01). Over the course of several IVF cycles, average STAI scores increased for both genders. When asked about specific stress factors on a 4-point scale from 'not at all' to 'very much so', women report as their main anxiety the failure to achieve a successful pregnancy, scoring significantly higher on questions like 'obtaining a negative pregnancy test' (3.24 ± 0.82, p < 0.01) and 'disclosure of infertility' (3.02 ± 1.10, p < 0.001). Their male partners are more concerned about the health risks the women have to take such as 'side effects of ovarian stimulation' (2.55 ± 0.77, p = 0.002) and 'bleeding or infection after the oocyte aspiration' (2.58 ± 0.84, p = 0.007). Both genders indicated to be very little worried about multiple pregnancies after IVF.
  
  
  CONCLUSIONS
  Women show a higher level of anxiety during IVF treatment and hold different concerns. Neither of the sexes appears to be familiar with the risks associated with multiple pregnancies, a matter that should better be addressed.
authors.affiliation: Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538, Luebeck, Germany. schallerm@gmail.com.
authors.forename: Martin Alexander
authors.identifier: http://orcid.org/0000-0003-1447-9908
authors.initials: MA
authors.lastname: Schaller
authors.affiliation: Department of Reproductive Medicine and Gynecological Endocrinology, University Hospital of Schleswig-Holstein, 23538, Luebeck, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Griesinger
authors.affiliation: Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538, Luebeck, Germany.
authors.forename: Constanze
authors.initials: C
authors.lastname: Banz-Jansen
mesh_terms: D000328:Adult; D001007:Anxiety / Q000453:epidemiology* / Q000209:etiology* / Q000523:psychology; D001008:Anxiety Disorders; D005260:Female; D005307:Fertilization in Vitro / Q000523:psychology*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007246:Infertility / Q000628:therapy; D008297:Male; D054315:Oocyte Retrieval; D010062:Ovulation Induction; D011247:Pregnancy; D011446:Prospective Studies; D012737:Sex Factors; D013315:Stress, Psychological / Q000453:epidemiology / Q000209:etiology*; D011795:Surveys and Questionnaires
keywords: Controlled ovarian stimulation; Cost; Gender differences; IVF; Patient dropouts; Resource utilization; Stress factors; Treatment anxiety