title: Addressing the needs of fertility treatment patients and their partners: are they informed of and do they receive mental health services?
abstract: To determine the extent to which fertility patients and partners received mental health services (MHS) and were provided with information about MHS by their fertility clinics, and whether the use of MHS, or the provision of information about MHS by fertility clinics, was targeted to the most distressed individuals.
  
  
  
  Prospective longitudinal cohort study.
  
  
  
  Five fertility practices.
  
  
  
  A total of 352 women and 274 men seeking treatment for infertility.
  
  
  
  No interventions administered.
  
  
  
  Depression, anxiety, and MHS information provision and use.
  
  
  
  We found that 56.5% of women and 32.1% of men scored in the clinical range for depressive symptomatology at one or more assessments and that 75.9% of women and 60.6% of men scored in the clinical range for anxiety symptomatology at one or more assessments. Depression and anxiety were higher for women and men who remained infertile compared with those who were successful. Overall, 21% of women and 11.3% of men reported that they had received MHS, and 26.7% of women and 24.1% of men reported that a fertility clinic made information available to them about MHS. Women and men who reported significant depressive or anxiety symptoms, even those with prolonged symptoms, were no more likely than other patients to have received information about MHS.
  
  
  
  Psychological distress is common during fertility treatment, but most patients and partners do not receive and are not referred for MHS. Furthermore, MHS use and referral is not targeted to those at high risk for serious psychological distress. More attention needs to be given to the mental health needs of our patients and their partners.
authors.affiliation: Department of Psychiatry, University of California, San Francisco, California. Electronic address: lauri.pasch@ucsfmedicalcenter.org.
authors.forename: Lauri A
authors.initials: LA
authors.lastname: Pasch
authors.affiliation: Department of Psychology, San Francisco State University, San Francisco, California.
authors.forename: Sarah R
authors.initials: SR
authors.lastname: Holley
authors.affiliation: Department of Family and Child Nursing, University of Washington, Seattle, Washington.
authors.forename: Maria E
authors.initials: ME
authors.lastname: Bleil
authors.affiliation: Private Practice, Portland, Oregon.
authors.forename: Dena
authors.initials: D
authors.lastname: Shehab
authors.affiliation: Department of Medicine, University of California, San Francisco, California.
authors.forename: Patricia P
authors.initials: PP
authors.lastname: Katz
authors.affiliation: Department of Psychiatry, University of California, San Francisco, California.
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Adler
mesh_terms: D001007:Anxiety / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D054626:Consumer Health Information; D003863:Depression / Q000175:diagnosis / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D005260:Female; D005298:Fertility; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D007246:Infertility / Q000150:complications / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D008137:Longitudinal Studies; D008297:Male; D008603:Mental Health; D008605:Mental Health Services; D011446:Prospective Studies; D012307:Risk Factors; D018454:Spouses / Q000523:psychology*; D013315:Stress, Psychological / Q000175:diagnosis / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D011795:Surveys and Questionnaires; D014481:United States
keywords: Fertility treatment; anxiety; depression; mental health