Journal of Reproduction & Infertility

Journal of Reproduction & Infertility

Certain Less Invasive Infertility Treatments Associated with Different Levels of Pregnancy-Related Anxiety in Pregnancies Conceived via In Vitro Fertilization

Authors
Eleanor Stevenson 1
Richard Sloane 2
1 Division of Health for Women, Children and Families, School of Nursing, Duke University, Durham, USA
2 School of Medicine, Duke University, Durham, USA
Abstract
Background: Research supports that in vitro fertilization causes anxiety and that anxiety can continue into the resulting pregnancy. Most women who have IVF will have a less invasive treatment for infertility prior to IVF; however, it is unclear if specific less invasive treatment cycles impact anxiety that is experienced in the pregnancy resulting from IVF. Methods: A prospective study was conducted for women who became pregnant via IVF, and data was collected about reported previous non-IVF treatment cycles as well as Pregnancy Related Anxiety Measure. Latent Class Analysis was conducted A p-value of ≤0.05 was considered significant. Results: 144 subjects participated and were highly educated, affluent, married, and primarily white. The LCA process yielded two groups that on average had similar levels on most items except for use of intra uterine insemination and/or ovarian stimulation. This information was used to generate four exhaustive and mutually exclusive groups: Stimulation Only (stim-only), Stimulation and Intra uterine Insemination (stim-IUI), Intra uterine Insemination only (IUI only), or No Treatment (No Tx). ANOVA found that those in the Stim Only group had statistically significantly higher PRAM scores than the Stim IUI (p=0.0036), the IUI only group (p=0.05), and the No Tx group (p=0.0013). Conclusion: Women who become pregnant via IVF and had a history of non-in vitro fertilization cycles that only involved ovarian stimulation experienced more pregnancy-specific anxiety in the pregnancy that results from in vitro fertilization.
Keywords
In vitro fertilization
Infertility
Intra uterine insemination
Pregnancy Anxiety
Stress
  1. Stephen EH, Chandra A, King RB. Supply of and demand for assisted reproductive technologies in the United States: clinic- and population-based data, 1995-2010. Fertil Steril. 2016;105(2):451-8.
  2. Sunderam S, Kissin DM, Crawford SB, Folger SG, Jamieson DJ, Barfield WD. Assisted reproductive technology surveillance-United States, 2011. MMWR Surveill Summ. 2014;63(10):1-28.
  3. Sazonova A, Källen K, Thurin-Kjellberg A, Wennerholm UB, Bergh C. Obstetric outcome after in vitro fertilization with single or double embryo transfer. Hum Reprod. 2011;26(2):442-50.
  4. Wisborg K, Ingerslev HJ, Henriksen TB. In vitro fertilization and preterm delivery, low birth weight, and admission to the neonatal intensive care unit: a prospective follow-up study. Fertil Steril. 2010;94(6):2102-6.
  5. Greil AL, Slauson-Blevins K, McQuillan J. The experience of infertility: a review of recent literature. Sociol Health Illn. 2010;32(1):140-62.
  6. Gana K, Jakubowska S. Relationship between infertility-related stress and emotional distress and marital satisfaction. J Health Psychol. 2016;21(6):1043-54.
  7. Olshansky EF. Psychosocial implications of pregnancy after infertility. NAACOGS Clin Issu Perinat Womens Health Nurs. 1990;1(3):342-7.
  8. Sandelowski M, Harris BG, Black BP. Relinquishing infertility: the work of pregnancy for infertile couples. Qual Health Res. 1992;2(3):282-301.
  9. Gourounti K. Psychological stress and adjustment in pregnancy following assisted reproductive technology and spontaneous conception: A systematic review. Women Health. 2016;56(1):98-118.
  10. Wu AK, Elliott P, Katz PP, Smith JF. Time costs of fertility care: the hidden hardship of building a family. Fertil Steril. 2013;99(7):2025-30.
  11. Berg BJ, Wilson JF. Psychological functioning across stages of treatment for infertility. J Behav Med. 1991;14(1):11-26.
  12. Mahajan NN, Turnbull DA, Davies MJ, Jindal UN, Briggs NE, Taplin JE. Changes in affect and state anxiety across an in vitro fertilization/intracytoplasmic sperm injection cycle. Fertil Steril. 2010;93(2):517-26.
  13. Wadhwa PD, Sandman CA, Porto M, Dunkel-Schetter C, Garite TJ. The association between prenatal stress and infant birth weight and gestational age at birth: a prospective investigation. Am J Obstet Gynecol. 1993;169(4):858-65.
  14. Check JH. A practical approach to diagnosing and treating infertility by the generalist in obstetrics and gynecology. Clin Exp Obstet Gynecol. 2015;42(4):405-10.
  15. Pandian Z, Gibreel A, Bhattacharya S. In vitro fertilisation for unexplained subfertility. Cochrane Database Syst Rev. 2015;11:CD003357.
  16. Davies CD, Craske MG. Psychophysiological responses to unpredictable threat: effects of cue and temporal unpredictability. Emotion. 2015;15(2):195-200.
  17. Stevenson EL, Hershberger PE, Bergh PA. Evidence-Based Care for Couples With Infertility. J Obstet Gynecol Neonatal Nurs. 2016;45(1):100-10.
  18. Hjelmstedt A, Widstrom AM, Collins A. Psychological correlates of prenatal attachment in women who conceived after in vitro fertilization and women who conceived naturally. Birth. 2006;33(4):303-10.
  19. Dhaliwal LK, Gupta KR, Gopalan S, Kulhara P. Psychological aspects of infertility due to various causes--prospective study. Int J Fertil Womens Med. 2004;49(1):44-8.
  20. Chiba H, Mori E, Morioka Y, Kashiwakura M, Nadaoka T, Saito H, et al. Stress of female infertility: relations to length of treatment. Gynecol Obstet Invest. 1997;43(3):171-7.
  21. Darwiche J, Lawrence C, Vial Y, Wunder D, Stiefel F, Germond M, et al. Anxiety and psychological stress before prenatal screening in first-time mothers who conceived through IVF/ICSI or spontaneously. Women Health. 2014;54(5):474-85.
  22. McMahon CA, Boivin J, Gibson FL, Hammarberg K, Wynter K, Saunders D, et al. Pregnancy-specific anxiety, ART conception and infant temperament at 4 months post-partum. Hum Reprod. 2013;28(4):997-1005.
  23. Dornelles LM, MacCallum F, Lopes RC, Piccinini CA, Passos EP. The experience of pregnancy resulting from Assisted Reproductive Technology (ART) treatment: A qualitative Brazilian study. Women Birth. 2016;29(2):123-7.
  24. Brandes M, van der Steen JO, Bokdam SB, Hamilton CJ, de Bruin JP, Nelen WL, et al. When and why do subfertile couples discontinue their fertility care? A longitudinal cohort study in a secondary care subfertility population. Hum Reprod. 2009;24(12):3127-35.
  25. Gameiro S, Boivin J, Domar A. Optimal in vitro fertilization in 2020 should reduce treatment burden and enhance care delivery for patients and staff. Fertil Steril. 2013;100(2):302-9.
  26. Leonard J Stevenson, EL. Team communication: critical in the care of the couple with fertility challenges. In: Stevenson EL, Hershberger PE, editors. Fertility and Assisted Reproductive Technology (ART): Theory, practice, policy, and research for health care professionals. New York, NY: Springer Publishing Company; 2016. p. 295-309.
  27. Hjelmstedt A, Widström A, Wramsby HM, Collins A. Patterns of emotional responses to pregnancy, experience of pregnancy and attitudes to parenthood among IVF couples: a longitudinal study. J Psychosom Obstet Gynaecol. 2003;24(3):153-62.
Journal of Reproduction & Infertility
Volume 18, Issue 1
Winter 2017
Pages 190-196