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Psychological health and infertility

Infertility and its treatment is widely recognised as a highly stressful life event, for both women and men.  For this reason, mental health professionals can provide an essential component of infertility treatment.  Unfortunately, while there is widespread agreement regarding the importance and efficacy of mental health support during fertility treatment, it seems that only a minority of patients actually participate in counselling sessions.

The association between stress and general health has been widely demonstrated.  Poorer mental health can influence a patient’s vulnerability to physical illness, as well as their perception of the nature and meaning of symptoms.  Stress is implicated in the cause of a diverse range of physical illnesses and has been found to influence the course and outcome of illness.  A relationship has been clearly demonstrated between stress and fertility rates, and also between stress and success in assisted reproductive technologies.  Higher levels of stress, depression and anxiety have been related to lower pregnancy rates.  Unfortunately, for many couples, stress results from the infertility itself, but often also as a result of its treatment.

There are a number of direct biological mechanisms through which psychological distress might increase the risk of infertility.  These relate to psychoendocrinology (such as elevated prolactin or cortisol levels), psychoimmunicology (such as impaired immune defences) and maladaptive behaviours (such as smoking, alcohol consumption and poor nutrition).  The clearest associations have been demonstrated in regards to the effect of stress altering levels of corticotrophin-releasing hormones and decreasing levels of luteinizing hormones, thereby impacting on fertility. 

Infertility treatment has been demonstrated to contribute to stress, depressed mood, increased rates of anxiety, problems with relationships, feelings of guilt and isolation, social adjustment problems, and sexual dysfunction.  Higher than realistic expectations of treatment success can specifically contribute to the development of depression in IVF patients.  Many studies have demonstrated that the stress associated with infertility treatment is a major cause of patients ceasing intervention.

Fortunately, treatment studies demonstrate that it is possible to reduce stress in individuals diagnosed with infertility.  A range of studies have demonstrated that psychotherapeutic interventions, such as counselling, psychotherapy, hypnotherapy, relaxation, cognitive therapy and cognitive behavioural group interventions can reduce the stress of infertility and its treatment, and even result in improved rates of pregnancy.

If you are concerned that the infertility you are experiencing, or its treatment, is causing you stress, or if you have other significant stress occurring in your life, you may benefit from contact with a counsellor.  Counselling offers the potential to learn more effective strategies for managing your stress,  and an opportunity to problem solve your way through some of these stressors.  The goal of counselling is to improve your general level of emotional and psychological functioning and assist in your goal of creating a family.  For more information, contact ACA for an appointment with the counsellor. 

Narelle Dickinson

Health Psychologist

Suite 9A, Administration Building
Greenslopes Private Hospital
Newdegate Street Greenslopes QLD 4120