1. CHAPTER 14: The Stress of Infertility

2. Introduction and Significance Infertility is estimated to affect 10% to 15% of U.S. couples. Definition: – Failure to become pregnant after one year or more of unprotected intercourse, or six months if over 35 years old – Includes women who are able to get pregnant but unable to stay pregnant or carry pregnancy to full term

3. Introduction and Significance Treatment choices are available for infertility patients: – Medical – Surgical – Psychological – Assisted reproductive technology (ART) In vitro fertilization (IVF)

4. Lifestyle Factors That Impact Infertility and Its Treatment Exercise, BMI, Nutrition Acupuncture and Complementary Medicine Alcohol Nicotine Psychiatric Disorders

5. Psychiatric Disorders Secondary to Infertility 30.8% of females and 10.2% of males undergoing IVF treatment were found to have a psychiatric disorder. – Anxiety disorders – Major depression

6. Psychological Factors Primary to Infertility When psychological factors precede and possibly contribute to infertility, they are called factors primary to infertility. – Stress – Personality disorders We cannot conclusively make causal statements about primary psychological factors and infertility.

7. Social Support and Relationship Quality Level of social support and relationship quality can predict women’s response to infertility. Healthy, communicative relationships and meaningful social support networks may be protective in terms of women’s psychological distress as a result of infertility.

8. Impact of Psychological Interventions for Infertility Common therapies include: – Cognitive-behavioral therapy – Behavioral modification – Relaxation training – Group support

9. Race, Ethnic, and Socioeconomic Differences Biological differences Differences in access to and use of care Differences in the psychosocial experience of infertility

10. Future Directions Improved methodological rigor More study of ethnically and culturally diverse populations More study of physician-patient relationship More opportunities for psychological treatments