Interrelation and mutual influence of mental health and reproductive function in women with infertility undergoing in vitro fertilization therapy

Infertility, as an emotionally significant and psychologically traumatic factor that threatens the fulfillment of a woman's fundamental biological need for motherhood, has a negative impact on mental health. In vitro fertilization (IVF), while providing a method to overcome infertility, also entails a few neuropsychiatric challenges.

Objective: to assess the dynamics of mental health and reproductive function in women with infertility undergoing IVF treatment, based on longterm follow-up.

Material and methods. The study included 190 mentally healthy women with infertility undergoing IVF treatment, observed over a two-year period. During this time, IVF led to 144 pregnancies (75.79%), of which 45 (31.25%) resulted in live births, while the majority (76.32%) remained infertile. Emotional state was assessed using the Hamilton Depression and Anxiety Rating Scales, before and after the IVF procedure.

Results. Preexisting depression and anxiety were significant risk factors for unsuccessful IVF outcomes. Initially mild depression (63.6%) and anxiety (65.6%) were more common in women whose IVF procedures failed (p≤0.01), with these rates increasing post-failure to 69.7% and 70.7% respectively (p≤0.01). Among women with successful IVF, preexisting depression and anxiety were present in 26.7% and 33.3% respectively. Successful childbirth led to stabilization of emotional state and depression persisted in 6.7% of women and anxiety in 13.3% (p≤0.01). A successful IVF outcome was also associated with increased marital satisfaction and improved spousal relationships (p≤0.01).

Conclusion. Infertility, the burdensome diagnostic procedures and surgeries associated with it, and the psychological strain of IVF-especially after unsuccessful attempts-contribute to the development of depressive and anxiety disorders. These, in turn, negatively affect the chances of conception and pregnancy maintenance, even with assisted reproductive technologies. These psychosomatic interactions must be considered in the diagnosis of infertility and in selecting appropriate treatment strategies.

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