Anxiety (DASS21) and the Quality of Life (FertiQol) of Infertile Women Underwent In Vitro Fertilization

Dian Tjahyadi, Bayu Indrayana Irsyad, Ahmad Yogi Pramatirta, Santi Andayani

Abstract


Infertility affects physical and mental health and has various consequences. In vitro fertilization (IVF) is one of the Assisted Reproductive Technology (ART) programs that include several phases, requiring longer time, more patience, and is expensive. This may make women who undergo the ART program to have higher stress level, especially anxiety. This study aimed to determine the relationship between anxiety and quality of life in infertile patients undergoing assisted reproductive technology programs. This was a cross-sectional observational analytic study performed at Aster Fertility Clinic, Dr. Hasan Sadikin General Hospital and Bandung Fertility Center, Limijati Hospital Bandung, Indonesia, from February until April 2020. The analysis was performed using the DASS21 scale and FertiQol count on 27 subjects undergoing the IVF program and 30 control subjects who were pregnant without IVF program. The statistical analyses used to determine the condition of anxiety and the condition of quality of life were the Chi-square and the Mann-Whitney tests, while the relationship between anxiety and quality of life as the main subject was measured using the Spearman correlation test. The anxiety level as measured with the DASS21 instrument in the subject and control groups was 6.2 vs 0.7 with p<0.001. From the analysis of the FertiQol instrument in the subject and control groups, the scores were 79.6 vs. 98.9 for the mind-body domain (p<0.001); 68.8 vs 98.5 for the emotional domain (p < 0.001); 83.2 vs 95.7 for the relational domain (p<0.001); and 77.6 vs 97.6 for the social domain (p<0.001). For the overall FertiQol core domains, the score was 77.3 vs 97.7 (p<0.001). The correlation between anxiety and the FertiQol total core domains were evident from the results of the Spearman correlation test, with an r-value of -0.479 (p<0.001). Therefore, there is a significant negative correlation between anxiety and quality of life.


Keywords


Anxiety; infertility; quality of life

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References


  1. Rutstein SO, Shah IH. Infecundity, infertility, and childlessness in developing countries. dhs comparative reports No. 9. Calverton, Maryland, USA: ORC Macro and the World Health Organization; 2004.
  2. Inhorn MC, Patrizio P. Infertility around the globe: new thinking on gender, reproductive technologies and global movements in the 21st century. Hum Reprod Update. 2015;21(4):411–26.
  3. Riset Kesehatan Dasar (Riskesdas). Badan Penelitian dan Pengembangan Kesehatan Kementerian Republik Indonesia tahun 2013. Available from: http://www.depkes.go.id/resources/download/general/hasil/riskesdas2013.pdf.
  4. Wu MH, Su PF, Chu WY, Huey NG, Lin CW, Ou HT, dkk. Quality of life and pregnancy outcomes among women undergoing in vitro fertilization treatment: A longitudinal cohort study. J Formos Med Assoc. 2020;119(1 Pt 3):471–9.
  5. Lok IH, Lee DT, Cheung LP, Chung WS, Lo WK, Haines CJ. Psychiatric morbidity amongst infertile Chinese women undergoing treatment with assisted reproductive technology and the impact of treatment failure. Gynecol Obstet Invest. 2002;53(4):195–9.
  6. Peterson BD, Newton CR, Feingold T. Anxiety and sexual stress in men and women undergoing infertility treatment. Fertil Steril. 2007;88(4):911–4.
  7. Rooney KL, Domar AD. The relationship between stress and infertility. Dialogues Clin Neurosci. 2018;20(1):41–7.
  8. Depression and Other Common Mental Disorders: Global Health Estimates. Geneva: World Health Organization. 2017.
  9. Greil AL, Shreffler KM, Schmidt L, McQuillan J. Variation in distress among women with infertility: evidence from a population-based sample. Hum Reprod. 2011;26(8):2101–12.
  10. Lazarus RS, Folkman S. Stress, appraisal, and coping. New York, NY: Springer Publishing. 1984.
  11. Zurlo MC, Cattaneo Della Volta MF, Vallone F. The association between stressful life events and perceived quality of life among women attending infertility treatments: the moderating role of coping strategies and perceived couple’s dyadic adjustment. BMC Public Health. 2019;19(1):1548.
  12. Brown TA, Chorpita BF, Korotitsch W, Barlow DH. Psychometric properties of the Depression Anxiety Stress Scales (DASS) in clinical samples. Behav Res Ther. 1997;35(1):79–89.
  13. FertiQoL Description.[Internet] 2019 [cited 2019 December 12]. Available from: http://sites.cardiff.ac.uk/fertiqol/background/
  14. Fallahzadeh H, Zareei Mahmood Abadi H, Momayyezi M, Malaki Moghadam H, Keyghobadi N. The comparison of depression and anxiety between fertile and infertile couples: A meta-analysis study. Int J Reprod Biomed (Yazd). 2019;17(3).
  15. Ramezanzadeh F, Aghssa MM, Abedinia N, Zayeri F, Khanafshar N, Shariat M, et al. A survey of relationship between anxiety, depression and duration of infertility. BMC Womens Health. 2004;4(1):9.
  16. Gameiro S, Boivin J, Peronace L, Verhaak CM. Why do patients discontinue fertility treatment? A systematic review of reasons and predictors of discontinuation in fertility treatment. Hum Reprod Update. 2012;18(6):652–69.
  17. Gameiro S, Finnigan A. Long-term adjustment to unmet parenthood goals following ART: a systematic review and meta-analysis. Hum Reprod Update. 2017;23(3):322–37.
  18. Turner K, Reynolds-May MF, Zitek EM, Tisdale RL, Carlisle AB, Westphal LM. Stress and anxiety scores in first and repeat IVF cycles: a pilot study. PLoS One. 2013;8(5):e63743.
  19. Berg BJ, Wilson JF. Psychological functioning across stages of treatment for infertility. J Behav Med. 1991;14(1):11–26.
  20. Kee BS, Jung BJ, Lee SH. A study on psychological strain in IVF patients. J Assist Reprod Genet. 2000;17(8):445–8.
  21. Vincent K, Warnaby C, Stagg CJ, Moore J, Kennedy S, Tracey I. Dysmenorrhoea is associated with central changes in otherwise healthy women. Pain. 2011;152(9):1966–75.
  22. Boivin J, Takefman J, Braverman A. The fertility quality of life (FertiQoL) tool: development and general psychometric properties. Fertil Steril. 2011;96(2):409–15 e3.
  23. Sexty RE, Griesinger G, Kayser J, Lallinger M, Rosner S, Strowitzki T, et al. Psychometric characteristics of the FertiQoL questionnaire in a German sample of infertile individuals and couples. Health Qual Life Outcomes. 2018;16(1):233.
  24. Xiaoli S, Mei L, Junjun B, Shu D, Zhaolian W, Jin W, et al. Assessing the quality of life of infertile Chinese women: a cross-sectional study. Taiwan J Obstet Gynecol. 2016;55(2):244–50.
  25. Xu H, Ouyang N, Li R, Tuo P, Mai M, Wang W. The effects of anxiety and depression on in vitro fertilisation outcomes of infertile Chinese women. Psychol Health Med. 2017;22(1):37–43.
  26. Terzioglu F, Turk R, Yucel C, Dilbaz S, Cinar O, Karahalil B. The effect of anxiety and depression scores of couples who underwent assisted reproductive techniques on the pregnancy outcomes. Afr Health Sci. 2016;16(2):441–50.
  27. Boivin J, Griffiths E, Venetis CA. Emotional distress in infertile women and failure of assisted reproductive technologies: meta-analysis of prospective psychosocial studies. BMJ. 2011;342:d223.
  28. Ying L, Wu LH, Loke AY. The effects of psychosocial interventions on the mental health, pregnancy rates, and marital function of infertile couples undergoing in vitro fertilization: a systematic review. J Assist Reprod Genet. 2016;33(6):689–701.
  29. Verkuijlen J, Verhaak C, Nelen WL, Wilkinson J, Farquhar C. Psychological and educational interventions for subfertile men and women. Cochrane Database Syst Rev. 2016;3:CD011034.
  30. Chow KM, Cheung MC, Cheung IK. Psychosocial interventions for infertile couples: a critical review. J Clin Nurs. 2016;25(15-16):2101–13.




DOI: https://doi.org/10.15395/mkb.v55n2.2934

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