Tuesday, 5 May 2015

Psychological impact of infertility on couples


When I came back from my short holiday, the staff told me, “Madam, yesterday also she called and shouted over phone, she is using bad words”. This scenario of the patient losing temper and using verbal abuse on staff is not very common in the field of infertility, but it is not very rare either. The person is not being rude because of her personality or because of any medical negligence on our part. It is quite natural to have psychological disturbances, especially in women due to the social pressure, when they are unable to bear a child.

If you think this happens only in conservative societies, then you are mistaken. Studies prove that psychological problems are common in infertile couple all over the world irrespective of caste, creed or financial background. The stress due to the non-fulfillment of the wish to parenthood has been associated with anger, depression, anxiety, marital problems and feelings of worthlessness. The extreme anxiety to conceive, ironically increases sexual dysfunction and social isolation. Marital discord often develops in infertile couples, especially when they are under pressure to make medical decisions.

As one would expect, male and female partners respond differently to this situation. Women show higher levels of distress and anxiety than their male partners in most cases. Exceptions are found, when the reason is a male infertility problem like azoospermia.

A number of studies have examined stress and mood state, as predictors of outcome in assisted reproduction techniques. Most of these researches support the theory that stress and depression is directly linked with lower success rates among women pursuing infertility treatment. I have personally found this true in my clinical practice. Generally I have observed that happy to go lucky and relaxed patients, who do not have much pressure on them seems to get pregnant easily with IVF / ICSI or even with IUI. The success rates of patients who are under stress, social pressure or negative in their thinking seems to be low and they often have to undergo multiple attempts, before getting a positive result.

On the other hand psychiatric diseases like depression can cause infertility. Depression could directly affect infertility due to the physiology of the depressed state which is characterized by elevated prolactin levels, disruption of the hypothalamic-pituitary-adrenal axis and thyroid dysfunction. The result is these women or men do not produce eggs or sperms as required.

Infertility can produce psychological problems and vice versa, hence it can be concluded that mental well being is a prerequisite for success in Assisted reproductive techniques like IVF or ICSI. Stress and negative behavior can reduce chances of pregnancy in ART.
How to Reduce psychological trauma:

1. Proper financial planning 
2. Early and proper scientific investigations
3. Good counseling and consultation
4. Step up treatment methods 
5. Continuation of work and social life 
6. Avoidance of unnecessary interference by relatives
7. Most importantly SUPPORT FROM PARTNER

Above all, the patient will need tolerant doctor /staff, who can understand their state of mind and put up with their tantrums.

Dr. Anita Mani
Infertility& Surrogacy Specialist at Gift IVF Centre



Dr. Anita Mani is a renowned infertility specialist in south India with 15 years experience in ART (Assisted Reproductive Technology). Dr. Anita has successfully set up ART hospitals in Cochin and Bangalore, along with her spouse Dr. S Mani, who specialises in surrogacy. She completed MRCOG, from Royal College of Obstetrician and Gynaecologist London, DFFP from ART Warwick university and worked in UK for 5 years. Dr. Anitha believes in scientific and ethical practice and is currently the director of Gift Gyno IVF centre Cochin and Bangalore. Apart from advanced laparoscopic surgeries, she is also an expert in various ART techniques including IVF, IUI, ICSI , donor egg / sperm and surrogacy. Her proficiency is in genetic abnormalities and high risk pregnancies.

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