Mental Health and Psychosocial Care · Infertility Distress
RRM Academy Synopsis
Women trying to conceive longer report more stress, less control
Women who had tried to conceive longer reported more stress in this survey of 108 women at an infertility consultation. The authors say fertility centers should consider a mind-body program.
Key Findings
- The authors conclude that fertility centers "should consider" a "mind-body program" for women seeking fertility care.
- Time trying to conceive correlated with stress (r=0.48, p< .001) and with a lower feeling of control over fertility (r=-.21, p= .03).
- 49.1% had been trying to conceive for 12 months or more, and 14% for 2 years or more.
- Interest was high in help with eating (88%), exercise (84.3%) and mental health (75.9%). After the first visit, 46% still wanted direction on these.
- 108 women answered the survey before the visit in 2016-2017. Only 26 answered the follow-up questionnaire.
Interpretation
The published abstract is the only source for this synopsis. The design is a questionnaire survey, so the correlations show association and cannot show that time trying to conceive causes stress. The follow-up questionnaire covers 26 of the 108 women. The abstract describes women only and reports no test of a mind-body program. The conclusions are the authors' recommendations.
RRM Context
Restorative reproductive medicine starts by looking for the cause of infertility in both partners. The authors propose health optimization around fertility care, which shares the restorative aim of working with the body. Stress and control belong in that picture.
Abstract
Objective
The care of infertility patients offers providers the unique opportunity to optimize health in the preconception phase. Assisting women to preemptively achieve a healthier lifestyle may not only improve fertility and pregnancy outcomes, but also diminish the psychological burden of infertility. The study sought to characterize modifiable lifestyle factors within an infertility population and address patient needs for lifestyle-based counseling before and after initial reproductive care consultation.
Design
Survey
Materials and Methods
Patients presenting for an initial infertility consultation responded to a 26-item survey regarding clinical demographics, prior medical care, complementary medicine use, and perception of lifestyle habits and fertility prior to their visit. A follow-up 11-item survey was administered to determine the impact of the initial consultation. Questions were both structured and open-ended. Chi-squared, Spearman’s correlation, Mann Whitney U, Wilcoxon signed rank and McNemar’s tests were used for analysis.
Results
A total of 108 women (35.3 4.67 y) completed the preconsultation survey from 2016-2017; 26 women completed the follow-up questionnaire. Almost half (49.1%) were trying to conceive (TTC) for ≥12 months, with 14% trying for ≥2 years. Time TTC had a strong positive correlation with stress (r=0.48, p< .001) and a negative correlation with feeling control over fertility (r=-.21, p= .03). A longer time TTC correlated with greater likelihood of changing one’s lifestyle to be more fertility friendly (r= .26, p= .006), but those who made lifestyle adjustments also experienced more stress (p< .001). Participants who were up-to-date on their primary medical and dental care felt a greater sense of control (general practitioner: p= .01, dentist: p= .02) and less stress (dentist: p= .005) over their fertility. BMI had a negative correlation with interest in counseling on lifestyle (r= .2, p= .04). Women with a higher BMI were interested in weight management guidance (p= .005), but not in diet or physical activity counseling. Most respondents were interested in guidance on diet (88%), physical activity (84.3%) and mental health (75.9%), and 46% of women still desired direction on these factors after the initial visit.
Conclusions
Prior to initial consultation, infertility patients may experience high levels of stress and feelings of uncertainty. A greater emotional burden is often encountered among women who spend a longer time TTC. Women may feel empowered if providers encourage them to engage with their primary care team earlier and offer methods to optimize their overall health and wellness. These interventions may help to alleviate anxiety and promote women’s sense of control during their infertility treatments. Fertility centers should consider the development of a mind-body program to optimize preconception health and enhance quality of life for women seeking fertility care.
