Mahmut YASSA, Erol ARSLAN, Duru Saygin GULBAHAR

İnfertilite tedavisinin anksiyete ve depresyon düzeyleri üzerine etkisi

Amaç: Bu çalışmamın amacı kadınların depresyon ve anksiyete skorlarıyla en fazla ilişkili faktörlerin ortaya konması ve açıklanamayan infertiliteye sahip primer ve sekonder infertil kadınlar arasındaki olası farkların bulunmasıdır.Gereç ve Yöntem: Bu çalışma 166 primer ve 60 sekonder infertil kadını içeren kontrollü prospektif bir çalışmadır. Bunlar hormonal ya da uterin patholojisi olmayıp açıklanamayan infertilite grubundaydı. Hastalar Beck depresyon envanteri ve Hamilton anksiyete skorlamasını içeren bir anket formunu doldurdular. Bulgular: İki grup arasında anksiyete ve depresyon skorları arasında fark bulunamadı. Alt grup analizileri arasında da sadece şiddetli depresyon sekonder infertil grupta anlamlı derecede daha yüksekti (11/60 ile 10/166,). Hastaların yaşı ile anksiyete skorları ve tedavi deneme sayısı ile depresyon skorları arasında korelasyon olduğu görüldü.Sonuç: İnfertilite tedavisinin kadın sağlığı üzerine fiziksel yan etkileri olduğu kadar onlara psikolojik bir yük de getirmektedir.Belli kültürlerde çocuk sahibi olmak oldukça önemli olsa da yine de infertilite tedavisine başlamış ve daha fazla çocuk isteyen sekonder infertillerde stresi azaltmayabilmektedir. Primer ya da sekonder infertil olmasına bakılmaksızın infertilite tedavisine başlayacak hastaların desteklenmesi onların mizacını olumlu yönde etkilyeceği gibi tedavi başarısını arttırması bakımından da önemlidir.

Anahtar Kelimeler:

Açıklanamayan infertilite, kadın, depresyon, anksiyete

Effects of infertility treatment on anxiety and depression levels

Purpose: In this study, we aimed to show the most related factors with women's anxiety and depression levels as well find out the differences between primary and secondary infertile women with unexplained reason. Materials and Methods: This was a prospective controlled study of 166 primary and 60 secondary infertile women. They had unexplained infertility and had not any hormonal or uterine pathology. Beck Depression Inventory and Hamilton Anxiety Rating Scale were used for questionnaire. Results: While there were not any differences between two groups for anxiety and depression scores as well for subgroups, secondary infertile women showed a higher rate of severe depression than primary infertile women (11/60 vs. 10/166). While patients' age was correlated with anxiety score, number of treatment attempts was correlated with depression score.Conclusion: Infertility treatment does not have only physical side effects but it has also a psychological burden for women. While having a child is very important for some cultures it may not decrease the stress of women who started infertility treatment and wanted to have more. It is important to support the women who undergo infertility treatment whether is primary or secondary infertile, while this affects the patient's mood positively as well may increase the success of treatment.

Keywords:

Unexplained infertility, women, depression, anxiety,

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1- Datta J, Palmer MJ, Tanton C, Gibson LJ, Jones KG, Macdowall W et al. Prevalence of infertility and help seeking among 15000 women and men Hum Reprod. 2016;31:2108-18.
2- National Collaborating Centre for Women’s and Children’s Health (UK) Fertility: Assessment and Treatment for People with Fertility Problems NICE Clinical Guidelines, No.156;2013.
3- Nyboe Andersen A, Goossens V, Bhattacharya S, Ferraretti AP, Kupka MS, de Mouzon J et al. Assisted reproductive technology and intrauterine inseminations in Europe, 2005: results generated from European registers by ESHRE: ESHRE. The European IVF Monitoring Programme (EIM), for the European Society of Human Reproduction and Embryology (ESHRE). Hum Reprod. 2009;24:1267- 87.
4- Kupka MS, Ferraretti AP, de Mouzon J, Erb K, D'Hooghe T, Castilla JA et al. Assisted reproductive technology in Europe, 2010: results generated from European registers by ESHRE Hum Reprod. 2014;29:2099-113.
5- 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.
6- Gameiro S, Boivin J, Dancet E, de Klerk C, Emery M, Lewis-Jones C et al. ESHRE guideline: routine psychosocial care in infertility and medically assisted reproduction-a guide for fertility staff Hum Reprod. 2015;30:2476-85.
7- Winkelman WD, Katz PP, Smith JF, Rowen TS; Infertility Outcomes Program Project Group. The sexual impact of infertility among women seeking Fertility Care. Sex Med. 2016;4:e190-7.
8- Hisli N. A study about currency Beck'sDepression Inventory. J Psychol. 1988;22:118-22.
9- Yazici K, Demir B, Tanriverdi N, Karaagaoglu E, Yolac P. Hamilton anksiyete değerlendirme ölçeği, değerlendiriciler arası güvenirlik ve geçerlik çalışması. Turk Psikiyatri Derg. 1998;9:114-7.
10- Lakatos E, Szigeti JF, Ujma PP, Sexty R, Balog P. Anxiety and depression among infertile women: A cross-sectional survey from Hungary. BMC Womens Health. 2017;17:48.
11- Pinar G, Zeyneloglu HB. Quality of life, anxiety and depression in Turkish women prior to receiving assisted reproductive techniques. Int J Fertil Steril. 2012:6:1-12.
12- Yusuf L. Depression, anxiety and stress among female patients of infertility; A case control study. Pak J Med Sci. 2016;32:1340-43.
13- Chiaffarino F, Baldini MP, Scarduelli C, Bommarito F, Ambrosio S, D'Orsi C et al. Prevalence and incidence of depressive and anxious symptoms in couples undergoing assisted reproductive treatment in an Italian infertility department. Eur J Obstet Gynecol Reprod Biol. 2011;158:235-41.
14- Verhaak CM, Smeenk JM, Evers AW, Kremer JA, Kraaimaat FW, Braat DD. Women's emotional adjustment to IVF: a systematic review of 25 years of research. Hum Reprod Update. 2007;13:27-36.
15- Cousineau TM, Domar AD. Psychological impact of infertility. Best Pract Res. Cl Ob. 2007;21:293-308. 16- Greil AL, McQuillan J, Lowry M, Shreffler KM. Infertility treatment and fertility-specific distress: a longitudinal analysis of a population-based sample of U.S. women. Soc Sci Med. 2011;73:87–94.
17- Reis S, Xavier MR, Coelho R, Montenegro N. Psychological impact of single and multiple courses of assisted reproductive treatments in couples: a comparative study. Eur J Obstet Gynecol Reprod Biol. 2013;171:61–66.
18- Ogawa M, Takamatsu K, Horiguchi F. Evaluation of factors associated with the anxiety and depression of female infertility patients. Biopsychosoc Med.. 2011;5:15.
19- Holter H. Experiences of infertility - From a patient perspective. 2014 Gothenburg, Sweden; University of Gothenburg,
20- Sexty RE, Hamadneh J, Rösner S, Strowitzki T, Ditzen B, Toth B, Wischmann T. Cross-cultural comparison of fertility specific quality of life in German, Hungarian and Jordanian couples attending a fertility center. Health Qual Life Outcomes. 2016;14:27.
21- Epstein YM, Rosenberg HS. Depression in primary versus secondary infertility egg recipients. Fertil Steril. 2005;83:1882-4.
22- Raque-Bogdan TL, Hoffman MA. The relationship among infertility, self-compassion, and well-being for women with primary or secondary infertility. Psychol Women Q. 2015;39:484-96.