According to the CDC, about 10 percent of women age 44 and younger, or 6.7 million, have trouble getting pregnant or staying pregnant. Women account for a third of infertility problems and men for another third.
In a session at Health Journalism 2013, Alice D. Domar, Ph.D., executive director of the Domar Center for Mind/Body Health said, “There is no other medical condition that has a negative impact on so many areas of a person’s life like infertility.”
She explained the link between infertility and emotional well being. “As infertility treatment continues, the risk for depression may increase which may reduce the chance for pregnancy.” Domar said, “infertility patients have the same anxiety and depression as HIV patients, cancer and heart disease patients.”
Why do people drop out of fertility treatment? The psychological burden of infertility takes a toll on fertility: the more the depressed patients are before in vitro fertilization is started, the higher the drop-out rate for infertility treatment.
Domar suggests treating the depression before they get IVF treatment. Domar reports “many people fail to fill out depression scale because they don’t want to share the depth of misery they feel, hence they don’t receive treatment for depression.” Domar also said that the more stressed a women is during the infertility treatment, the more likely she will not get pregnant.
Domar suggested behavior cognitive therapy over taking selective serotonin reuptake inhibitors, saying that, while the data is not conclusive, it appears that SSRI’s have a negative effect on fertility. Domar listed the risks of SSRI’s during pregnancy, including birth defects, miscarriage, preterm birth, preeclampsia and smaller fetal growth.
Camille T.C. Hammond, M.D., M.P.H., who leads the Cade Foundation, shared personal stories regarding infertility. Her mother, at age 55, carried Hammond’s triplets. To conceive, Hammond underwent six rounds of IVF.
Aaron A. Styer, M.D., the associate director of the Basic Science Research Program and reproductive endocrinology and infertility fellowship at Massachusetts General Hospital, said the causes of infertility include low sperm count, endometriosis and tubal issues. The prime treatment options include stimulation of eggs, artificial insemination and IVF.
He said that when couples need a surrogate or a gestational carrier, there are many legal issues that have to be considered, such as medical insurance for carriers or surrogate as well as genetic rights. And with same-sex marriages now legal in some states, those couples need to be sure who their state “identifies” as the parent.
Styer identified one of the main efforts in infertility as reducing multiple births. He said many specialists are looking for the best ways to do that, mainly by transferring fewer fertilized eggs but ensuring those that are transferred are healthy.
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It can definitely become a loop. Infertility = depression = possibly reduced fertility. The depression impacts dads as well as moms. It’s tough to stay afloat sometimes when you’re dealing with this.