Minimising the negative psychological effects of infertility for all patients requires effective help and strategies from all members of the multidisciplinary team in a fertility service. Dr Marta Jansa Perez, Director of Embryology at Bridge Clinic London, highlights the importance of the patient’s psychological health.
Infertility can be a very stressful and psychologically complex. Difficulties conceiving and fertility treatment can affect the mental health of patients. The World Health Organisation states that 1 in 6 people globally are affected by infertility and most encounter problems such as social isolation, stigma, and stress, with women more often being made responsible for the fertility problems than men.
Although IVF treatment is successful in a proportion of the patients, stress from the process including the possibility of treatment failure can trigger significant mental health issues. Minimising the negative psychological effects of infertility for all patients requires effective and efficient help and strategies from all members of the multidisciplinary team in a fertility service.
The every day, emotional impact
Although infertility is generally caused by at least one physiological cause, the psychological effects of multiple treatments, which are often required, can result in stress, fear, strained relationships, and mental health issues such as depression and anxiety. At the heart of all these challenges are family, friends, and clinical staff that can inadvertently cause further stress to patients by exposing them to constant reminders of their condition through treatments or other interventions.
The importance that society places on childbearing can contribute to the pressure that patients have to grapple in their daily lives as they undergo treatment. At a practical level, they need to reconfigure their lives due to stimulation cycles, clinic appointments, and medication as well as changes in activity levels, mood, sleep, and social engagement.
The financial cost
An additional pressure is the financial cost, as most patients have to pay for their own treatment, which can be very expensive, especially if they require several cycles. Indeed, diagnosis and treatment of infertility remains underfunded and inaccessible to many patients due to high costs. According to the latest figures from the Human Fertilisation and Embryology Authority, the use of private funding by patients across the UK aged 18-34 has continued to increase with 63% of IVF cycles funded privately in 2021. The physical demands of IVF treatment alone are challenging but affordability poses a further barrier with patients having to invest significant financial resources into procedures that might not be successful.
Individuals who cannot afford these costs might miss out on treatment all together. Limited support and evidence-based information, combined with the stigma around discussing IVF, means patients may waste time and money on unhelpful consultations and unnecessary tests and/or treatments. The devastating effect of negative pregnancy outcomes can then become multiplied in the face of financial difficulties.
Finding and providing the right support
Accessible, UK-based options are needed to support fertility patients, including a high-quality care provider that can also provide up-to-date knowledge and evidence-based treatments that patients require to make informed decisions. This includes informing patients on all the options available to them throughout the process and giving patients realistic expectations of IVF success and failure. Not only patients then begin the process properly informed, but it offers them the opportunity to discuss and prepare for grief and sadness as well as for the possibility of success. Specialised fertility counsellors are key to a patient centered fertility service and a great resource to provide patients with the specific support they need at different stages. Also, offering transparent treatment costs avoids any surprises further down the line and provides patients with the option of realistically budgeting for their treatment.
Accessible and transparent fertility care providers are important to support patients who desperately need access to affordable high-quality fertility care. Other specialist interventions that might help patients get through treatment could also include advice on relaxation techniques, stress management, coping skills training, and group support. In cases where patients require psychological treatment, a referral for a psychological assessment might be required. Most importantly, ensuring that state-of-the-art optimised treatment is given to each, and every patient can mitigate some of the stresses whilst undergoing IVF treatment.
Building this trust between clinic and patient through these means no doubt improves patient care. In the treatment of infertility, sometimes the mental stress of the process is overlooked, but it is important that the patient’s psychological health is not left out in this field. In the management of infertility, as with any other health condition, the patient needs to have support during and after treatment, irrespective of its outcome. Ultimately, this is about putting the patients’ needs at the centre of what we do as fertility professionals to ensure they can manage both the journey and the outcome of their treatment.