Infertility takes psychological toll on patients

In a study from the Feinberg School of Medicine at Northwestern University, Chicago, researchers assessed the levels of anxiety, depression, and strain on marital relationships of couples being evaluated for male factor infertility.

The results indicated that 56% of the women and 29.8% of the men reported elevated levels of anxiety according to the STAI, and this difference between genders was statistically significant (p=.03). On the CES-D questionnaires, 36.2% of men and 64% of women were above the normal range, consistent with the presence of depression. RDAS scores were 53.1 for men and 53.6 for their female partners-both within the normal range.

"Despite the elevated levels of depression and anxiety, couples did not report an increased strain on their interpersonal relationships," Dr. Russell said.

The second study, from Weill Medical College, Cornell University, New York, under the direction of senior author John Mulhall, MD, focused on how the infertility of either partner affected the quality of life of men specifically. Couples seeking treatment for infertility completed the SF-36 Health Survey and the CES-D. Thirty-nine men, with an average age of 37.5 ±7 years, were included in the sample.

On the Mental Health subscale (MHS) of the SF-36, men in the study reported significantly lower scores compared with those considered normal for the general population (p<.05). Higher SF-36 MHS scores were positively associated with men's age (p<.05) in multivariate analysis. The researchers also observed a trend toward a negative association with being married, but this finding was not statistically significant (p<.10). Based on CES-D results, the data indicated that 23% of the participants had moderate depressive symptoms, and 8% had severe depression.

Presenter and lead author Michael Ohebshalom, MD, said urologists should work with psychiatrists on treatment for depression in men dealing with infertility.

"Men could develop a decreased urge for intercourse and, possibly, even erectile dysfunction as effects of the depression," Dr. Ohebshalom explained.