The Effects of Fertility Treatment on Depression, Anxiety, and Marital Satisfactions

Objectives: To evaluate anxiety, depression, and marital satisfaction of couples undergoing fertility treatment. Methods: This was a prospective study of couples presenting for fertility treatment. All couples were provided the General Anxiety Disorder 7-item scale (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Evaluation and Nurturing Relationship Issues, Communication and Happiness (ENRICH) marital satisfaction questionnaires at the initial visit and at each mid-cycle visit. Survey responses were scored using validated methods. Depression and anxiety scores were grouped by severity using published methods. Continuous variables were compared using t-tests; categorical variables were compared using chi-square or Fisher's exact tests. Change in measured anxiety and depression was measured with Jonckheere-Terpstra tests. A repeated measures regression model was used to assess change in marital satisfaction over treatment cycles. Results: Fifty-eight couples enrolled in the study; 18 couples completed at least one treatment cycle. There was no difference in measured anxiety between sexes during any treatment cycle. There was significant increase in female anxiety between baseline and cycle 1 (p=0.0154). A higher proportion of women had mild depression than men at both baseline (p=0.024) and cycle 1 (p=0.045). Neither men nor women had a change in depression severity over treatment cycles. There was no difference in marital satisfaction by sex at any individual treatment cycle. For both sexes, there was no change in marital satisfaction over treatment cycles (p=0.858). Conclusions: Women had an increase in anxiety on initiation of fertility treatment, but measured levels of anxiety, depression, and marital satisfaction remained stable over treatment cycles.