Treatment-related stresses and depression in couples undergoing assisted reproductive treatment by IVF or ICSI

The purposes of the study were to compare treatment-related stresses of cou ples undergoing IVF or ICSI treatment (ejaculated, epididymal or testicular spermatozoa) and to identify sex differences and risk factors for depressi on. A one-year cohort of couples was retrospectively sent questionnaires on infertility and treatment-related distress and depression (Depression Scal e, D-S). Two hundred and eighty-one women and 281 men (61% of those eligibl e) were included. As determined by analysis of the medical charts, successf ul couples were more likely to participate. Treatment-related distress was generally higher for women than for men. Treatment by ICSI carried addition al burdens for the men: they reported a greater subjective responsibility f or the infertility, impact of childlessness on daily life, treatment-relate d stresses (particularly for MESA/TESE) and time demands. Ea en when clinic al differences between treatments (e.g. age, previous treatments) were cont rolled statistically, depression scores did not differ. Independent of the treatment, women were significantly more depressed than their age-matched f emale controls from the general population and their husbands. The men only reported marginally elevated depression scores compared to their controls. Meaningful characteristics were identified that could guide clinicians to give psychological support to those couples at risk for depression, e.g. an unsuccessful treatment outcome, repeated treatment cycles, a low socioecon omic status, foreign nationality, or, for women, a lack of partner support.