Psychological toll of fertility issues lasts for years
Researchers are calling for the inclusion of regular mental health assessments in fertility treatment guidelines and ongoing support after research shows that fertility problems contribute to women’s psychological distress, even if the fertility issues are resolved.
Researchers from the University of Newcastle and the Hunter Medical Research Institute (HMRI) found that half of the women with fertility issues experienced psychological distress compared to women without fertility issues. For women whose fertility issues were resolved, 45 per cent still reported psychological distress.
Lead researcher Dr Tanmay Bagade from HMRI’s Women’s Health Research program said infertility affected millions of people globally and an estimated one in six couples in Australia. In their study, women reporting infertility is steadily increasing in Australia.
“Unfortunately, the societal burden of a couple’s struggle to have a biological child falls disproportionately on women. Women are pressured to have children due to societal and cultural norms, and if they are unable to conceive, I have seen them carry this burden and stigma for a long time,” said Dr Bagade, who is an obstetrician with 16 years clinical experience and who is now dedicated to research reproductive health issues from a women’s rights perspective.
“Infertility is emerging to be a significant but ignored public health and equity issue. Couples with fertility issues might spend several years on an incredibly stressful and expensive journey to conceive using Assisted Reproductive Technology.
“Importantly, our research shows that even when women’s fertility journey is successful, and they have a baby, they continue to experience higher levels of psychological distress than women who didn’t have fertility issues,” Dr Bagade said.
This is the first Australian study to take a longitudinal approach by investigating the changes to women’s mental health over time. The researchers analysed changes to the mental health and fertility status of more than 6,500 women over a period of 18 years.
The women, born between 1973 and 1978, are participants in the Australian Longitudinal Study on Women’s Health (ALSWH). The ALSWH is the largest project of its kind ever conducted in Australia. It follows the changing health and wellbeing of over 57,000 women – some of whom have participated for more than 25 years.
The researchers also found that having a partner, being underweight or overweight, addiction to tobacco smoking, and high-risk alcohol drinking increased the odds of psychological distress in women suffering fertility issues.
Interestingly, women with fertility issues who were in paid employment had significantly lower odds of psychological distress, possibly because they could better afford fertility treatment and associated out-of-pocket costs.
Mental health, and maternal, sexual, and reproductive health, are two of the five priority areas identified in the Australian Government’s National Women’s Health Strategy 2020-2030.
“This research quantifies what women are telling us, and that’s an important step in providing policymakers and health providers with an evidence-base for change,” Dr Bagade said.
“The next step is to strengthen the government policies and clinical guidelines to provide women with equitable access to cost-effective and reliable fertility treatments, and to ensure that they receive regular mental health checks and mental health support.”
The study was funded by HMRI. Journal reference: https://doi.org/10.1038/s41598-022-15064-2
The research on which this media release is based was conducted as part of the Australian Longitudinal Study on Women’s Health by the University of Queensland and the University of Newcastle. We are grateful to the Australian Government Department of Health and Aged Care for funding and to the women who provided the survey data.
* HMRI is a partnership between the University of Newcastle, Hunter New England Health, and the community.
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