Hum. Reprod. Advance Access originally published online on July 22, 2009
Human Reproduction 2009 24(11):2810-2820; doi:10.1093/humrep/dep257
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The impact of social relations on the incidence of severe depressive symptoms among infertile women and men
The Institute of Public Health, University of Copenhagen, 5 Øster Farimagsgade, PO Box 2099, DK-1014 Copenhagen K, Denmark
1 Correspondence address. Tel: +45-35-32-79-92; Fax: +45-35-35-11-81; E-mail: r.lund{at}pubhealth.ku.dk
BACKGROUND: The present study investigates anticipated support and perceived appreciation as well as perceived negative aspects of social relations as determinants of the incidence of severe depressive symptoms among women and men in unsuccessful fertility treatment.
METHODS: A prospective cohort study of consecutively recruited, new couples in fertility treatment completed questionnaires immediately before initiating treatment (T1) and at 1-year follow-up (T2) (response rates 80%, 88%). The study population included 695 participants (355 women and 340 men) who had no severe depressive symptoms at T1, who had no child together at T1 and whose treatment had failed. We measured severe depressive symptoms with Mental Health Inventory 5 from Short-Form 36, functional aspects of general social relations and of infertility-specific social relations.
RESULTS: Fifteen per cent of women and 6% of men in unsuccessful treatment reported severe depressive symptoms at T2. Among men, low emotional support, low appreciation and high excessive demands from the partner were significant determinants of the incidence of severe depressive symptoms. Among women and men, low appreciation from the family, many conflicts and high excessive demands from family, friends and neighbours were significant determinants of severe depressive symptoms. The analyses were controlled for gender. Duration of infertility, infertility diagnosis and socio-economic position did not confound the associations.
CONCLUSIONS: More women than men report severe depressive symptoms after 1 year of unsuccessful treatment. It is important to be aware of the possible negative impact of relational strain among fertility patients in unsuccessful treatment.
Key words: assisted reproduction/depressive symptoms/prospective cohort study/relational strain/social relations
Submitted on February 20, 2009; resubmitted on May 4, 2009; accepted on May 20, 2009.
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