Hum. Reprod. Advance Access published online on June 25, 2008
Human Reproduction, doi:10.1093/humrep/den227
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Psychological implications of infertility in women with polycystic ovary syndrome
1 Division of Endocrinology, Department of Medicine, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany 2 Center for Endocrine and Metabolic Diseases, Wuppertal, Germany 3 Department of Medical Psychology and Behavioral Immunobiology, University Hospital of Essen, University of Duisburg-Essen, Hufelandstr. 55, 45122 Essen, Germany 4 Endokrinologikum, Hamburg, Germany 5 Department of Obstetrics and Gynaecology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany 6 Center of Internal Medicine and Dermatology, Clinic for Internal Medicine and Psychosomatics, Charité - University Medicine Berlin, Berlin, Germany
7 Correspondence address. Tel: +49-201-723-4502; Fax: +49-201-723-5948; E-mail: sigrid.elsenbruch{at}uk-essen.de
BACKGROUND: In polycystic ovary syndrome (PCOS), one of the main features is chronic anovulation associated with lower pregnancy rates. Little is known regarding the psychological aspects associated with infertility in these patients. Therefore, we examined the influence of an unfulfilled wish to conceive on various aspects of psychological functioning in PCOS women.
METHODS: Standardized questionnaires assessing quality-of-life (36-item short-form health survey, SF-36), depressiveness (Beck Depression Inventory), emotional distress (Symptom Check List 90, SCL-90-R), sexual satisfaction and self-worth (visual analogue scales), and a questionnaire on the desire for a child (FKW) were administered at the outpatient endocrine clinic to consecutive PCOS patients.
RESULTS: Questionnaires from 115 PCOS patients were analysed. The majority (76.1%) worried about remaining childless in the future, and 51.3% reported a current wish to conceive. 23.9% of patients had scores indicating mild to moderate depression, and 25.2% had scores indicating clinically relevant depression. Furthermore, all quality-of-life scores were significantly lower compared with normative data (P < 0.001). Unexpectedly, comparisons of patients with a current unfulfilled desire to conceive to those with no present wish for a child revealed no discernable impact on depressive symptoms, quality-of-life or emotional distress. Reduced sexual satisfaction and self-worth were largely determined by partnership status and not infertility. However for PCOS patients who wished to conceive, the wish for a child was a significantly greater priority when compared with normative data from infertile patients.
CONCLUSIONS: PCOS represents a major risk factor for psychosocial and emotional problems, but at least in this sample of PCOS patients, infertility does not appear to constitute a primary determinant of psychological problems.
Key words: PCOS/infertility/depression/quality-of-life/sexual satisfaction
Submitted on September 28, 2007; resubmitted on January 24, 2008; accepted on April 28, 2008.