Stress of infertility, challenges and Interventions-Unmet Needs Of Infertility Remedies !!

Medical interventions may exacerbate anxiety, depression, and stress.
While the causes of infertility are overwhelmingly physiological, the resulting heartache — often exacerbated by the physical and emotional rigors of infertility treatment — may exact a huge psychological toll.

Gender Impact and Human Psyche-

Less research has been done on men's reactions to infertility, but they tend to report experiencing less distress than women. However, one study found that men's reactions may depend on whether they or their partners are diagnosed with infertility. When the problem is diagnosed in their wives or partners, men do not report being as distressed as the women do. But when men learn that they are the ones who are infertile, they experience the same levels of low self esteem, stigma, and depression as infertile women do

Stress of infertility and interventions-

Individuals who learn they are infertile often experience the normal but nevertheless distressing emotions common to those who are grieving any significant loss — in this case the ability to procreate. Typical reactions include shock, grief, depression, anger, and frustration, as well as loss of self-esteem, self-confidence, and a sense of control over one's destiny.

Relationships may suffer — not only the primary relationship with a spouse or partner, but also those with friends and family members who may inadvertently cause pain by offering well-meaning but misguided opinions and advice. Couples dealing with infertility may avoid social interaction with friends who are pregnant and families who have children. They may struggle with anxiety-related sexual dysfunction and other marital conflicts.

There are about 40 ways to treat infertility. About 85% to 90% of patients are treated with conventional methods, including advice about timing of intercourse, drug therapy to promote ovulation or prevent miscarriages, and surgery to repair reproductive organs. Only about 3% of patients make use of more advanced assisted reproductive technology such as in vitro fertilization (IVF). While medical interventions offer much-needed help and hope, studies suggest that they may also add to the stress, anxiety, and grief that patients are already experiencing from infertility itself.

Medication side effects- Drugs and hormones used to treat infertility may cause a variety of psychological side effects. For example, the synthetic estrogen clomiphene citrate, frequently prescribed because it improves ovulation and increases sperm production, may cause anxiety, sleep interruptions, mood swings, and irritability in women. (These side effects have not been documented in men.) Other infertility medications may cause depression, mania, irritability, and thinking problems. Patients and clinicians may find it hard to figure out which reactions are psychological and which are caused by medications — yet identifying causes is essential for determining next steps.

Money worries- In India we dont have insurance coverage for infertility treatment so all burden on pocket of couple so those not being able to obtain treatment may contribute to feeling helpless and hopeless.

Choices and outcomes-Over all, infertility interventions help about half of patients become parents, with the likelihood of success decreasing with age. Patients who learn they are to become parents may be overjoyed, but also must learn to adjust to new roles and pressures — both during pregnancy and after childbirth. Women who have suffered multiple miscarriages, for example, are likely to feel anxious about whether they will be able to carry to term. Older couples may debate whether to undergo prenatal testing such as amniocentesis.

Treatment failure- may trigger a renewed cycle of grieving and distress.

Treatment End Point !!-
It's also difficult to know when to stop seeking treatment. Frequently one partner wants to end treatment before another, which can strain the relationship. Most patients need to gradually, and with great difficulty, make the transition from wanting biological children to accepting that they will have to pursue adoption or come to terms with being childless.

Additional mental health challenges

Case reports and studies using self-report measures indicate that infertile patients feel more distressed than other people. More rigorous research, however, has concluded that — for the most part — rates of anxiety, depression, and other mental health disorders are not greater than in the general population. Patients may experience serious mental health problems on a transient basis, as they deal with the emotional and physical roller coaster typical of infertility treatment.

Infertility treatment can also exacerbate existing psychiatric conditions. Infertile women with a history of depression, for example, are more likely than other infertile women to become depressed during treatment.

Therapies that may help-

Many patients find a way to cope on their own, or they seek support from friends, family, or one of the many infertility support groups now available in person and online. But others need additional help.

Counseling-Referrals for short-term counseling are common — especially to increase coping strategies, or to provide help with making decisions (as patients face many choices during treatment). Patients who experience prolonged changes in mood or sleep patterns or who have relationship problems should seek a more comprehensive evaluation, as these may be signs of anxiety or depression.

Ideally, counseling should begin before patients start infertility treatment, as some studies — though not all — suggest that addressing psychological factors such as depression, anxiety, and stress may help increase the chances of giving birth to a child. Clinicians working with infertile patients can provide information on how to manage fatigue, reduce stress and anxiety, and improve communication with others.

Psychotherapy- Specific types of therapy may also be useful. For example, studies have concluded that interpersonal therapy (which focuses on improving relationships or resolving conflicts with others) and cognitive behavioral therapy (which identifies and tries to change unhealthy patterns of thought or behavior) can give relief to infertile patients suffering from mild to moderate depression. Researchers have shown that psychotherapy can be helpful for anxiety or depression whether delivered individually, to couples, or in a group.

Relaxation techniques-Given that infertility and its treatment often cause considerable stress, experts recommend various relaxation techniques. For example, mindfulness meditation, deep breathing, guided imagery, and yoga promote stress management.

Medications-. Antidepressants and anti-anxiety medications are useful when symptoms are moderate to severe. However, it's wise for women taking psychiatric medication to consider the risks to the developing fetus. Further complicating treatment, some infertility medications can interact with psychiatric drugs It is important for patients and clinicians to weigh all these factors when making medication decisions.