Around one-third of couples who embark upon fertility treatment are not successful in their endeavor, leaving them to adjust to an unfulfilled child-wish. Now, a new study published in the journal Human Reproduction suggests women who have difficulty accepting that they will not conceive a child after fertility treatment have worse long-term mental health than those who are able to let go of their desire to reproduce.
Researchers from the study, led by Dr. Sofia Gameiro of the School of Psychology at Cardiff University in the UK, say theirs is the first to use a large group of women to assess the different factors that could affect mental health a decade after unsuccessful fertility treatment.
“It was already known that people who have infertility treatment and remain childless have worse mental health than those who do manage to conceive with treatment,” says Dr. Gameiro. But she adds that previous research did not consider other factors for why this is.
As such, for their study, the researchers included other circumstances, such as whether or not they have children, whether they still want children, their diagnosis and medical treatment.
To conduct their research, the team – which included colleagues from the Netherlands – analyzed questionnaire answers from over 7,000 women who initiated fertility treatment at hospitals in the Netherlands between 1995-2000.
Because the questionnaires were sent to the women between January 2011-2012, their last fertility treatment would have been between 11-17 years prior to answering the questionnaire.
The questionnaire inquired about age, marital status, education, menopausal status, whether the infertility was due to them, their partners or both, and what fertility treatment they had received. They also completed a mental health questionnaire that asked how they felt during the past 4 weeks.
In addition to the questionnaires, the researchers asked the women whether they had children, and if so, whether they were biological or adopted, as well as whether they still wished for children.
Though the majority of women had accepted the failure of their fertility treatment, the researchers found that 6% of them still wanted children at the time of the questionnaire, and this coincided with worse mental health.
In fact, Dr. Gameiro notes that the women who still wanted to have children were up to 2.8 times more likely to have mental health problems than those women who had accepted their circumstances.
She further explains:
“The strength of this association varied according to whether women had children or not. For women with no children, those with a child-wish were 2.8 times more likely to have worse mental health than women without a child-wish.
For women with children, those who sustained a child-wish were 1.5 times more likely to have worse mental health than those without a child-wish. This link between a sustained wish for children and worse mental health was irrespective of the women’s fertility diagnosis and treatment history.”
The findings also revealed that when infertility was due to male factors or had an unknown cause, women tended to have better mental health. Additionally, women who started fertility treatment at older ages had better mental health than those who started younger.
“It is quite striking to see that women who do have children but still wish for more children report poorer mental health than those who have no children but have come to accept it,” adds Dr. Gameiro.
Though their sample size was large and nationally representative, the researchers note a limitation to their study: women without psychological data were less likely to have biological children, and nearly 16% of women who did not respond deemed the questionnaire too confronting or replied that it elicited too many emotional memories.
As such, the researchers say this could have resulted in an underestimation of the proportion of women with a continued child-wish.
The team also says their findings only show that there is a connection between an unfulfilled child-wish and worse mental health, not that the unfulfilled wish is the cause of the mental health problems.
Still, the researchers say their findings show the importance of psychological care for infertility patients and that more attention should be paid to the adjustment over longer periods of time.
Dr. Gameiro concludes:
“We live in societies that embrace determination and persistence. However, there is a moment when letting go of unachievable goals (be it parenthood or other important life goals) is a necessary and adaptive process for wellbeing. We need to consider if societies nowadays actually allow people to let go of their goals and provide them with the necessary mechanisms to realistically assess when is the right moment to let go.”
Medical News Today recently wrote a spotlight feature investigating whether infertility is primarily seen as a woman’s problem.