Abstract
Purpose:Since the Austrian propagation bill of July 1, 1992, was passed into law, Austrian physicians are committed to offer psychological counseling to women before performing assisted reproductive techniques, unless refused by the patient. The acceptance of psychotherapeutic counseling (PSITCO) and its influence on pregnancy rate were carefully reviewed.
Methods:The study comprised 1156 consecutive patients (mean age, 33.3 years) and 1736 in vitro fertilization (IVF) cycles. In a consent form for follicle puncture, the patients were interviewed about PSITCO as follows. Several methods of psychological support during IVF–embryo transfer treatment were offered to patients especially psychotherapy, hypnotherapy, and relaxation and physical perception exercises.
Results:Forty-two and three-tenths percent of patients rejected PSITCO, 17.8% had already received PSITCO, and 10.4% were willing to undergo PSITCO. The acceptance of PSITCO had no relevance on pregnancy rate. The cumulative calculation of pregnancy rates showed that up to 56.4% of women who had undergone PSITCO conceived. In patients who were planning to undergo PSITCO, the pregnancy rate was 41.9%. Concerning the cumulative pregnancy rate, this study showed that patients who accepted or underwent PSITCO had a higher pregnancy rate than those who did not avail themselves of this possibility.
Conclusions.These results should encourage sterility specialists to consider psychological therapy as an essential aspect of IVF. Solely a written declaration of the patient stating his/her awareness of the possibility to undergo PSITCO is, in our opinion, insufficient.
Keywords: in vitro fertilization–embryo transfer, psychotherapeutic counseling, pregnancy rate, vaginal follicle puncture
Full Text
The Full Text of this article is available as a PDF (551.0 KB).
REFERENCES
- 1.Beaurepaire J, Jones M, Thiering P. Psychosocial adjustment to infertility and its treatment: Male and female reponses at different stages of IVF/ET treatment. J Psychosom Res. 1994;38:229–240. doi: 10.1016/0022-3999(94)90118-x. [DOI] [PubMed] [Google Scholar]
- 2.Bernt WD, Bernt H, Scheunemann P. Zur Rolle der Angst als psychologischer Kofaktor bei invasiver Sterilitätsbehandlung. Zent Gynäkol. 1989;111:1220–1223. [PubMed] [Google Scholar]
- 3.Boivin J, Takefman JE. Stress level across stages of in vitro fertilization in subsequently pregnant and nonpregnant women. Fertil Steril. 1995;64:802–810. doi: 10.1016/s0015-0282(16)57858-3. [DOI] [PubMed] [Google Scholar]
- 4.Brandt KH, Zech H. Auswirkungen von Kurzzeitpsychotherapie auf den Erfolg in einem In-vitro-Fertilisierung/Embryo-transfer-Programm. WMW. 1990;1/2:17–19. [PubMed] [Google Scholar]
- 5.Brandt KH, Zech H. Ergebnisse einer Prognosestudie für In-vitro-Fertilisierung nach Kurzpsychotherapie. Geburtsh Frauenheilk. 1992;52:297–300. doi: 10.1055/s-2007-1023752. [DOI] [PubMed] [Google Scholar]
- 6.Callan VJ, Hennessey JF. Emotional aspects and support in in vitro fertilization and embryo transfer programs. J Vitro Fertil Embryo Transfer. 1988;5:10–14. doi: 10.1007/BF01132180. [DOI] [PubMed] [Google Scholar]
- 7.Connolly KJ, Edelmann RJ, Bartlett H. An evaluation of counsel-ling for couples undergoing treatment for in-vitro-fertilization. Hum Reprod. 1993;8:1332–1338. doi: 10.1093/oxfordjournals.humrep.a138252. [DOI] [PubMed] [Google Scholar]
- 8.Feichtinger W. Environmental factors and fertility. Hum Reprod. 1991;6:1170–1175. doi: 10.1093/oxfordjournals.humrep.a137505. [DOI] [PubMed] [Google Scholar]
- 9.Harlow CR, Fahy UM, Talbot WM. Stress and stress-related hormones during in-vitro fertilization treatment. Hum Reprod. 1996;11:274–279. doi: 10.1093/humrep/11.2.274. [DOI] [PubMed] [Google Scholar]
- 10.Kemeter P. Studies on psychosomatic implications of infertility—Effects of emotional stress on fertilization and implantation in in-vitro fertilization. Hum Reprod. 1988;3:341–352. doi: 10.1093/oxfordjournals.humrep.a136706. [DOI] [PubMed] [Google Scholar]
- 12.Lindheim SR, Legro RS, Morris RS. Altered responses to stress in women undergoing in-vitro fertilization and recipients of oocyte donation. Hum Reprod. 1995;10:320–323. doi: 10.1093/oxfordjournals.humrep.a135935. [DOI] [PubMed] [Google Scholar]
- 13.Mazure CM, Greenfeld DA. Psychological studies of in vitro fertilization/embryo transfer participants. J Vitro Fertil Embryo Transfer. 1989;6:242–255. doi: 10.1007/BF01132873. [DOI] [PubMed] [Google Scholar]
- 14.Merari D, Feldberg D. Psychological and hormonal changes in the course of in vitro fertilization. J Assist Reprod Genet. 1992;9:161–169. doi: 10.1007/BF01203757. [DOI] [PubMed] [Google Scholar]
- 15.Newton CR, Hearn MT, Yuzpe AA. Psychological assessment and follow-up after in vitro fertilization: assessing the impact of failure. Fertil Steril. 1990;54:879–885. doi: 10.1016/s0015-0282(16)53950-8. [DOI] [PubMed] [Google Scholar]
- 16.Seibel MM, Boivin J, Greenfeld DA.Controversies in assisted reproduction J Assist Reprod Genet 199714181–188.9130062 [Google Scholar]