Effect of anxiety and depression on ART outcome

Background: There is increasing evidence that psychological factors like anxiety and depression can affect IVF/ICSI treatment results. Objective: This study aimed to clarify the role of women’s anxiety and depression on the outcome of ART cycles using Intra Cytoplasmic Sperm Injection (ICSI). Materials and Methods: This was a prospective pilot study. One hundred six (106) consecutive women undergoing ICSI cycles were enrolled between January 2006 and 2007. Age, duration and cause of infertility, number and score of transferred embryos were recorded for each patient. Data regarding the state of anxiety and depression of each volunteer were collected using the translated and validated Iranian Cattle Anxiety and Beck Depression Inventories. Results: Among 106 women enrolled in the study, 25 cases (23.5%) of clinical pregnancies occurred. In univariate analysis, there was no significant difference regarding age and cause and duration of infertility between groups. Number of transferred embryos was significantly associated with higher pregnancy rates (3.4± 1.15 vs. 2.5±1.38 in pregnant and nonpregnant group respectively). Among the 106 participants, 73.58% had anxiety and 30.18% showed various degrees of depression. Out of 28 patients with no anxiety, 21(75%) and out of 74 patients with no depression, 24(32%) became pregnant. There was significant association between depression/anxiety and pregnancy rate (p=0.034 and p=0.00 respectively). Logistic regression model showed that anxiety/depression affect the outcome of ART significantly. Conclusion: It is crucial to identify infertile patients at greater demand for psychological support before starting ART cycles.