Psychological aspects of infertility due to various causes--prospective study

One hundred and twenty infertile couples (30 each among unexplained infertility, anovulation, tubal factor, and male factor groups) and 30 fertile couples as controls were evaluated for psychological assessment by different psychological test instruments. Initial evaluation was done at recruitment, followed by reassessment at 3, 6, 9 and 12 months during the infertility work-up, and at the end when the specific diagnosis and the management and prognosis were disclosed.

Psychological components were found to play a significant role in infertility of unknown etiology, especially in the male partner. They affected the personality and social behavior of the male partner and caused anxiety, but led to depression in the female partner. In cases of organically caused infertility, partners were worried about the other's reaction. Anxiety was significantly greater in the partner with the fertility problem than in the other partner. Life events were significant in the partner in whom the fertility problem was detected. Periodic psychological assessment was not affected by infertility work-up on the male partner in any of the groups, whereas anovulation and tubal factor infertility showed a significant psychological effect on the female partner at the end of work-up. Depression and anxiety in the female partner were evident soon after the investigation started.