Fertility treatments may put women at risk for PTSD symptoms, study suggests

Rachael Rettner
MyHealthNewsDaily

Women who undergo fertility treatments may find the situation so distressing that they develop post-traumatic stress disorder (PTSD), a new study says.

In the study, close to 50 percent of participants met the official criteria for PTSD, meaning they could be diagnosed with the condition.

That's about six times higher than the percentage of people in the general population who suffer from PTSD (8 percent.)

The findings suggest the definition of PTSD may need to be changed so that its causes include potentially traumatic experiences such as infertility, said study researcher Allyson Bradow, director of psychological services at Home of the Innocents, a nonprofit organization that helps families in need in Louisville, Ky.

Currently, the definition of PTSD says people must have experienced or witnessed a life-threatening event, or event that could cause serious injury.

"The definition of trauma should be expanded to include expectations of life," said Bradow, who went through fertility treatments herself, and conducted the study as a doctoral student at Spalding University in Louisville. "Having children, expanding your family, carrying on your genetic code — that's an instinctual drive that we have as human beings. And when that is being threatened, it's not necessarily your life being threatened, but your expectation of what your life can be or should be like," she said.

The finding also shows that a greater effort should be made to counsel those who go through fertility treatments, to help them cope with the emotional and psychological effects of the experience, Bradow said.

Coping with infertility
Bradow had her first child without any trouble at age 26. But when she and her husband tried to conceive a second child several years later, they were not able to. The couple was diagnosed with secondary infertility, which refers to infertility experienced after a couple has a child.

"The general diagnosis of infertility, or not being able to have a baby, is kind of this giant earthquake that rocks your world. And then, there's all the aftershocks," of fertility testing and treatment, Bradow said.

Bradow said the symptoms she experienced during fertility treatment went beyond those of depression and grief, conditions previously linked to fertility treatment. Others she spoke with felt the same.

To find out how widespread these feelings were, Bradow and colleagues surveyed 142 people who had undergone fertility treatments, and who visited online support groups for infertility. Survey participants — 97 percent of whom were women — completed an online survey to assess their symptoms of PTSD. They were asked to consider their infertility diagnosis and fertility treatment as their traumatic event.

About a third of participants had been trying to conceive for one to two years, and about 60 percent had undergone fertility treatments for more than a year.

Overall, 46 percent met the criteria for PTSD. Among this group, 75 to 80 percent said they felt upset at reminders of their infertility, such as seeing commercials for baby diapers. Other common symptoms included feeling distant or cut off from people, or feeling irritable. Many also said they felt hopeless, and had changes in their personality.

Need for counseling
During her treatment, Bradow said no one mentioned anything about how it would affect her emotionally or psychologically.

"They're focused on getting you pregnant…and that's their job," Bradow said. "But we also have to consider the psychological impact of what happens when you're getting medical interventions for this," Bradow said. She eventually became pregnant again, through artificial insemination, and had her second daughter at age 31.

Ideally, Bradow said, mental health counseling should be a required part of fertility treatment. However, this may be a long way off, partly because fertility treatment is not usually covered by health insurance, and doctors may be reluctant to give their clients an extra cost, Bradow said.

Bradow presented her findings last week at the American Psychological Association meeting in Orlando, Fla.

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Discuss this post

The number of things defined as a psychological ailment/disorder/illness is getting ridiculous another 2-3 decades and having a thought of "fill the blank" will be considered an illness in need of a pill.

There is a thing called life. It's stressful, it doesn't always meet expectations. One can buckup and face it head on or they can fold and say poor pitiful me. Our culture today encourages the second as it increases decadency on others (read gov't).

As a person who is Bi-polar and successfully un-medicated for many years now (and yes I still have all the symptoms), I have learned I can do one of 2 things when it comes to the mood swings; give in to the "feelings" (submit) or I can face them and let them flow over me (fight). I have learned that I am not responsible for the problem I am however responsible for what I do with it.

I can choose to be a victim or a survivor. Today I am a survivor and I will not let my broken default brain chemistry control me. I am a rational human being capable of making choices and today I choose how I feel even when my subconsciousness tries to tell me otherwise.

  • 5 votes
Reply#1 - Wed Aug 8, 2012 3:36 PM EDT

As a women who has struggled with infertility, I can attest that the struggle can take a horrible toll on your mind, body and spirit.

It has been a long struggle and after losing 2 babies and nearly dying from a ruptured ectopic pregnancy, I have had to come to terms with the fact that I will never give birth to my own biological child.

I invite anyone who doesn't believe that these kind of experiences can cause a great deal of trauma to walk a mile in my shoes.

    Reply#2 - Fri Aug 10, 2012 8:38 AM EDT

    Of course it can cause sadness or loss of expectations but PTSD? Please people. Why is it so important for folks to carry on so called genetic code? Unless you are an Eistein or something, in most cases peoples offspring are average. Life is full of stressors and does not always work out the way we want. Next you will have infertile women and men seeking compensation to cover the ptsd.

    • 2 votes
    Reply#3 - Mon Aug 13, 2012 12:17 AM EDT

    Please ming-315743, why don't you enlighten me with YOUR personal experience on the subject.

    Next, you will have all sorts of people that have no experience or expertise giving there opinion on a subject they no NOTHING about.

    It never ceases to amaze me the lack of compassion or understanding that people have in this day and age.

      #3.1 - Tue Aug 14, 2012 12:19 PM EDT
      Reply

      Nobody wants to jump on the PTSD "bandwagon" and anyone who thinks we would want to is a moron. It took us 8 yrs to get my precious child and we tried for 4 more yrs for #2. The first one was 2yo before I fully mentally accepted that I am finally a mom and nothing bad is going to happen to take this away from us. I didn't need this study to know I have PTSD and am dealing with it on my own. I am glad that IF is getting some validation that is so traumatic, losing a baby is traumatic, having your body fail you month after month is traumatic. Being socially alienated is traumatic. Mother's day was hell. Stop judging something you have NO IDEA about and no first hand experience with.

      • 1 vote
      Reply#4 - Tue Aug 21, 2012 1:51 PM EDT

      I have to say that I am extremely disappointed in this article. As a psychologist, I conduct diagnostic evaluations on a daily basis. PTSD is a specific constellation of symptoms and does not result from every experience of trauma. The statement, "The definition of trauma should be expanded to include expectations of life," said Bradow," is not only disappointing to hear but factually incorrect. The actual criteria A for PTSD is a)the person witnessed or was confronted with an event that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others and b) the person's response involved intense fear, helplessness or horror (direct quote from the DSM-IV-TR). THIS is the criteria for PTSD and as much as Bradow would like to change the criteria and expand it to "life expectations" she does not have the authority to do so. That would be like a medical doctor deciding that he/she wants to change the criteria for cancer or the flu. There are other conditions that might aptly capture what women going through fertility treatments are experiencing – something like Adjustment Disorder. But studies/articles like this serve to only overpathologize us rather than accept that as humans we have a full range of emotions – and some of those emotions are really unpleasant. I do agree with one point and that is that women who are going through fertility treatment should be encouraged to seek counseling/therapy – it's always good to have someone to talk to when we are going through rough times and having someone who objective and not so emotionally tied to the situation can be especially helpful. Sorry for my "rant" but I think that people should be informed – PTSD is a very serious diagnosis and unfortunately it seems that mental health diagnoses in general are being applied to people without much thought to the actual criteria for diagnosis.

      • 2 votes
      Reply#5 - Thu Aug 30, 2012 9:58 AM EDT

      Three thoughts:

      1) Perhaps if infertility were seen as a serious condition (as evidenced by remarks like, "who cares about passing on your genes? There are plenty of kids waiting to be adopted", and "Hey, at least not having children isn't gonna kill you, like cancer or heart disease"), women wouldn't be as reluctant to admit they are having trouble conceiving and thus it would be more out in the open than it is.

      2) All the hormonal manipulation involved with conception/pregnancy can wreak havoc with anyone's mental health; how was this accounted for in the study?

      3) Half of all fertility issues are either "non-specified" (meaning there is no discernible reason for the infertility) or due to issues with the male. Did the women who fell into these categories suffer the same PTSD symptoms as those who were diagnosed with a reason for the infertility?

        Reply#6 - Sun Sep 2, 2012 10:18 PM EDT

        I don't even need to be a woman to know that no matter how traumatic being unable to have children of your own is, it's not in the same league as being violently raped or seeing a friend's head explode like a watermelon. Stop freaking pathologizing every single negative emotion or life experience, the fact that it hurts like hell doesn't mean it's mental illness.

          Reply#7 - Wed Sep 5, 2012 12:36 AM EDT

          I have learned to ignore the adoption advocates. They have no idea how hard adoption is, how expensive it can be, and how unattainable it is for certain people.

          Those of us living with infertility are living most people's worst nightmare. They're right, infertility won't kill you; you'll just wish you were dead. That said, maybe infertiles don't have PTSD but it's the closest thing in our vocabulary that explains what it's like. If you disagree, my guess is you've never personally experienced your baby dying every month for years on end.

          • 1 vote
          Reply#8 - Tue Sep 18, 2012 11:17 AM EDT

          Perhaps PTSD isn't exactly the right term to use. Much of the stress while dealing with infertility occurs during and for a few years after resolution. (Resolution can be success in achieving pregnancy and live baby, adoption, or the decision to remain childless.)

          I experienced both primary and secondary infertility and can relate to the things others have said about the experience. As agonizing as the situation is, having people who view it as a "minor inconvenience...not life and death" doesn't help.

          During infertility treatments, your life is built around a schedule of doctors, medical procedures, tests, and treatments. Hope can be seen on ultrasound each month only to end in yet another disappointment. The emotional roller coaster is horrible but the woman is often going through medications and medical procedures that are invasive and can have side effects that include physical, emotional, and the family and friends she would turn to for other stressful life events (cancer, death of loved one, etc.) often don't understand the depth at which infertility affects a woman and a couple, don't know how to offer encouragement, are afraid to give false hope, and begin to distance themselves from the woman as if for self-protection from living the ups and downs of this situation with her.

          Perhaps infertility could have a different lable regarding the emotional stress a couple goes through. Perhaps something like PROLONGED Stress Syndrome.

          Even after giving birth to my second child, I experienced a few years where I would feel a sense of "why?" and "What if?" whenever I would see a parent with a baby or toddler.

          There are plenty enough things that an infertile couple must deal with, they do not need others telling them how they should feel or having to defend themselves for the choices they take in seeking to remedy their situation. After all....the couple who had several kids without trying were free to make THEIR choice to do so.

            Reply#9 - Thu Dec 6, 2012 2:02 PM EST

            Great post!!! Seriously how I feel, we had only secondary IF, but it sucks and yes, after 2 years and countless invasive treatments, we got our baby, (he's 5 months now) but it still stings when I see people get pregnant easily or have several kids close in age, etc. I figure eventually it'll get better (it is already than before) but it'll take a while.

              #9.1 - Wed Mar 13, 2013 10:43 PM EDT
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                Reply#10 - Wed Mar 13, 2013 10:43 PM EDT
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