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How Stress Impacts the Decision to Pursue Fertility Treatment

April 11, 2013

A staggering truth is that as many as 14% of couples will have trouble conceiving, and as many as 62% drop out of fertility treatment before having their first child. In light of this statistic, a study published in the April issue of Fertility and Sterility sought to examine the reasons and rate at which couples discontinued fertility treatment. Interestingly, the study focused on male factor infertility cases to get a better sense of the male perspective and role in decision-making regarding treatment.

The study examined the cases of 1,735 French couples who had presented for a fertility workup and treatment between January 2000 and December 2004. The couples had no history of female factor infertility; those with tubal factor infertility or anovulation were excluded from the study. Medical records were examined to determine the type and severity of infertility, types of treatment, and outcomes of treatment cycles within the four year span. Semen samples were collected and graded to test for male factor infertility. Of the 1,735 couples, 1,345 men demonstrated abnormal semen analysis results and 879 of those men agreed to continue with the study. Four hundred and seven couples (48%) dropped out of treatment without having a child. The decision to discontinue treatment was made by the joint couple more often than either partner or a medical professional, and included reasons like:

  • Emotional and physical pain of treatment
  • Poor prognosis or ineffectiveness of treatment
  • Decision to adopt

Few couples cited separation as the reason for dropping out of treatment; many maintained a stable relationship.

It is a well-known fact that fertility treatment imposes physical and emotional stress on couples diagnosed with infertility. The study team theorized that such a high rate of discontinuation due to physical and emotional pain could be due to the male partner’s unwillingness to subject his female partner to such great lengths of treatment because of his own infertility diagnosis. Given the high rate of fertility treatment discontinuity due to emotional burden, these findings suggest a great need for psychological support to help alleviate the stress of fertility treatment.

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