Effect of anxiety and depression levels on pregnancy outcome

Pinarbasi, Filiz Demirhan; Basar, Fatma; Oguc, Ahmet Fatih

doi:10.1590/1806-9282.20230922

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Revista da Associação Médica Brasileira

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ORIGINAL ARTICLE • Rev. Assoc. Med. Bras. 70 (2) • 2024 • https://doi.org/10.1590/1806-9282.20230922 copy

Effect of anxiety and depression levels on pregnancy outcome

Authorship SCIMAGO INSTITUTIONS RANKINGS

SUMMARY

OBJECTIVE:

The aim of this study was to determine the effect of anxiety and depression on pregnancy outcome in couples receiving in vitro fertilization treatment.

METHODS:

A total of 102 couples (102 females and 102 males) with unexplained infertility were included in the study. Personal Information Form was used to collect data, Case Follow-up Form to record the treatment process, and Spielberger’s State-Trait Anxiety Inventory and Beck Depression Inventory to measure the anxiety and depression levels of couples. Couples were measured twice: before treatment and on oocyte pickup day.

RESULTS:

There was no statistically significant difference between the anxiety and depression levels and oocyte count of women (p>0.05). There were statistically significant differences between State-Trait Anxiety Inventory level and sperm count and between BID level and sperm motility (p<0.05). There was no statistically significant difference between the anxiety and depression levels and pregnancy outcomes of women (p>0.05).

CONCLUSION:

Anxiety and depression had no effect on pregnancy outcome. More studies are needed to investigate the effect of anxiety and depression on pregnancy outcome in unexplained infertility.

KEYWORDS
Infertility; Anxiety; Depression; Pregnancy outcome; In vitro fertilization

Characteristics	Women (n=102)		Men (n=102)
Characteristics	n%		n%
Age (years) Mean±SD	28.58±3.92		31.72±3.91
Educational level
Primary school	8	7.8	10	9.8
Middle school	20	19.6	10	9.8
High school	25	24.5	30	29.4
University	49	48	52	51
Employment status	44	43.1
Employed			100	98
Unemployed	58	56.9	2	2
Duration of marriage^* Frequency distribution of categorical data. *Common data for men and women.
0–1 years	6	5.9	6	5.9
1–5 years	72	70.6	72	70.6
6–10 years	20	19.6	20	19.6
Over 11 years	24	3.9	24	3.9
Duration of ınfertility Treatment^* Frequency distribution of categorical data. *Common data for men and women.
0–1 years	44	43.1	44	43.1
1–2 years	33	32.4	33	32.4
3–5 years	24	23.5	24	23.5
6–10 years	1	1	1	1
Number of IVF trials^* Frequency distribution of categorical data. *Common data for men and women.
First	87	85.3	87	85.3
Second	12	11.8	12	11.8
Fourth	2	2	2	2
Over five	1	1	1	1

Scales	Level	n	Oocyte count	t	p
Scales	Level	n	$\bar{X}$ ±SS	t	p
	Mild (20–39)	64	15.73±8.36	10.10	0.273
STAI-S (pre-treatment )	Moderate (40–59)	38	13.7±9.89
	Mild (20–39)	55	15.12±8.25	0.178	0.859
STAI-S (day of OPU)	Moderate (40–59)	47	14.80±9.83
	Mild (20–39)	36	12.88±8.89	–1.71	0.090
STAI-T^* t: Student’s t-test. *As there were only three women whose trait anxiety scores were at the severe anxiety level, the mean number of oocytes of these women was excluded from the analysis.	Moderate (40–59)	63	16.07±8.94
	No	69	14.37±8.17	–0.98	0.328
BDI (pre-treatment)	Yes	33	16.24±10.46
	No	75	14.20±8.12	–1.47	0.144
BDI (day of OPU)	Yes	27	17.14±10.86
Scales	Level	n	Sperm count (×10⁶) (Pre-treatment)	t	p
Scales	Level	n	$\bar{X}$ ±SS	t	p
	Mild (20–39)	65	28.20±14.10	1.21	0.228
STAI-S (pre-treatment )	Moderate (40–59)	37	24.37±17.24
	Mild (20–39)	36	29.30±15.70	2.42	0.017
STAI-T	Moderate (40–59)	63	21.60±13.33
	No	92	26.44±14.47	–0.73	–0.465
BDI (pre-treatment)	Yes	10	30.20±22.55
	No	92	26.51±12.13	–1.47	0.144
BDI (day of OPU)	Yes	10	31.00±17.81	–1.05	0,293
Scales	Level	n	Sperm count (×10⁶) (Day of OPU)	t	p
Scales	Level	n	$\bar{X}$ ±SS	t	p
	Mild (20–39)	68	27.76±12.76	0.91	0.365
STAI-S (day of OPU)	Moderate (40–59)	34	25.32±12.77
	No	92	26.51±12.13	–1.05	0.293
BDI (day of OPU)	Yes	10	31.00±17.81
Scales	Level	n	Sperm motility (%) (Pre-treatment)	t	p
Scales	Level	n	$\bar{X}$ ±SS	t	p
	Mild (20–39)	65	66.24±12.79	1.078	0.284
STAI-S (pre-treatment )	Moderate (40–59)	37	63.37±13.12
	Mild (20–39)	69	66.21±13.19	1.144	0.255
STAI-T	Moderate (40–59)	33	63.09±12.27
	No	92	66.06±12.64	2.069	0.041
BDI (pre-treatment)	Yes	10	57.30±13.51
Scales	Level	n	Sperm motility (%) (day of OPU)	t	p
Scales	Level	n	$\bar{X}$ ±SS	t	p
	Mild (20–39)	68	68.79±10.93	0.456	0.649
STAI-S (day of OPU)	Moderate (40–59)	34	67.79±9.34
	No	92	69.04±10.26	1.735	0.086
BDI (day of OPU)	Yes	10	63.10±10.57

STAI-S (pre-treatment)	Pregnant (n=60)		Not pregnant (n=42)		Total (n=102)	X2	p
STAI-S (pre-treatment)	n	%	n	%	Total (n=102)	X2	p
Mild (20–39)	38	59.37	26	40,62	64	0.022	0.883
Moderate (40–59)	22	57.89	16	42.10	38	0.022	0.883
STAI-S (day of OPU)	Pregnant (n=60)		Not pregnant (n=42)		Total (n=102)	X2	p
STAI-S (day of OPU)	n	%	n	%	Total (n=102)	X2	p
Mild (20–39)	33	60	22	40	55	0.068	0.794
Moderate (40–59)	27	57.44	20	42.55	47	0.068	0.794
Pregnant (n=57)			Not pregnant (n=42)		Total (n=99)	X2	*p^ X2: chi-square test. As there were only three women with a STAI-T score of severe anxiety, these three individuals were excluded from the analysis.*
STAI-T	n	%	n	%	Total (n=99)	X2
Mild (20–39)	22	61.11	14	38.88	36	0.289	0.591
Moderate (40–59)	35	55.55	28	44.44	63	0.289	0.591
BDI (pre-treatment)	Pregnant (n=60)		Not pregnant (n=42)		Total (n=102)	X2	p
BDI (pre-treatment)	n	%	n	%	Total (n=102)	X2	p
No	39	56.52	30	43.47	69	0.467	0.495
Yes	21	63.63	12	36.36	33	0.467	0.495
BDI (Day of OPU)	Pregnant (n=60)		Not Pregnant (n=42)		Total (n=102)	X2	p
BDI (Day of OPU)	n	%	n	%	Total (n=102)	X2	p
No	42	56	33	44	75	0.933	0.334
Yes	18	66.66	9	33.33	27	0.933	0.334

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[1] * Corresponding author: fatma.basar@ksbu.edu.tr