Mental stress in infertility: a tertiary care hospital-based study

Susmita Bhattacharya, Amit Kyal, Payel Mondal, Partha Mukhopadhyay, Mrinalini Chowdhury, Debasubhra Mitra


Background: Most of the couples suffering from infertility report it to be the most stressful and depressing period of their life, more so if it is a primary infertility. Studies regarding the prevalence and role of infertility-specific stress especially in eastern part of India is very limited. The objective of the present study was to estimate the prevalence of infertility-specific stress and its role in marital adjustment in women diagnosed with infertility.

Methods: It was a cross-sectional study done on 80 married couple diagnosed with infertility (both primary and secondary) over 1 year from July 2016 to June,2017. Dyadic Adjustment Scale (DAS), "semi-structured questionnaire" compiled by the authors and "ICD-10 Classification of Mental and Behavioral Disorders (Clinical Descriptions and Diagnostic Guidelines)" were used for the evaluation. The analysis was done using SPSS (version 16) and Chi-square test.

Results: Around 86% infertile women and 21% infertile men were found to suffer from mental stress. Infertility related stress were more in patients with primary infertility than in secondary one. Women mostly (56.5%) coped with stress by self-blaming whereas men (58.2%) by blaming the partner.

Conclusions: Mental stress was significantly associated with infertility. In fact, maladjustment in marital relation caused by the stress adversely affected the conjugal life and thus also the fertility. Proper counselling of both partners might be helpful to solve this problem.


Infertility, Mental Stress, Stress

Full Text:



World Health Organization (2015) Infertility Definitions and Terminology. Available at:

World Health Organization (2016) Global Prevalence of Infertility, Infecundity and Childlessness. Available at:

Mascarenhas MN, Flaxman SR, Boerma T, Vanderpoel S, Stevens GA. National, regional, and global trends in infertility prevalence since 1990: a systematic analysis of 277 health surveys. PLoS Medicine. 2012;9(12):e1001356.

Molid HA, Varaghchi JR. Psychological meta-analysis of the infertility researches in Iran. Iranian J Obstet, Gynecol Infertil. 2012;15(13):26-33.

Cousineau TM, Domar AD. Psychological impact of infertility. Best Practice Res Clinical Obstet Gynaecol. 2007;21(2):293-308.

Peloquin K, Brassard A. Infertility: a social and spousal reality that needs to be studied. IntegratingScience and Practice. 2013:3,22-6.

Jafarzadeh-Kenarsari F, Ghahiri A, Zargham-Boroujeni A, Habibi M. Exploration of the counseling needs ofinfertile couples: a qualitative study. Iran J Nursing and Midwifery Res.2015;20(5):552-9.

Center for Human Reproduction, USA (2015) In-Vitro Fertilization (IVF). Available at:

Aarts JW, van Empel IW, Boivin J, Nelen WL, Kremer JA, Verhaak CM. Relationship between quality of life and distress in infertility: a validation study of the Dutch Ferti QoL. Hum Reprod. 2011; 26(5):1112-8.

Frederiksen Y, Farver-Vestergaard I, Skovgård NG, Ingerslev HJ, Zachariae R. Efficacy of psychosocial interventions for psychological and pregnancy outcomes in infertile women and men: a systematic review and meta-analysis. BMJ open. 2015;5(1):e006592.

Chan CH, Ng EH, Chan CL, Chan TH. Effectiveness of psychosocial group intervention for reducing anxiety in women undergoing in vitro fertilization: a randomized controlled study. Fertility and Sterility. 2006;85(2):339-46.

Shahnooshi M, Karimi Z. [Sociological impact of infertility upon family in Isfahan province] J Soc Sci. 2010;11(4):171-98.

Dyer SJ, Abrahams N, Mokoena NE, Van der Spuy ZM. Psychological distress among women suffering from couple infertility in South Africa: a quantitative assessment. Hum. Reprod. 2004;19(7):960-7.

Bayley TM1, Slade P, Lashen H.Relationships between attachment, appraisal, coping andadjustment in men and women experiencing infertility concerns. Human Reproduction. 2009;24(11):2827-37.

Peterson BD, Sejbaek CS, Pirritano M, Schmidt L. Are severe depressive symptoms associated with infertility-related distress in individuals and their partners? Human Reprod.2013;29(1):76-82.

Keskin U, Coksuer H, Gungor S, Ercan CM, Karasahin KE, Baser I. Differences in prevalence of sexual dysfunction between primary and secondary infertile women. Fertil Steril. 2011;96(5):1213-7.

Sahin A, Urkmez A, Verit A, Yuksel OH, Verit FF. Psychologic and sexual dysfunction in primary and secondary infertile male patients. Archivio Italiano di Urologia e Andrologia. 2017;89(2):120-4.

Wischmann T, Stammer H, Scherg H, Gerhard I, Verres R.Psychosocial characteristics of infertile couples: a study by the 'Heidelberg Fertility Consultation Service'. Hum Reprod. 2001;16(8):1753-61.

Peterson BD, Newton CR, Rosen KH, Skaggs GE. Gender differences in how men and women who are referred for IVF cope with infertility stress. Human Reproduction. 2006;21(9):2443-9.

Ozkan S, Karabulut A, Oğuz N, Sorkun HC.Coping with the Stress of Infertility. Males Versus Females.J Reprod Med. 2015;60(7-8):339-44.

Sansone A, Di Dato C, de Angelis C, Menafra D, Pozza C, Pivonello R, Isidori A, Gianfrilli D. Smoke, alcohol and drug addiction and male fertility. Reproduct Biol Endocrinol. 2018;16(1):3.