Emotional impact of reduced access to assisted reproductive care

OBJECTIVE: To evaluate the impact of cessation of fertility services on patients with infertility. STUDY DESIGN: A cross-sectional, anonymous mail survey was conducted in a university hospital setting. A total of 281 female infertility patients treated from 2003– 2006 were mailed surveys. The main outcome measures of the study were the Perceived Stress Scale 10 (PSS- 10) and the Impact of Events Scale (IES). RESULTS: Of the 281 patients, 175 (62.3%) responded to the questionnaire. Of those, 51 (29.1%) reported being affected by the closure. The majority (58.9%) reported a somewhat or very negative impact on their perceived quality of life. Affected patients were more likely than unaffected patients to have an elevated PSS-10 result (odds ratio [OR] 2.1, 95% confidence interval [CI] 1.04–4.3). No significant difference was seen in IES results, with 90.2% of affected and 81.5% of unaffected patients scoring in the high distress range (OR 2.1, 95% CI 0.77–5.65). Self-reported average stress levels were reduced following news of resumption of services (3.3, scale 1–10) as compared to both prior to (5.1) and during (7.4) the closure. CONCLUSION: When fertility services are discontinued, there may be significant emotional distress among the population affected. Health care providers should be aware of the impact infertility has on stress-coping and quality of life and be prepared to offer psychological services.