To investigate symptoms of anxiety and depression in lesbian couples undergoing assisted reproductive treatment ARTand to study the relationship of demographic data, pregnancy outcome and future reproductive plans with symptoms of anxiety and depression. A consecutive sample of lesbian couples requesting assisted reproduction, of whom participated. Anxiety and depression HADSpregnancy outcome and future reproductive plans.
The vast majority of lesbian women Female despression caused by no sperm assisted reproduction reported no symptoms of anxiety and depression at the three assessment points. The overall pregnancy outcome was high; almost three-quarters of lesbian couples gave birth 2—5 years after sperm donation treatments.
Open-ended comments illustrated joy and satisfaction about family building. Lesbian women in Sweden reported good psychological health before and after treatment with donated sperm. Lesbian women conceiving through donor insemination are of particular interest as lesbian couples represent a growing group of patients in obstetric and maternity health care. Anxiety and depressive disorders are common in fertile women 2 and in the general population, and are two to three times as common in women than in men.
Although available research is limited, 19 the perinatal period has been identified as a time of increased risk of psychiatric illness in women, 19 — 21 and women with previous mental health problems have been found to be more vulnerable to maternal distress 192122 and postpartum depression.
Symptoms of anxiety and depression in heterosexual women undergoing in vitro fertilisation IVF treatment have frequently been reported 2324 and, although many of the aspects of conceiving and parenthood are shared between lesbian and heterosexual women, lesbian women may differ from heterosexual women with regard to a number of variables that have been associated with perinatal mental health.
The aim of this study was to investigate symptoms of anxiety and depression in lesbian couples during a 2-year period after sperm donation treatment, and to study Female despression caused by no sperm relationship of demographic background data educational level and previous childrenpregnancy outcome after sperm donation treatment and future reproductive plans with symptoms of anxiety and depression. The Swedish study on gamete donation is a prospective longitudinal study of donors and recipients of donated gametes.
This study presents data from lesbian couples using donor sperm to conceive. During —, a consecutive cohort of lesbian couples at the commencement of assisted reproductive treatment ART were approached for participation, and data were collected consecutively during — The first questionnaires were handed out to the couples by staff at the fertility clinic. The second and third questionnaires were distributed by mail, together with a prepaid return envelope and a covering letter stating the purpose of the study and guaranteeing confidentiality.
Nonresponders were Female despression caused by no sperm two reminders. Participants individually completed questionnaires at three time points: As the third questionnaire aimed to investigate psychosocial aspects in the family when the donor offspring were around 12 months of age, the third questionnaire was sent out when the child was between 12 and 18 months of age.
Because of this, T3 varies within the couples and the responses from T3 were collected 2—5 years after the first treatment T1. Couples that did not complete at least one Female despression caused by no sperm of treatment which included one sperm insemination treatment or one cycle of regular IVF were excluded from the study.
Couples who did not speak or read Swedish were also excluded. Reasons for nonparticipation were as follows: Medical data were collected from of the treated lesbian women five missing. Sperm insemination in a natural cycle without hormonal treatment is less medically complicated, but has a poorer pregnancy outcome than regular IVF treatment.
Ovulation stimulation takes place in order to induce physical ovulation in women with anovulation before intrauterine insemination IUIor as a step in regular IVF treatment.
It is common to offer IVF treatment after, for example, two unsuccessful natural or stimulated cycle sperm inseminations. The following demographic data were collected at T1: In addition, the women could leave written comments about their future reproductive plans.
Medical data, number of received treatments and length of relationship were collected from the medical record. In a long-term prospective study such as this, over time participants drop out.
Figure 1 presents an overview of participants and nonparticipants at each time point. Flow chart of participants and nonparticipants during assisted reproductive treatment ART. Furthermore, an analysis was performed in order to investigate the characteristics and possible reasons of those dropping out.
To assess anxiety and symptoms of depression, HADS was used. HADS was developed by Zigmond and Snaith, 27 inand is a self-assessment scale which has been found to be a reliable instrument for the detection of states of anxiety and depression in the setting of a hospital medical outpatient clinic. HADS comprises two subscales, one for anxiety symptoms and one for depression.
At T2 and T3, the couples were asked to report pregnancy outcome, i. The third questionnaire contained questions about whether the participants were living with the same partner as at the commencement of treatment, as well as the couple's future reproductive plans: Six statements with four response alternatives each composed this questionnaire.
The response alternatives were: The couples were asked to respond to all of these six statements.
Because of this, Female despression caused by no sperm response rate differed between the statements. In addition, open-ended comments were collected from 40 treated women and 36 partners. Chi squared test and Fisher's exact test were used to compare differences between the treated woman and her partner.
Data collected in open-response format were categorized according to content. To illustrate and enrich the results, quotes from participants are presented. Demographic and medical data are displayed in Table 1. The treated women were slightly younger than the partners, with a mean Female despression caused by no sperm of Both the treated women and the partners had previous children.
The mean length of the relationship was 5. HADS scores are displayed in Table 2. Few women in the lesbian couples reported symptoms of anxiety and depression throughout the period of ART. An analysis comparing symptoms of anxiety and depression between the three time points was performed. Among the partners, anxiety scores decreased between T1 and T2, and depression scores increased between T1 and T2 and between T2 and T3.
At T3, when the treatment was terminated, only five of the treated lesbian women reported symptoms of depression. Consequently, because of the few women with symptoms of depression, no relationships between demographic data, pregnancy outcome, future reproductive plans and symptoms of anxiety and depression were found.
The second questionnaire included questions about the couple's current situation.