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Introduction

In Vitro Fertilisation (IVF) was created in 1978 when the first baby Louise Joy Brown was born into the world being the world’s first ‘test tube baby’. Since the birth of Louise Brown there have been over 8 million babies been born from IVF around the world. This report identifies the impacts in which the IVF process has on couple’s mental health using a variety of sources, including interviews with couple’s who were successful and unsuccessful with their process of IVF. In addition, surveys were completed by couple’s that have undergone the IVF process and secondary research was used, including books and various internet research.

What is In Vitro Fertilisation? (IVF)
IVF is a complex series of procedures where eggs are collected from the ovaries and fertilized by sperm in a lab, then the fertilized egg (embryo) or eggs are implanted in the uterus. This procedure is used to treat fertility or genetic problems and assist with the conception of a child through a series of complex procedures. Although for some couples there was no specific reason as to why they were not falling pregnant or there is a hereditary disease in their genetics that they want to avoid for their child. Furthermore, 1 in 8 couples have trouble getting pregnant or sustaining a pregnancy, with 11.9% of women receiving information that they are infertile. This study’s survey findings reflect this wide range of reasons why couples decide to go through the IVF process. Figure 1

The effectiveness of IVF and the resulting positive impacts
The use of IVF has resulted in over 200,000 live births since Louise Brown was first born in 1978, is evidence of its effectiveness as a way of conceiving a child. Although it is reported as only being a 33% success rate per embryo transfer for women under 35 years old. In addition, series of cycles with frozen embryos more than 90% of women will eventually fall pregnant using IVF. The research literature also reports the effectiveness of IVF when conducting women who are between the age of 20-29 to have a 58%-79% success rate. This studies survey participant results supports the reports of the effectiveness observations. 83% of the 31 respondents confirmed that their IVF journey was effective, resulting in the birth of a baby. One respondent commented, ‘IVF helped myself and my husband have a baby when my body couldn’t’. Deborah Knight who is a journalist, television presenter and news presenter shares her IVF journey where she shares all of her positive impacts while going through IVF. Deborah says that the journey has impacted her by strengthening her marriage, heightened her appreciation for family and become a kinder person and a better friend. Again, the experiences from Deborah Knight correlate with the survey data where many of the respondents confirmed various positive impacts whether being successful or unsuccessful.

Furthermore, results from Repromed Fertility show the success rates of a variety ages for the Live birth rates and Clinical Pregnancy Rates in 2017 Figure 2 which correlate with the literature reviews and survey results of how effective the IVF process actually is.

However, with the effectiveness of the IVF process, it is very important to recognise that the IVF process effectiveness is not experienced by all participants of IVF. Interviewees, Penny and Stephen Walters who underwent IVF as they were unable to conceive naturally, shared, “Yes it definitely brought myself and my husband closer together, I was not successful and we decided to adopt”. Interviewees, Lily Peters and Violet May who participated in IVF because Violet was infertile shared, “As we are a same sex couple we first were required to be diagnosed with infertility to be eligible to proceed with the IVF process, which was not a positive experience for either of us once we realised this was our only option”.

IVF process negative physiological effects
Furthermore, as the question of effectiveness is raised, couples must also consider the possible negative physiological effect they may experience while going through the IVF process.

Side effects and Injections
The negative physiological effects that the IVF process has on women consist of multiple side effects and include regular injections to increase the fertilization of eggs. Table 1 is showing the negative physiological side effects that were experienced within the survey group.

These surveys findings correlate with the medical literature, which reports nausea, discomfort, vomiting and migraines/headaches. Lily Peters stated that she experiences a collective of these side-effects while participating in the IVF journey, along with “having to administer daily injections which added to my discomfort”.

It is very evident that these side-effects have a major impact on women whilst journeying through the IVF process. These side-effects experienced by many women may also have an effect on their social life, relationships, social participation and ability to go to work. Penny Walters shared, “I didn’t want to catch up with any of my friends or family as I was constantly feeling sick. I was also experiencing major discomfort and sometimes couldn’t go to work”.

Table 2 is representing the responses from survey participants of how the IVF process side-effects impacted their everyday life activities. From this survey it is showing how couples social life can be effected due to participating in the IVF process.

Furthermore, when couples are administering injections into the women’s backside or torso there are possible side-effects that couples can face which can also have an impact on their social life and day-to-day activities. These side-effects include; tenderness, swelling, or bruising at the injection site, hot flashes, blurred vision, nausea, bloating, headache, irritability, restlessness, Breast tenderness or swelling and a risk of Ovarian Hyper Stimulation (OHSS).

IVF process psychological effects
As the IVF process can have negative physiological side-effects, with impacts to daily life activities, it can also have negative psychological effects, which can also have a major impact on the couple’s mental health and daily activities. Although along with a negative psychological effect it can also have a positive psychological effect on couple’s mental health.

Negative effects
The negative psychological effects that the IVF process has on couples consists of stress, anxiety, tension, sadness, anger, depression, distress, loss and helplessness. A study conducted by Alicia Malina and Julie Ann Pooley on the psychological consequences of IVF show that all of these negative symptoms were shown in the responses of IVF women. They say that women suffer harder negative emotions compared to their spouse as they are the ones experiencing the changes in their body. Penny Walters stated during the interview that “During my process I experienced great amounts of stress and disappointment. I tried to stay positive but it was very hard.”

Furthermore, another study was conducted by Jacky Boivin who looked at the overall impact of the IVF process, including the psychological effects, where the concern for stress arose. Boivin specified that when going through each stage of the IVF process the most stressful part found was the waiting period, to see if all of it was worth it, the stress of seeing if the round was successful or unsuccessful. In this study, it also found that when a couple has an unsuccessful treatment it has a further impact on the negative emotions experienced throughout this process and after. This supports the findings of Alicia Malina and Julie Ann Pooley’s research as when they conducted a 20-year-follow-up it showed that women who had undergone IVF treatment, reported more depressive, obsessive-compulsive and somatization symptoms. This means that the IVF process can have long-lasting effects on both male and females.

Although this information is very valid, these experiences are not from the entire population of couples who have undergone the IVF treatment. This concludes that not everyone will experience all or any of these negative effects while going through IVF.

In addition to saying that, these acknowledged negative effects experienced by couples who have gone through the IVF process, cannot be underestimated. An analysis of survey respondents’ identification of the impacts that these negative psychological effects have on couple’s social life, relationships, social participation and ability to go to work. Table 3

Through the medical literature and this study’s reporting, it is evident that these negative effects experienced throughout the IVF treatment have a major impact on couples lives in a wide range of ways.

Positive effects
Although going through the IVF process has a fair amount of negative effects it also has some positive effects that make the process less stressful and more copable for couples to go through. Sofia Kaliarnta (2011) conducted a study of 109 participants who participated in online forums to gather their experiences of the IVF process. Kaliarnta found that many of the participants had a positive experience while doing IVF with only a few complications which were easy to overcome. This correlated with the interview conducted with Lily Peters and Violet May where they expressed feels of positivity when they were faced with challenges as it brought them closer together as a couple. They further mentioned that having a successful treatment brought them optimism for when they decide to go through another round of IVF to have another child. This statement from Lily Peters and Violet May supports the research conducted by Boivin who found that when the embryo transfer stage is approaching participants felt large amounts of optimism as they couldn’t conceive naturally, along with feeling optimistic when previously going through the IVF process and being successful.

In addition, this study’s survey respondents shared that their positive effects of the IVF process were “Being able to have a child. It made me stronger as it was such a difficult journey. I felt now also feel more open about my experiences that I can share my journey with others to help them.”
Conclusion
This evidence reveals that the IVF process is an effective method for assisting in the conception of a child when conceiving naturally is not an option. The IVF journey can have both negative physiological and psychological effects. These negative physiological side-effects are relatively low, although these side-effects can have a great impact on the quality of life that the pregnant women go through. Despite the evidence, the negative physiological side-effects are just as significant as the psychological effects as both impact on couple’s social life, relationships, social participation and the ability to go to work. In addition to these negative effects there are also positive impacts of participating in the IVF process. This includes how couple’s handle the challenges together by strengthening their relationship and bringing them closer as a result of as successful IVF attempt resulting in a much-loved baby. These findings reveal that is it important for the couple’s mental health to be in a stable relationship prior to commencing the IVF journey.

The evidence also suggests that the psychological effects, both positive and negative, stay with the couple throughout their entire lives, especially the women. The men appear to accept the journey and the outcome and move on, whereas the women tend to remain emotionally attached to the memories.