Depressive symptoms, anxiety, and quality of life of Japanese women at initiation of ART treatment

Assisted reproductive technology (ART) treatment accounted for 6% of total births in 2017 and is increasing which places Japan among the top worldwide in number of treatments performed. Although ART treatment patients often experience heavy physical and psychological burden, few epidemiologic studies have been conducted in Japan. We examined mental health and health-related quality of life (QOL) among women at early stages of treatment. We recruited 513 women who have initiated ART treatment, either in-vitro fertilization or intracytoplasmic sperm injection, from four medical facilities in the Tokyo area and through web-based approaches. At baseline, we collected socio-demographic information and assessed depressive symptoms, anxiety, and QOL. Descriptive analyses were performed overall and stratified by factors such as age. Mild depressive symptoms or worse, assessed with Quick Inventory of Depressive Symptoms, were observed among 54% of participants. Mean score for State-Trait Anxiety Inventory was 52 with a standard deviation of 11 for the state, and 39% were categorized as high anxiety. QOL results, assessed with SF-12, showed the same negative tendency for social functioning and role (emotional), while general health and physical functioning were consistent with the national average. Young participants appeared to suffer mentally more than older participants (p<0.01 for depressive symptoms). Our findings suggest that patients may be at high risk of depressive symptoms, high anxiety, and low QOL even from the early stages of ART treatment.