Emotional factors and the in vitro fertilization and embryo transfer process.

In vitro fertilization is nearly always a treatment of a last resort. This fact, along with the treatment's multiplicity of procedures and intensity, place unique emotional demands on patients. The goal of this research was to describe both the acknowledged emotional state of patients at the time they began the in vitro fertilization and embryo transfer (IVF-ET) process and the emotional experience of the actual procedures themselves. The findings can be used to develop strategies for providing emotional support. Data were collected from self-administered questionnaires returned by 94 IVF-ET patients in three Houston programs during a 6-month period. At the time of the IVF procedure, 77% of the population reported that infertility was still a painful concern, not something with which they had learned to live. The loss of control, seen by most patients as infertility's most stressful dimension, left them vulnerable to the intense stresses of in vitro fertilization, less able to handle its multiple demands. Thus for many, the IVF-ET procedures were like an emotional roller coaster on which they experienced a wide range of feelings during a brief period of time. Not surprisingly, emotional strain was a major consideration influencing the decision whether or not to repeat IVF. Patients indicated specific services which the staff could provide to reduce the stress of the procedures.