INTRODUCTION
Infertility is defined as not establishing pregnancy in the absence of
contraception despite regular sexual intercourse for one year. According
to the data of the World Health Organization, 8-10% of couples have
infertility problems and this rate is increasing
gradually.1 For most couples, infertility is a
psychological trauma; even described by many couples as the most
difficult life experience in their lives.2 Besides the
psychological challenges of infertility, the treatment process also
affects couples psychologically, economically, and
physically.3 Additionally, the mental state of the
couple acts not only on the process of coping with the treatment
procedures but on the pregnancy process and the upcoming parenting
process as well.4,5 However, it is thought that there
is a bidirectional relationship between infertility and psychological
factors. Infertility and treatment processes affect mental health and
mental health acts on infertility.3 However, a
literature review reveals that studies have been conducted mostly to
investigate the effects of infertility on mental
health.6-8 Many studies have shown that the two most
common psychiatric disorders in infertile patients are anxiety disorders
and depression.9,10 Depression and anxiety in such
patients are attributed to subjective feelings of stress, future
uncertainty, concerns about treatment processes and techniques, and
economic difficulties.9
The concept of ”psychogenic infertility” has a long history in the field
of infertility.11,12 The concern that mental stress
could put a possible pregnancy at risk is discomforting not only for
women endeavouring to get pregnant but also for their physicians.
Although some studies are available supporting that mental disorders
such as anxiety or depression cause infertility,13,14the number of population-based prospective studies investigating the
effect of stress on live births is limited.15 In 2014,
a study showed that biomarker levels indicating high stress severity in
fertile women are associated with a longer time to establish a pregnancy
and an increased risk of infertility.16 Stress
suppresses gonadotropin-releasing hormone (GNRH) in the
hypothalamic-pituitary axis and causes alterations in the secretion of
gonadal steroids and suppression of luteinizing hormone (LH), leading to
impaired reproductive functions.17 Furthermore, it is
suggested that stress may be involved in the pathophysiology of
infertility by culminating in lifestyle changes and decisions that may
lead to a reduction in fertility. On the other hand, controversial
results were reported by other studies that investigated the
relationship between mental stress and fertility.18,19
In this study; which was planned based on the hypothesis that medically
unexplained infertility might be a stress-related somatic symptom,
infertile patients were divided into groups according to whether
aetiology was known or not, aiming to compare the levels of alexithymia,
anxiety sensitivity, and exaggeration of body sensations of infertile
individuals to those of fertile individuals.