Bio-psychosocial aspects of infertility: Illustrative case of recurrent failure with assisted reproductive technologies

Infertility is associated with psychological problems being experienced by both partners, and in vitro fertilization (IVF) is one of many infertility treatment procedures. IVF significantly influences patients and their family’s psychology. This report reviews the biopsychosocial aspectsof infertility in relation to recurrent IVF failure. A 42-year-old female patient with primary infertility for the past 16 years requested consultation on pregnancy programs. She had a history of cystectomy surgery for endometriotic cysts. At presentation, there were no problems with the husband’s sperm quality, the patient had undergone three failed insemination attempts, followed by three failed IVF attempts. Ultrasound examination found left tubal enlargement size 25 × 13 × 16 mm3, correspond to hydrosalpinx. The patient was also diagnosed as having diminished ovarian reserves. She underwent a hysteroscopy with subsequent laparoscopy for endometriosis in the left fallopian tube, which resulted in a left-sided salpingectomy. After laparoscopic surgery, the patient plans to undergo one final IVF procedure. After failed IVF cycles, women experience an increase in depressive symptoms with lower levels of self-esteem, compared to those before the treatment cycle. A problemsolving coping strategy is associated with better psychological adjustment, whereas the use of avoidance coping and social isolation has the opposite effect; hence, behavioral strategies may help these patients deal with their loss of control. In conclusion. This case illustrates the association between infertility and ART failure and its biopsychosocial implications that require appropriate support to reduce patient distress, help patients come to terms with their situation, and facilitate decision making.