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===Psychological=== The consequences of infertility are manifold and can include societal repercussions and personal suffering. Advances in assisted reproductive technologies, such as [[in vitro fertilisation|IVF]], can offer hope to many couples where treatment is available, although barriers exist in terms of medical coverage and affordability. The [[Fertility medication|medicalization of infertility]] has unwittingly led to a disregard for the emotional responses that couples experience, which include distress, loss of control, stigmatization, and a disruption in the developmental trajectory of adulthood.<ref>{{cite journal | vauthors = Cousineau TM, Domar AD | title = Psychological impact of infertility | journal = Best Practice & Research. Clinical Obstetrics & Gynaecology | volume = 21 | issue = 2 | pages = 293β308 | date = April 2007 | pmid = 17241818 | doi = 10.1016/j.bpobgyn.2006.12.003 }}</ref> One of the main challenges in assessing the distress levels in women with infertility is the accuracy of self-report measures. It is possible that women "fake good" to appear mentally healthier than they are. It is also possible that women feel a sense of hopefulness/increased optimism before initiating infertility treatment, which is when most assessments of distress are collected. Some early studies concluded that infertile women did not report any significant differences in symptoms of anxiety and depression than fertile women. The further into treatment a patient goes, the more often they display symptoms of depression and anxiety. Patients with one treatment failure had significantly higher levels of anxiety, and patients with two failures experienced more depression when compared with those without a history of treatment. However, it has also been shown that the more depressed the infertile woman, the less likely she is to start infertility treatment and the more likely she is to drop out after only one cycle. Researchers have also shown that despite a good prognosis and having the finances available to pay for treatment, discontinuation is most often due to psychological reasons.<ref>{{cite journal | vauthors = Rooney KL, Domar AD | title = The relationship between stress and infertility | journal = Dialogues in Clinical Neuroscience | volume = 20 | issue = 1 | pages = 41β47 | date = March 2018 | doi = 10.31887/DCNS.2018.20.1/klrooney | pmid = 29946210 | pmc = 6016043 }}</ref> Fertility does not seem to increase when the women takes antioxidants to reduce the oxidative stress brought by the situation.<ref>{{cite journal | vauthors = Showell MG, Mackenzie-Proctor R, Jordan V, Hart RJ | title = Antioxidants for female subfertility | journal = The Cochrane Database of Systematic Reviews | volume = 8 | issue = 11 | pages = CD007807 | date = August 2020 | pmid = 32851663 | pmc = 8094745 | doi = 10.1002/14651858.CD007807.pub4 }}</ref> Infertility may have psychological effects. Parenthood is one of the major transitions in adult life for both men and women. The stress of the non-fulfilment of a wish for a child has been associated with emotional consequences such as anger, depression, anxiety, marital problems, and feelings of worthlessness.<ref name="Deka, P. K. 2010">Deka, P. K., & Sarma, S. (2010). Psychological aspects of infertility. British Journal of Medical Practitioners, 3(3), 336.</ref> Partners may become more anxious to conceive, increasing [[sexual dysfunction]].<ref name=barrattberger>Donor insemination Edited by C.L.R. Barratt and I.D. Cooke. Cambridge (England): Cambridge University Press, 1993. 231 pages., page 13, citing Berger (1980)</ref> Marital discord often develops, especially when they are under pressure to make medical decisions. Women trying to conceive often have depression rates similar to women who have heart disease or cancer.<ref>{{cite journal | vauthors = Domar AD, Zuttermeister PC, Friedman R | title = The psychological impact of infertility: a comparison with patients with other medical conditions | journal = Journal of Psychosomatic Obstetrics and Gynaecology | volume = 14 | issue = Suppl | pages = 45β52 | year = 1993 | pmid = 8142988 }}</ref> Emotional stress and marital difficulties are greater in couples where the infertility lies with the man.<ref name=barrattconnolly>Donor insemination Edited by C.L.R. Barratt and I.D. Cooke. Cambridge (England): Cambridge University Press, 1993. 231 pages., page 13, in turn citing Connolly, Edelmann & Cooke 1987</ref> [[Psychological effects of male infertility|Male]] and female partners respond differently to infertility problems. In general, women show higher depression levels than their male partners when dealing with infertility. A possible explanation may be that women feel more responsible and guilty than men during the process of trying to conceive. On the other hand, infertile men experience psychosomatic distress.<ref name="Deka, P. K. 2010"/>
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