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.