The impact of subfertility and successful fertility treatment on long-term mental health of women
In the UK, around 2% of babies are born after Assisted Reproductive Treatment, such as IVF. ART is often a stressful process, with impacts on the relationships and lives of the couples involved. There are a few well-recognised risks to the woman at the time of treatment, but when treatment is successful the longer-term implications for the mother are often overlooked.
Difficult conceptions, perceived high-risk pregnancies and anxiety about birth can all have a lasting impact, and yet the epidemiological evidence for the association between fertility problems and maternal mental health is equivocal. Thus with increasing numbers of women being treated the long-term impacts of ART on maternal mental health are of increasing concern.
research experience, research methods and training
The studentship will involve generic research skills such as reviewing the literature, developing hypotheses, analysing both quantitative and qualitative data, and writing up results.
A large component of the studentship will be data analysis. The student will use routinely collected primary care data from the Clinical Practice Research Datalink, linked to fertility treatment records. They will construct and describe fertility trajectories for around 400,000 mothers, using reported consultations and referrals, and augmented with HFEA records of fertility treatment for those who have had ART. The student will need to identify and categorise episodes of depression, anxiety or mental health problems throughout each mother’s registration period, and explore the association between fertility history and mother’s mental health outcomes. It is anticipated that this will be completed with the use of standard statistical techniques such as logistic regression, although there may be scope to conduct more advanced statistical methods.
The final aspect of the DPhil will be a qualitative study of women who have experienced mental health problems, prior to, during or after infertility, providing the student with experience of qualitative methods in health research. The target group for this qualitative work will be informed by the results of the statistical analyses.
The student will be expected to write papers for peer-reviewed journals as they complete each stage of their research. These papers can form the basis of the thesis, and will benefit the student by building their academic CV during their studies.
Field work, secondments, industry placements and training
The analysis of CPRD data will include training in analytic methods, as well as data management of large datasets, in STATA.
The qualitative study will recruit women living in England, estimated at around 10-15 participants, and will involve travel to interview sites. Training will be provided for students who do not have previous experience.
Previous training or experience in epidemiology or a health-related degree, strong statistical skills, and an interest in maternal mental health and in developing qualitative research skills.