Infertility treatment and marital relationships: A 1-year prospective study among successfully treated ART couples and their controls

Department of Obstetrics and Gynaecology, University of Helsinki, Helsinki, Uusimaa, Finland
Human Reproduction (Impact Factor: 4.57). 06/2007; 22(5):1481-91. DOI: 10.1093/humrep/dem013
Source: PubMed


Evidence about the effects of infertility and assisted reproduction technique (ART) on marital relationships is discrepant. Here, we examined the impact of ART on marital relationships. The roles of life stressors, infertility and treatment characteristics in predicting marital relations were also evaluated.
Subjects: 367 couples with singleton IVF/ICSI pregnancies. Controls: 379 couples with spontaneous singleton pregnancies. Women and men were assessed when the child was 2 months (T2) and 12 months old (T3). They further reported stressful life events at T2 and depression in pregnancy.
No between-group differences were found in marital satisfaction and dyadic cohesion. Dyadic consensus deteriorated from T2 to T3 only among control women. Sexual affection was low among control men at T2 and stressful life events decreased it further. Depression during pregnancy predicted deteriorated marital relations only in control couples. Several unsuccessful treatment attempts were associated with good dyadic consensus and cohesion among ART women. Spontaneous abortions and multiple parity predicted poor marital satisfaction in ART women, whereas long duration of infertility and multiple parity predicted poor marital relations in ART men.
Successful ART does not constitute a risk for marital adjustment. The shared stress of infertility may even stabilize marital relationships.

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Available from: Leena Repokari, Oct 06, 2015
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    • "These paradoxical findings might be explained by the unique characteristics of the sample, because studies of other populations of infertile couples reported that stress from infertility treatment and failure to conceive contributes to greater marital distress [24]. It should be noted that reduced sexual desire and coital frequency may occur due to the loss of sexual spontaneity [21] that is secondary to certain strategies used to increase the chances of pregnancy [31],such as scheduled coitus [32].A study by [12] also reported that infertile females had better partner relationships than fertile females and [22] demonstrated that several unsuccessful attempts at treatment of infertility were associated with good dyadic consensus and cohesion. It is possible that partners become more supportive by sharing the stressful experiences associated with treatment of infertility, and this may improve the marital relationship and increase dyadic cohesion. "
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    • "The research by Pasch et al. [14] on marital quality in ART couples showed that when the spouses both were involved in the infertility treatment process the effects on the relationship were positive [14]. In a Finnish study by Repokari et al. [15] on marital relationships in ART couples (using their own gametes) and controls the results at the one year follow-up showed that the couples who had experienced involuntary childlessness were more resistant to negative psychosocial stressors compared to the control couples who were able to spontaneously conceive [15]. They also reported that they had a good and stable marital relationship throughout the treatment process. "
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    ABSTRACT: Background Long-term follow-up on relationship quality in couples who use sperm donation is scarce. Therefore, this study aimed to analyse changes over time in satisfaction with relationship in heterosexual couples who were scheduled for treatment with sperm donation and IVF couples treated with their own gametes and to compare the two groups undergoing different treatment for infertility. Method A prospective follow-up study in which data were collected twice on two groups; couples receiving sperm donation and IVF couples using their own gametes. The ENRICH instrument was used to gain information about the individuals’ subjective experience of their relationship at the time of acceptance for treatment and again 2–5 years later. Results At the time of acceptance for treatment the men and women in the two groups assessed their relationships as being very solid on all dimensions and that there were no differences between the two groups. At the second assessment there was a decline in the satisfaction scores on the dimensions “Children and parenting” and “Egalitarian”, while an increase in scores was observed on “Conception of life” and “Conflict resolution” both for men and woman and also for the two groups. For the couples that had a successful treatment and gave birth to a child/children there was a decrease in satisfaction of the relation in the sperm donation group as well as in the group of couples having IVF with own gametes. Conclusion In conclusion, the overall quality of relationship is stable in couples receiving donated sperm and does not differ from couples undergoing IVF-treatment with own gametes.
    Reproductive Health 08/2014; 11(1):62. DOI:10.1186/1742-4755-11-62 · 1.88 Impact Factor
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    • "It is argued that the good mental health among women and men undergoing ARTs may simply reflect their satisfaction with successful treatment and fulfillment of their hope for parenthood (34). In addition, as noted by Repokari et al. (36), lack of mental health symptoms in women who experience a stressful period of infertility treatment, could be explained by ego defence mobilization, which could be considered as an interesting subject for future study. "
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    ABSTRACT: Background: Childbearing for the first time is a unique experience. Quality of life is an important indicator in health studies. This study aimed to assess the quality of life of women who were conceived by ARTs and had successful childbirth for the first time and to compare it with quality of life in women who become pregnant naturally and similarly had successful childbirth for the first time. Materials and methods: This was a cross sectional comparative study. The accessible sam- ple was recruited from patients attending an infertility clinic and two obstetric and gynecology clinics in Tehran, Iran, during March 2010 to March 2011. In all 276 patients were approached. Of these, 162 women (76 women in natural conception group and 86 women in assisted reproduction technologies group) who met the inclusion criteria were entered into the study. Quality of life was assessed using the 36-item Short Form Health Survey (SF-36). Women completed the questionnaire at two time points: i. last trimester and ii. first month after delivery. Comparison was made between two groups using Mann-Whitney U test and paired samples t test. Results: Comparing the SF-36 scores between women in natural conception group and ARTs group before childbirth, it was found that natural group had better condition on physical functioning, role limitation due to physical problems, bodily pain and social functioning, while the ARTs group reported better status on general health, vitality, role limitation due to emotional problems, and mental health. However, after childbirth, the ARTs group reported a better condition almost on all measures, except for physical functioning. Comparing differences in obtained scores between two groups before and after childbirth, the results showed that improvements in health related quality of life measures for the ARTs group were greater in all measures, expect for general health. Conclusion: The findings from this study suggest that health-related quality of life was improved in women who became a mother for the first time by either method. Comparing to women who became mother by natural conception, women who received ARTs showed better quality of life from this first successful experience.
    International journal of fertility & sterility 07/2014; 8(2):167-74. · 0.47 Impact Factor
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