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Couples with infertility and the desire to conceive: examining the association between discrepancies in the desire to conceive and relationship and sexual satisfaction

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Abstract

Infertility has been shown to be associated sexual and relationship dissatisfaction. This study examined one potential source of relationship distress among couples with infertility: discrepancy between partners in their desire to conceive a child. Mixed-gender couples (N = 105) were recruited through online forums, a support group, and a fertility clinic. Partners separately completed online questionnaires assessing the importance that they placed on conceiving a child and their perceptions of the importance their partner placed on conceiving a child. They also completed measures of sexual and relationship satisfaction. Women reported slightly but significantly greater desire to conceive than men. An actual discrepancy in conception desire, as well as a perceived discrepancy in conception desire, was associated with lower sexual and relationship satisfaction among woman and lower relationship satisfaction among men. There was no association between a partner's misperception of an individual's desire to conceive and that individual's relationship or sexual satisfaction. Notably, women misperceived their male partner's desire to conceive more often than men misperceived their female partner's desire to conceive. Results suggest that, for therapists working with couples with infertility, it might be beneficial to help couples acknowledge and address actual or perceived differences in their conception desires.

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To evaluate the hypothesis that infertility may result in a decrease in quality of life and an increase in marital discord and sexual dysfunction. The burden of infertility is physical, psychological, emotional, and financial. Couples seeking treatment for infertility were asked to complete standardized validated questionnaires assessing quality of life (Quality of Well-Being Scale-Self Administered, version 1.04), marital adjustment (Locke-Wallace Marital Adjustment Test), and sexual function (Brief Index of Sexual Functioning for Women and International Index of Erectile Function for men). Couples seeking elective sterilization served as the control subjects. Eighteen infertile couples and 12 couples seeking elective sterilization participated in the study. The mean age, years together, and household income were comparable. Infertile couples had made a mean of 14.5 office visits for infertility, and 83% of couples reported feeling societal pressures to conceive. The Marital Adjustment Test scores for the women of the infertile couples were significantly lower than the scores of the controls (P = 0.01); however no difference was noted in the men. A trend toward lower quality-of-life scores was noted in women (P = 0.09) but not in the men of infertile couples. No statistically significant impact on sexual functioning in women was noted; however, the men in the infertile couples had lower total International Index of Erectile Function scores (P = 0.05) and intercourse satisfaction scores (P = 0.03). Women in infertile couples reported poor marital adjustment and quality of life compared with controls. Men may experience less intercourse satisfaction, perhaps because of the psychological pressure to try to conceive or because of the forced timing of intercourse around the woman's ovulatory cycle.
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