Marital benefit and coping strategies in men and women undergoing unsuccessful fertility treatments over a 5-year period
Chapman University, Crean School of Health and Life Sciences, Schmid College of Science, One University Drive, Orange, CA 92866, USA. Fertility and sterility
(Impact Factor: 4.59).
02/2011; 95(5):1759-63.e1. DOI: 10.1016/j.fertnstert.2011.01.125
To assess the relationship between infertility, marital benefit, and coping in a sample of men and women undergoing unsuccessful fertility treatments.
Prospective longitudinal cohort design using multilevel modeling.
Danish public and private hospitals (n = 5) specializing in treating fertility patients.
Participants were Danish men and women about to start a cycle of medically assisted reproduction treatment who were followed for a 5-year period of unsuccessful treatments.
The Copenhagen Multicenter Psychosocial Infertility research program Coping Strategy Scales and Marital Benefit Measure.
Compared with men, a greater percentage of women reported high levels of marital benefit. For active-avoidance coping, there was a significant partner effect by gender interaction. Meaning-based strategies increased between 1 and 5 years for men and women. The use of meaning-based coping had a significant positive actor effect with marital benefit for both men and women.
Approximately one-third of participants undergoing unsuccessful fertility treatments reported high marital benefit as a positive consequence of the infertility experience. Partner effects for men and women related to active-avoidance coping may be related to the degree of emotional support that each spouse can offer the other, whereas differences in meaning-based coping indicate a possible timing effect related to gender.
Available from: Agneta Skoog Svanberg
- "It could be that the men who had previously experienced infertility had subsequently had time to reflect, build relationships with their partners and cope with their experiences so that their childlessness did not negatively affect their wellbeing. In a longitudinal study from Denmark on relationship in couples coping strategies showed that different and better coping strategies occur for one-third of couples being subjective to a unsuccessful IVF treatment and that emotional support from spouses reinforce this opinion in the couples . The men in this study all received IVF between 1986 and 1989. "
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Infertility and infertility treatment are known to have negative short-term psychological consequences for men and women, with more long-term consequences for women. The long-term wellbeing and mental health of men who have experienced in vitro fertilisation (IVF) treatment has not been extensively described in the literature. Therefore, the aim of this study was to analyse the mental health of men 20 to 23 years after IVF treatment.
The Symptom Checklist 90 tool was used to assess the self-perceived mental health of men who were part of a couple that underwent IVF treatment at Linköping University Hospital, Sweden, 20 to 23 years earlier. We enrolled 292 out of the 490 men who took part in the hospital's IVF programme from 1986 to 1989 and compared them to an aged-matched control group. In addition, the men who had remained childless were compared to those who had fathered biological children and those who had adopted children.
The overall mental health of the men who had received IVF was good. We found that 54 % of the men had fathered their own biological children, 21 % were childless and the remainder were part of a couple that had gone on to adopt. The childless men displayed more mental health problems than the other men in the study, as did men who were unemployed, single or divorced.
This study carried out 20 to 23 years after IVF treatment showed that the majority of the men who took part were in good mental health. Those who remained childless faced an increased risk of negative psychological symptoms and men who were single showed more symptoms of depression and anxiety disorders.
Available from: Agneta Skoog Svanberg
- "They also reported that they had a good and stable marital relationship throughout the treatment process. Research from Denmark [5,16] reported positive effects on marriage as a result of infertility experiences. These couples were IVF-couples using their own gametes after both successful and unsuccessful treatments. "
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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.
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.
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.
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.
Available from: humrep.oxfordjournals.org
- "The importance of studying the experience of infertility in couples using the couple as the unit of analysis has been emphasized in recent studies (Peterson et al., 2008; Johnson and Johnson, 2009). One member of the couple can influence the other's psychosocial adjustment or fertility stress through perceptions of controllability (Benyamini et al., 2009) or of the likelihood of becoming pregnant (Thompson et al., 2012a,b), depressive symptoms (Knoll et al., 2009) or the use of coping strategies (Berghuis and Stanton, 2002; Peterson et al., 2006a Peterson et al., ,b, 2008 Peterson et al., , 2009 Peterson et al., , 2011). This paper specifically examines whether each partner's perceived social support influences the other's way of adjusting to infertility stress. "
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ABSTRACT: Is perceived social support from partner, family, and friends associated with increased infertility-related stress?
While men's perceived support did not seem to influence their partners' stress, women's perceptions of spousal and familial support can affect the way men deal with the challenge of infertility.
Previous studies showed that low levels of social support are associated with poor psychosocial adjustment and treatment termination in women and men. Studies examining the impact of social support using the couple as unit of analysis are lacking.
A cross-sectional sample of 613 Portuguese patients participated in the research, online over a 3-month period, and in a public fertility clinic over 11 months.
The final sample comprised 213 married or cohabiting couples (191 from the fertility clinic) who were actively attempting to have a child, were seeking infertility treatment and had not undergone previous preimplantation genetic diagnosis. Perceived social support was assessed through the Multidimensional Scale of Perceived Social Support and infertility-related stress was assessed with the fertility problem inventory. Hypotheses were tested by applying the actor-partner interdependence model using structural equation modeling.
Couples had been living together for an average (±SD) of 6 ± 3.5 years, and attempting a pregnancy for 3.8 ± 2.6 years. Nearly half of the couples had undergone infertility treatment (41.3%). Infertility stress was found to be associated with low family support for women (β = -0.27, P = .003), and low partner support for both men (β = -0.29, P = .001) and women (β = -0.45, P = .006). Both women and men's perceived friend support were not significantly related to male or female infertility stress. Men infertility stress was also associated with their partners low levels of partner (β = -0.24, P = .049) and family support (β = -0.23, P < .001). No significant partner effects were observed for women. Despite being related to actor effects alone (female partner and family support), the explained variance of the model in women's fertility stress was greater (R(2) = 21%) than that (R(2) = 15.6%) for the combined actor and partner effects in men's fertility stress (male partner support, female partner and family support).
The study data are cross-sectional and the generalizability of results is limited by self-selection. The characteristics of non-participants in both the clinical and online samples were not available, the perception of infertility-specific supportive behaviors was not assessed and differential analyses according to infertility diagnosis were not included in this study.
Our data underline the importance of partner support in alleviating the burden of infertility. Men may experience infertility indirectly through the impact that it has on their partners. Our findings reinforce the need to involve the male partner throughout the whole treatment process and for couple-based interventions when providing infertility counseling. Further prospective research should be aimed at investigating the male experience of infertility.
This research was supported by a PhD scholarship from the Portuguese Foundation for Science and Technology granted to M.M. (FCT, SFRH/BD/44232/2008). The authors have no conflicts of interest to declare.
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