Does infertility history affect the emotional adjustment of couples undergoing assisted reproduction? the mediating role of the importance of parenthood

Abstract

ObjectivesThe emotional adjustment of couples undergoing assisted reproductive technology (ART) treatments has been widely studied; however, it remains unclear whether infertility history contributes to couples' adjustment. This study examined the impact of infertility history (duration of infertility and number of previous ART treatment cycles) on the emotional adjustment of couples undergoing an ART cycle and the mediating effect of importance of parenthood on that association.MethodsIn this cross‐sectional study, 70 infertile couples (70 women and 70 men) completed self‐report questionnaires assessing emotional adjustment and infertility stress during the hormonal stimulation phase of an ART cycle. Path models accounting for the dyadic nature of the data examined the direct and indirect effects (by affecting representations about parenthood and childlessness) of infertility history on emotional adjustment.ResultsThe number of previous cycles affected men's, but not women's, emotional adjustment by affecting the representations on the importance of parenthood and of childlessness. Duration of infertility had the opposite effect, as couples with longer infertility reported heightened importance of parenthood, which negatively affected their emotional adjustment.ConclusionsInfertility history was associated with emotional adjustment in men and women, although these associations were complex. The results suggest that progression through treatment is harder for those men and women who attribute higher importance to being parents, which is aggravated by longer infertility. Statement of contribution What is already known about the subject? Infertility is an unexpected and stressful life eventAssisted reproductive treatments (ART) are emotionally demanding What does this study add? The influence of infertility history on adjustment is mediated by the importance of parenthoodMen and women are affected by their past history of infertility differently

“In cycles of dreams, despair, and desperation:” Research perspectives on infertility specific distress in patients undergoing fertility treatments

“…It has been identified as an important outcome variable in most of the evidence-based data across many countries. [123456789101112] It is also known to vary with time and phases of fertility treatments. [12] Studies have identified that there are two major sources of infertility distress.…”

“…These include chronic uncontrollable stress,[10116566100101102103104] increasing the duration of infertility,[104] repeated cycles of treatments and their failures,[1516171821223233103104105106] gender-specific diagnosis and distress related to it,[10116366100104] treatment-related strain,[9102147107] disturbances in daily life activities while taking treatments,[108] treatment side-effects and discontinuation[29899100101102103104105106107108109110111112] and stress-mediated biological changes. [102107113114115116117118]…”

Depression and Health-Related Quality of Life Among Young Adult Breast Cancer Patients: The Mediating Role of Reproductive Concerns

“…Although there is a gap in the literature regarding representations of the importance of parenthood and its impact on women with cancer, this direct effect is not completely surprising and similar results have been found in infertile women. 27 These women have to deal with the uncertainty about their reproductive capacity and potential interruption or discontinuation of their family building projects. Particularly, when biological motherhood is a major goal in life, young adult women may find it more difficult to adjust their expectations, with acceptance and reorganization of a childless future resulting in more emotional difficulties.…”

Use and pattern of previous care received by infertile Nigerian women

“…Less than half of clients had been married for 5 years or more, and 38% have been infertile for duration of 5 or more years. This means they may have been exposed to the psychological adverse effect of infertility for long periods [16]. If women had received previous treatment in facilities where quality is good and resources available, then fertility treatment, should take a much shorter period and reduce the suffering women are exposed to.…”