Gratitude in infertility: a cross-sectional examination of dispositional gratitude in coping with infertility-related stress in women undergoing IVF

Abstract

STUDY QUESTION Do sense of meaning and acceptance mediate the relationships between gratitude and infertility-related stress among women undergoing IVF? SUMMARY ANSWER Among women undergoing IVF, the negative relationships between gratitude and infertility-related stress are explained by a general sense of meaningfulness and acceptance of life. WHAT IS KNOWN ALREADY Infertility experts increasingly call for a re-balancing of the deficit-based view of psychosocial adjustment in IVF, which has been heavily dominated by studies of risk factors and psychological distress. Attention has been given to strength-based perspectives that emphasize character strengths and personal growth. Gratitude has been found to be a potent protective factor in coping with life stressors; however, its salutary effects and protective processes for infertile women undergoing IVF are yet to be explored. STUDY DESIGN, SIZE, DURATION This study utilized baseline data of a randomized controlled trial for mind–body interventions with 357 Hong Kong Chinese women. Data collection was conducted between January 2015 and December 2017. PARTICIPANTS/MATERIALS, SETTINGS, METHODS Eligible women were approached by a research assistant immediately after their first medical consultation at an ART centre of a major university-affiliated hospital. Participants were asked to complete a battery of questionnaires, including the Gratitude Questionnaire-6, the Fertility Problem Inventory, and the Holistic Well-Being Scale. Mediation analyses were conducted with bootstrapped samples. MAIN RESULTS AND THE ROLE OF CHANCE Of the 494 women who were approached, 357 (72.3%) provided informed consent and participated in the study. Results show that gratitude was negatively associated with all infertility-related stress domains (rs = −0.19 to −0.36), and these relationships are mediated by acceptance and loss of sense of meaning. Further, the link between gratitude and relationship concerns is mediated by loss of sense of meaning in women with a definable cause of infertility (95% CI = [−0.31, −0.08]), but by acceptance among those with unexplained infertility (95% CI = [−0.33, −0.01]). LIMITATIONS, REASONS FOR CAUTION The cross-sectional nature of the study precluded inferences of causality. Self-selection and self-report biases could be present. Our findings may not be readily generalizable to women who do not intend to undergo psychosocial intervention for their infertility or ART. WIDER IMPLICATIONS OF THE FINDINGS Our findings support the salutary effects of gratitude in coping with IVF and highlight the role of unexplained infertility in the coping process. These findings offer preliminary support to the use of psychosocial interventions in promoting gratitude, acceptance, and meaning reconstruction for reducing infertility-related stress in women undergoing IVF. STUDY FUNDING/COMPETING INTEREST(S) This study was funded by the Hong Kong University Grant Council—General Research Fund (HKU27400414). All authors declare no competing interests. TRIAL REGISTRATION NUMBER HKUCTR-1984.

Analysis of the levels of hope and influencing factors in infertile women with first-time and repeated IVF-ET cycles

“…Some studies have also found that shared decision-making interventions can improve the psychological state of patients undergoing IVF-ET, improve their hope levels and treatment compliance, and significantly improve the pregnancy rate [ 35 ]. Helping patients to establish a sense of gratitude is helpful to alleviating the anxiety of patients in the process of IVF-ET [ 36 ]. This study was only a cross-sectional analysis, and we should try more interventions in the future.…”

The Comparison of Family Function and Related Factors in First-Child Infertile Women and Second-Child Infertile Women after “Two-Child” Policy in China

“…As a result, infertility is regarded as a bio-psycho-social crisis 18 . Age, social roles, and intricate family problems, in particular, contributed to a more complex refertility nature in patients after the full liberalization of the 'second child policy' 19 . Thus, the likelihood of developing psychological and family disorders in infertile patients is higher than in the other groups, and appropriate steps should be taken in this regard.…”

The Comparison of Family Function and its Related Factors in First-Child Infertile Women and Second-Child Infertile Women after 'Two-Child' Policy in China

“…Hence, infertility is considered a bio-psycho-social crisis as well [26]. Especially, after the full liberalization of the 'second child policy', factors such as age, social roles, and intricate family problems all contributed to more complex refertility nature in patients [27]. Thus, the probability of the development of psychological and family disorders in infertile patients is more prevalent than in the other groups, and necessary steps should be taken in this regard.…”