Positive and negative adjustment in couples undergoing infertility treatment: The impact of support exchange

Abstract

BackgroundPerceived social support relates to infertility-related distress in couples undergoing assisted reproductive technology (ART) treatment. Studies examining the effect of other support types on both positive and negative adjustment among infertile couples are scarce or non-existent. Therefore, this study investigated the effects of support receipt, provision, invisibility (the discrepancy between one partner’s received and the other partner’s provided support), and equity (the discrepancy between each partner’s received and provided support) on the positive (life purpose) and negative (depressive symptoms) indices of well-being in couples undergoing ART treatment.MethodsDepressive symptoms (CES-D), life purpose (PIL), and social support (BSSS) were assessed among 31 married couples (mean age 32.67 years) undergoing ART treatment. Data were analyzed by applying the Actor-Partner-Interdependence Model (APIM) using multilevel modeling.FindingsBoth receiving and providing support had beneficial effects in women and men. However, sub-analysis showed differences according to gender and the support exchange effects. Women reported higher depression and lower life purpose but benefited more from support, and their well-being was more dependent on their own perception of support provision and receipt. Men demonstrated higher adjustment to infertility but benefited less from support, and their well-being was mostly correlated with supportive behaviors of their wives.DiscussionAdjustment mechanisms of women and men undergoing ART treatment vary considerably; thus, gender should be taken into consideration in interventions. Future studies should focus on costs/benefits and gender differences of visible and invisible support in infertility settings.

Individual and Relational Well-Being at the Start of an ART Treatment: A Focus on Partners’ Gender Differences

“…In this direction, for example, another study (Schmitt, 2003) reported that men were not significantly more avoidant than women across all culture. Finally, although no difference between men and women was found for support, a higher percentage of men were at greater risk of perceiving lack of support, partially confirming findings of another study that found lower levels of benefit from support among men (Kroemeke and Kubicka, 2018;Casu et al, 2019).…”

“…It is possible to surmise that the higher commitment of women in ART treatments and their greater acceptance of these treatments gives a lower weight to the medical variables directly related to the treatments, compared to other variables (Nagórska et al, 2019). These findings suggest the importance of implementing support interventions for couples which take into consideration the specific needs and fragility of each partner (Kroemeke and Kubicka, 2018) as well as focusing on maintaining and enhancing a sense of partnership. Indeed, it appears that the couple in this specific moment (i.e., the beginning of an ART treatment), can function as an important resource for partners' distress and fatigue (Molgora et al, 2019b).…”

“…Another variable that has been examined in relation to infertility and medical treatments was social support. Findings revealed that receiving and providing support had positive effects in both men and women (Kroemeke and Kubicka, 2018). Moreover, it seems that partner's support has a protective role in facing infertility-related stress, whereas support provided by people outside the dyad has an adverse effect (Casu et al, 2019).…”

“…Specifically, women seemed to be more emotionally distressed and presented higher levels of stress, anxiety, and depressive symptoms and lower levels of self-esteem and overall quality of life than men ( Berghuis and Stanton, 2002 ; Agostini et al, 2017 ; Kroemeke and Kubicka, 2018 ; Patel et al, 2018 ; Meléndez et al, 2019 ). Furthermore, gender differences emerged about infertility-related cognitions and, specifically, for perception of helplessness and acceptance of infertility ( Patel et al, 2018 ); in particular, women accept ART to a greater extent than men, but men can accept childlessness more often than women ( Nagórska et al, 2019 ).…”

“…Furthermore, longer duration of infertility, higher frequencies of treatments, and female factor infertility were considered as risk factors for depression in women ( Ma et al, 2018 ); on the other hand, Patel et al (2018) found that men reported higher levels of distress when they were responsible for the couple’s inability to have a baby. Gender differences also emerged for social support: women benefited more from support, and their well-being was more dependent on perceived support (provided and received) than men ( Kroemeke and Kubicka, 2018 ).…”