Recovery after unsuccessfulin vitrofertilization: the complex role of resilience and marital relationships

Abstract

The failure rate of in vitro fertilization (IVF) is around 75% per cycle. These unsuccessful attempts can provoke acute clinical depression and other problems. Although practitioners often recommend cognitive reappraisal, rather than avoidance, to cope with these difficulties, previous research has not established the psychosocial determinants of adaptive coping strategies. Arguably, resilience could encourage cognitive reappraisal, because resilient individuals feel confident they can overcome their emotions, whereas marital quality could prevent avoidance, because individuals feel secure enough to reflect upon their distress. Consequently, resilience and marital quality could facilitate recovery over time. To explore these possibilities, 184 women, all of whom had unsuccessfully completed IVF treatment, completed a questionnaire that gauged their levels of self-reported depression since their last IVF attempt as well as resilience and marital quality. Immediately after the unsuccessful attempt, resilience was inversely, whereas marital quality was positively, related to depression. However, within this cross-sectional sample after greater time had elapsed, marital quality became increasingly beneficial and was negatively associated with depression. These findings imply that resilience can curb the initial distress; in contrast, marital quality may enable individuals to reflect upon their trauma, initially amplifying distress but eventually facilitating recovery. Future research would benefit from longitudinal studies, illustrating whether resilience and marital quality at one time predict changes in distress at subsequent times.

Depression and Anxiety Outcomes Associated with Failed Assisted Reproductive Technologies: A Systematic Review and Meta-Analysis

“…Notwithstanding these limitations, results from meta-analysed studies and those included in the narrative syntheses are in accordance with studies that have described and reported results on the impact of treatment failure including depression, anxiety and infertility-specific distress [52–54]. …”

Gender differences in emotional reactions to in vitro fertilization treatment: a systematic review

“…It has been reported that both women and men of infertile couples experience a stressful married life [3], and those seeking IVF treatment are more likely to have an unstable marital relationship because of the prolonged nature and demands of the treatment [5,43]. However, a supportive marital relationship can play a protective role for couples during the period of the IVF cycle [44], especially when the woman is not adapting effectively to IVF [45]. An intervention program aimed at enhancing the partnership in couples, helping the couples to support each other while undergoing IVF treatment, is needed.…”

The Partnership and Coping Enhancement Programme for couples undergoing in vitro fertilization treatment: the development of a complex intervention in China

“…The evidence has indicated the necessity for supportive interventions focusing on enhancing the partnership and coping strategies of infertile couples. When an undesirable partner relationship has been identified among couples seeking IVF treatment [26], it has been reported that the marital relationship could be a protective factor for interfile couples across different stages of the IVF treatment [41], particularly for women with negative treatment outcomes [42].…”