Unresolved grief in women and men in Sweden three years after undergoing unsuccessful in vitro fertilization treatment

Abstract

Objective. To explore the experience of undergoing unsuccessful in vitro fertilization (IVF) treatment and of remaining childless 3 years after IVF in both women and men. Design. Qualitative-approach study. Sample. Ten women and nine men who had attended a public fertility clinic in Sweden. Methods. Individual qualitative semi-structured interviews were conducted with qualitative content analysis guiding the analysis. Results. Three years after the end of IVF treatment, most men and women were still processing and had not adapted to childlessness, indicating that the grieving process was unresolved. Unsuccessful IVF was experienced by women in terms of grief, whereas men took upon themselves a supportive role and did not express grief. A need for professional support and counseling in how to handle grief was described. An unstructured end after IVF treatment left unanswered questions. Conclusions. The grieving process after unsuccessful IVF treatment was hampered among both men and women. The provision of additional individual support during IVF is recommended as men and women experienced childlessness differently. Support and counseling concerning grief reactions following IVF failure, and a structured final consultation after IVF may facilitate the grieving process after undergoing unsuccessful IVF treatment.

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

“…Infertile couples who had failed cycle experienced unresolved grief 3 years after treatment [17]. The findings of this review are consistent with the statement that the grieving process in the IVF cycle is often long [39].…”

“…The findings showed that compared with the women who became parents, those women who remained childless had a higher level of stress (Perceived Stress Scale, PSS, m = 14.88 vs. A qualitative study conducted in Sweden revealed that the grieving process for both men and women was unresolved even 3 years after unsuccessful IVF [17]. Women were more likely to express grief than their husbands, who tended to assume the supportive roles and suppress their own feelings.…”

“…The incidence of anxiety in women was high on the day of the oocyte retrieval (ZAS ≥ 40, 33.3 %; PRIME-MD, anxiety disorder: 14.8 %) [17,26], within 2 h after the embryo transfer (SAS 40, 38.5 %) [27], and 20 days after the embryo transfer (SAS > 40, 25.9 %) [32]. The mean anxiety score for women was higher at the time of the β-HCG dosage (the pregnancy test) than at pretreatment (ZAS, m = 32.64 vs. 31.95) [9].…”

“…The studies focused on infertile couples (n = 8), women of infertile couples (n = 13), and men of infertile couples (n = 1). These studies had an average sample size of 292 (range, 37-1,731), with a mean age of 33 The approaches adopted in the qualitative studies were grounded theory [14], interpretative phenomenological analysis [15], thematic analysis [16], and content analysis [17]. Sample sizes of these four studies ranged from 14 to 22.…”

“…Women and/or men's anxiety was explored in ten studies using different instruments: STAI [28][29][30], the Zung Anxiety Scale (ZAS) [9,26], MAACL [10,31], SAS [27,32], and PRIME-MD [17]. The incidence of anxiety in women was high on the day of the oocyte retrieval (ZAS ≥ 40, 33.3 %; PRIME-MD, anxiety disorder: 14.8 %) [17,26], within 2 h after the embryo transfer (SAS 40, 38.5 %) [27], and 20 days after the embryo transfer (SAS > 40, 25.9 %) [32].…”