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Pellerone M, Martinez-Torvisco J, Razza SG, Commodari E, Miccichè S. Precursors of Prenatal Attachment and Anxiety during Pregnancy in Women Who Procreate Naturally and Pregnant Women following Assisted Reproduction Technology. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6945. [PMID: 37887682 PMCID: PMC10606198 DOI: 10.3390/ijerph20206945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 07/21/2023] [Accepted: 10/17/2023] [Indexed: 10/28/2023]
Abstract
The process of adaptation of the woman to pregnancy seems to be influenced by many factors, such as the type of conception, the mother's age, the possible presence of other children, and socio-cultural factors. Women who conceived with an assisted reproductive technique are emotionally vulnerable; compared with pregnant women who procreated naturally, they manifest elevated anxiety, which seems to be correlated to the fright of being separated from their child. Objectives of the present research are as follows: (1) to analyze the relationship between age, gestational age, time expectancy, previous failed attempts, perception of a high-risk pregnancy, and presence of other children, with the level of maternal-fetal attachment (MFA); (2) explore the level of maternal-infant attachment and anxiety by comparing the control and experimental group; (3) to measure a possible relationship between anxiety levels and MFA in ART pregnant women; (4) to identify variables predictive of prenatal attachment. The study group is formed by ninety-five women aged between 18-42 years (M = 30.57; S.D. = 5.47), pregnant from the 23rd to the 37th week (M = 28.95; S.D. = 3.99); on which 50 women who procreate naturally and 45 pregnant women following assisted reproductive technology. They completed: Maternal-Fetal Attachment Scale (MFAS), State-Trait Anxiety Inventory (STAI), and ad hoc questionnaire to collect anamnestic data. The results show the presence of a correlation between gestational age and waiting period, between the number of assisted fertilization attempts with the worry about their ability to become pregnant, but a negative correlation between pregnancy weeks and the level of maternal-fetal attachment. The study shows the predictive role of anxiety on the MFA. The applications and indications for future research are analyzed.
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Affiliation(s)
- Monica Pellerone
- Faculty of Human and Social Sciences, Kore University of Enna, 94100 Enna, Italy; (S.G.R.); (S.M.)
| | - Juan Martinez-Torvisco
- Department of Cognitive, Social and Organizational Psychology, La Laguna University, 38200 Santa Cruz de Tenerife, Spain;
| | - Stesy Giuseppa Razza
- Faculty of Human and Social Sciences, Kore University of Enna, 94100 Enna, Italy; (S.G.R.); (S.M.)
| | - Elena Commodari
- Department of Educational Sciences, University of Catania, 95126 Catania, Italy;
| | - Sandra Miccichè
- Faculty of Human and Social Sciences, Kore University of Enna, 94100 Enna, Italy; (S.G.R.); (S.M.)
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Calvo V, Fusco C, Pellicelli C, Masaro C. Romantic attachment, infertility-related stress, and positive body image of women dealing with infertility. Front Psychol 2023; 13:1067970. [PMID: 36687918 PMCID: PMC9852893 DOI: 10.3389/fpsyg.2022.1067970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 12/12/2022] [Indexed: 01/07/2023] Open
Abstract
Introduction Infertility is a condition that can affect the physical, emotional, social, and relational well-being of women. Women's bodies seem to assume a crucial relevance as part of the experience of infertility and its treatments. An extended body of literature supports the role of romantic attachment orientations in facing infertility-related stress. However, the association between romantic attachment orientations, infertility-related stress, and women's body image has not been explored. Methods This cross-sectional study aimed to investigate the role of romantic attachment and infertility-related stress concerning positive body image in 113 women dealing with infertility. Data were analyzed with correlation and mediation path analyses. Results Results showed that high levels of attachment anxiety, attachment avoidance, and infertility-related stress were negatively associated with positive body image. Path analyses indicated that positive body image may be directly associated with romantic attachment anxiety. The negative association of attachment avoidance with body image appeared to be mediated by infertility-related stress. Discussion Findings suggest that romantic attachment insecurities and infertility-related stress are significantly associated with a worsened body image in infertile women. Implications for future research are discussed.
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Affiliation(s)
- Vincenzo Calvo
- Department of Philosophy, Sociology, Pedagogy and Applied Psychology, University of Padua, Padua, Italy,*Correspondence: Vincenzo Calvo,
| | - Chiara Fusco
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Camilla Pellicelli
- Department of Philosophy, Sociology, Pedagogy and Applied Psychology, University of Padua, Padua, Italy
| | - Chiara Masaro
- Department of Philosophy, Sociology, Pedagogy and Applied Psychology, University of Padua, Padua, Italy
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Péloquin K, Boucher S, Benoit Z, Jean M, Beauvilliers L, Carranza-Mamane B, Brassard A. "We're in this together": Attachment insecurities, dyadic coping strategies, and relationship satisfaction in couples involved in medically assisted reproduction. JOURNAL OF MARITAL AND FAMILY THERAPY 2023; 49:92-110. [PMID: 36047353 DOI: 10.1111/jmft.12608] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 08/11/2022] [Accepted: 08/16/2022] [Indexed: 06/15/2023]
Abstract
Attachment is an important predictor of relationship satisfaction and attachment insecurities are a risk factor for couples under stress. Drawing from the Vulnerability-Stress-Adaptation model, we investigated whether dyadic coping strategies (DCS) would explain the links between attachment insecurities and relationship satisfaction in 97 couples involved in medically assisted reproduction (MAR). Path analyses revealed that for women and men, attachment insecurities (anxiety, avoidance) were associated with their own lower relationship satisfaction through their lower use of positive DCS. Attachment avoidance was also associated with participants' own lower relationship satisfaction through their own lower use of negative DCS. Men's attachment avoidance was also related to their partner's lower relationship satisfaction via their own and their partner's lower use of positive DCS. The findings suggest that promoting the use of positive DCS may be important to preserve relationship satisfaction in couples involved in MAR.
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Affiliation(s)
| | - Stéphanie Boucher
- Psychology Department, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Zoé Benoit
- Psychology Department, Université de Montréal, Montreal, Quebec, Canada
| | - Mireille Jean
- Psychology Department, Université de Montréal, Montreal, Quebec, Canada
| | | | - Belina Carranza-Mamane
- Department of Obstetrics and Gynecology, GREI Division, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Audrey Brassard
- Psychology Department, Université de Sherbrooke, Sherbrooke, Quebec, Canada
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Kiesswetter M, Danay E, Duschek S. Changes in Life Satisfaction in Couples after Successful In vitro Fertilization and Natural Pregnancy. FAMILY PROCESS 2022; 61:1559-1576. [PMID: 34939190 DOI: 10.1111/famp.12732] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 10/15/2021] [Accepted: 10/25/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Previous research suggested reduced well-being and quality of life in couples with an unfulfilled desire to have a child. However, changes in psychological variables in infertile couples after successful in-vitro fertilization (IVF) have been scarcely investigated. PURPOSE This prospective study explored changes in life satisfaction, stress burden and habitual worry related to the birth of a child in couples undergoing IVF, and in those experiencing natural pregnancy. METHODS In total, 77 couples with successful IVF and 50 couples with natural pregnancy completed the Life Satisfaction Questionnaire, Perceived Stress Questionnaire and Penn State Worry Questionnaire; data were recorded before pregnancy (baseline) and 6 and 12 months after childbirth. Multi-level models were applied for data analysis. RESULTS Couples with IVF reported lower life satisfaction, and higher stress burden and worry, than those with natural pregnancy at baseline. Moreover, they showed a steep increase in life satisfaction at 6 and 12 months after childbirth, and decreased stress and worry. In couples with natural pregnancy, life satisfaction scores decreased, and those of stress and worry increased, at month 6 after childbirth and returned to initial state at month 12. CONCLUSIONS The group difference at baseline underlines the psychosocial burden of infertility. However, the increase in life satisfaction and decreases in stress and worry suggest that the burden is lessened after the birth of a child. The changes in couples with natural pregnancy reflect the impact of the typical challenges posed by childbirth and successful readjustment during the first year of the child´s life.
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Affiliation(s)
- Manuel Kiesswetter
- Institute of Psychology, UMIT Tirol - University of Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
| | - Erik Danay
- Institute of Psychology, UMIT Tirol - University of Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
| | - Stefan Duschek
- Institute of Psychology, UMIT Tirol - University of Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
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Elyasi F, Parkoohi PI, Naseri M, Gelekolaee KS, Hamedi M, Peyvandi S, Azizi M. Relationship between coping/attachment styles and infertility-specific distress in Iranian infertile individuals: A cross-sectional study. Int J Reprod Biomed 2021; 19:347-360. [PMID: 33997594 PMCID: PMC8106813 DOI: 10.18502/ijrm.v19i4.9061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 07/11/2020] [Accepted: 10/12/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Infertility has been recognized as a stressful clinical condition, significantly affecting couples' emotional functioning. OBJECTIVE To investigate the relationship between coping/attachment styles and infertility-specific distress (ISD) in infertile participants. MATERIALS AND METHODS Atotal number of 240 infertile participants (120 women and 120 men) who attend the Outpatient Infertility Clinic in Sari, Iran between February and October 2017 were selected using the convenience sampling method. Data were collected using a questionnaire addressing sociodemographic variables. In addition, coping and attachment styles were evaluated via the Coping Strategies Questionnaire and the Revised Adult Attachment Scale by Collins and Read (1990); respectively. Ultimately, the Infertility Distress Scale was used to assess ISD. RESULTS The mean ISD score was 42.53 ± 9.63. Secure and insecure attachment styles were observed in 37.9% and 62.1% of the cases, respectively. There was a significant difference among ISD and different groups of attachment styles (p = 0.001) and emotion-focused coping style (p = 0.021). However, no significant relationship was found between problem-focused coping style and ISD (p = 0.985). CONCLUSION Considering the relationship between coping/attachment styles and ISD, it was recommended to implement stress prevention and coping education within the framework of coping/attachment theories for infertile individuals.
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Affiliation(s)
- Forouzan Elyasi
- Department of Psychiatry, Psychiatry and Behavioral Sciences Research Center, Sexual and Reproductive Health Research Center, Addiction Institute, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Parisa Islami Parkoohi
- Psychiatry and Behavioral Sciences Research Center, Addiction Research Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahshid Naseri
- School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Keshvar Samadaee Gelekolaee
- Department of Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoume Hamedi
- IVF Ward, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Sepideh Peyvandi
- Sexual and Reproductive Health Research Center IVF Ward, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Marzieh Azizi
- Department of Reproductive Health and Midwifery, Nursing and Midwifery Faculty, Tehran University of Medical Science, Tehran, Iran
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Molgora S, Baldini MP, Tamanza G, Somigliana E, Saita E. Individual and Relational Well-Being at the Start of an ART Treatment: A Focus on Partners' Gender Differences. Front Psychol 2020; 11:2027. [PMID: 33117204 PMCID: PMC7549400 DOI: 10.3389/fpsyg.2020.02027] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 07/21/2020] [Indexed: 12/17/2022] Open
Abstract
Infertility and ART treatments represent stressful experiences for the couples, impacting on the overall psychological well-being of partners as well as on their couple adjustment. Several variables were analyzed as risk factors for infertility-related distress. The impact of these experiences has been well-documented in both women and men, reporting important gender differences. The aim of this study was to assess gender differences in individual and relational well-being in infertile couples. Gender differences for psychological and medical variables predicting psychological distress were investigated. Two hundred and thirty couples who entered an ART program at a public hospital in Milan were recruited. Each partner completed the following scales: ScreenIVF, Dyadic Adjustment Scale, and Experience in Close Relationship Questionnaire. Findings revealed several gender differences with women reporting higher levels of both anxiety and depressive symptoms, anxiety and avoidance attachment, and helplessness, but lower levels of acceptance than men. Differences emerged also in factors predicting well-being: poor support predicted anxiety in men and depression in women. Furthermore, individual well-being was predicted only for men by attachment anxiety and previous treatment. Finally, in the women subsample, couple's adjustment was predicted by anxiety attachment, while in men predictors were helplessness and type of diagnosis. These results suggest the importance of implementing support interventions for couples which take into consideration the specific needs and fragility of each partner as well as focusing on enhancing a sense of partnership.
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Affiliation(s)
- Sara Molgora
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
| | - Maria Pia Baldini
- IRCCS Ca’Granda Foundation Maggiore Policlinico Hospital, Milan, Italy
| | | | | | - Emanuela Saita
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
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Kayabaşi Ö, Yaman Sözbir Ş. The relationship between quality of life, perceived stress, marital satisfaction in women conceived through ART. J Reprod Infant Psychol 2020; 40:108-117. [PMID: 32602747 DOI: 10.1080/02646838.2020.1788211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND The stress experienced during pregnancy and the decrease in marital satisfaction affects the quality of life of the woman negatively. OBJECTIVE This study conducted to determine the quality of life and the relationship with perceived stress and marital satisfaction in pregnant women with ART. METHODS This study is a descriptive and corelational study. The study sample consisted of 120 pregnant women with ART. The patient descriptive form, the Married Life Scale (SWML), The Perceived Stress Scale (PSS) and The Fertility Quality of Life (FertiQoL) were used for data collection in this study. RESULTS The mean of the total score of PSS was 16.38 ± 4,721, the mean score of SWML was 23.03 ± 4.42 and the mean of the total score of FertiQoL was 81,25 ± 17,56. There was a moderate negative correlation (r = -0,551, p = 0,001) between the total score of the FertiQol and the total score of PSS and there was a moderate positive correlation (r = 0,452, p = 0,001) between FertiQol total score and SWML. CONCLUSION This study found that the rate of perceived stress affected the quality of life negatively and marital satisfaction affected the quality of life positively in pregnant women with ART.
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Affiliation(s)
- Özlem Kayabaşi
- Faculty of Health Sciences, Nursing Department, Ob/Gyn Nursing, Gazi University, Ankara, Turkey
| | - Şengül Yaman Sözbir
- Faculty of Health Sciences, Nursing Department, Ob/Gyn Nursing, Gazi University, Ankara, Turkey
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Renzi A, Di Trani M, Solano L, Minutolo E, Tambelli R. Success of assisted reproductive technology treatment and couple relationship: A pilot study on the role of romantic attachment. Health Psychol Open 2020; 7:2055102920933073. [PMID: 32637146 PMCID: PMC7323283 DOI: 10.1177/2055102920933073] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Infertility is a deeply distressing experience, which can threaten important personal and martial goals, frequently affecting the psychophysical health. A supportive relationship and a secure romantic attachment appear to reduce infertility stress, as well as play a relevant role in the success of assisted reproductive technology treatments. The principal aim of the study is to investigate the predictive effect of romantic attachment, couple characteristics, quality of life and age on assisted reproductive technology outcome. A total of 88 infertile women, enrolled in an assisted reproductive technology Centre of Rome, completed the Experience in Close Relationship-Revised, the Couple Relationship Inventory, the Fertility Quality of Life and a socio-demographic questionnaire. The participants completed the questionnaires at the beginning of the medical treatment. Data analyses showed significant associations among Experience in Close Relationship-Revised dimensions, Couple Relationship Inventory and Fertility Quality of Life Scales. Assisted reproductive technology outcome was negatively correlated to Experience in Close Relationship-Revised Avoidance and positively related to Couple Relationship Inventory Dependence. A multi-variable logistic regression revealed that Experience in Close Relationship-Revised Avoidance decreased the probability of pregnancy. The present findings partially confirmed the study hypotheses since several associations among couple characteristics, attachment anxiety and avoidance dimensions, infertility-related quality of life in infertile women were found. Furthermore, according to a definition of Avoidance, assisted reproductive technology positive outcome appears to be associated to lower levels of fear of dependence and interpersonal intimacy, and to a low need both for self-reliance and for reluctance to self-disclose within the romantic relationship. Further investigations are needed both to confirm this preliminary finding and for promoting focused therapeutic interventions for couples facing assisted reproductive technology.
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Affiliation(s)
- Alessia Renzi
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
| | - Michela Di Trani
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
| | - Luigi Solano
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
| | | | - Renata Tambelli
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
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Kiesswetter M, Marsoner H, Luehwink A, Fistarol M, Mahlknecht A, Duschek S. Impairments in life satisfaction in infertility: Associations with perceived stress, affectivity, partnership quality, social support and the desire to have a child. Behav Med 2020; 46:130-141. [PMID: 30726170 DOI: 10.1080/08964289.2018.1564897] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Between 10% and 15% of couples in western society are affected by infertility. As a major source of psychological distress, infertility may be accompanied by a substantial decline in well-being, and mental symptoms including those of depression and anxiety. This study aimed to quantify impairments in life satisfaction in infertile couples and to identify psychosocial variables moderating these impairments. For this purpose, 228 infertile couples completed the Life Satisfaction Questionnaire (LSQ), Perceived Stress Questionnaire (PSQ), Positive and Negative Affect Schedule (PANAS), Penn State Worry Questionnaire (PSWQ), Partnership Questionnaire (PQ), Social Support Questionnaire, (SSQ) and Questionnaire on the Desire to Have a Child (QDC). Our sample scored below the norm of the general population on the LSQ sum score and various subscales, including those assessing social relationships, health, sexuality, leisure activities, and self-evaluation. Correlation and regression analysis revealed an inverse association of life satisfaction (LSQ) with stress (PSQ), negative affect (PANAS), and worry (PSWQ), and positive associations with positive affect (PANAS), partnership quality (PQ), social support (SSQ), and the strength of the desire to have a child (QDC). These findings support the notion of markedly reduced satisfaction with numerous life areas in the context of infertility. Psychosocial factors such as increased stress related to infertility treatment, affective impairments, partnership problems, lack of social support or social exclusion may contribute to this reduction. Psychological interventions aimed at controlling stress, strengthening partnerships, and improving social inclusion may be helpful in reducing the burden of infertility and improving the life satisfaction of affected couples.
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Affiliation(s)
- Manuel Kiesswetter
- Institute of Psychology, UMIT - University for Health Sciences Medical Informatics and Technology, Austria
| | - Heidi Marsoner
- Reference Center for Reproductive Medicine, General Hospital of Brunico, Italy
| | - Arne Luehwink
- Reference Center for Reproductive Medicine, General Hospital of Arco, Italy
| | | | | | - Stefan Duschek
- Institute of Psychology, UMIT - University for Health Sciences Medical Informatics and Technology, Austria
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Purcell-Lévesque C, Brassard A, Carranza-Mamane B, Péloquin K. Attachment and sexual functioning in women and men seeking fertility treatment. J Psychosom Obstet Gynaecol 2019; 40:202-210. [PMID: 29749292 DOI: 10.1080/0167482x.2018.1471462] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
Abstract
Objective: The purpose of the study was to examine the frequency of sexual difficulties and the associations among attachment insecurities (anxiety, avoidance) and sexual functioning (problems with sexual function, sexual dissatisfaction) in women and couples seeking fertility treatment. Methods: In a cross-sectional study, 88 Canadian women and 45 couples receiving fertility treatments completed self-reported measures of adult attachment and sexual functioning. Results: The frequency of problems in sexual function varied from 14.8% (pain) to 58.0% (desire) in women and from 6.7% (satisfaction with orgasm) to 28.9% (desire) in men. Among women, attachment-related avoidance predicted their low levels of sexual satisfaction (β = -0.30, p = .007) and sexual pain (β = 0.22, p = .044). Dyadic analyses revealed associations between men's attachment-related anxiety and their difficulties in reaching erection (β = 0.30, p = .042) and orgasm (β = 0.33, p = .009). Anxiety in women was related to their lubrication difficulties (β = 0.44, p = .006). One partner effect was found: men's avoidance was related to their partners' difficulty in achieving orgasms (β = 0.39, p = .045). Conclusions: Results support the pertinence of attachment theory and the relevance of using dyadic designs to understand sexuality in couples seeking fertility treatment.
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Affiliation(s)
| | - Audrey Brassard
- a Department of Psychology , Université de Sherbrooke , Sherbrooke , Quebec , Canada
| | - Belina Carranza-Mamane
- b Department of Obstetrics and Gynecology , Université de Sherbrooke , Sherbrooke , Quebec , Canada
| | - Katherine Péloquin
- c Department of Psychology , Université de Montreal , Montréal , Quebec , Canada
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Kalaitzaki AE, Mavrogiannaki S, Makrigiannakis A. A prospective, cross-sectional study of the protective and risk psychological factors of successful in vitro fertilisation outcome: preliminary results in a Greek sample. J OBSTET GYNAECOL 2019; 40:382-387. [DOI: 10.1080/01443615.2019.1631766] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Argyroula E. Kalaitzaki
- Laboratory of Interdisciplinary Approaches for the Enhancement of Quality of Life, Department of Social Work, School of Health Sciences, School of Health Sciences, Hellenic Mediterranean University, Heraklion, Greece
| | - Stella Mavrogiannaki
- Department of Obstetrics and Gynecology, School of Medicine, University Hospital of Heraklion, University of Crete, Heraklion, Greece
| | - Antonios Makrigiannakis
- Department of Obstetrics and Gynecology, School of Medicine, University Hospital of Heraklion, University of Crete, Heraklion, Greece
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Molgora S, Fenaroli V, Acquati C, De Donno A, Baldini MP, Saita E. Examining the Role of Dyadic Coping on the Marital Adjustment of Couples Undergoing Assisted Reproductive Technology (ART). Front Psychol 2019; 10:415. [PMID: 30906270 PMCID: PMC6418016 DOI: 10.3389/fpsyg.2019.00415] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 02/12/2019] [Indexed: 11/13/2022] Open
Abstract
A couple is considered to be infertile if unable to conceive after 12 months of unprotected sexual intercourse. An extended body of literature supports that infertility and infertility treatments contribute to emotional, social, sexual, and relational issues that can have a negative impact on each partner's well-being and on the couple relationship. Recent findings suggest that a dyadic approach should be used when working with couples coping with these stressors. However, most research to date has focused on the association between infertility and individual's psychological outcomes, rather than on the experience of infertility-related stress and coping from a relational perspective. Consequently, assuming that infertility is a dyadic stressor and that the ability of the partners to cope with this experience is the result of both individual and relational coping strategies, this study aimed to investigate dyadic coping and marital adjustment among couples at the beginning of an Assisted Reproductive Technology (ART) treatment. A sample of 167 heterosexual couples (N = 334) undergoing ART treatment at the fertility clinic of a large hospital in Milan from January to December 2017 was recruited. Each participant completed self-reported questionnaires examining marital adjustment (Dyadic Adjustment Scale) and dyadic coping (Dyadic Coping Questionnaire). Demographics and clinical variables were also collected. Data were analyzed using the Actor Partner Interdependence Model (APIM), testing the effect of each partner's dyadic coping style on their own and their partner's marital adjustment. Results revealed that both women and partners' scores on positive dyadic coping styles (common, emotion-focused, problem-focused, and delegated dyadic coping) contributed to higher marital adjustment. This result suggests that couples unable to engage in this type of reciprocal supportive behaviors and those unsatisfied with their coping efforts may be more vulnerable while undergoing ART treatments. Furthermore, findings highlighted some gender differences for stress communication and negative dyadic coping suggesting the presence of specific dynamics within couples facing an ART treatment. Implications for clinical practice and future research are discussed.
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Affiliation(s)
- Sara Molgora
- Department of Psychology, Catholic University of Sacred Hearth, Milan, Italy
| | - Valentina Fenaroli
- Department of Psychology, Catholic University of Sacred Hearth, Milan, Italy
| | - Chiara Acquati
- Graduate College of Social Work, University of Houston, Houston, TX, United States
| | - Arianna De Donno
- Department of Psychology, Catholic University of Sacred Hearth, Milan, Italy
| | - Maria Pia Baldini
- IRCCS Ca 'Granda Foundation Maggiore Policlinico Hospital, Milan, Italy
| | - Emanuela Saita
- Department of Psychology, Catholic University of Sacred Hearth, Milan, Italy
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The Partnership and Coping Enhancement Programme for couples undergoing in vitro fertilization treatment: the development of a complex intervention in China. J Assist Reprod Genet 2016; 34:99-108. [PMID: 27744588 DOI: 10.1007/s10815-016-0817-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Accepted: 09/20/2016] [Indexed: 10/20/2022] Open
Abstract
PURPOSE Couples as dyads suffer from the diagnosis of infertility and related treatment. These couples commonly experience emotional and physical pain and tension in their marital lives. The purpose of this study is to report on the process of developing a potentially feasible and effective complex intervention for couples undergoing in vitro fertilization treatment in China. METHODS The Medical Research Council (MRC) framework for developing and evaluating the complex intervention was adopted to guide the development of the Partnership and Coping Enhancement Programme (PCEP). In developing the PCEP, three steps were taken, namely, (1) identifying evidence by conducting literature reviews, a concept analysis and a qualitative study; (2) identifying/developing a theory-in this case, a preliminary Endurance with Partnership Conceptual Framework (P-EPCF) was proposed; and (3) modelling the process and outcomes of the PCEP. RESULTS The PCEP that was developed is targeted mainly at the domains of the partnership mediators of stress in the P-EPCF. It consists of two sections-partnership and coping-and will be delivered to infertile couples on the day of embryo transfer. The main focuses of the programme are to facilitate mutual sharing and support in infertile couples, and to improve their individual and dyadic coping strategies while undergoing IVF treatment, especially in the period when they are waiting for the results of a pregnancy test and after the disclosure of a negative treatment outcome. The programme is couple-based, consisting of experience sharing, psychoeducation, meditation exercise, skill practise and supplemental written materials. CONCLUSIONS The Partnership and Coping Enhancement Programme (PCEP) for couples undergoing in vitro fertilization treatment was developed according to the guideline of the MRC framework. It is recommended that a pilot study be conducted to evaluate its feasibility and to model the process and outcomes of the programme.
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How do individual attachment patterns of both members of couples affect their perceived infertility stress? An actor–partner interdependence analysis. PERSONALITY AND INDIVIDUAL DIFFERENCES 2016. [DOI: 10.1016/j.paid.2015.12.023] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Ying L, Wu LH, Loke AY. Gender differences in emotional reactions to in vitro fertilization treatment: a systematic review. J Assist Reprod Genet 2016; 33:167-79. [PMID: 26712577 PMCID: PMC4759000 DOI: 10.1007/s10815-015-0638-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 12/10/2015] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The purposes of this paper are to provide a comprehensive picture of men and women's emotional reactions to infertility treatment, specifically In Vitro Fertilization (IVF) pursued by heterosexual couples, and to identify any differences between the genders. METHODS Nonexperimental studies exploring the psychological effects of IVF treatment on infertile couples were included. Six electronic databases were used to conduct a systematic search from the years 2000 to 2014. The references of the articles selected for review and other related systematic reviews were also screened to retrieve additional relevant articles. The quality of the included studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist. Descriptive analysis was adopted to synthesize the results. RESULTS A total of 22 quantitative and 4 qualitative studies were identified and included in this review. Although both men and women experienced psychological distress during the treatment, gender differences existed. Women had elevated anxiety and depression levels prior to the treatment, which became even higher on the day of the oocyte retrieval, pre- and post embryo transfer, and during the waiting period before the pregnancy test. Men of the infertile couples reported elevated depression scores before treatment, which usually increased during the time spent waiting for the outcome of the IVF treatment. Both men and women had lower scores on positive affect before the pregnancy test. A failed IVF cycle had long-term negative psychological consequences for both spouses. CONCLUSIONS The results of this review pointed to the need for a couple-based support program, aimed at improving the psychological well-being of couples.
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Affiliation(s)
- Liying Ying
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China.
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
| | - Lai Har Wu
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China.
| | - Alice Yuen Loke
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China.
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Moura-Ramos M, Gameiro S, Canavarro MC, Soares I, Almeida-Santos T. Does infertility history affect the emotional adjustment of couples undergoing assisted reproduction? the mediating role of the importance of parenthood. Br J Health Psychol 2015; 21:302-17. [PMID: 27059275 PMCID: PMC5061027 DOI: 10.1111/bjhp.12169] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Revised: 09/25/2015] [Indexed: 11/29/2022]
Abstract
Objectives The 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. Methods In 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. Results The 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. Conclusions Infertility 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 event Assisted reproductive treatments (ART) are emotionally demanding
What does this study add? The influence of infertility history on adjustment is mediated by the importance of parenthood Men and women are affected by their past history of infertility differently
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Affiliation(s)
- Mariana Moura-Ramos
- Faculty of Psychology and Educational Sciences, University of Coimbra, Portugal
| | - Sofia Gameiro
- Cardiff Fertility Studies Research Group, School of Psychology, Cardiff University, UK
| | | | - Isabel Soares
- School of Psychology, University of Minho, Braga, Portugal
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The Experience of Chinese Couples Undergoing In Vitro Fertilization Treatment: Perception of the Treatment Process and Partner Support. PLoS One 2015; 10:e0139691. [PMID: 26431545 PMCID: PMC4592197 DOI: 10.1371/journal.pone.0139691] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 09/16/2015] [Indexed: 11/19/2022] Open
Abstract
Background Couples undergoing In Vitro Fertilization (IVF) Treatment suffer as dyads from the stressful experience of the painful treatment and the fear that the IVF cycle will fail. They are likely to report that their marital relationship has become unstable due to the prolonged period of treatment. Methods This is a qualitative study that was conducted to explore the experiences that Chinese couples have had with IVF treatment, especially their perceptions of the process and the support between couples. Results The interviews revealed that couples suffered from the process, experiencing physical and emotional pain, struggling with the urgency and inflexibility of bearing a child, and experiencing disturbances in their daily routines and work. The participants described how they endured the hardships as a couple and how it affected their relationship. The couples felt that sharing feelings and supporting each other contribute to psychological well-being and improves the marital relationship. They also identified some unfavorable aspects in their partner relationship. They were ambivalent about receiving social support from friends and family members. Conclusions With the couples indicating that the support that they received from each other affected their experience during the treatment process, it is suggested that a supportive intervention that focuses on enhancing the partnership of the couples and dealing with their inflexibility on the issue of bearing a child might result in improvements in the psychological status and marital relationship of infertile couples undergoing IVF treatment.
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Smith NK, Madeira J, Millard HR. Sexual Function and Fertility Quality of Life in Women Using In Vitro Fertilization. J Sex Med 2015; 12:985-93. [DOI: 10.1111/jsm.12824] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Rockliff HE, Lightman SL, Rhidian E, Buchanan H, Gordon U, Vedhara K. A systematic review of psychosocial factors associated with emotional adjustment in in vitro fertilization patients. Hum Reprod Update 2014; 20:594-613. [PMID: 24676468 DOI: 10.1093/humupd/dmu010] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND IVF treatment is usually stressful for patients, but individual differences in emotional response do exist. Differences in the stress response may be related to reproductive outcomes as well as to the development of psychiatric problems. This review collates research exploring which psychosocial factors (e.g. personality traits and coping strategies) are associated with the emotional adjustment of IVF patients. The aim is to reveal what is currently known about risk and protective factors for coping with the stress of IVF treatment and where further enquiry would be most beneficial. METHODS The databases, MEDLINE/PUBMED (US National Library of Medicine), PsycINFO (American Psychological Association), Web of Science (Social Sciences Citation Index) and EMbase, were searched from 1978 to September 2012 using relevant key words. All published peer-reviewed studies exploring associations between psychosocial factors and emotional adjustment outcomes were considered for inclusion. RESULTS There were 23 studies identified for review. One-third of the psychosocial factors explored were found to be significantly related to emotional adjustment outcome measures. Neuroticism and the use of escapist coping strategies were positively associated with distress by multiple studies. Social support was negatively associated with distress by several studies. A number of other psychosocial variables appear to be associated with distress, including self-criticism, dependency, situation appraisals and attachment style, but these have only been explored by one or two studies at most. There is a paucity of research using positive emotional outcome measures (e.g. well-being, positive affect, happiness or life satisfaction) to quantify emotional adjustment. CONCLUSIONS Whilst some psychosocial variables appear to be consistently associated with distress for IVF patients, two-thirds of the variables tested to date do not appear to be associated with emotional adjustment. This review highlights key psychosocial factors to assist the identification of patients at high risk of psychological distress. These findings highlight at least two psychological factors that may be amenable to alteration with psychological or educational interventions. Future work should explore whether experimental manipulation of such psychosocial factors can provide effective stress reduction in this clinical context.
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Affiliation(s)
- Helen E Rockliff
- Department of Clinical Sciences, University of Bristol, Whitson Street, Bristol BS1 3NY, UK
| | - Stafford L Lightman
- Department of Clinical Sciences, University of Bristol, Whitson Street, Bristol BS1 3NY, UK
| | - Emily Rhidian
- Department of Clinical Sciences, University of Bristol, Whitson Street, Bristol BS1 3NY, UK
| | - Heather Buchanan
- School of Community Health Sciences, University of Nottingham, Nottingham NG7 2RD, UK
| | - Uma Gordon
- Bristol Centre for Reproductive Medicine, Southmead Hospital, Bristol BS10 5NB, UK
| | - Kavita Vedhara
- School of Community Health Sciences, University of Nottingham, Nottingham NG7 2RD, UK
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Massar K, Buunk AP, Gruijters SLK. Pregnant Women’s View on Their Relationship: A Comparison With Nonpregnant Women. INTERPERSONA: AN INTERNATIONAL JOURNAL ON PERSONAL RELATIONSHIPS 2013. [DOI: 10.5964/ijpr.v7i2.122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Donarelli Z, Lo Coco G, Gullo S, Marino A, Volpes A, Allegra A. Are attachment dimensions associated with infertility-related stress in couples undergoing their first IVF treatment? A study on the individual and cross-partner effect. Hum Reprod 2012; 27:3215-25. [PMID: 22926837 DOI: 10.1093/humrep/des307] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION Are attachment anxiety and avoidance dimensions in female and male partners in couples seeking infertility treatment associated with her and his infertility-related stress? SUMMARY ANSWER Attachment dimensions are significantly associated with several aspects of infertility stress in couples undergoing IVF treatment. WHAT IS KNOWN AND WHAT THIS PAPER ADDS Attachment dimensions of anxiety and avoidance (where highly anxious individuals fear rejection and are preoccupied with maintaining proximity to their partner and highly avoidant individuals are uncomfortable with intimacy and prefer to maintain distance from their partner) may influence the well being of individuals undergoing IVF/ICSI treatment. This study showed that one partner's attachment dimensions had a direct effect on the infertility-related stress of the other partner. DESIGN Cross-sectional study of consecutive couples before starting their first IVF/ICSI treatment in 2009-2011 at the ANDROS clinic in Palermo, Italy. PARTICIPANTS AND SETTING Three hundred and fifty-nine couples undergoing fertility treatments were invited to participate in the research. The final sample comprised 316 females and 316 males who filled out the psychological questionnaires (Experiences in Close Relationships; Fertility Problem Inventory; State scale of State-Trait Anxiety Inventory). The participants included patients who had a primary infertility diagnosis and were about to undergo their first IVF or ICSI treatment. DATA ANALYSIS METHOD Paired t-tests were used to examine gender differences on the study variables (attachment anxiety, attachment avoidance, infertility stress, state anxiety, etc.). Associations between infertility-related stress and the study variables were explored using hierarchical stepwise multivariate linear regression analyses. MAIN RESULTS AND THE ROLE OF CHANCE Attachment anxiety and attachment avoidance were significantly associated with global infertility stress in both women (β = 0.24, P < 0.01 and β = 0.27, P < 0.01) and men (β = 0.23, P < 0.01 and β = 0.37, P < 0.01). Regarding the cross-partner effects, men's infertility stress and relationship concerns were associated with their partners' attachment avoidance (β = 0.10 P < 0.05 and β = 0.12, P < 0.05); and the infertility stress of women and the scores for need of parenthood were associated with their partners' attachment anxiety (β = 0.14 P < 0.05 and β = 0.16, P < 0.05). BIAS, CONFOUNDING AND OTHER REASONS FOR CAUTION The study data are cross sectional, and specifically focus on associations between adult attachment style and infertility stress. Treating the data from couples as independent observations may be a limitation of the analysis. Potential moderators of such relationships (e.g. coping strategies, stress appraisal) are not included in this study. STUDY FUNDING/COMPETING INTEREST(S) This research was supported by funds provided by Centro Andros S.r.l., Palermo, Italy. The authors declare no financial or commercial conflicts of interest in this study.
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Galhardo A, Pinto-Gouveia J, Cunha M, Matos M. The impact of shame and self-judgment on psychopathology in infertile patients. Hum Reprod 2011; 26:2408-14. [DOI: 10.1093/humrep/der209] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Van den Broeck U, D'Hooghe T, Enzlin P, Demyttenaere K. Predictors of psychological distress in patients starting IVF treatment: infertility-specific versus general psychological characteristics. Hum Reprod 2010; 25:1471-80. [DOI: 10.1093/humrep/deq030] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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