Marital Duration, and Fertility-Related Stress as Predictors of Quality of life: Gender Differences among Primary Infertile Couples

The actor-partner interdependence model of fertility stress and marital quality among couples undergoing in vitro fertilization and embryo transfer: The mediating role of dyadic coping

To explore the relationships among fertility stress, dyadic coping and marital quality in couples undergoing in vitro fertilization-embryo transfer (IVF-ET). Couples receiving IVF-ET treatment at the clinic of the reproductive medicine centre of a hospital in China from February 2023 to October 2023 were selected by convenience sampling. A general information questionnaire, the Infertility Fertility Stress Scale (COMP-FPSS-SF), the dyadic coping inventory, and the marital adjustment test were used to evaluate the results. AMOS24.0 software was used to construct an actor-partner interdependence model that extended to mediation to analyze the relationships among couples' fertility stress, dyadic coping, and marital quality. The fertility stress level of IVF-ET wives was significantly higher than that of their husbands (p < 0.05). Wives' levels of dyadic coping and marital quality were significantly lower than those of husbands (p < 0.05). Fertility stress, dyadic coping, and marital quality were positively correlated between IVF-ET couples (p < 0.01). In terms of the actor effect, the fertility stress of IVF-ET couples had a significant impact on their marital quality through their dyadic coping (β = -0.188, p < 0.05; β = -0.109, p < 0.05). In terms of partner effects, wives' fertility stress significantly affected their husbands' marital quality through their own or their husbands' dyadic coping (β = -0.055, p < 0.01; β = 0.157, p < 0.01). Dyadic coping mediates the relationship between fertility stress and marital quality in IVF-ET couples. Nurses can use husbands and wives as central individuals and dyadic coping as the starting point to formulate intervention measures to reduce fertility stress and improve marital quality.

Infertility-Related Stress, and Dyadic Coping as Predictors of Quality of Life: Gender Differences Among Couples with Infertility Issues

Background

The purpose of this study was to explore the relationship between infertility-related stress and dyadic coping with quality of life (QoL) in couples with infertility issues, and verify gender differences and dyadic interactions in the associations between them.

Methods

This cross-sectional study included 340 couples who were recruited from the First Affiliated Hospital of Lanzhou University between March 2022 and November 2022. The Fertility Problem Inventory, Dyadic Coping Inventory and FertiQoL were used to measure infertility-related stress, dyadic coping and QoL. The Actor-Partner Interdependence Model was used to analyze the effects of infertility-related stress and dyadic coping on the couple's own QoL (actor effect) as well as on their partner's QoL (partner effect).

Results

Female patients perceived significantly lower levels of QoL and dyadic coping than those of husbands. There was no statistically significant difference in the infertility-related stress between wives and husbands. Husbands' infertility-related stress had actor and partner effects on their own and their wives' QoL, while wives' infertility-related stress only had an actor effect on their own QoL. Husbands' dyadic coping had both actor effect and partner effects on their own and their wives' QoL, meanwhile wives' dyadic coping had both actor effect and partner effects on their own and their husbands' QoL.

Conclusion

Husbands' QoL was impacted by their own infertility-related stress, dyadic coping and their wives' dyadic coping. Whereas wives' QoL was influenced by infertility-related stress and dyadic coping from both their own and their spouses. Therefore, elevating the level of dyadic coping may contribute to improving QoL for both husbands and wives. Moreover, enhancing the ability to cope with infertility-related stress might be useful for husbands and indirectly contribute to wives' QoL.

Determinants of Quality of Life in Serbian Infertile Couples

Background

This study aimed to examine the quality of life and the factors that determine the quality of life of infertile couples.

Methods

The research was conducted as a cross-sectional study at the Gynecology and Obstetrics Clinic "Narodni Front" in Belgrade, the Special Gynecology Hospital "Ferona" in Novi Sad, the Special Hospital for the Treatment of Sterility and In Vitro Fertilization "Spebo Medikal" in Leskovac and the General Hospital in Valjevo, Serbia in 2022, on a sample of 378 infertile couples. The data were collected by means of a questionnaire, the integral part of which is the standardized FertiQoL scale. Independent t-test and one-way ANOVA were used to determine differences. A value of P<0.05 was considered statistically significant.

Results

Women achieve a significantly lower score on the quality of life questionnaire (69.34±11.05) compared to men (73.96±9.87). Women exhibit significantly lower scores in the area of physical, emotional and social functioning (P<0.05). Men who live in the countryside show a lower quality of life score in the emotional (P=0.029) and social (P=0.042) domains. In addition, men over 40 years of age and with a high level of education have a lower quality of life (P=0.08).

Conclusion

Women have a lower quality of life, as do men from rural areas and over 40 years of age. A multi-disciplinary approach and community education, as well as the provision of social support with a special emphasis on emotional and material support, would significantly contribute to improving the quality of life of infertile couples.

A Systematic Review and Meta-analysis of the Psychiatric Morbidities and Quality of Life Differences Between Men and Women in Infertile Couples

Infertility is often associated with diverse psychiatric morbidities and quality of life impairments. Hence, this meta-analysis aimed to compare stress, depression, anxiety and quality of life (QoL) among infertile men and women. We retrieved the relevant articles from multiple databases. For the statistical analyses, we used Comprehensive Meta-Analysis software v. 3.7 (Biostat Inc., Englewood, NJ). Standardized mean differences (SMD) with 95% confidence intervals (CI) were calculated and displayed in forest plots. Among the 4123 articles identified, 35 studies met the inclusion criteria. Our results revealed that stress, depression, and anxiety were higher in infertile women compared to men. Similarly, infertile women presented a lower QoL than infertile men. Subgroup analysis revealed that the assessment tool used, study design, and geographical origin were a source of heterogeneity. This meta-analysis showed that psychological disturbances were higher in infertile women compared to men. Physicians need to consider this difference to enable couples to better understand and support each other.

The effect of male and female factor infertility on women's anxiety, depression, self-esteem, quality of life and sexual function parameters: a prospective, cross-sectional study from Turkey

OBJECTIVES

Despite the development of diagnosis and treatment methods, the psychological effects of infertility on women were not adequately addressed. This study investigated the effect of male and female factor infertility on women's anxiety, depression, self-esteem, quality of life, and sexual function parameters.

METHODS

In this prospective, cross-sectional study, 480 women [n = 234, with male factor infertility (MFI) (MFI group) and n = 246, with female factor infertility (FFI) (FFI group)], who could not conceive despite unprotected intercourse for 1 year, and 242 fertile healthy women (control group) who had children within the last 1 year were included. Beck Anxiety Inventory (BAI), Beck Depression Inventory-II (BDI-II), Rosenberg Self Esteem Scale (RSES), Fertility Quality of Life (FertiQol) and Female Sexual Function Index (FSFI) questionnaires were used for patients' evaluation.

RESULTS

RSES, BAI and BDI-II scores were significantly higher and FSFI score was significantly lower in the FFI group compared to other groups. RSES, BAI and BDI-II scores were also significantly higher and FSFI score was significantly lower in the MFI group compared to the control group. FertiQol total score was significantly lower in the FFI group compared to the MFI group. RSES score was positively correlated with BDI-II and BAI scores; however, it was negatively correlated with FertiQol and FSFI scores.

CONCLUSIONS

The negative psychological effects of infertility are ignored by many centres, especially in the treatment process of infertility. Regardless of the infertility factor (male or female), we believe that psychological support should be given to all women to improve their life quality.

Infertility-related stress and quality of life among infertile women with polycystic ovary syndrome: Does body mass index matter?

OBJECTIVE

Infertility and obesity are common among women with Polycystic ovary syndrome (PCOS) and related to poor quality of life (QoL). Obesity may confer an elevated adverse effect of infertility-related stress given its relationship with increased susceptibility to stress. This study aimed to investigate the association of infertility-related stress with QoL among infertile women with PCOS, and to evaluate whether body mass index (BMI) modifies this association.

METHODS

A cross-sectional study was conducted with 306 participants recruited from the infertility outpatient clinic. A self-administered, structured questionnaire including COMPI Fertility Problem Stress Scale (COMPI-FPSS) and the modified PCOS health-related QoL questionnaire (MPCOSQ) was conducted in this study. The moderation model was conducted by the PROCESS macro using SPSS.

RESULTS

The mean score of QoL was 142.67 (SD = 20.11), ranged from 93 to 183 (theoretical range = 30-210). QoL was negatively associated with infertility-related stress (r = -0.373, P < 0.001). Moderation analysis indicated that the interaction term between infertility-related stress and BMI significantly predicted QoL (β = -0.154, P = 0.005, f² = 0.03) as well as emotional disturbance (β = -0.170, P = 0.002, f² = 0.04). Specifically, higher BMI significantly exacerbated the effect of infertility-related stress on QoL and emotional disturbance.

CONCLUSION

Infertile women with PCOS experienced poor QoL. The moderation role of BMI provides a better understanding of individual difference in relationship between infertility-related stress and QoL. Interventions aiming to improve QoL among infertile women with PCOS should focus on alleviating infertility-related stress, especially among women with high BMI.