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.

Highlights

  • Starting from the historical definition of the World Health Organization that defined infertility as the inability for a couple to conceive after a year of regular, unprotected sexual intercourse (World Health Organization, 1992), its current definition has been expanded to cover a wider spectrum of conditions that affect individuals’ and couples’ capacity to reproduce (Zegers-Hochschild et al, 2017)

  • Paired-sample t-test analyses showed no differences between men and women either regarding the Dyadic Adjustment Scale (DAS) score or the Dyadic Coping Questionnaire (DCQ) score, with the exception of stress communication and efficacy of dyadic coping

  • Since infertility and assisted reproductive technology (ART) treatments represent stressful experiences for each partner as well as for the couple relationship, independently of the specific type of treatment (Van Der Merwe and Greeff, 2015; Koert and Daniluk, 2018), the present study examined the relationship between dyadic coping and marital adjustment in a sample of Italian infertile couples at the beginning of ART treatment

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Summary

Introduction

Starting from the historical definition of the World Health Organization that defined infertility as the inability for a couple to conceive after a year of regular, unprotected sexual intercourse (World Health Organization, 1992), its current definition has been expanded to cover a wider spectrum of conditions that affect individuals’ and couples’ capacity to reproduce (Zegers-Hochschild et al, 2017). This datum can be explained by considering the phenomenon of the progressive postponement of births in our country, so that, currently, the average age of first childbirth is 32.4 years for women and 35.3 for men, placing Italy as the second country in the European context for delayed maternity (Istat, 2017; Loghi and Crialesi, 2017). After a diagnosis of infertility, many couples undergo assisted reproductive technology (ART) treatments in order to become parents This is a term that includes a wide spectrum of techniques developed to help couples achieve a viable pregnancy. ART treatments have been steadily increasing in recent years (European IVFmonitoring Consortium (EIM) et al, 2017), and, in the same way, the proportion of ART babies among the total number of babies born has increased over the years, reaching 2.4% (Ferraretti et al, 2017)

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