Infertility Treatment and Marital Relationships: A 1-Year Prospective Study Among Successfully Treated ART Couples and Their Controls

Abstract

Today many infertile couples become parents through assisted reproduction techniques (ART). A successful outcome improves emotional well-being in a majority of cases, but comparatively little is known about whether and how marital relations are affected during the transition to parenthood. The investigators studied the influence of ART on marital relations in 367 couples achieving singleton pregnancies by in vitro fertilization or intracytoplasmic sperm injection and 379 control couples who conceived spontaneously. The dyadic adjustment scale was used to assess parents' perceptions of their marriages when the child was 2 months (T2) and 12 months (T3) of age. Depression was rated during pregnancy using a short version of the Beck Depression Inventory. The ART and control couples did not differ significantly with regard to dyadic cohesion or marital satisfaction. Dyadic consensus deteriorated from T2 to T3 in control women but not those in the ART group. Men in the control group reported lower levels of sexual affection than did those in the ART group at T2, and stressful life events exaggerated this effect; no such difference was apparent at T3. Depression during pregnancy predicted worsened marital relations in control couples only. ART women experiencing several unsuccessful attempts at treatment exhibited good dyadic consensus and cohesion. Both spontaneous abortions and multiparity predicted relatively poor marital satisfaction in ART women. In ART men, a long duration of infertility and multiparity predicted poor marital relations. The investigators conclude from these findings that successful ART does not predispose to adverse marital adjustment. It is conceivable that the common stress of being infertile has the potential to stabilize marital relationships. This is only one example of how any life crisis may activate a couple's resources and strengthen their marriage.