Abstract
Research has shown a direct relationship between infertility-related stress and anxiety in infertile patients. The present study goes into this relationship in depth, testing the moderating role of coping strategies (Seeking Social Support, Avoidant, Positive Attitude, Problem-Solving, Turning to Religion) in the associations between specific infertility-related stress dimensions (Social Concern, Need for Parenthood, Rejection of Childfree Lifestyle, Couple’s Relationship Concern) and State-Anxiety among male and female partners of infertile couples. Gender differences were also explored. Both members of 254 infertile couples completed a questionnaire consisting of Socio-demographics, Fertility Problem Inventory–Short Form (FPI-SF), Coping Orientation to Problem Experienced–New Italian Version (COPE-NIV), and State-Trait Anxiety Inventory-Y (STAI-Y). The results revealed that Social Concern and Couple’s Relationship Concern, in both partners, and Need for Parenthood, in female partners, had positive correlations with State-Anxiety. Seeking Social Support and Avoidant coping were related to increasing levels of State-Anxiety in both partners, whereas Positive Attitude coping strategies were related to lower levels of State-Anxiety in female partners. Problem-Solving and Avoidant coping played moderating roles between specific infertility-related stress dimensions and State-Anxiety in unexpected directions. Problem-Solving exacerbated the negative effects of Social Concern, whereas Avoidant coping buffered the negative effects of several infertility-related stress dimensions in both partners. Interventions to improve stress management and psychological health in infertile couples should consider that the adequacy of coping strategies is inherently situation specific. It therefore follows that patient-centered clinical interventions should consider the potential inadequacy of promoting Problem-Solving strategies, and that even Avoidance can be an efficient strategy for dealing with specific infertility-related stress dimensions.
Highlights
Infertility condition was recognized among the greater stressors that may occur in life (Maroufizadeh et al, 2019)
Infertility-Related Stress Dimensions Infertility-related stress dimensions were measured by using the Fertility Problem Inventory–Short Form (FPI-SF; Italian version: Zurlo et al, 2017), which consists of 27 items on a sixpoint Likert scale ranging from one (Strongly disagree) to six (Strongly agree) divided into four subscales: Social Concern (10 items; Cronbach’s α = 0.88); Need for Parenthood; Couple’s Relationship Concern; Rejection of Childfree Lifestyle
State-Anxiety Anxiety symptoms were measured by using the State scale from the State-Trait Anxiety Inventory (STAI-Y; Spielberger, 1972; Italian version: Pedrabissi and Santinello, 1989), which consists of 20 items on a four-point Likert scale ranging from one (Not at all) to four (Very much)
Summary
Infertility condition was recognized among the greater stressors that may occur in life (Maroufizadeh et al, 2019). Anxiety is a normal adaptive response of individuals in stressful situations (Semple and Smyth, 2019), research performed in international context underlined that the prevalence of anxiety in members of infertile couples is significantly higher than in fertile controls and in the general population (Anderson et al, 2003; Matthiesen et al, 2011; Fallahzadeh et al, 2019; Kiani et al, 2020) Because both the prevalence and incidence of stress and anxiety symptoms stemming from infertility condition are worthy of note, research efforts were made to develop studies targeting a greater understanding of infertility-related stress process. State-Anxiety scores were converted into percentages and, according to the Italian validation study (Pedrabissi and Santinello, 1989), a score of 50.93 for female partners and 45.70 for male partners were considered to be the cut-off point to define the clinical cases
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