Abstract
Infertility constitutes an essential source of stress in the individual and couple’s life. The Infertility-Related Stress Scale (IRSS) is of clinical interest for exploring infertility-related stress affecting the intrapersonal and interpersonal domains of infertile individuals’ lives. In the present study, the IRSS was translated into Brazilian–Portuguese, and its factor structure, reliability, and relations to sociodemographic and infertility-related characteristics and depression were examined. A sample of 553 Brazilian infertile individuals (54.2% female, mean aged 36 ± 6 years) completed the Brazilian–Portuguese IRSS (IRSS-BP), and a subsample of 222 participants also completed the BDI-II. A sample of 526 Italian infertile individuals (54.2% female, mean aged 38 ± 6 years) was used to test for the IRSS measurement invariance across Brazil and Italy. Results of exploratory structural equation modeling (ESEM) indicated that a bifactor solution best represented the structure underlying the IRSS-BP. Both the general and the two specific intrapersonal and interpersonal IRSS-BP factors showed satisfactory levels of composite reliability. The bifactor ESEM solution replicated well across countries. As evidence of relations to other variables, female gender, a longer duration of infertility, and higher depression were associated with higher scores in global and domain-specific infertility-related stress. The findings offer initial evidence of validity and reliability of the IRSS-BP, which could be used by fertility clinic staff to rapidly identify patients who need support to deal with the stressful impact of infertility in the intrapersonal and interpersonal life domains, as recommended by international guidelines for routine psychosocial care in infertility settings.
Highlights
According to the World Health Organization (World Health Organization [WHO], 2006), approximately 10% of couples of reproductive age worldwide have difficulties achieving pregnancy
We considered the proportion of item variance explained by the model: σ2 error, σ2 true related to the first-order factors in the first-order exploratory structural equation modeling (ESEM) and the G-Factor and S-Factors in the bifactor ESEM, and σ2 true related to cross-loadings (Perreira et al, 2018; Morin et al, 2020)
Our findings indicated that the underlying structure of Infertility-Related Stress Scale (IRSS)-BP scores was best represented by a bifactor solution incorporating an overarching infertility-related stress factor and two specific components of intrapersonal and interpersonal life domains affected by infertility stress
Summary
According to the World Health Organization (World Health Organization [WHO], 2006), approximately 10% of couples of reproductive age worldwide have difficulties achieving pregnancy. Infertile individuals and couples experience considerable stress because of failing to achieve a meaningful life goal such as parenthood and its accompanying social stigma (Loke et al, 2012; Öztürk et al, 2021a). Implications of infertility include physical symptoms, reduced psychological well-being and quality of life, feelings of guilt and shame, use of negative avoidance coping strategies, and social isolation (Rockliff et al, 2014; Luk and Loke, 2015; Rooney and Domar, 2016; Swanson and Braverman, 2021). Women are the most affected by the infertile experience, consistently showing greater social vulnerability, stress and emotional distress, and lower quality of life than men (Patel et al, 2018; Casu et al, 2019; Ha and Ban, 2020)
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