Academic journal article Health and Social Work

Associations of Psychosocial Factors with the Stress of Infertility Treatment

Academic journal article Health and Social Work

Associations of Psychosocial Factors with the Stress of Infertility Treatment

Article excerpt

One in six couples will experience fertility problems at some time in their lives, and only one-half will succeed in becoming pregnant (Seibel, 1997). Infertility rates are projected to increase during the next 20 years as the age distribution of the U.S. population reflects the passing of the baby boom generation through middle age (Chandra & Stephen, 1998). Also, a cohort of couples may have delayed childbearing because of financial and career considerations. If projections prove accurate, many will face fertility problems and complex decisions regarding the use of reproductive technologies, often associated with considerable physical, emotional, and financial cost (Greenfeld, 1997).

Infertility has been associated with substantial levels of stress, generally attributed to its indeterminate and often prolonged time frame and the uncertainty and ambiguity of the diagnosis and treatment process. Infertility is variable in time, and with treatment, can span more than a decade, the average being five years (Domar & Seibel, 1997). For example, by the time a couple initiates an in vitro procedure, they may have been infertile for up to six years and in treatment for four (Boivin, 2003). Infertility treatment has been found to have consequences for subsequent health functioning, quality of life, and psychological well-being during presumed childbearing years (Shapiro, 1982). People may feel depleted, isolated, and vulnerable to the experience of prolonged stress (Valentine, 1986). Research in other populations suggests that psychosocial factors may play a role in mediating or moderating stress appraisal and its consequences.

We investigated psychosocial factors thought to be associated with perceived stress over the course of infertility treatment. Purposes of the study were to identify the extent to which psychosocial factors were associated with variation in perceived stress at regular time intervals during infertility treatment and to identify the extent to which psychosocial factors were associated with change in perceived stress over the course of treatment. Identifying factors that may explain stress or provide potential targets for intervention to reduce stress has significance for those who provide care for infertile couples (Batterman, 1985; Gibson & Myers, 2002). Social workers may be instrumental in implementing psychosocial interventions to help couples (Bergart, 2000; Covington, 1988; Daniels, 1993; Greenfeld, Diamond, Breslin, & DeCherney, 1986; Needleman, 1987).


The impact of stress on health and the disease process has been established for sonic time (House, 1987). Although substantial stress has been associated with infertility,, systematic research examining the way that stress may affect the reproductive system has not received the level of attention focused on other physiological processes (Kelly, Hertzman, & Daniels, 1997). Stress associated with infertility is increasingly considered both a determinant and a consequence of reduced fertility (Klonoff-Cohen, Chu, Natarajan, & Sieber, 2001). Although no clear pattern has emerged, studies investigating changes in psychoendocrine stress response during in vitro fertilization have found physiological alterations associated with stress (Facchinetti, Matteo, Artini, Volpe, & Genazzani, 1997).

Stress levels across study samples undergoing infertility treatment have been found variable and inconsistent (Kee, Jung, & Lee, 2000). Discrepancies have been attributed to theoretical, conceptual, and methodological problems in earlier infertility-stress research. The use of general rather than context-specific measures, self-report measures with clinic samples vulnerable to pressure to obtain desired treatment protocols, and patients pooled at different stages of infertility treatment have limited the usefulness of several studies (Edelmann, 1990). …

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