Infertility-related stress in men and women predicts treatment outcome 1 year later

Objective

To examine the separate and joint effects of male and female fertility problem (FP) stress and the source of stress (e.g., personal, social, marital) on treatment outcome.

Design

Prospective, epidemiological cohort design.

Setting

Fertility clinics in Denmark.

Patient(s)

Eight hundred eighteen couples who were about to begin a new course of treatment.

Intervention(s)

An FP stress inventory was administered at the start of treatment, and the treatment outcome was evaluated 12 months later.

Main Outcome Measure(s)

Number of treatment cycles in 12-month study period and treatment outcome (i.e., success, no success).

Result(s)

Fertility problem stress was associated with a poorer treatment outcome in women (pooled within-groups [WGr] correlation,WGr = .517) and men (WGr = .392) with the effect significantly more pronounced for women (z = 3.19, P<.001). Fertility problem stress arising in the personal and marital domain showed greater associations with treatment outcome than did FP stress from the social domain. Logistic regression indicated that women who reported more marital distress required more treatment cycles to conceive (median 3) than women reporting less marital distress (median 2) (odds ratio [OR] = 1.20: Model χ²(3) = 77.21, P<.001).

Conclusion(s)

The findings provide evidence that infertility-related stress has direct and indirect effects on treatment outcome.

Key Words:  Stress , psychology , psychosocial , reproduction , marital , gender , counselling , infertility , in vitro fertilization , fertility