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The Experience of Infertility: An Unexpected Barrier in the Transition to Parenthood

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Pathways and Barriers to Parenthood

Abstract

Infertility is defined as the inability to achieve a pregnancy or deliver a live birth after one year of regular sexual intercourse without the use of contraceptives. Infertility commonly represents an interruption in a couple’s normative life course, and as such, the stress individuals and couples endure is substantial as they attempt to resolve this unexpected barrier to parenthood. The specific stressors faced by men and women include significant emotional, physical, and psychological burdens. Coping strategies can include avoidance, seeking social support, emotional self-controlling, cognitive distancing, and finding new meaning. The effectiveness of these strategies varies by gender. Although strategies which are shown to be beneficial for individuals can positively impact one’s partner, they can also have a negative impact. Counseling strategies can provide couples with tools to help navigate the infertility experience, strengthen their relationships, assist in decision-making, and facilitate feelings of grief and loss. At a societal level, infertility can also be addressed by enhancing provider education and increasing fertility awareness. Primary, secondary, and tertiary prevention strategies are critical to address the expansive needs of individuals who are affected, or may be affected, by infertility. Finally, societies can promote preventative efforts that serve individuals and communities in the effort to reduce the prevalence and distress resulting from infertility.

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Authors and Affiliations

  1. Crean College of Health and Behavioral Sciences, Department of Marriage and Family Therapy, Chapman University, Orange, CA, 92866, USA

    Brennan Peterson

  2. Department of Nutrition & Health Science, Women’s and Gender Studies Affiliate, Ball State University, Muncie, IN, 47306, USA

    Jean Marie S. Place

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  1. Bar-Ilan University, Ramat Gan, Israel

    Orit Taubman – Ben-Ari

Appendix 2.1: Additional Fertility Resources

Appendix 2.1: Additional Fertility Resources

  • Screen IVF

Screen IVF is a 34-item instrument designed to screen infertility patients prior to treatment in order to identify those at risk for emotional distress and pre-treatment dropout (Verhaak, Lintsen, Evers, & Braat, 2010). It was originally developed for Dutch fertility patients, has been translated into English, and has been found to have both construct and criteria validity. The measure includes 10 items for anxiety (state and trait), 7 items for depression, 12 items for cognitions regarding fertility problems, and 5 items for social support. Recommended cut-off scores are provided to assist in the identification of at-risk patients. It has also been recommended for use by fertility clinics at the beginning of treatment (Ockhuijsen, van Smeden, van den Hoogen, & Boivin, 2017).

  • FertiCalm

FertiCalm is a smart phone app developed by Alice Domar and Elizabeth Grill, two of the world’s leading experts in reproductive psychology. The app is a repository of over 500 coping options that can be accessed by women whenever and wherever they feel distressed by infertility-specific life situations. There are more than 50 specific life situations women are likely to encounter, each with custom-made solutions to increase well-being in that moment. The solutions include cognitive techniques to restructure thoughts, behavioral suggestions, social solutions, relaxation techniques that include 10–20 different guided relaxations, and links to ideas for humor and self-nurturing. For more information, please see http://www.ferticalmapp.com/.

  • FertiSTAT

FertiSTAT is a 22-question, online fertility status awareness tool developed and validated by Cardiff University researchers Jacky Boivin and Laura Bunting (Bunting & Boivin, 2010). Based on a woman’s responses to her age, lifestyle, and health, it provides personalized guidance about reducing risk, optimizing behaviors, and seeking timely medical advice. The tool is aimed at women but includes an opportunity to assess male partner risk. For more information, please see http://www.fertistat.com/.

  • FertiQoL

FertiQoL is the first validated instrument to reliably measure the impact of fertility problems and its treatment on quality of life for men and women (Boivin, Takefman, & Braverman, 2011). The tool has 36 items, covering emotional, mind-body, relational and social domains, as well as the impact of treatment quality and tolerability on quality of life. The instrument is available in over 20 languages. For more information, please see www.fertiqol.org.

  • PCRI (Positive Reappraisal Coping Intervention)

Research suggests that the two-week waiting period between embryo transfer and the pregnancy test is a particularly stress-inducing time (Boivin & Takefman, 1995). The PCRI is a self-help, at-home intervention, consisting of a single pocket-sized card or flyer with statements designed to help patients cognitively redefine difficult situations to find more positive meaning. Studies have found that use of the PCRI can increase positive affect (Lancastle & Boivin, 2008; Ockhuijsen, van den Hoogen, Eijkemans, Macklon and Bovin, 2014b), as well as significantly reduce anxiety levels during the waiting period and up to 6 weeks after the start of the waiting period (Ockhuijsen et al., 2014a).

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Peterson, B., Place, J.M.S. (2019). The Experience of Infertility: An Unexpected Barrier in the Transition to Parenthood. In: Taubman – Ben-Ari, O. (eds) Pathways and Barriers to Parenthood. Springer, Cham. https://doi.org/10.1007/978-3-030-24864-2_2

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