Journal of Behavioral Medicine

, Volume 14, Issue 1, pp 11–26 | Cite as

Psychological functioning across stages of treatment for infertility

  • Barbara J. Berg
  • John F. Wilson
Article

Abstract

Psychological functioning was examined for a cross section of 104 couples in different stages of medical investigation for infertility. Couples were separated into three stages based upon the length of time they had been pursuing medical treatment for infertility: year 1, year 2, and year 3 and beyond. Emotional strain was moderately elevated during the first year, returned to more normal levels during the second year, and showed marked increases beyond year 3. Indices of marital adjustment and sexual satisfaction were stable across the first two stages but deteriorated after the third year. These data suggest that the stage of treatment may exert a major influence upon psychological functioning for infertile couples pursuing medical assistance. The results are consistent with a model of psychological strain that reflects an acute stress reaction to the initial diagnosis and treatment overlaid with a chronic strain response to longer-term treatment.

Key words

infertility strain stress treatment stage 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Baram, D., Tourtelot, E., Muechler, E., and Huang, K.-E. (1988). Psychosocial adjustment following unsuccessful in vitro fertilization.J. Psychosom. Obstet. Gynecol. 9: 181–190.Google Scholar
  2. Berg, B. J., and Wilson, J. F. (1990). Psychiatric morbidity in the infertility population: A reconceptualization.Fertil. Steril. 53: 654–661.Google Scholar
  3. Berger, D. M. (1980). Couples' reactions to male infertility and donor insemination.Am. J. Psychiat. 137: 1047–1049.Google Scholar
  4. Bernstein, J., and Zaratskie, R. N. (1989). A certification review course for nurses: Reproductive endocrinology/infertility.Serono Symp, 127–132.Google Scholar
  5. Callan, V. J. (1987). The personal and marital adjustment of mothers and of voluntarily and involuntarily childless wives.J. Marr. Fam. 49: 847–858.Google Scholar
  6. Camilleri, A. P. (1980). A realistic approach to infertility.Practitioner 224: 835–837.Google Scholar
  7. Daniluk, J. C. (1988). Infertility: Intrapersonal and interpersonal impact.Fertil. Steril. 49: 982–990.Google Scholar
  8. Derogatis, L. R. (1983).SCL-90-R Administration, Scoring & Procedures Manual-II for the R(evised) Version and Other Instruments of the Psychopathology Rating Scale Series, 2nd ed., Clinical Psychometric Research, Towson, Md.Google Scholar
  9. Derogatis, L. R., Morrow, G. R., Petting, J., Penman, D., Piasetsky, S., Schmale, A. M., Henrichs, M., and Carnicke, L. M., Jr. (1983). The prevalence of psychiatric disorders among cancer patients.JAMA 249: 751–757.Google Scholar
  10. Downey, J., Yingling, S., McKinney, M., Husami, N., Jewelewicz, R., and Maidman, J. (1989). Mood disorders, psychiatric symptoms, and distress in women presenting for infertility evaluation.Fertil. Steril. 52: 425–432.Google Scholar
  11. Edelmann, R. J., and Connolly, K. J. (1986). Psychological aspects of infertility.Br. J. Med. Psychol. 59: 209–219.Google Scholar
  12. Freeman, E. W., Garcia, C. R., and Rickels, K. (1983). Behavioral and emotional factors: Comparisons of anovulatory infertile women with fertile and other infertile women.Fertil. Steril. 40: 195–201.Google Scholar
  13. Freeman, E. W., Boxer, A. S., Rickels, K., Tureck, R., and Mastroianni, L., Jr. (1985). Psychological evaluation and support in a program of in vitro fertilization and embryo transfer.Fertil. Steril. 43: 48–53.Google Scholar
  14. Freeman, E. W., Rickels, K., Tausig, J., Boxer, A., Mastroianni, L., Jr., and Tureck, R. W. (1987). Emotional and psychosocial factors in follow-up of women after IVF-ET treatment.Acta Obstet. Gynecol. Scand. 66: 517–521.Google Scholar
  15. Garcia, C., Freeman, E. W., Rickels, K., Wu, C., Scholl, G., Galle, P. C., and Boxer, A. S. (1985). Behavioral and emotional factors and treatment responses in a study of ovulatory inferile women.Fertil. Steril. 44: 478–483.Google Scholar
  16. Haseltine, F. P., Mazure, C., De L'Aune, W., Greenfeld, D., Laufer, N., Tarlatzis, B., Polan, M. L., Jones, E. E., Graebe, R., Nero, F., D'Lugi, A., Fazio, D., Masters, J., and DeCherney, A. H. (1985). Psychological interviews in screening couples undergoing in vitro fertilization.Ann. N.Y. Acad. Sci. 422. 504–521.Google Scholar
  17. Lalos, A., Lalos, O., Jacobsson, L., and von Schoultz, B. (1985a). The psychosocial impact of infertility two years after completed surgical treatment.Acta Obstet. Gynecol. Scand. 64: 599–604.Google Scholar
  18. Lalos, A., Lalos, O. Jacobsson, L., and von Schoultz, B. (1985b). Psychological reactions to the medical investigation and surgical treatment of infertility.Gynecol. Obstet. Invest. 20: 209–217.Google Scholar
  19. Leiblum, S. R., Kemmann, E., Colburn, D., Pasquale, S., and DeLisi, A. (1987a). Unsuccessful in vitro fertilization: A follow-up study.J. Vitro Fert. Embryo Transfer 4: 46–50.Google Scholar
  20. Leiblum, S. R., Kemmann, E., and Lane, M. K. (1987b). The psychological concomitants of in vitro fertilization.J. Psychosom. Obstet. Gynecol. 6: 165–178.Google Scholar
  21. Locke, H. J. (1951).Predicting Adjustment in Marriage: A Comparison of a Divorced and Happily Married Group, Henry Holt, New York.Google Scholar
  22. Locke, H. J., and Wallace, K. M. (1959). Short marital-adjustment and prediction tests: Their reliability and validity.Man. Fam. Liv. 21: 251–255.Google Scholar
  23. Mahlstedt, P. P., Mac Duff, S., and Bernstein, J. (1987). Emotional factors and the in vitro fertilization and embryo transfer process.J. Vitro Fert. Embryo Transfer 4: 232–236.Google Scholar
  24. Mai, F. M. M., and Rump, E. E. (1972). Are infertile men and women neurotic?Austr. J. Psychol. 24: 83–86.Google Scholar
  25. Mai, F. M. M., Munday, R. N., and Rump, E. E. (1972). Psychiatric interview comparisons between infertile and fertile couples.Psychosom. Med. 34: 431–440.Google Scholar
  26. Mao, K., alnd Wood, C. (1984). Barriers to treatment of infertility by in-vitro fertilization and embryo transfer.Med. J. Austr. 140: 532–533.Google Scholar
  27. McEwan, K. L., Costello, C. G., and Taylor, P. J. (1987). Adjustment to infertility.J. Abnorm. Psychol. 96: 108–116.Google Scholar
  28. Morse, C., and Dennerstein, L. (1985). Infertile couples entering an in vitro fertilization programme: A preliminary survey.J. Psychosom. Obstet. Gynecol. 4: 207–219.Google Scholar
  29. National Center for Health Statistics (1982).Reproductive Impairments Among Married Couples: United States, Vital and Health Statistics, Public Health Service, U.S. Government Printing Office, Washington, D.C.Google Scholar
  30. Office, of Technology Assessment (1988).Infertility: Medical and Social Choices (OTA-BA-358), U.S. Government Printing Office, Washington, D.C.Google Scholar
  31. O'Moore, A. M., O'Moore, R. R., Harrison, R. F., Murphy, G., and Garruthers, M. E. (1983). Psychosomatic aspects in idiopathic infertility: Effects of treament with autogenic training.J. Psychosom. Res. 27: 145–151.Google Scholar
  32. Shapiro, C. H. (1988).Infertility and Pregnancy Loss: A Guide for Helping Professionals, Jossey-Bass, San Francisco.Google Scholar
  33. Shaw, P., Johnston, M., and Shaw, R. (1988). Counselling needs, emotional and relationship problems in couples awaiting IVF.J. Psychosom. Obstet. Gynecol. 9: 171–180.Google Scholar
  34. Slade, P. (1981). Menstrual cycle symptoms in infertile and control subjects: A re-evaluation of the evidence for psychological changes.J. Psychosom. Res. 25: 175–181.Google Scholar
  35. Takefman, J. E., Brender, W., Boivin, J., and Tulandi, T. (1990). Sexual and emotional adjustment of couples undergoing infertility investigation and the effectiveness of preparatory information.J. Psychosom. Obstet. Gynecol. 11, 275–290.Google Scholar
  36. Weltzien, J. (1983/1984).A Study of Psychological Factors Associated with Infertility: Depression, Locus of Control, Quality of Marital Interaction, University of Houston, Houston, Tex. (Available as Publication No. 44: 2910-B, University Microfilms, Ann Arbor, Mich.Google Scholar

Copyright information

© Plenum Publishing Corporation 1991

Authors and Affiliations

  • Barbara J. Berg
    • 1
  • John F. Wilson
    • 1
  1. 1.Department of Behavioral Science, College of Medicine Office BuildingUniversity of KentuckyLexington

Personalised recommendations