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Psychological coping strategies associated with improved mental health in the context of infertility


To examine the use of psychological coping strategies across the menstrual cycle in relation to within-person changes in depressed mood, anxious mood, and infertility-related distress, in a sample of women struggling to conceive. Sixty-five women from Canada and the USA (aged 19–43 years) trying to conceive naturally for ≥ 12 months were recruited via social media. On the first day of each participant’s menstrual period, and every 3 days until the end of their cycle, participants completed questionnaires assessing depressed and anxious mood, and infertility-related distress. In addition, participants completed a 13-item coping questionnaire assessing four general coping strategies: emotional suppression, active coping, engagement in activities unrelated to trying to conceive, and downplaying the importance of biological children. The within-person effect of daily coping strategies on person-centred mood and infertility-related distress was examined. Day-to-day use of behavioural engagement was associated with lower person-centred depression scores, β(SEM) = − 3.25(.51), p < .0001, anxiety scores, β(SEM) = − 2.07(.36), p < .0001, and infertility-related daily distress, β(SEM) = − .64(.22), p = .005. Downplaying the importance of biological children was also associated with person-centred depression scores, β(SEM) = 1.14(.47), p = .016. Neither active coping nor emotional suppression was related to depression, anxiety, or distress (ps > .0125). These findings point to promising targets of future intervention studies, including promoting increased engagement in behaviours unrelated to conceiving and promoting acceptance, rather than denial and resistance, of feelings throughout the infertility journey.

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We would like to thank Tianna Sauer for her help with data collection.


This study was funded by the Saskatchewan Health Research Foundation Patient-Oriented Research Leader Award (grant no. 4577). Dr. Gordon is also supported by a Tier II Canadian Institutes of Health (CIHR) Canada Research Chair.

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Correspondence to Jennifer L. Gordon.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Chernoff, A., Balsom, A.A. & Gordon, J.L. Psychological coping strategies associated with improved mental health in the context of infertility. Arch Womens Ment Health 24, 73–83 (2021).

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  • Infertility
  • Natural cycle
  • Coping strategies
  • Menstrual cycle
  • Reproductive health