Family Alliance Trajectories from Infertility to Parenthood



This chapter focuses on coparenting and family dynamics during the transition from infertility to parenthood. Eighty couples who had infertility issues were assessed before they underwent infertility medical treatment. Of these, 29 couples who were successful in becoming pregnant within 1 year were assessed again during pregnancy and after childbirth. We analyzed their family alliance trajectories from the fifth month of pregnancy to the ninth month after birth. Our results revealed three distinct family alliance trajectory groups from pregnancy to the postpartum period: One group showed a decrease in family alliance (average to low pattern, n = 11); a second group remained stable in their family alliance (high stable pattern, n = 11); and a third group showed improvements in their family alliance (low to high pattern, n = 7). Analysis of the pretreatment data revealed no significant group differences in narrative quality, infertility-related stress, and marital satisfaction. Additionally, pretreatment variables did not predict subsequent family alliance trajectories. We provide a case illustration of each family alliance trajectory, in order to illustrate the challenges faced by couples who have experienced infertility and successfully undergone medically assisted procreation.


Prenatal coparenting Family alliance Infertility Reproductive techniques Pregnancy 



This work was supported by the Swiss National Science Foundation (Grant N° 32003B-111985).


  1. Altenburger, L. E., Schoppe-Sullivan, S., Lang, S. N., Bower, D. J., & Kamp Dush, C. M. (2014). Associations between prenatal coparenting behavior and observed coparenting behavior at 9-months postpartum. Journal of Family Psychology, 28, 495–504. Scholar
  2. Baor, L., & Soskolne, V. (2010). Mothers of IVF and spontaneously conceived twins: A comparison of prenatal maternal expectations, coping resources and maternal stress. Human Reproduction, 25, 1490–1496. Scholar
  3. Benyamini, Y., Gozlan, M., & Kokia, E. (2009). Women’s and men’s perceptions of infertility and their associations with psychological adjustment: A dyadic approach. British Journal of Health Psychology, 14, 1–16. Scholar
  4. Boivin, J., & Schmidt, L. (2005). Infertility-related stress in men and women predicts treatment outcome 1 year later. Fertility and Sterility, 83, 1745–1752. Scholar
  5. Cairo, S., Darwiche, J., Tissot, H., Favez, N., Germond, M., Guex, P., et al. (2012). Family interactions in IVF families: Change over the transition to parenthood. Journal of Reproductive and Infant Psychology, 30, 5–20. Scholar
  6. Carneiro, C., Corboz-Warnery, A., & Fivaz-Depeursinge, E. (2006). The Prenatal Lausanne Trilogue Play: A new observational assessment tool of the prenatal co-parenting alliance. Infant Mental Health Journal, 27, 207–228. Scholar
  7. Cumming, G. (2014). The New Statistics: Why and How. Psychological Science, 25, 7–29.
  8. Cowan, P. (1991). Individual and family life transitions: A proposal for a new definition. In P. A. Cowan & M. Hetherington (Eds.), Family transitions (pp. 3–30). Hillsdale: Lawrence Erlbaum Associates, Publishers.Google Scholar
  9. Crane, D. R., Allgood, S. M., Larson, J. H., & Griffin, W. (1990). Assessing marital quality with distressed and nondistressed couples: A comparison and equivalency table for three frequently used measures. Journal of Marriage and the Family, 52, 87–93. Scholar
  10. Darwiche, J., Favez, N., Maillard, F., Germond, M., Guex, P., Despland, J.-N., & de Roten, Y. (2013). Couples’ resolution of an infertility diagnosis before undergoing in vitro fertilization. Swiss Journal of Psychology, 72, 91–102. Scholar
  11. Darwiche, J., Favez, N., Simonelli, A., Antonietti, J. P., & Frascarolo, F. (2015). Prenatal coparenting alliance and marital satisfaction when pregnancy occurs after assisted reproductive technologies or spontaneously. Family Relations, 64, 534–546. Scholar
  12. Darwiche, J., Fivaz-Depeursinge, E., & Corboz-Warnery, A. (2016). Prenatal intuitive coparenting behaviors. Frontiers in Psychology, 7, 1662. Scholar
  13. Datta, J., Palmer, M. J., Tanton, C., Gibson, L. J., Jones, K. G., Macdowall, W., et al. (2016). Prevalence of infertility and help seeking among 15 000 women and men. Human Reproduction, 31, 2108–2118. Scholar
  14. Favez, N., Frascarolo, F., & Fivaz-Depeursinge, E. (2006). Family alliance stability and change from pregnancy to toddlerhood and marital correlates. Swiss Journal of Psychology, 65, 213–220. Scholar
  15. Favez, N., Lavanchy Scaiola, C. L., Tissot, H., Darwiche, J., & Frascarolo, F. (2011). The family alliance assessment scales: Steps toward validity and reliability of an observational assessment tool for early family interactions. Journal of Child and Family Studies, 20, 23–37. Scholar
  16. Favez, N., Lopes, F., Bernard, M., Frascarolo, F., Lavanchy Scaiola, C., Corboz-Warnery, A., & Fivaz-Depeursinge, E. (2012). The development of family alliance from pregnancy to toddlerhood and child outcomes at 5 years. Family Process, 51, 542–556. Scholar
  17. Fiese, B. H., Sameroff, A. J., Grotevant, H. D., Wamboldt, F. S., Dickstein, S., & Fravel, D. L. (1999). The stories that families tell: Narrative coherence, narrative interaction, and relationship beliefs (Monographs of the Society for Research in Child Development, 64 (serial N° 257)). Malden: Blackwell Publishers.Google Scholar
  18. Fisher, J. R., Hammarberg, K., & Baker, G. H. (2007). Antenatal mood and fetal attachment after assisted conception. Fertility & Sterility, 89, 1103–1112. Scholar
  19. Fivaz-Depeursinge, E., & Corboz-Warnery, A. (1999). The primary triangle: A developmental systems view of mothers, fathers, and infants. New York: Basic Books.Google Scholar
  20. Fivaz-Depeursinge, E., Frascarolo, F., & Corboz-Warnery, A. (2010). Observational tool: The Pre- natal Lausanne Trilogue Play. In S. Tyano, M. K. Head, H. Herrman, & J. Cox (Eds.), Parenthood and mental health: A bridge between infant and adult psychiatry (pp. 121–127). New York: Wiley. Scholar
  21. Frederiksen, Y., Farver-Vestergaard, I., Skovgård, N. G., Ingerslev, H. J., & Zachariae, R. (2015). Efficacy of psychosocial interventions for psychological and pregnancy outcomes in infertile women and men: A systematic review and meta-analysis. BMJ Open, 5, e006592. Scholar
  22. Gana, K., & Jakubowska, S. (2016). Relationship between infertility-related stress and emotional distress and marital satisfaction. Journal of Health Psychology, 21, 1043–1054. Scholar
  23. Gourounti, K. (2016). Psychological stress and adjustment in pregnancy following assisted reproductive technology and spontaneous conception: A systematic review. Women & Health, 56, 98–118. Scholar
  24. Greil, A. L., Slauson-Blevins, K., McQuillan, J., Lowry, M. H., Burch, A. R., & Shreffler, K. M. (2018). Relationship satisfaction among infertile couples: Implications of gender and self-identification. Journal of Family Issues, 39, 1304–1325. Scholar
  25. HaCohen, N., Amir, D., & Wiseman, H. (2018). Women’s narratives of crisis and change: Transitioning from infertility to pregnancy. Journal of Health Psychology, 23, 720–730. Scholar
  26. Hjelmstedt, A., Widström, A.-M., Wramsby, H., & Collins, A. (2003). Patterns of emotional responses to pregnancy, experience of pregnancy and attitudes to parenthood among IVF couples: A longitudinal study. Journal of Psychosomatic Obstetrics and Gynecology, 24, 153–162. Scholar
  27. Hjelmstedt, A., Widström, A.-M., & Collins, A. (2006). Psychological correlates of pre- natal attachment in women who conceived after in vitro fertilization and women who conceived naturally. Birth, 33, 303–310. Scholar
  28. Kluwer, E. S. (2010). From partnership to parenthood: A review of marital change across the transition to parenthood. Journal of Family Theory & Review, 2, 105–125. Scholar
  29. Marvin, R. S., & Pianta, R. C. (1996). Mothers’ reactions to their child’s diagnosis: Relations with security of attachment. Journal of Clinical Child Psychology, 25, 436–445. Scholar
  30. Milligan, G. W., & Cooper, M. C. (1985). An examination of procedures for determining the number of clusters in a data set. Psychometrika, 50(2), 159–179. Scholar
  31. Monti, F., Agostini, F., Fagandini, P., Paterlini, M., La Sala, G. B., & Blickstein, I. (2008). Anxiety symptoms during late pregnancy and early parenthood following assisted reproductive technology. Journal of Perinatal Medicine, 36, 425–432. Scholar
  32. Newton, C. R., Sherrard, W., & Glavac, I. (1999). The fertility problem inventory: Measuring perceived infertility-related stress. Fertility and Sterility, 72, 54–62. Scholar
  33. Nicoloro-Santa Barbara, J., Busso, C., Moyer, A., & Lobel, M. (2018). Just relax and you'll get pregnant? Meta-analysis examining women’s emotional distress and the outcome of assisted reproductive technology. Social Science & Medicine.
  34. Pandey, S., Shetty, A., Hamilton, M., Bhattacharya, S., & Maheshwari, A. (2012). Obstetric and perinatal outcomes in singleton pregnancies resulting from IVF/ICSI: A systematic review and meta-analysis. Human Reproduction Update, 18, 485–503. Scholar
  35. Patterson, J. M., & Garwick, A. W. (1994). The impact of chronic illness on families: A family systems perspective. Annals of Behavioral Medicine, 16, 131–142. Scholar
  36. Pianta, R. C., & Marvin, R. S. (1993). Manual for classification of the reaction to diagnosis interview. Unpublished material, University of Virginia, Charlottesville.Google Scholar
  37. Raguz, N., McDonald, S. W., Metcalfe, A., O’Quinn, C., & Tough, S. C. (2014). Mental health outcomes of mothers who conceived using fertility treatment. Reproductive Health, 11, 19. Scholar
  38. Ratkowsky, D. A., & Lance, G. N. (1978). A criterion for determining the number of groups in a classification. Australian Computer Journal, 10(3), 115–117.Google Scholar
  39. Ross, L. E., & McLean, L. M. (2006). Anxiety disorders during pregnancy and the postpartum period: A systematic review. The Journal of Clinical Psychiatry.
  40. Schmidt, L., Holstein, B., Christensen, U., & Boivin, J. (2005). Does infertility cause marital benefit? An epidemiological study of 2,250 women and men in fertility treatment. Patient Education and Counseling, 59, 244–251. Scholar
  41. Spanier, G. (1976). Measuring dyadic adjustment: New scales for assessing the quality of marriage and similar dyads. Journal of Marriage and the Family, 38, 15–28. Scholar
  42. Sydsjö, G., Wadsby, M., Kjellberg, S., & Sydsjö, A. (2002). Relationships and parenthood in couples after assisted reproduction and in spontaneous primiparous couples: A prospective long-term follow-up study. Human Reproduction, 17, 3242–3250. Scholar
  43. Ulrich, D., Gagel, D. E., Hemmerling, A., Pastor, V.-S., & Kentenich, H. (2004). Couples becoming parents: Something special after IVF? Journal of Psychosomatic Obstetrics and Gynecology, 25, 99–113. Scholar
  44. Vänskä, M., Punamäki, R. L., Tolvanen, A., Lindblom, J., Flykt, M., Unkila-Kallio, L., et al. (2017). Paternal mental health trajectory classes and early fathering experiences: Prospective study on a normative and formerly infertile sample. International Journal of Behavioral Development, 41, 570–580. Scholar
  45. Verhaak, C. M., Smeenk, J. M. J., Van Minnen, A., Kremer, J. A. M., & Kraaimaat, F. W. (2005). A longitudinal, prospective study on emotional adjustment before, during and after consecutive fertility treatment cycles. Human Reproduction, 20, 2253–2260. Scholar
  46. Ward, J. H. (1963). Hierarchical grouping to optimize an objective function. Journal of the American Statistical Association, 58, 236–244.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2021

Authors and Affiliations

  1. 1.Family Development Research Center, Institute of PsychologyUniversity of LausanneLausanneSwitzerland
  2. 2.Center for Family Studies, CHUVLausanneSwitzerland

Personalised recommendations