he psychological impact of infertility on patients undergoing assisted reproductive treatment

Authors

  • Raquel Putin Saura Universidad Ramon Llull
  • Olga Herrero Esquerdo Universidad Ramon Llull; Barcelona, España.
  • Emma Ribas Rabert Women’s Health Institute. Clínica Ginecológica Carmona Dexeus; Barcelona, España.
  • Sergi Corbella Universidad Ramon Llull; Barcelona, España.

Keywords:

Infertility, Emotional distress, Grief, Sense-making, Adaptive resources, Partner relationship

Abstract

Facing a diagnosis of infertility and its subsequent treatment generates emotional impact and a process of grief. This study aims to contribute to knowledge about the experience of individuals undergoing assisted reproductive treatments. A correlational and cross-sectional study was conducted with a sample of 105 individuals (48 men and 57 women) to determine differences in emotional distress, personal and interpersonal adaptive resources based on gender and type of infertility, and to identify relationships between emotional distress, resources, and partner relationships. Additionally, the relationship between sense-making and emotional distress was analysed based on gender and type of infertility. The results show that women have higher levels of emotional distress than men, while men show more resources than women. Furthermore, significant negative relationships were found between emotional distress and partner relationships, as well as between sense-making and emotional distress. These results provide protective and risk indicators that should be considered in psychological interventions, and we introduce a new variable to consider: sense-making.

References

Agostini, F., Monti, F., De Pascalis, L., Paterlini, M., La Sala, G. B. y Blickstein, I. (2011). Psychosocial support for infertile couples during assisted reproductive technology treatment. Fertility and sterility, 95(2), 707-710. https://doi.org/10.1016/j.fertnstert.2010.06.011

Arroyo, L. y Castañeda, L. I. (2021). Padeciendo los cuerpos: significados de las paternidades, maternidades y la familia en mujeres y hombres infértiles. Revista de Estudios de Género, La Ventana, 6(54), 39-73. https://doi.org/10.32870/lv.v6i53.7189

Aulet, A., Herrero, O. y Neimeyer, R. A. (2019). Ser tú o ser yo: esa es la cuestión. Elaboración del duelo por la muerte de una madre. Revista de Psicoterapia, 30(114), 155-170. https://doi.org/10.33898/rdp.v30i114.322

Ávila Espada, A. y Moreno-Rosset, C. (2008). La intervención psicológica en infertilidad: orientaciones para un protocolo de actuación clínica. Papeles Del Psicólogo, 29(2), 186-196. https://pdfs.semanticscholar.org/ee3d/aa8a4d7e9c92b55b90015eefc756a66c5bb2.pdf

Biringer, E., Howard, L. M., Kessler, U., Stewart, R. y Mykletun, A. (2015). Is infertility really associated with higher levels of mental distress in the female population? Results from the North-Trondelag Health Study and the Medical Birth Registry of Norway. Journal of Psychosomatic Obstetrics and Gynecology, 36(2), 38-45. https://doi.org/10.3109/0167482X.2014.992411

Boivin, J., Oguz, M., Duong, M., Cooper, O., Filipenko, D., Markert, M., Samuelsen, C. y Lenderking, W.R. (2023). Emotional reactions to infertility diagnosis: thematic and natural language processing analyses of the 1000 Dreams survey. Reproductive BioMedicine Online, 46(2), 399-409. https://doi.org/10.1016/j.rbmo.2022.08.107

Boivin, J., Vassena, R., Costa, M., Vegni, E., Dixon, M., Collura, B., Market, M., Samuelsen, C., Guiglotto, J., Roitmann, E. y Domar, A. (2022). Tailored support may reduce mental and relational impact of infertility on infertile patients and partners. Reproductive BioMedicine Online, 44(6), 1045-1054. https://doi.org/10.1016/j.rbmo.2022.01.015

Botella, L. y Feixas, G. (1998). Teoría de los constructos personales: Aplicaciones a la práctica psicológica. Laertes.

Burke, L.A. y Neimeyer, R.A. (2012). Spirituality and health: Meaning making in bereavement. En M. Cobb, C. Puchalski y B. Rumbold (Eds.), The textbook on spirituality in healthcare (pp. 127–133). Oxford University Press. https://doi.org/10.1093/med/9780199571390.003.0019

Castro, H., Mendoza, A., Martínez, L., González I. y De León, R. (2021). Estresores vinculados a la infertilidad en mujeres y hombres que inician un tratamiento de reproducción asistida en la Clínica de la Pareja Infértil del Departamento de Investigación en Salud Sexual y Reproductiva. Revista Médica de Panamá, 40(2), 107–121. https://doi.org/10.37980/im.journal.rmdp.20201717

Cocchiaro, T., Meneghini, C., Dal Lago, A., Fabiani, C., Amodei, M., Miriello, D., Crisafulli, M., Meneghini, C., Capone, B., Cannarella, R., Condorelli, R.A., La Vignera, S., Calogero, A.E., Lenzi, A. y Rago, R. (2020). Assessment of sexual and emotional distress in infertile couples: validation of a new specific psychometric tool. Journal of Endocrinological Investigation, 43(12), 1729–1737. https://doi.org/10.1007/s40618-020-01263-z

Currier, J. M., Holland, J. M. y Neimeyer, R. A. (2006). Sense-making, grief, and the experience of violent loss: Toward a mediational model. Death studies, 30(5), 403-428. https://doi.org/10.1080/07481180600614351

Currier, J. M., Holland, J. M., Rozalski, V., Thompson, K. L., Rojas-Flores, L. y Herrera, S. (2013). Teaching in violent communities: The contribution of meaning made of stress on psychiatric distress and burnout. International Journal of Stress Management, 20(3), 254-277.https://doi.org/10.1037/a0033985

Dadhwal, V., Choudhary, V., Perumal, V. y Bhattacharya, D. (2022). Depression, anxiety, quality of life and coping in women with infertility: A cross‐sectional study from India. International Journal of Gynecology & Obstetrics, 158(3), 671-678. https://doi.org/10.1002/ijgo.14084

Davis, C. G., Nolen-Hoeksema, S. y Larson, J. (1998). Making sense of loss and benefiting from the experience: two construals of meaning. Journal of personality and social psychology, 75(2), 561-574.

Davis, C. G. y Nolen-Hoeksema, S. (2001). Loss and meaning: How do people make sense of loss?. American Behavioral Scientist, 44(5), 726-741. https://doi.org/10.1177/0002764201044005003

De Berardis, D., Mazza, M., Marini, S., Del Nibletto, L., Serroni, N., Pino, M. C., Valchera, A., Ortolani, C, Ciarrocchi, F., Martinotti, C. y Di Giannantonio, M. (2014). Psychopathology, emotional aspects and psychological counselling in infertility: a review. Clinical Therapeutics, 165(3), 163-169. Psychopathology_emotional_aspects_and_ps20160314-29344-xlsmq4-libre.pdf

Del Castillo, M., Moreno-Rosset, C., Martín M.D. y Ramírez-Uclés, I. (2009). Diferencias de género en afecto, desajuste emocional y recursos adaptativos en parejas infértiles: un enfoque positivo. Anuario de Psicología Clínica y de La Salud, 5, 41-48. http://institucional.us.es/apcs/doc/APCS_5_esp_41-48.pdf

Doka, K.J. (2002). Disenfranchised grief: New Directions, Challenges and Strategies for Practice. Research Press.

Dolan, A., Lomas, T., Ghobara, T. y Hartshorne, G. (2017). ‘It’s like taking a bit of masculinity away from you’: towards a theoretical understanding of men’s experiences of infertility. Sociology of Health and Illness, 39(6), 878–892. https://doi.org/10.1111/1467-9566.12548

Eddy, B. P., Trujillo-DeFronzo, A. y Turns, B. A. (2022). Infertility, Grief, and Trauma Related to Fathering. En S. Molloy, P. Azzam, A. Isacco (Eds.), Handbook of the Psychology of Fatherhood (pp. 183-195). Springer, Cham.

Epstein, Y. M. y Rosenberg, H. S. (2005). Depression in primary versus secondary infertility egg recipients. Fertility and sterility, 83(6), 1882-1884. https://doi.org/10.1016/j.fertnstert.2005.01.098

Feixas, G. y Villegas, M. (1990). Constructivismo y psicoterapia. Desclée de Brouwer.

Fernández-Sola, C., Martínez-Caba, M. I., Hernández-Padilla, J. M., Carmona-Samper, E. y Granero-Molina, J. (2016). Experiences of Spanish women undergoing hysterosalpingography as part of the infertility process: A phenomenological study. Journal of Clinical Nursing, 25(3-4), 494-504. https://doi.org/10.1111/jocn.13077

Frederiksen, Y., Farver-Vestergaard, I., Skovgård, N. G., Ingerslev, H. J. y 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(1), 1-18. https://doi.org/10.1136/bmjopen-2014-006592

Gameiro, S., Boivin, J., Dancet, E., De Klerk, C., Emery, M., Lewis-Jones, C., Thorn, P., Van der Broeck, U., Venetis, C., Verhaak, C.M., Wischmann, T. y Vermeulen, N. (2015). ESHRE guideline: Routine psychosocial care in infertility and medically assisted reproduction - A guide for fertility staff. Human Reproduction, 30(11), 2476-2485. https://doi.org/10.1093/humrep/dev177

Gerrish, N.J., Steed L.G. y Neimeyer, R.A. (2010). Meaning reconstruction in bereaved mothers: A pilot study using the biographical grid method. Journal of Constructivist Psychology, 23(2), 118–142. https://doi.org/10.1080/10720530903563215

Guerra, D. (1998). Cómo afrontar la infertilidad. Barcelona: Editorial Planeta.

Herrero, O., Aulet, A., Alves, D., Rosa, C. y Botella, L. (2019). Psychotherapist Interventions Coding System (PICS). Narrative Inquiry, 29(1), 157-184. https://doi.org/10.1075/ni.18035.her

Herrero, O. y Botella, L. (2002). La reconstrucción dialógica en un caso de duelo: Mecanismos pragmático-retóricos en psicoterapia. Revista de Psicoterapia, 13(49), 47-76. RP49.P65

Herrero, O., Corbella, S. y Putin, R. (2023). Desgranando la teoría del duelo tras el suicidio de un ser querido. Revista de Psicoterapia, 34(124), 101-116. https://doi.org/10.5944/rdp.v34i124.37051

Hjelmstedt, A., Andersson, L., Skoog-Svanberg, A., Bergh, T., Boivin, J. y Collins, A. (1999). Gender differences in psychological reactions to infertility among couples seeking IVF-and ICSI-treatment. Acta obstetricia et gynecologica Scandinavica, 78(1), 42-49. https://www.tandfonline.com/doi/abs/10.1080/j.1600-0412.1999.780110.x?

Jenaro, C., Moreno-Rosset, C., Antequera, R. y Flores, N. (2008). La evaluación psicológica en infertilidad: El “dera” una prueba creada en España. Papeles Del Psicologo, 29(2), 176–185. https://www.redalyc.org/pdf/778/77829204.pdf

Kelly, G.A. (1955/1991). The psychology of personal constructs (Vol. 1-2). Routledge.

Kissane, D. W. y Hooghe, A. (2011). Family therapy for the bereaved. En R. Neimeyer, D.L. Harris, H.R. Winokuer y G.F. Thornton (Eds.), Grief and bereavement in contemporary society (pp. 287-302). Routledge.

Kızılay, F., Şahin, M. y Altay, B. (2018). Do sperm parameters and infertility affect sexuality of couples? Andrologia, 50(2), 1-6. https://doi.org/10.1111/and.12879

Lancaster, S. L. y Carlson, G. C. (2015). Meaning made, distress, and growth: An examination of the Integration of Stressful Life Experiences Scale. International Journal of Stress Management, 22(1), 92. https://doi.org/10.1037/a0038296

Lehman, D. R., Wortman, C. B. y Williams, A. F. (1987). Long-term effects of losing a spouse or child in a motor vehicle crash. Journal of personality and social psychology, 52(1), 218-231. https://doi.org/10.1037/0022-3514.52.1.218

López García de Madinabeitia, A. P. (2011). Duelo perinatal: un secreto dentro de un misterio. Revista de La Asociación Española de Neuropsiquiatría, 31(109), 53-70. https://doi.org/10.4321/s0211-57352011000100005

Massarotti, C., Gentile, G., Ferreccio, C., Scaruffi, P., Remorgida, V. y Anserini, P. (2019). Impact of infertility and infertility treatments on quality of life and levels of anxiety and depression in women undergoing in vitro fertilization. Gynecological Endocrinology, 35(6), 485-489. https://doi.org/10.1080/09513590.2018.1540575

Masterson, M. P., Schuler, T. A. y Kissane, D. W. (2013). Family focused grief therapy: A versatile intervention in palliative care and bereavement. Bereavement Care, 32(3), 117-123. https://doi.org/10.1080/02682621.2013.8545444

McGrath, C., Unsal, A. y O'Hare, N. (2020). A systematic review of the grief, loss and associated psychological outcomes in women and men experiencing infertility. Journal of Psychosomatic Obstetrics & Gynecology, 41(4), 241-254. https://doi.org/10.1080/0167482X.2020.1732913

McIntosh, D. N., Silver, R. C. y Wortman, C. B. (1993). Religion's role in adjustment to a negative life event: coping with the loss of a child. Journal of personality and social psychology, 65(4), 812-821. https://doi.org/10.1037/0022-3514.65.4.812

Mizrahi, M., Reis, H. T., Maniaci, M. R. y Birnbaum, G. E. (2019). When insecurity dampens desire: Attachment anxiety in men amplifies the decline in sexual desire during the early years of romantic relationships. European Journal of Social Psychology, 49(6), 1223–1236. https://doi.org/10.1002/ejsp.2567

Moreno-Rosset, C., Antequera, R. y Jenaro, C. (2008). Cuestionario de Desajuste Emocional y Recursos Adaptativos en Infertilidad. TEA Ediciones.

Moreno-Rosset, C., Antequera, R., Jenaro, C. y Gómez Sánchez, Y. (2009). La Psicología de la Reproducción: la necesidad del psicólogo en las Unidades de Reproducción Humana. Clínica y Salud, 20(1), 79-90.http://dialnet.unirioja.es/servlet/extart?codigo=3008166

Moreno-Rosset, C., Ávila Espada, A., Castro-Pita, F. J. y Rodríguez-Muñoz, M.F. (2015). Programa de Apoyo Psicológico en Infertilidad (PAPI). Eficacia clínica a través del estudio de un caso. Revista Argentina de Clínica Psicológica, 24(1), 5–12. https://dialnet.unirioja.es/servlet/extart?codigo=5428410

Moreno-Rosset, C., Del Castillo, M., Ramírez-Uclés, I. y Martín, M. D. (2011). Estados emocionales y afectivos en infertilidad: Un estudio comparativo con personas fértiles. Behavioral Psychology/ Psicología Conductual, 19(3), 683–703. https://pdfs.semanticscholar.org/d60a/b6736f0609879374be8e401a6df86c6b675b.pdf

Neimeyer, R.A., Burke, L.A., Mackay, M.M. y Van Dyke Stringer, J.G. (2010). Grief therapy and the reconstruction of meaning: From principles to practice. Journal of Contemporary Psychotherapy, 40(2), https://doi.org/10.1007/s10879-009-9135-3

Neimeyer, R.A., Herrero, O. y Botella, L. (2006). Chaos To Coherence: Psychotherapeutic Integration Of Traumatic Loss. Journal of Constructivist Psychology, 19(2), 127–145. https://doi.org/10.1080/10720530500508738

Organización Mundial de la Salud. (2020). Infertility. https://www.who.int/news-room/fact-sheets/detail/infertility

Ortega, M. P. y Mairal, J. B. (2016). Calidad de vida relacionada con la salud en los procesos de reproducción asistida. Una revisión. EduPsykhé: Revista de psicología y psicopedagogía, 15(2), 113-129. https://doi.org/10.57087/edupsykhe.v15i2.3978

Ozkan, B., Orhan, E., Aktas, N. y Coskuner, E. R. (2016). Sexual dysfunction and depression among Turkish women with infertile husbands: the invisible part of the iceberg. International Urology and Nephrology, 48(1), 31–36. https://doi.org/10.1007/s11255-015-1142-6

Paricio, R., Castillo, D. y Usaola, P. (2020). Maternidad e Identidad materna: descontrucción terapéutica de narrativas. Revista Asociación Española de Neuropsiquiatría, 40(138), 33–54. https://doi.org/10.4321/S0211-573520200020003

Park, C. L. (2010). Making sense of the meaning literature: An integrative review of meaning making and its effects on adjustment to stressful life events. Psychological Bulletin, 136(2), 257–301. https://doi.org/10.1037/a0018301

Peterson, B. D., Newton, C. R., Rosen, K. H. y Skaggs, G. E. (2006). Gender differences in how men and women who are referred for IVF cope with infertility stress. Human Reproduction, 21(9), 2443-2449. https://doi.org/10.1093/humrep/del145

Robaina, N. F., Jenaro, C. y Moreno-Rosset, C. (2008). Terapia de pareja en infertilidad. Papeles Del Psicologo, 29(2), 205-2012. https://www.redalyc.org/pdf/778/77829207.pdf

Rooney, K. L. y Domar, A. D. (2022). The relationship between stress and infertility. Dialogues in clinical neuroscience, 20(1), 41-47. https://doi.org/10.31887/DCNS.2018.20.1/klrooney

Rosen, N. O., Bailey, K. y Muise, A. (2018). Degree and Direction of Sexual Desire Discrepancy are Linked to Sexual and Relationship Satisfaction in Couples Transitioning to Parenthood. Journal of Sex Research, 55(2), 214–225. https://doi.org/10.1080/00224499.2017.1321732

Rozalski, V., Holland, J.M. y Neimeyer, R.A. (2016). Circumstances of Death and Complicated Grief: Indirect Associations Through Meaning Made of Loss. Journal of Loss and Trauma, 22(1), 11-23. https://doi.org/10.1080/15325024.2016.1161426

Ruiz-Porras, D., Ruiz-Porras, L. y Cruz-Repiso, V. (2020). La depresión en su relación con las técnicas de reproducción asistida y la influencia del asesoramiento profesional durante el proceso. Psicología y Salud, 30(1), 15-23. https://doi.org/10.25009/pys.v30i1.2614

Sahraeian, M., Lotfi, R., Qorbani, M., Faramarzi, M., Dinpajooh, F. y Ramezani Tehrani, F. (2019). The Effect of Cognitive Behavioral Therapy on Sexual Function in Infertile Women: A Randomized Controlled Clinical Trial. Journal of Sex and Marital Therapy, 45(7), 574–584. https://doi.org/10.1080/0092623X.2019.1594476

Sánchez-Cánovas, J. (2021). Escala de bienestar psicológico. (4ª Ed). Barcelona: Hogefre TEA Ediciones.

Sater, A. C., Miyague, A. H., Schuffner, A., Nisihara, R. y Teixeira, D. M. (2022). Impact of assisted reproduction treatment on sexual function of patients diagnosed with infertility. Archives of Gynecology and Obstetrics, 305(6), https://doi.org/1595-1604. https://doi.org/10.1007/s00404-021-06367-2

Schuler, T. A., Zaider, T. I. y Kissane, D. W. (2012). Family grief therapy: A vital model in oncology, palliative care and bereavement. Family Matter, 90(1),77-86. Family grief therapy: A vital model in oncology, palliative care and bereavement.

Stanhiser, J. y Steiner, A. Z. (2018). Psychosocial aspects of fertility and assisted reproductive technology. Obstetrics and Gynecology Clinics, 45(3), 563-574. https://doi.org/10.1016/j.ogc.2018.04.006

Tuval-Mashiach, R. y Dekel, R. (2014). Religious meaning-making at the community level: The forced relocation from the Gaza Strip. Psychology of Religion and Spirituality, 6(1), 64-71. https://doi.org/10.1037/a0033917

Yokota, R., Okuhara, T., Okada, H., Goto, E., Sakakibara, K. y Kiuchi, T. (2022). Association between stigma and anxiety, depression, and psychological distress among Japanese women undergoing infertility treatment. Healthcare, 10(7), 1300. https://doi.org/10.3390/healthcare10071300

Verhaak, C. M., Smeenk, J. M., Van Minnen, A., Kremer, J. A. y Kraaimaat, F. W. (2005). A longitudinal, prospective study on emotional adjustment before, during and after consecutive fertility treatment cycles. Human reproduction, 20(8), 2253-2260. https://doi.org/10.1093/humrep/dei015

Wang, Q., Koh, J. B. K. y Song, Q. (2015). Meaning making through personal storytelling: Narrative research in the Asian American context. Asian American Journal of Psychology, 6(1), 88-96. https:// doi:10.1037/a0037317

Wdowiak, A., Makara-Studzińska, M., Raczkiewicz, D. y Cyranka, K. (2022). Reproductive problems and intensity of anxiety and depression in women treated for infertility. Psychiatria Polska, 56(1), 153-170. https://doi.org/10.12740/PP/125885

Wong, P. T. (2010). Meaning therapy: An integrative and positive existential psychotherapy. Journal of Contemporary Psychotherapy, 40(2), 85-93. https://doi.org/10.1007/s10879-009-9132-6

Published

2023-12-27

How to Cite

Putin Saura, R., Herrero Esquerdo, O., Ribas Rabert, E., & Corbella, S. (2023). he psychological impact of infertility on patients undergoing assisted reproductive treatment. Calidad De Vida Y Salud Journal, 16(2), 2-25. Retrieved from http://revistacdvs.uflo.edu.ar/index.php/CdVUFLO/article/view/395

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