Top

BMC Public Health

Published in:

Open Access 01-12-2019 | Fertility | Research article

The association between stressful life events and perceived quality of life among women attending infertility treatments: the moderating role of coping strategies and perceived couple’s dyadic adjustment

Authors: Maria Clelia Zurlo, Maria Francesca Cattaneo Della Volta, Federica Vallone

Published in: BMC Public Health | Issue 1/2019

Abstract

Background

Research highlighted that Stressful Life Events have high incidence among infertile patients and significant impact on physical and medical parameters related to reproductive functions, but their potential role among factors influencing the infertile patients’ perception of fertility-related Quality of Life (QoL) has not been explored. The present study aims to investigate the associations of Stressful Life Events (Stressful events in the family of origin, In family pre-existing pregnancy difficulties, Health problems in childhood) with perceived fertility-related QoL in women attending infertility treatments, examining the potential moderating role of adopted coping strategies and perceived couple’s dyadic adjustment.

Methods

A questionnaire consisting of Socio-demographics and Infertility-related characteristics, Stress-inducing events in the couples’ lives Questionnaire (FLS), Coping Orientations to Problem Experienced (COPE), Dyadic Adjustment Scale (DAS), and Core and Treatment subscales of Fertility Quality of Life (FertiQoL) was administered to 266 women attending infertility treatments. A descriptive correlational design with cross-sectional comparison was used. Results Logistic Regression Analyses after adjusting for socio-demographic and infertility-related characteristics revealed that women who reported Stressful events in the family of origin and In family pre-existing pregnancy difficulties were more likely to report lower levels of perceived Core QoL, while women who reported Health problems in childhood were more likely to report lower levels of perceived Treatment QoL. Couple’s dyadic adjustment and specific coping strategies were significantly associated with perceived Core and Treatment QoL and they also significantly moderated the associations between stressful life events and perceived QoL.

Conclusions

Data provided original evidence on the strong association between stressful life events and perceived fertility-related QoL also highlighting individual and couples’ resources to define counselling interventions with women attending infertility treatments.

Zegers-Hochschild F, Adamson GD, de Mouzon J, Ishihara O, Mansour R, Nygren K, Sullivan E, van der Poel S. The International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) revised glossary on ART terminology. Fertil Steril. 2009;92(5):1520–4. https://doi.org/10.1016/j.fertnstert.2009.09.009.CrossRefPubMed

Boivin J, Bunting L, Collins JA, Nygren KG. International estimates of infertility prevalence and treatment-seeking: potential need and demand for infertility medical care. Hum Reprod. 2007;22(6):1506–12. https://doi.org/10.1093/humrep/dem046.CrossRefPubMed

Cserepes RE, Kollár J, Sápy T, Wischmann T, Bugán A. Effects of gender roles, child wish motives, subjective well-being, and marital adjustment on infertility-related stress: a preliminary study with a Hungarian sample of involuntary childless men and women. Arch Gynecol Obstet. 2013;288(4):925–32. https://doi.org/10.1007/s004-013-2835-7.CrossRefPubMed

Ying LY, Wu LH, Loke AY. Gender differences in experiences with and adjustments to infertility: a literature review. Int J Nurs Stud 2015;52(10):1640–1652. https://doi.org/https://doi.org/10.1016/j.ijnurstu.2015.05.004.

Peterson BD, Newton CR, Rosen KH. Examining congruence between partners' perceived infertility-related stress and its relationship to marital adjustment and depression in infertile couples. Fam Process. 2003;42(1):59–70. https://doi.org/10.1111/j.1545-5300.2003.00059.x.CrossRefPubMed

Huppelschoten AG, van Dongen AJCM, Verhaak CM, Smeenk JMJ, Kremer JAM, Nelen WLDM. Differences in quality of life and emotional status between infertile women and their partners. Hum Reprod. 2013;28(8):2168–76. https://doi.org/10.1093/humrep/det239.CrossRefPubMed

Karaca N, Karabulut A, Ozkan S, Aktun H, Orengul F, Yilmaz R, Ates S, Batmaz G. Effect of IVF failure on quality of life and emotional status in infertile couples. Eur J Obstet Gynecol Reprod Biol. 2016;206:158–63. https://doi.org/10.1016/j.ejogrb.2016.09.017.CrossRefPubMed

Ragni G, Mosconi P, Baldini MP, Somigliana E, Vegetti W, Caliari I, Nicolosi AE. Health-related quality of life and need for IVF in 1000 Italian infertile couples. Hum Reprod. 2005;20(5):1286–91. https://doi.org/10.1093/humrep/deh788.CrossRefPubMed

Verhaak CM, Aarts JWM, Boivin J, Kremer JAM, Van Empel IWH. O-038 measuring quality of life in infertility using the Fertiqol questionnaire. Hum Reprod. 2010;25(20100600):i16–7.

10.

Valsangkar S, Bodhare T, Bele S, Sai S. An evaluation of the effect of infertility on marital, sexual satisfaction indices and health-related quality of life in women. J Hum Reprod Sci. 2011;4(2):80–5. https://doi.org/10.4103/0974-1208.86088.CrossRefPubMedPubMedCentral

11.

Mousavi SA, Masoumi SZ, Keramat A, Pooralajal J, Shobeiri F. Assessment of questionnaires measuring quality of life in infertile couples: a systematic review. J Reprod Infert. 2013;14(3):110.

12.

Cousineau TM, Domar AD. Psychological impact of infertility. Best Pract Res Clin Obstet Gynaecol. 2007;21(2):293–308. https://doi.org/10.1016/j.bpobgyn.2006.12.003.CrossRefPubMed

13.

Luk BHK, Loke AY. The impact of infertility on the psychological well-being, marital relationships, sexual relationships, and quality of life of couples: a systematic review. J Sex Marital Ther. 2015;41(6):610–25. https://doi.org/10.1080/0092623X.2014.958789.CrossRefPubMed

14.

Peterson BD, Sejbaek CS, Pirritano M, Schmidt L. Are severe depressive symptoms associated with infertility- related distress in individuals and their partners? Hum Reprod. 2014;29(1):76–82. https://doi.org/10.1093/humrep/det412.CrossRefPubMed

15.

Zurlo MC, Cattaneo Della Volta MF, Vallone F. Infertility-related stress and psychological health outcomes in infertile couples undergoing medical treatments: testing a multi-dimensional model. J Clin Psychol Med S. 2019. https://doi.org/10.1007/s10880-019-09653-z.

16.

Tennen H, Affleck G, Mendola R. Causal explanations for infertility: their relationship to control appraisals and psychological adjustment. In: Stanton AL, Dunkel-Schetter C, editors. Infertility. Perspectives from stress and coping research. New York, London: Plenum press; 1991. p. 109–131.

17.

Wischmann T, Stammer H, Gerhard I, Verres R. Couple counseling and therapy for the unfulfilled desire for a child–the two-step approach of the “Heidelberg infertility consultation service”. In: Strauss B, editor. Involuntary childlessness: psychological assessment, counseling, and therapy. Seattle, Toronto, Bern, Göttingen: Hogrefe & Huber Publishers; 2002. p. 127–49.

18.

Van den Broeck U, Emery M, Wischmann T, Thorn P. Counselling in infertility: individual, couple and group interventions. Patient Educ Couns. 2010;81(3):422–8. https://doi.org/10.1016/j.pec.2010.10.009.CrossRefPubMed

19.

The WHOQOL Group. The development of the World Health Organization Quality of Life Assessment Instrument (the WHOQOL). In: Orley J, Kuyken W, editors. Quality of Life Assessment: International Perspectives. Berlin Heidelberg: Springer; 1994.

20.

Boivin J, Takefman J, Braverman A. Development and preliminary validation of the fertility quality of life (FertiQoL) tool. Hum Reprod. 2011a;26(8):2084–91. https://doi.org/10.1093/humrep/der171.CrossRefPubMedPubMedCentral

21.

Boivin J, Takefman J, Braverman A. The fertility quality of life (FertiQoL) tool: development and general psychometric properties. Fertil Steril. 2011b;96(2):409–15. https://doi.org/10.1016/j.fertnstert.2011.02.046.CrossRefPubMed

22.

Boivin J, Takefman J, Braverman A. FertiQoL International, Fertility Quality of Life Questionnaire [Questionario sulla qualità della vita prendendo in considerazione la fertilità]; 2008. Available from: http://sites.cardiff.ac.uk/fertiqol/files/2015/02/fertiqol-Italian.pdf [Accessed 27th June 2018].

23.

Chachamovich JR, Chachamovich E, Ezer H, Fleck MP, Knauth D, Passos EP. Investigating quality of life and health-related quality of life in infertility: a systematic review. J Psychosom Obstet Gynecol. 2010;31(2):101–10. https://doi.org/10.3109/0167482X.2010.481337.CrossRef

24.

Aarts JWM, Van Empel IWH, Boivin J, Nelen WL, Kremer JAM, Verhaak CM. Relationship between quality of life and distress in infertility: a validation study of the Dutch FertiQoL. Hum Reprod. 2011;26(5):1112–8. https://doi.org/10.1093/humrep/der051.CrossRefPubMed

25.

Chachamovich JR, Chachamovich E, Zachia S, Knauth D, Passos EP. What variables predict generic and health-related quality of life in a sample of Brazilian women experiencing infertility? Hum Reprod. 2007;22(7):1946–52. https://doi.org/10.1093/humrep/dem080.CrossRefPubMed

26.

Abbey A, Andrews FM, Halman LJ. Psychosocial predictors of life quality: how are they affected by infertility, gender, and parenthood? J Fam Issues. 1994;15(2):253–71. https://doi.org/10.1177/0192513X94015002006.CrossRef

27.

Zurlo MC. Cattaneo Della Volta MF, Vallone F. predictors of quality of life and psychological health in infertile couples: the moderating role of duration of infertility. Qual Life Res. 2018;27(4):945–54. https://doi.org/10.1007/s11136-017-1781-4.CrossRefPubMed

28.

Karabulut A, Özkan S, Oğuz N. Predictors of fertility quality of life (FertiQoL) in infertile women: analysis of confounding factors. Eur J Obstet Gynecol Reprod Biol. 2013;170(1):193–7. https://doi.org/10.1016/j.ejogrb.2013.06.029.CrossRefPubMed

29.

Monga M, Alexandrescu B, Katz SE, Stein M, Ganiats T. Impact of infertility on quality of life, marital adjustment, and sexual function. Urology. 2004;63(1):126–30. https://doi.org/10.1016/j.urology.2003.09.015.CrossRefPubMed

30.

Lau JT, Wang Q, Cheng Y, Kim JH, Yang X, Yi TH. Infertility-related perceptions and responses and their associations with quality of life among rural Chinese infertile couples. J Sex Marital Ther. 2008;34(3):248–67. https://doi.org/10.1080/00926230701866117.CrossRefPubMed

31.

Onat G, Beji NK. Effects of infertility on gender differences in marital relationship and quality of life: a case control study of Turkish couples. Eur J Obstet Gynecol Reprod Biol. 2012;165(2):243–8. https://doi.org/10.1016/j.ejogrb.2012.07.033.CrossRefPubMed

32.

Chartier MJ, Walker JR, Naimark B. Separate and cumulative effects of adverse childhood experiences in predicting adult health and health care utilization. Child Abuse Negl. 2010;34(6):454–64. https://doi.org/10.1016/j.chiabu.2009.09.020.CrossRefPubMed

33.

De Venter M, Demyttenaere K, Bruffaerts R. The relationship between adverse childhood experiences and mental health in adulthood. A systematic literature review. Tijdschr Psychiatr. 2013;55(4):259–68.PubMed

34.

Grandin LD, Alloy LB, Abramson LY. Childhood stressful life events and bipolar spectrum disorders. J Soc Clinl Psychol. 2007;26(4):460–78. https://doi.org/10.1521/jscp.2007.26.4.460.CrossRef

35.

Heim C, Newport DJ, Wagner D, Wilcox MM, Miller AH, Nemeroff CB. The role of early adverse experience and adulthood stress in the prediction of neuroendocrine stress reactivity in women: a multiple regression analysis. Depress Anxiety. 2002;15(3):117–25. https://doi.org/10.1002/da.10015.CrossRefPubMed

36.

Wickrama KA, Lee TK, O'Neal CW. Stressful life experiences in adolescence and cardiometabolic risk factors in young adulthood. J Adolesc Health. 2015;56(4):456–63. https://doi.org/10.1016/j.jadohealth.2014.12.009.CrossRefPubMed

37.

Sokratous S, Merkouris A, Middleton N, Karanikola M. The association between stressful life events and depressive symptoms among Cypriot university students: a cross-sectional descriptive correlational study. BMC Public Health. 2013;13(1):1121. https://doi.org/10.1186/1471-2458-13-1121.CrossRefPubMedPubMedCentral

38.

Corso PS, Edwards VJ, Fang X, Mercy JA. Health-related quality of life among adults who experienced maltreatment during childhood. Am J Public Health. 2008;98(6):1094–100. https://doi.org/10.2105/AJPH.2007.119826.CrossRefPubMedPubMedCentral

39.

Edwards VJ, Anda RF, Felitti VJ, Dube SR. Adverse childhood experiences and health-related quality of life as an adult. In: Kendall-Tackett KA, editor. Application and practice in health psychology. Health consequences of abuse in the family: A clinical guide for evidence-based practice. Washington, DC, US: American Psychological Association; 2004. p. 81–94. doi:https://doi.org/10.1037/10674-005.

40.

Salinas-Miranda AA, Salemi JL, King LM, Baldwin JA, Austin DA, Scarborough K, Spooner KK, Zoorobrj Salihu HM. Adverse childhood experiences and health-related quality of life in adulthood: revelations from a community needs assessment. Health Qual Life. 2015;13(1):123. https://doi.org/10.1186/s12955-015-0323-4.CrossRef

41.

Sherbourne CD, Meredith LS, Rogers W, Ware JE. Social support and stressful life events: age differences in their effects on health-related quality of life among the chronically ill. Qual Life Res. 1992;1(4):235–46. https://doi.org/10.1007/BF00435632.CrossRefPubMed

42.

Pocnet C, Antonietti JP, Strippoli MPF, Glaus J, Preisig M, Rossier J. Individuals’ quality of life linked to major life events, perceived social support, and personality traits. Qual Life Res. 2016;25(11):2897–908. https://doi.org/10.1007/s11136-016-1296-4.CrossRefPubMed

43.

Wischmann, T. Heidelberger Kinderwunsch-Sprechstunde: eine Studie zu psychosozialen Aspekten ungewollter Kinderlosigkeit [Heidelberg fertility consultation service: a study of psychosocial aspect of involuntary childlessness]. Frankfurt/M: Peter Lang; 1998.

44.

Wischmann T, Stammer H, Scherg H, Gerhard I, Verres R. Psychosocial characteristics of infertile couples: a study by the Heidelberg fertility consultation service. Hum Reprod. 2001;16(8):1753–61. https://doi.org/10.1093/humrep/16.8.1753.CrossRefPubMed

45.

Wischmann T, Scherg H, Strowitski T, Verres R. Psychosocial characteristics of women and men attending infertility counselling. Hum Reprod. 2009;24(2):378–85. https://doi.org/10.1093/humrep/den401.CrossRefPubMed

46.

Jacobs MB, Boynton-Jarrett RD, Harville EW. Adverse childhood event experiences, fertility difficulties and menstrual cycle characteristics. J Psychosom Obstet Gynecol. 2015;36(2):46–57. https://doi.org/10.3109/0167482X.2015.1026892.CrossRef

47.

Gollenberg AL, Liu F, Brazil C, Drobnis EZ, Guzick D. Overstreet, Redmon JB, Sparks a, Wang C, swan SH. Semen quality in fertile men in relation to psychosocial stress. Fertil Steril. 2010;93(4):1104–11. https://doi.org/10.1016/j.fertnstert.2008.12.018.CrossRefPubMed

48.

Ebbesen SMS, Zachariae R, Mehlsen MY, Thomsen D, Højgaard A, Ottosen L, Petersen T, Ingerslev HJ. Stressful life events are associated with a poor in-vitro fertilization (IVF) outcome: a prospective study. Hum Reprod. 2008;24(9):2173–82. https://doi.org/10.1093/humrep/dep185.CrossRef

49.

Nakamura K, Sheps S, Arck PC. Stress and reproductive failure: past notions, present insights and future directions. J Assist Reprod Genet. 2008;25(2–3):47–62. https://doi.org/10.1007/s10815-008-9206-5.CrossRefPubMedPubMedCentral

50.

Pottinger AM, Nelson K, McKenzie C. Stressful events and coping with infertility: factors determining pregnancy outcome among IVF couples in Jamaica. J Reprod Infant Psyc. 2016;34(1):3–14. https://doi.org/10.1080/02646838.2015.1093613.CrossRef

51.

Berghuis JP, Stanton AL. Adjustment to a dyadic stressor: a longitudinal study of coping and depressive symptoms in infertile couples over an insemination attempt. J Consult Clinl Psych. 2002;70(2):433–8. https://doi.org/10.1037/0022-006X.70.2.433.CrossRef

52.

Jordan C, Revenson TA. Gender differences in coping with infertility: a meta-analysis. J Behav Med. 1999;22(4):341–58. https://doi.org/10.1023/A:1018774019232.CrossRefPubMed

53.

Kraaij V, Garnefski N, Schroevers MJ. Coping, goal adjustment, and positive and negative affect in definitive infertility. J Health Psychol. 2009;14(1):18–26. https://doi.org/10.1177/1359105308097939.CrossRefPubMed

54.

Peterson BD, Newton CR, Rosen KH, Skaggs GE. Gender differences in how men and women who are referred for IVF cope with infertility stress. Hum Reprod. 2006;21(9):2443–9. https://doi.org/10.1093/humrep/del145.CrossRefPubMed

55.

Peterson BD, Pirritano M, Christensen U, Schmidt L. The impact of partner coping in couples experiencing infertility. Hum Reprod. 2008;23(5):1128–37. https://doi.org/10.1093/humrep/den067.CrossRefPubMed

56.

Carver CS, Scheier MF, Weintraub JK. Assessing coping strategies: a theoretically based approach. J Pers Soc Psychol. 1989;56(2):267–83. https://doi.org/10.1037/0022-3514.56.2.267.CrossRefPubMed

57.

Sica C, Magni C, Ghisi M, Altoè G, Sighinolfi C, Chiri LR, Franceschini S. Coping orientation problems experienced - Nuova versione italiana (COPE-NVI): Uno strumento per la misura degli stili di coping [coping orientation to the problems experienced-new Italian version (COPE-NVI)]. Psicoterapia Cognitiva e Comportamentale. 2008;14(1):27–53.

58.

Gentili P, Contrearas L, Cassaniti M, D'Arista F. La dyadic adjustment scale. Una misura dell'adattamento di coppia [the dyadic adjustment scale. A measurement of dyadic adjustment]. Minerva Psichiatr. 2002;43(2):107–16.

59.

Spanier GB. Measuring dyadic adjustment: new scales for assessing the quality of marriage and similar dyads. J Marriage Fam. 1976;38(1):15–28. https://doi.org/10.2307/350547.CrossRef

60.

Gameiro S, Boivin J, Dancet E, de Klerk C, Emery M, Lewis-Jones C, Thorn P, Van den Broeck U, Venetis C, Verhaak CM, Wischmann T, Vermeulen N. ESHRE guideline: routine psychosocial care in infertility and medically assisted reproduction—a guide for fertility staff. Hum Reprod. 2015;30(11):2476–85. https://doi.org/10.1093/humrep/dev177.CrossRefPubMed

Title: The association between stressful life events and perceived quality of life among women attending infertility treatments: the moderating role of coping strategies and perceived couple’s dyadic adjustment
Authors: Maria Clelia Zurlo
Maria Francesca Cattaneo Della Volta
Federica Vallone
Publication date: 01-12-2019
Publisher: BioMed Central
Keywords: Fertility
Infertility
Infertility
Published in: BMC Public Health / Issue 1/2019
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-019-7925-4

At a glance: The STEP trials

Springer Medicine

The association between stressful life events and perceived quality of life among women attending infertility treatments: the moderating role of coping strategies and perceived couple’s dyadic adjustment

Abstract

Background

Methods

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2019

Geographic disparities and temporal changes in risk of death from myocardial infarction in Florida, 2000–2014

Evaluation of the promising neighbourhoods community program to reduce health inequalities in youth: a protocol of a mixed-methods study

Economic burden of multiple sclerosis in a population with low physical disability

A randomized controlled trial for overweight and obesity in preschoolers: the More and Less Europe study - an intervention within the STOP project

Outcomes of a tertiary-based innovative approach to engage primary care providers in provision of hepatitis C treatment in community settings

Childhood sensorineural hearing loss and adult mental health up to 43 years later: results from the HUNT study