Psychological functioning in couples undergoing in vitro fertilisation (IVF) or donor insemination (DI) treatment for infertility
This study was designed to investigate the emotional, marital and sexual functioning of female infertility patients and their male partners, to examine factors influencing psychological functioning, and to assess ways that patients cope with their infertility. Patients attending one of two London clinics for in vitro fertilisation (IVF) or donor insemination (DI) treatment were assessed prior to treatment and approximately 9 months later. At initial assessment, fifty-nine women were interviewed and completed self-report questionnaires assessing state and trait anxiety, depression, sex role, marital and sexual functioning and strategies used to cope with infertility. Thirty-four of their partners also completed questionnaires. Prior to treatment, participants experienced high levels of anxiety, but not depression. They did not have significant levels of marital or sexual problems. High levels of avoidance coping were associated with higher levels of anxiety and depression, but coping strategies were not related to marital or sexual functioning. More female participants were classified as having feminine sex roles in comparison with the general population. High levels of masculinity were associated with lower anxiety but not depression for both men and women. Female IVF patients had higher trait anxiety than female DI patients, but there were no other differences in psychological functioning between the treatment groups. In terms of factors influencing emotional functioning, avoidance coping was a consistent predictor of anxiety and depression in both women and men. The response to follow up was poor: only 46% of female participants completed assessments. For most participants, treatment was unsuccessful. There was a strong relationship between functioning at initial and follow up assessment for these patients. Couples who undergo IVF and DI are a select group of patients: although anxious prior to treatment their emotional functioning is generally good. Reasons for these findings are discussed and proposals for interventions to reduce anxiety and enable appropriate coping strategies are made.