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Literature Review: The Effects of Infertility on Marriage

Sage Ricks

Brigham Young University – Idaho

FAML300: Marriage

Brother Bradley Barnett

29 October 2022
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Defining the Problem

Infertility has been a great producer of stress for married couples for a long time, and it

effects their marital satisfaction and overall stress levels. In 2016, Gana and Jakubowska looked

at 150 infertile couples and studied the connection between stress related to infertility and

emotional distress and marital satisfaction. They used multiple models and processes in order to

understand the predictive factors of the relationship between infertility stress and emotional

distress, as well as between infertility stress and martial satisfaction. Researchers found that

infertility-related stress has a higher impact on psychological distress than marital satisfaction.

Instead, the psychological distress was the factor that had a direct effect on marital satisfaction.

They also found that women experience higher stress regarding infertility than men, and that

women experienced more marital dissatisfaction than men.

Also, studying the effects of infertility, Luk and Loke (2015) analyzed 20 articles

published between 2000 and 2014 that focused on the effect of infertility on couples. They saw

that four main aspects of the couple’s lives that were affected: psychological well-being, marital

relationship, sexual relationship, and quality of life. They found that infertility had an effect on

each person’s psychological well-being, and it was usually a negative impact. They also found

that infertility affects the sexual and marital relationships of couples due to the stress and

alteration of their emotions. Lastly, they found that the effect of infertility is not population or

culturally specific. Everyone who experiences infertility is likely to be affected by it, positively

or negatively.

Kim, Shin, and Yun (2018) examined 121 couples that were dealing with infertility. They

wanted to understand the relationship between levels of infertility stress, marital adjustment,

depression, and their overall quality of life. They did a cross-sectional study using multiple
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questionnaires, including the Fertility Quality of Life, Fertility Problem Inventory, Revised

Dyadic Adjustment Scale, and Beck Depression Inventory. When directly related to infertility,

the quality of life for women was lower, and their depression levels were higher than for men.

Lastly, they found that there were actor-and-partner effects of stress, adjustment, and depression

on the quality of life of couples.

Understanding the Problem

Infertility-related stress is often increased when married couples influence each other’s

feelings and do not communicate well. Maroufizadeh (2019) examined 141 infertile couples in

order to look at the relationship specifically between infertility-relation stress and marital

satisfaction. Researchers used the Actor-Partner Interdependence Model (APIM) to understand

the effects of stress on satisfaction between husbands and wives. The actor effect is the impact of

a person’s stress on their own marital satisfaction, while the partner effect is the impact of a

person’s stress on their partner’s satisfaction. The results show that both men and women had an

actor effect on their partners, but only women had a partner effect on their husbands. Both

spouses are influenced by their own stress and their partner’s.

Especially in women, marital quality and satisfaction play an important role in stress

perception. Sadiq, Rana, and Munir (2022) looked at 115 women, ages 20-25, who were

struggling with infertility. The goal of the study was to understand the connection between

emotional distress, marital quality, and self-compassion in women. They used the Relationship

Assessment Scale, the Self-compassion Scale, and the Depression, Anxiety, and Stress Scale to

analyze how they each affected each other. Marital quality and self-compassion were positively

associated, and both marital quality and self-compassion were negatively associated with

emotional distress. Researchers found the marital quality could be used to predict depression and
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stress in infertile women, but self-compassion could predict depression, stress, and anxiety.

These findings can help with managing stress related to infertility.

In 2002, Pasch looked at 48 volunteer couples who were currently seeking fertility

treatment. Researchers performed a cross-sectional study in order to test a theoretical model

about the correlation between communication and a couple’s approach to infertility using

interviews, questionnaires, and a marital discussion task. They measured the quality of

communication between partners during their tasks and the effect of infertility on marriage. The

results showed that wives were more involved in trying to have children and wanted children

more than men. Women tried to have conversations about infertility and trying to have children

more than their husbands, and they experienced lower self-esteem.

Finding a Solution

The impact of infertility related stress can be diminished by bringing couples together

and focusing on being positive and finding appropriate coping mechanisms. A study done in

2020 by Sauvé examined possible marital benefits that infertile couples could experience.

Researchers only interviewed three couples who were seeking fertility treatment. They

interviewed the partners separately, and they asked open-ended questions about the process of

trying to conceive and dealing with infertility. The results showed five types of benefits: working

on a shared hardship together, feeling closer, feeling more reassured in the relationships, working

on their communication skills and supporting each other, and trusting that their partner can

remain strong during adverse times. This study showed that focusing on the positive aspects of

trials can help couples feel more confident in each other and can strengthen their relationship.
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To study coping mechanisms, Andrew, Abbey, and Halman (1991) looked at 157 couples

who were medically diagnosed as infertile. Researchers wanted to see how stress to infertility

was linked to the quality of life and marriage. They interviewed wives and husbands separately,

but most of the findings applied to both groups. They found that infertility stress had direct

effects on many things, including an increase in conflict and a decrease in sexual confidence,

satisfaction with performance, and frequency. They found that the overall life quality for married

people is significantly affected and explained by marital factors. Their life quality could be

improved and less affected by stress if they learn about their situation and apply appropriate

coping mechanisms.

The effects of infertility-related stress can also be lessened when men and women get the

help that they need in order to be good partners. Chaves, Canavarro, and Moura-Ramos (2019)

looked at 67 couples struggling with infertility in order to understand the role of dyadic coping

used by the couple. Dyadic coping means the way that couples handle stress and work to

overcome it together. Each participant self-reported on a questionnaire about stress related to

infertility, dyadic coping and adjustment, and depression and anxiety symptoms. Researchers

found that there was an indirect effect between adjustment due to infertility through the

differences in how each member of the couple viewed their own actions and their partners. They

found that men need to practice dyadic coping methods for their personal and martial adjustment.

It would also be helpful to include them in more the fertility treatment process.

Chehreh (2019) looked at 150 couples dealing with infertility and aimed to find

connections between infertility-related stress and its relationship with infertility factors.

Researchers used the Fertility Problem Inventory (FPI) to collect data and analyzed it with

inferential statistics. They found that women’s stress scores were much higher than men’s, and
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that their stress increased even more with the failure of fertility treatment. Women also had

higher scores regarding social concern and a need for parenthood. Overall, women experience

greater infertility-related stress than men, and it is recommended that women be psychologically

evaluated before going through the treatment process.

References

Andrews, F. M., Abbey, A., & Halman L. J. (1991). Stress from infertility, marriage factors, and

subjective well-being of wives and husbands. Journal of Health and Social Behavior,

32(3), 238-253.

Chaves, C., Canavarro, M. C., & Moura‐Ramos, M. (2019). The role of dyadic coping on the

marital and emotional adjustment of couples with infertility. Family Process, 58(2), 509-

523. https://10.1111/famp.12364

Chehreh, R., Ozgoli, G., Abolmaali, K., Nasiri, M., & Mazaheri E. (2019). Comparison of the

infertility-related stress among couples and its relationship with infertility factors.

International Journal of Women’s Health and Reproduction Sciences, 7(3), 313-318.

https://10.15296/ijwhr.2019.52

Gana, K., & Jakubowska, S. (2016). Relationship between infertility-related stress and emotional

distress and marital satisfaction. Journal of Health Psychology, 21(6), 1043; 1043-1054;

1054. https://10.1177/1359105314544990

Kim, J. H., Shin, H. S., & Yun, E. K. (2018). A dyadic approach to infertility stress, marital

adjustment, and depression on quality of life in infertile couples. Journal of Holistic

Nursing, 36(1), 6-14. https://10.1177/0898010116675987

Luk, B. H., & Loke, A. Y. (2015). The impact of infertility on the psychological well-being,

marital relationships, sexual relationships, and quality of life of couples: A systematic

review. Journal of Sex & Marital Therapy, 41(6), 610-625.

https://10.1080/0092623X.2014.958789
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Maroufizadeh, S., Hosseini, M., Foroushani, A. R., Omani-Samani, R., & Amini, P. (2019). The

relationship between perceived stress and marital satisfaction in couples with infertility:

Actor-partner interdependence model. International Journal of Fertility & Sterility, 13(1),

66-71. https://10.22074/ijfs.2019.5437

Pasch, L. A., Dunkel-Schetter, C., & Christensen, A. (2002). Differences between husbands’ and

wives’ approach to infertility affect marital communication and adjustment. Fertility and

Sterility, 77(6), 1241-1247. https://10.1016/S0015-0282(02)03097-2

Sadiq, U., Rana, F., & Munir, M. (2022). Marital quality, self-compassion and psychological

distress in women with primary infertility. Sexuality & Disability, 40(1), 167-177.

https://10.1007/s11195-021-09708-w

Sauvé, M., Péloquin, K., & Brassard, A. (2020). Moving forward together, stronger, and closer:

An interpretative phenomenological analysis of marital benefits in infertile couples.

Journal of Health Psychology, 25(10), 1532-1542. https://10.1177/1359105318764283