Iran Journal of Nursing

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Amini L, Ghorbani B, Afshar B. The Comparison of Infertility Stress and Perceived Social Support in Infertile Women and Spouses of Infertile Men. IJN 2020; 32 (122) :80-90
URL: http://ijn.iums.ac.ir/article-1-3139-en.html

Background & Aims: Infertility is a stressful condition, which could adversely affect the mental health of couples. Although the diagnosis and treatment fertility may be a frustrating crisis affecting both spouses and causing mental distress, a sense of loneliness, disappointment, and lack of control, it seems that these issues are more apparent in women than men since the physical and mental burden of infertility and the consequences of the possible failure mostly falls on women. Women (especially in eastern communities and Iranian women) live in a culture in which having a child and fertility are revered more than other communities. Even when a woman is fertile and has an infertile spouse, infertility stress is experienced similarly since regardless of the cause of infertility, the outcome is eventually is childlessness. The social stigmas experienced by infertile women become more intense when they do not enjoy familial support, causing depression in these women. Therefore, the social support of these individuals could play a key role in their adaptation process to the issue of infertility. In Iran, several studies have been focused on the quality of life and psychological issues of infertile individuals, while most of these studies have investigated the psychological issues of infertile women without much regard for the spouses of infertile men. The present study aimed to compare infertility stress and perceived social support in infertile women and the spouses of the infertile men referring to Akbar Abadi Teaching Hospital in Tehran, Iran.
Materials & Methods: This cross-sectional study was conducted on 164 infertile women and 93 spouses of infertile men referring to the infertility clinic of Akbar Abadi hospital in Tehran during 2015-2016. After obtaining the required permit from Iran University of Medical Sciences by the researcher and co-researcher, they visited the clinic on working days for sampling. After providing the necessary explanations to the hospital authorities and conforming to ethical principles (e.g., obtaining written consent), continuous sampling was performed until the completion of the sample size. The inclusion criteria were the Iranian nationality of the couples, infertility in only one spouse, willingness to participate in the study, absence of chronic physical diseases or known mental disorders, and no consumption of the medications affecting the nervous system by the couples. The subjects were allowed to withdraw from the study at any stages. Data were collected using a demographic questionnaire, Newton infertility stress inventory, and the functional social support questionnaire, which were completed in a self-report manner or with the help of the researcher, enquiring the subjects, and review of their medical records. Data analysis was performed in SPSS version 16 using descriptive and inferential statistics, including Chi-square and independent t-test at the significance level of P<0.05.
Results: No significant differences were observed between the two study groups in terms of age (infertile women: 31.24±5.68 years; spouses of infertile men: 30.79±5.19 years), duration of marriage (infertile women: 7.29±4.81 years; spouses of infertile men: 7.54±4.13 years), duration of infertility (infertile women: 4.52±4.01 years; spouses of infertile men: 4.66±3.45 years), education level, occupation status, and economic status. In addition, 63.6% of the infertile women and 77.3% of the spouses of infertile men had primary infertility, while no significant difference was observed between the groups in this regard. No significant differences were denoted between the groups in terms of the scores of the subscales of infertility stress, including social concerns, sexual concerns, communicational concerns, and concerns regarding the lifestyle without a child, with the exception of the subscale of the need for parenthood (P=0.038). In addition, the total score of infertility stress had no significant difference between the study groups (P=0.043). The comparison of the mean perceived social support in the infertile women and spouses of infertile men indicated no significant difference in this regard. 
Conclusion: Although it seems that regardless of the male or female cause of infertility, women experience stress in case of infertility, the overall stress and stress induced by the need for parenthood were higher in the infertile women compared to the spouses of the infertile men. According to the results, the spouses of the infertile men were as stressed as the infertile women in many subscales of infertility. This could be due to the fact that even when the male gender is the cause of infertility, diagnostic and therapeutic procedures are often imposed on women, which increases their concerns compared to their spouses. In the face of infertility stress, women react through anxiety, stress, depression, and grief. One of the major causes of such stress in these women is the fear of divorce and loss of the ability of motherhood. Since pregnancy and the motherhood role are exclusive to women, social expectations are higher in the case of women compared to men, and the fear of the stigma of infertility is more severe in women. It could be stated that due to cultural components and the pre-defined social expectations, the foremost expectation and predicted role for married men and women is to have a child, and lack thereof is frowned upon in the Iranian culture. This shows that in the Iranian culture, the inability to have a child is synonymous with the absence of a fruitful life. Although social support could diminish the stress of infertile individuals, they may still feel the emptiness of their childless life in private, which in turn adversely affects marital relations. Furthermore, it seems that having a child is more important to women than men, and men are able to cope with a childless life more easily than women. Regardless of the cause of infertility, the findings of this study indicated that social support in both the infertile women and spouses of infertile men was similar.