Identifying Barriers and Outcomes in Infertile Couples During Assisted Reproductive Treatments (ART): A Qualitative Study

Document Type : Original Article (s)

Authors

1 PhD Student, Counseling Department, School of Social Sciences and Humanities, Islamic Azad University, Science and Research Unit, Tehran, Iran

2 Department of Psychology, Women Research Center, Alzahra University, Tehran, Iran

3 Associate Professor of Counseling Department, School of Humanities and Social Sciences, Ardakan University, Yazd, Iran

4 Department of Psychology and Educational Sciences, School of Educational Sciences and Psychology, Kharazmi University, Karaj, Iran

Abstract

Background: Infertility is one of the health problems that currently affects about 20% of couples in Iran. The purpose of this study was to identify the obstacles and consequences of Iranian infertile couples during assisted reproductive treatment.
Methods: For the investigation of this issue, a qualitative approach and a qualitative content analysis method were used. According to the theoretical foundations and background of the research, the purposeful sampling method was used to interview people. This study involved conducting semi-structured, in-depth interviews with 32 infertile individuals, 22 of whom were women and 10 were men. The interviews continued until reaching the principle of theoretical saturation and not extracting and emerging a new concept from the data.
Findings: Obstacles and strategies in the present study are categorized into nine selective codes, 30 central codes, and 114 open codes in the general concept of an "uneven path to understanding the sense of motherhood and fatherhood". The consequences were defined by individual-internal, physical, family, and marital codes. Obstacles are also categorized by economic, socio-cultural, marital, religious codes, and unpredictable events.
Conclusion: The results showed that infertile couples struggle with many problems during fertility treatment, and various consequences occur during the treatment. Therefore, these people need attention from society, family, and health systems, and there is a need to have a multi-faceted view of people during the treatment so that this path is less challenging.

Highlights

Fatemeh Fayyaz: Google Scholar

Yasser Rezapour Mirsaleh:  Google Scholar

Keywords

Main Subjects


  1. Vander Borght M, Wyns C. Fertility and infertility: Definition and epidemiology. Clin Biochem 2018; 62: 2-10.
  2. Salie M, Roomaney R, Andipatin M, Volks C. Scoping review of the psychosocial aspects of infertility in developing countries: protocol. BMJ Open 2021; 11(5): e044003.
  3. Gamel WMA, Hassan HE, El-ezazy AA. Male

    Infertility and Psychological Repercussions: Α Neglected Problem in Northern Upper Egypt. International Journal of Studies in Nursing 2019; 4(4): 1.
  4. Facchin F, Leone D, Tamanza G, Costa M, Sulpizio P, Canzi E, et al. Working with infertile couples seeking assisted reproduction: an interpretative phenomenological study with infertility care

    Front Psychol 2020; 11: 586873.
  5. Bai CF, Sun JW, Li J, Jing WH, Zhang XK, Zhang X, et al. Gender differences in factors associated with depression in infertility patients. J Adv Nurs 2019; 75(12): 3515-24.
  6. Renzi A, Solano L, Di Trani M, Ginobbi F, Minutolo E, Tambelli R. The effects of an expressive writing intervention on pregnancy rates, alexithymia and psychophysical health during an assisted reproductive treatment. Psychol Health 2020; 35(6): 718-33.
  7. Akhondi MM, Ranjbar F, Shirzad M, Ardakani ZB, Kamali K, Mohammad K. Practical difficulties in estimating the prevalence of primary infertility in Iran. Int J Fertil Steril 2019; 13(2): 113-7.
  8. Zhang J, Liu H, Luo S, Lu Z, Chávez-Badiola A, Liu Z, et al. Live birth derived from oocyte spindle transfer to prevent mitochondrial disease. Reprod Biomed Online 2017; 34(4): 361-8.
  9. Alpers LM. Distrust and patients in intercultural healthcare: A qualitative interview study. Nursing Ethics 2018; 25(3): 313-23.
  10. Fisher JR, Hammarberg K. Psychological and social aspects of infertility in men: an overview of the evidence and implications for psychologically informed clinical care and future research. Asian J Androl 2012; 14(1): 121-9.
  11. Greil AL, Shreffler KM, Schmidt L, McQuillan J. Variation in distress among women with infertility: evidence from a population-based sample. Hum Reprod 2011; 26(8): 2101-12.
  12. Chazan L, Kushnir T. Losses and gains of psychosocial resources: effects on stress among women undergoing infertility treatments and participating in social network systems. Psychiatric Quarterly 2019; 90(4): 717-32.
  13. Greil AL, Slauson-Blevins KS, Lowry MH, McQuillan J. Concerns about treatment for infertility in a probability-based sample of US women. J Reprod Infant Psychol 2020; 38(1): 16-24.
  14. Janković I, Todorović J. Lived experiences of woman in relation to infertility–a review of the qualitative research. Facta Universitatis, Series: Philosophy, Sociology, Psychology and History 2021: 137-48.
  15. Deka PK, Sarma S. Psychological aspects of infertility. Br J Med Pract 2010; 3(3): a336.
  16. Martens M, Schroer M, Williams T, Kennedy B. Identifying mental health issues associated with infertility. J Nurse Pract 2023; 19(2): 104471.
  17. Naz B, Batool SS. Infertility related issues and challenges: perspectives of patients, spouses, and infertility experts. Pak J Soc Clin Psychol 2017; 15(2): 3-11.
  18. Sharma A, Shrivastava D. Psychological problems

    related to infertility. Cureus 2022; 14(10): e30320.
  19. Soudani M, Shahryari Y, Shafeabady A. A study of the effect of structural family therapy through group methods in reducing marital conflicts among couples referred to council for disagreement solution (CDS) in Baghmalek [in Persian]. Journal of Social Psychology 2009; 4(12): 7-21.
  20. 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.
  21. Papp LM. Topics of marital conflict in the everyday lives of empty nest couples and their implications for conflict resolution. Journal of Couple & Relationship Therapy 2017; 17(1): 1-18.
  22. Ullah A, Ashraf H, Tariq M, Aziz SZ, Zubair S, Sikandar KUR, et al. Battling the Invisible Infertility Agony. Journal of Ethnic and Cultural Studies 2021; 8(2): 89-105.
  23. Xie Y, Ren Y, Niu C, Zheng Y, Yu P, Li L. The impact of stigma on mental health and quality of life of infertile women: A systematic review. Front Psychol 2023; 13: 1093459.
  24. Musick K, Meier A, Flood S. How parents fare: Mothers’ and fathers’ subjective well-being in time with children. American Sociological Review 2016; 81(5): 1069-95.
  25. Li X, Ye L, Tian L, Huo Y, Zhou M. Infertility-Related stress and life satisfaction among chinese infertile women: a moderated mediation model of marital satisfaction and resilience. Sex Roles 2020; 82: 44-52.
  26. Nelson SK, Kushlev K, Lyubomirsky S. The pains and pleasures of parenting: When, why, and how is parenthood associated with more or less well-being? Psychol Bull 2014; 140(3): 846-95.
  27. Afshani S, Abooei A, Ruhani A. Lived experience of infertile women of their infertility issue [in Persian]. Woman in Development & Politics 2022; 20(1): 1-21.
  28. Momenimovahed Z, Taheri S, Tiznobaik A, Salehiniya H. Do the fertility drugs increase the risk of cancer? A review study. Front Endocrinol (Lausanne) 2019; 10: 313.
  29. Givertz M, Segrin C, Woszidlo A. Direct and indirect effects of commitment on interdependence and satisfaction in married couples. J Fam Psychol 2016; 30(2): 214-20.
  30. Kamalian T, Mirzahoseini H, Monirpoor N. Comparison of the effectiveness of Emotional Schema Therapy with Self-Differentiation Method on marital burnout in women [in Persian]. Journal of Applied Psychology 2020; 14(1): 9-33.
Volume 42, Issue 765
1st Week, July
July and August 2024
Pages 341-350
  • Receive Date: 28 February 2024
  • Revise Date: 13 July 2024
  • Accept Date: 05 August 2024