The Psychosocial Impacts of Infertility - Special Academic Support

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Infertility is defined as the inability for couples to achieve a pregnancy after twelve months of regular, unprotected intercourse when the woman is less than 35 years of age or after 6 months past the age of 35 (Perry, Hockenberry, Lowdermilk, Wilson, Keenan-Lindsay, 2017). Infertility has increasingly become a serious health concern and is affecting the quality of life of 11.5-15.7% of childbearing age couples (Perry et al., 2017). Due to its increasing incidence and complex nature, it is important for health care providers to better understand the psychosocial implications of infertility and how to improve the health of infertile couples (Sherrod, 2014). The purpose of this paper is to discuss the psychosocial impacts of infertility on childbearing couples, including the emotional consequences manifested by loss of control over ones life and marital dissatisfaction. This paper will also discuss how social support networks impact the health of infertile couples, as well as emotional and physical nursing strategies to improve their health.

Failure to conceive children can cause men and women to feel extreme emotional suffering (Cousineau & Domar, 2007). Whether the infertility is implicated by the man, woman, or both, the psychosocial health of the couple is compromised through emotional suffering (Cousineau & Domar, 2007). For many couples one of the most painful emotional consequences is the loss of control over ones life (Cousineau & Domar, 2007). When couples experience infertility it tends to become a prime focus in the relationship (Cousineau & Domar, 2007). This often causes the couple to exclude other important aspects of their lives and temporarily put their career and lifestyle aspirations on hold, or, completely eliminate them (Cousineau & Domar, 2007). When a couple decides to partake in medical treatment, significant life changes need to be made in order to accommodate the strict demands (Cousineau & Domar, 2007). Families may need to adjust their lifestyle according to the frequency of treatments and doctor visits, whether the timing is convenient for them or not (Cousineau & Domar, 2007). Consequently, this loss of control is difficult for couples to accept and adjust to therefore impacting their psychosocial health by increasing their stress and anxiety (Cousineau & Domar, 2007). Another emotional consequence that affects the psychosocial health of infertile couples is decreased marital satisfaction (Cousineau & Domar, 2007). Because medical treatments need to be accurately scheduled, the demand of allocating time to the medical needs can be difficult which disrupts marital satisfaction (Cousineau & Domar, 2007). According to Cousineau and Domar (2007), the demand of scheduled intercourse can lead the couple to view sex as mechanized and as a result reduces the desire and intimate nature of sex, which to some, is an important aspect of marriage. Marital dissatisfaction intensifies the challenges that infertile couples are already facing, therefore increasing their stress and impacting their psychosocial health (Cousineau & Domar, 2007). The emotional consequences of losing control of ones life and the marital dissatisfaction that may occur, can be difficult for infertile couples to cope with. Their increased levels of stress and anxiety, while common, need to be carefully managed to ensure that the negative impacts on couples psychosocial health does not persist.

Infertile couples often experience social isolation from family and friends. Their assumed or actual feelings of unacceptance and lack of empathy due to their infertility can cause a couple to isolate themselves from their social support networks (Cousineau & Domar, 2007). Social support networks affect the health behaviours of individuals and their use of the health care system through practical, emotional, information, and affirmational support (Potter & Perry, 2014). As reported by clinicians and researchers, women often view infertility and treatments as stressful, therefore, impacting their psychosocial health (Lykeridou, Gourounti, Sarantaki, Loutradis, Vaslamatzis, & Deltsidou, 2011). It is crucial to understand the couples level of stress and ensure they have adequate, positive social support networks to help them cope with a difficult experience (Lykeridou et al., 2011). Because bearing children is seen as a natural and crucial part of marriage, couples who are unable to conceive often feel alone in their experiences (Luk & Loke, 2015). Infertility can question an individuals role as a man or woman, and therefore resort to isolation from others. According to research conducted by Luk and Loke (2015), the best way to cope with infertility is mutual support and consideration from partners. Their research found that infertile women who were unsatisfied with their husbands support experienced increased stress levels than those who were satisfied (Luk & Loke, 2015). In support of this research, Chow, Cheung, & Cheung (2016), found that couples who supported each other through their infertility were able to better cope with their challenges (Chow, Cheung, & Cheung, 2016). Also, findings from Allan (2013), showed that couples who reached out to support groups in the community were beneficial as psychosocial interventions, and that sharing experiences helped couples through their difficult time (Allan, 2013). Social support networks from family, friends, and the community allow individuals to experience positive health outcomes. It is important for infertile couples to engage in positive social support networks since infertility can be a very stressful and heartbreaking experience to cope with.

Nurses play an integral role in supporting the health of couples who experience infertility. Nursing strategies may include being an emotional support to the couple by providing counselling or psychotherapy, or, nurses may implement physical interventions for diagnostic or treatment purposes (Sherrod, 2004). Education is also important for couples as it allows them to cope with the infertility processes and teaches them that the psychosocial responses to their infertility challenges are normal (Chow, Cheung, & Cheung, 2016). Regardless of the nursing strategy used, knowledge of emotional and physical aspects of the interventions will increase the positive health outcomes for the couple (Sherrod, 2004). Stress and anxiety are among the few psychosocial health aspects that nurses need to focus on minimizing and managing within infertile couples. In a study conducted by Chow, Cheung, and Cheung (2016), the result of cognitive-behavioural therapy and supportive psychotherapy was a significant decrease in levels of stress, anxiety and depression related to infertility (Chow, Cheung, & Cheung, 2016). Also in the study, interventions relating to coping skills training resulted in a significant decrease in anxiety level in women receiving IVF treatment (Chow et al., 2016). Physical interventions such as mind-body interventions which incorporate relaxation techniques as well as health behaviour trainings also resulted in improved depressive symptoms, decreased stress levels, and increased social supports (Chow et al., 2016). Infertility may be a difficult obstacle to over come for many couples. Nurses need to implement emotional and physical interventions such as counselling, coping-skills training, and mind-body interventions in order to improve the psychosocial health of infertile couples (Chow et al., 2016).

Infertility has increasingly become a serious health concern among childbearing age couples (Perry et al., 2017). This time period for some can be very painful and therefore impact their psychosocial health. The emotional consequences of infertility including loss of control of ones life and increased marital dissatisfaction may increase the level of stress and anxiety in some couples which may cause them to draw away from their social support networks (Cousineau & Domar, 2007). It is important for nurses to play an active role in not only educating the family, but also to implement research-based strategies proven to improve heath of infertile couples including emotional and physical interventions.

References

Allan, H. T. (2013). The anxiety of infertility: the role of the nurses in the fertility clinic. Human Fertility, 16(1), 17-21.
Chow, K., Cheung, M., & Cheung, I. (2016). Psychosocial interventions of infertile couples: a critical review. Journal of critical nursing, 25, 21012113.
Cousineau, T. M., & Domar, A. D. (2007). Psychological impact of infertility. Best Practice & Research Clinical Obstetrics & Gynaecology, 21(2), 293-308.
Luk, B. H. K., & 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 Luk, B. H. K., & Loke, A. Y. (2015).
Lykeridou, K., Gourounti, K., Sarantaki, A., Loutradis, D., Vaslamatzis, G., & Deltsidou, A. (2011). Occupational social class, coping responses and infertilityrelated stress of women undergoing infertility treatment. Journal of clinical nursing, 20(1314), 1971- 1980.
Perry, S. E., Hockenberry, M. J., Lowdermilk, D. L., Wilson, D., Keenan-Lindsay, L. & Sams, C. (2017). Maternal child nursing care in Canada (2nd ed.). Elsevier, Canada.
Potter, P. A., Perry, A.G., Stockert, P.A., & Hall, A.M. (Eds.). (2014). Canadian fundamentals of nursing (5th Cdn. ed.) (J. C. Ross-Kerr, M. J. Wood, B. J. Astle & W. Duggleby, Cdn. Adapt.). Toronto, ON: Elsevier Canada.
Sherrod, R. A. (2004). Understanding the emotional aspects of infertility: implications for nursing practice. Journal of psychosocial nursing and mental health services, 42(3), 41- 47.

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