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Health Affects of Infertility on Women and Infertility Related Marital and Emotional Distress
Most people consider having a child to be one of the biggest achievements that one could reach in their lifetime. Without the ability to reproduce at a consistent rate the world, along with the species that inhabit it, will parish. Having a child gives a person a chance to not only make sure that their own genic code will live on for another generation, but it also gives a person a chance to pass on their views on how life should be lived as far as lifestyle, religion and overall wisdom. According to the Central Intelligence Agency the current birth rate for the world is approximately 259 children born world wide per minute, which equates to about 4.3 births every second (CIA, 2018). The total fertility rate for women as of 2018 is about 2.4 children born per woman (CIA, 2018). Unfortunately, not every woman has the opportunity to experience the trials and tribulations of childbirth by natural means. While there are many different definitions, one definition of infertility is a disease of a persons reproductive system, which results in their inability to conceive a child though natural means of sexual intercourse or to carry a child to full term after trying to conceive over the span of 12 months (WHO, 2019). About 11% of women in the United States between the ages of 15 and 44 are either unable to get pregnant or cannot carry a child to full term (Boulet, Smith, Crawford, Kissin, & Warner, 2017). People have placed more of a priority on their individual independence and financial health than they have on settling down and starting a family. While in past years it was normal for a person to be married with a child by the age of 21, more and more people are waiting to have their first child later in life in their late 30s and early 40s. Even though there is nothing wrong with wanting to be established before bringing another life into the world, after the age of 35 a womans chances of naturally conceiving declines (WebMD, 2005). If the woman is able to become pregnant after the age of 35, their pregnancy is considered to be geriatric meaning they are at a higher risk of complications such as a miscarriage at any time during the pregnancy (WebMD, 2005). Apart from known physical implications on fertility, there are many women and men that have no true diagnosis on why they are unable to conceive a child by natural means.
There are several methods of combating infertility such as the use of a surrogate, in-vitro fertilization (IVF), and artificial insemination (AI). Options such as these may not be available to all that require the services due to the excessive cost of the procedures. Unfortunately, even with the advances in medical reproduction practices, there are still those that experience infertility and difficulty carrying a child to full term. Infertility is something that far too many people experience and can easily create a heavy burden on both the man and the women that are experiencing it. It has been shown that infertility can have not only had a negative affect on peoples mental health, but their physical health and marital status could be at risk also. The articles that were reviewed looked at how physical, mental, emotional and marital health has been affected by infertility struggles for both men and women.
The first article that was reviewed focused on the quality of life for women that had either experienced infertility or difficulty remaining pregnant as it related to their overall health. The study sought out to determine if women who had experienced infertility or difficulty getting pregnant had a lower health related quality of life (HRQOL) than those that had never experienced either scenario. To conduct the study information from the Behavioral Risk Factor Surveillance Survey (BRFSS) was gathered. The BRFSS is a telephone survey that collects information on chronic conditions (such as high blood pressure and diabetes) and health behaviors of an individual, as well as their mental and physical function along with their health status (Boulet, Smith, Crawford, Kissin, & Warner, 2017). The data is specific to each state for U.S. residents (Boulet, Smith, Crawford, Kissin, & Warner, 2017). The survey was used to gather information on how many women had reported to have experienced infertility, difficulty staying pregnant, never experienced infertility, and never experienced difficulty staying pregnant. The findings from the analysis of the BRFSS were then compared against the health related quality of life indicators to determine the health of women who fall into one of the four infertility categories. Results of the research found that women who have experienced infertility reported twice as many days of poor overall health, chronic conditions, and depressive disorders than the women who have not gone through infertility or had not experienced difficulty staying pregnant for a full term (Boulet, Smith, Crawford, Kissin, & Warner, 2017). Women who had difficulty staying pregnant were also found to have a higher report of depression and limited overall physical activity (Boulet, Smith, Crawford, Kissin, & Warner, 2017). It was concluded that women who experience infertility or difficulty staying pregnant have a lower physical and mental health quality than women who do experience these things (Boulet, Smith, Crawford, Kissin, & Warner, 2017). However, women who reported with difficulty staying pregnant had the lowest out of all four categories for health related quality of life (Boulet, Smith, Crawford, Kissin, & Warner, 2017). The article stated that infertility is an important health concern based on the quality of life measures for women and men who have gone through the experience (Boulet, Smith, Crawford, Kissin, & Warner, 2017). While infertility can affect the physical and mental health of women, it can also have negative effects on the marital status of those that are having trouble successfully reproducing.
The purpose of the second article reviewed was to determine the relationship between stress related to infertility, marital satisfaction, and emotional distress. The information for this study was gathered by inviting 78 males and 72 females in an infertility clinic in France, who had been trying to conceive for about 3 years, to participate in the study anonymously. Participants were told that they could leave the study at any time (Gana & Jakubowska, 2014). The people that participated in the study filled out a fertility problem inventory (FPI) questionnaire, which assessed the individuals social concern, sexual concern, relationship concern, need for parenthood, and rejection of a childfree life (Gana & Jakubowska, 2014). Participants rated how much they agreed with each query as it related to marital status on a scale of 0-5 with higher scores indicating higher marital satisfaction (Gana & Jakubowska, 2014). Those who participated also filled out a Beck Depression Inventory (BDI) that measures depressive characteristics as well as a State-Trait Anxiety Inventory (STAI) to measure the state and trait of the participants anxiety (Gana & Jakubowska, 2014). The collective results of each survey determined that infertility directly relates to emotional distress as well as to marital dissatisfaction (Gana & Jakubowska, 2014). It was also found that there were gender differences between men and women on marital satisfaction (Gana & Jakubowska, 2014). The study determined that women experience more infertility stress than men (Gana & Jakubowska, 2014). The women in this study who have experienced infertility were found to have higher marital satisfaction than men. This finding was inconsistent with findings from other research studies that found women to have a lower marital satisfaction rating than men who are experiencing infertility (Gana & Jakubowska, 2014). The study was found to be limited because data was only taken from a small number of people from one infertility clinic (Gana & Jakubowska, 2014).
With the importance that some people place on having a child, I agree with the findings of each of these studies. Those that go through the difficulties of infertility may feel as though they are a failure and ultimately start to develop more depressive thoughts and actions. The strain that this puts on individuals will ultimately affect the way they interact with those closet to them. Knowing several people who have gone though infertility or failure to maintain a pregnancy to full term due to explained and unexplained medical conditions, I have seen how people start to display more signs depression and decreased physical activity. I feel that the research from the first article was conducted adequately with the given sample size and was successful in breaking down the information into several categories in order to determine both the physical and mental health of women how are infertile and those that have trouble carrying a baby full term versus those that have not experienced either event. The second article could have improved on its sample size. Having a sample size of only 150 people from one infertility clinic in France does not give a good indicator on the overall population. While the research did find gender differences between the stress and mental health of men and women who undergo infertility, both articles could have expanded their research to determine if there was a difference between races, socioeconomic statues, or same sex couples versus heterosexual couples. Both studies relied on the participant to self-report on their emotions or recall specific events, which could have skewed the end results of each study. Since it was shown that chronic conditions that contribute to infertility have a negative impact on both men and womens health, it would be helpful to determine ways that chronic conditions can be avoided all together in an effort to minimize infertility as a whole.
A question that remains to be answered is if the distresses of infertility on mental and physical health improve if the person utilizes other options such as adoption. It has yet to be determined that if the infertility related depression is due solely to lack of being able to conceive or carry a baby to term or if it is due to lack of a baby in the household all together. Most people want a baby that shares their genome but is it possible for them to be just as happy or feel as though they have succeeded with a child that is not biologically theirs? There are many crises throughout our lives that we are consistently trying to overcome. While many of us will achieve success in our different struggles that life throws at us, there are many never reach their personal goals and must figure out ways to continue to progress in their lives in positive way. It is important that those undergoing infertility and difficulty staying pregnant have a strong support system around them and are not afraid to reach out for professional help on their mental status if at all needed.
Works Cited
- Boulet, S. L., Smith, R. A., Crawford, S., Kissin, D. M., & Warner, L. (2017, July 18). Health-Related Quality of Life for Women Ever Experiencing Infertility or Difficulty Staying Pregnant . Matern Child Health Journal .
- CIA. (2018). World Fact Book. Retrieved November 20, 2019, from Central Intelligence Agency: https://www.cia.gov/library/publications/the-world-factbook/geos/xx.html
- Gana, K., & Jakubowska, S. (2014). Relationship between infertility- related stress and emotional distress and marital satisfaction. Journal of Health Psychology .
- WebMD. (2005). Managing a High-Risk Pregnancy . Retrieved November 20, 2019, from WebMD: https://www.webmd.com/baby/managing-a-high-risk-pregnancy#1
- WHO. (2019). World Health Organization. Retrieved November 20, 2019, from Infertility Definitions and Terminology: https://www.who.int/reproductivehealth/topics/infertility/definitions/en/
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