Responsible: Lene Tølbøll Blenstrup

 

Research Questions

The main focus of this project is to determine how and to what extent selected characteristics of couples and their relationships, influence their subsequent family history. The characteristics relate to the intensity of the wish for a child, their sense of infertility related stress, how they communicate about the infertility and cope with the stress measured in the scales previously described. The family histories are studied by whether the couples preserve or dissolve their relationship and whether and how they establish a daily life with children subsequent to the treatment, including their own children (with a distinction between spontaneous conceived children, ART-children, adopted children and step-children), and whether they have contact with children they do not live with.

     In line with the idea of human development being a process and individuals as ascribing meaning to events to create and maintain a coherent sense of self, the project focuses on determining how men’s and women’s perception of and ways of coping with infertility as well as their assessment of the impact on the relationship change during five years after the first treatment. It is an overall intention of the project to view the family history in relation to the partners’ mutual relation, focusing on men and women jointly, as a couple, and on the development and possible changes of their relation.

     We follow the perspective on the life courses of individuals as being intertwined and in the analysis of the influence of communication strategies the partners are analysed as dyads. We further view differences and similarities in the ways men and women perceive and cope with their infertility as an aspect of their relation. Based on previous results by Peterson et al. (2009) we expect the degree of concordance between the partners’ coping strategies to play a role for the continuation.

 

Design and methods

One part of this project is a descriptive analysis of the family histories of all couples who have completed the 5-year follow-up questionnaire, e.g. whether they preserve or dissolve their relation, and how this is influenced by the characteristics of the couples.

     Another part applies a comparative analytic design. Firstly, socio-demographic characteristics, including family histories of all couples in the COMPI-cohort are compared to histories of couples, identified in SDD, who has conceived during the same period without being included in the COMPI-cohort. By this, socio-demographic selection into treatment can be taken into account. Secondly, only including couples in the COMPI-cohort, comparisons will be made between those who did not have a child and those who did have a child, aiming at determining the influence of socio-demographic determinants on the family histories, when the result of the treatment is taken into account.

     The third part concentrates on couples who remained childless, analysing how family histories are influenced by the couples’ communication and coping during the 5 year-period from initiation of treatment. A method created by the co-applicants Peterson and Pirritani estimating the effect of partner’s coping on the individuals’ feeling of infertility related stress (Peterson et al. 2009), will be further developed in cooperation between LTB and Peterson and Pirritani to include the degree of concordance between the parners’ strategies, to determine it’s influence on the subsequent family histories.

     Special emphasis will be on differences in the assessments made between the partners; based on the anticipation that a different perception of the consequences for the relationship as such will be a significant challenge for the couple. The assessment of the consequences for the relationship will be measured with The COMPI Marital Benefit Measure (Schmidt 2006), and with measures related to infertility related stress and coping strategies that directly relates to the relations within the couple.                     

     Thus groups with different levels of stress are compared in the analysis of which strategies have the greatest mediating effects at a given level of stress and the importance of the degree of concordant strategies among the partners. This is based on internal comparison between groups characterised by variables in the COMPI-cohort data set, as the stress related questions are specific for infertility, and therefore not available for groups who have not been under treatment.

 

Literature

Peterson BD, Pirritano M, Christensen U, Boivin J, Block J, Smidt L (2009). The longitudinal oimpact of partner coping in couples following 5 years of unsuccessful fertility treatments. Human Reproduction 2009; 24: 1656-64.

Schmidt L (2006). Infertility and assisted reproduction in Denmark. Epidemiology and psychosocial consequences [Medical dissertation]. Cop