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Despite the fact that, statistically, women of low socioeconomic status (SES) experience greater difficulty conceiving children, infertility is generally understood to be a wealthy, white woman's issue. InMisconception, Ann V. Bell overturns such historically ingrained notions of infertility by examining the experiences of poor women and women of color. These women, so the stereotype would have it, are simply too fertile. The fertility of affluent and of poor women is perceived differently, and these perceptions have political and social consequences, as social policies have entrenched these ideas throughout U.S. history. Through fifty-eight in-depth interviews with women of both high and low SES, Bell begins to break down the stereotypes of infertility and show how such depictions consequently shape women's infertility experiences. Prior studies have relied solely on participants recruited from medical clinics-a sampling process that inherently skews the participant base toward wealthier white women with health insurance. In comparing class experiences,Misconceptiongoes beyond examining medical experiences of infertility to expose the often overlooked economic and classist underpinnings of reproduction, family, motherhood, and health in contemporary America.

Objectives: This study aimed to explore the relationship between resilience, infertility self-efficacy, infertility coping strategies, and fertility quality of life (fertility QoL) in women with infertility. Additionally, it sought to examine the mediating roles of self-efficacy and infertility coping strategies in the relationship between resilience and fertility QoL. Methods: A cross-sectional study was conducted on infertile women undergoing assisted reproductive treatment from December 2021 to March 2022 in reproductive centers in Wuhan, China. A total of 314 participants were recruited using convenience sampling to complete a socio-demographic characteristics questionnaire, the 10-item Connor–Davidson Resilience Scale (CD-RISC-10), the Infertility Self-efficacy Scale (ISE), the Copenhagen Multi-Centre Psychosocial Infertility (COMPI) Coping Strategy Scale, and the Fertility QoL Scale. Results: Resilience (r = 0.375, p < 0.01), infertility self-efficacy (r = 0.584, p < 0.01), and meaning-based coping strategy (r = 0.191, p < 0.01) were positively correlated with fertility QoL. The other three infertility coping strategies, including active-avoidance coping (r = −0.367, p < 0.01), active-confronting coping (r = −0.143, p < 0.05), and passive-avoidance coping (r = −0.130, p < 0.05), were negatively correlated. The indirect effect of resilience on fertility QoL through three mediators, including infertility self-efficacy (β = 0.467, p < 0.001), active-confronting coping (β = −0.214, p < 0.001), and meaning-based coping (β = 0.161, p < 0.001), was significant (value of total indirect effect = 0.263, 95% CI, 0.188 to 0.350) with an effect of 71.5%. Conclusions: Resilience may be a psychological resource that promotes adaptive coping strategies. This allows women to be more confident in their management of infertility and treatment-related concerns, which promotes a better fertility QoL.

Background: Assisted reproductive technology treatments are stressful procedures, but there are individual differences in the emotional response to them. Differences in response to this stress may be related to the outcome of infertility treatment. Objective: This study aimed to investigate the relationship between coping strategies and infertility self-efficacy with pregnancy outcomes of women undergoing in vitro fertilization/intracytoplasmic sperm injection treatment. Materials and Methods: This was a prospective cohort study and the 154 infertile women were psychologically evaluated in 2 stages: once before ovarian stimulation and again during embryo transfer. The research measurements used were the Revised COPE, the Depression Anxiety Stress Scale (DASS-21) and the Infertility Self-Efficacy Scale. Results: There was no significant difference between the group of non-pregnant women and the positive pregnancy group in terms of coping strategies (mental rumination, self-blame, active confronting, goal replacement, avoidance) or self-efficacy in either of the 2 stages of ovarian stimulation and embryo transfer. The Mann-Whitney test did not show any statistical difference between the clinically pregnant women and the only laboratory positive pregnant group. Moreover, the self-blame and mental rumination strategies were positively related with anxiety and depression. Conversely, active confronting, goal replacement, avoidance and self-efficacy were associated with decreased depression, anxiety and stress levels. Conclusion: It can be concluded that there is no relationship between coping strategies and infertility self-efficacy with in vitro fertilization/intracytoplasmic sperm injection outcomes. Further research is needed to clarify the effects of other psychological factors on the pregnancy outcomes of assisted reproductive treatment. Key words: Coping strategy, Self-efficacy, Infertility, In vitro fertilization, Depression, Anxiety.

The number of infertility treatment cycles in Japan is the highest worldwide. Studies have shown that stigma is a predictor of stress-related symptoms including anxiety and depression in women undergoing infertility treatment. Stress management to prevent stress-related symptoms may be crucial; however, few studies have examined the model of stigma and stress responses. Based on the stress-coping model, we hypothesized that stigma threatens the identity of such women and that coping failure increases stress responses. We aimed to explore the role of cognitive appraisals and coping strategies as mediators of the association between the stigma of infertility and stress responses. In December 2021, we conducted a cross-sectional study in Japan, in which 254 women undergoing infertility treatment completed a web-based survey. Hierarchical multiple regression analysis was conducted to analyze the associations between stigma, cognitive appraisals, coping strategies, and stress responses. The results showed that explanatory power increased with each additional variable in the following order: stigma, cognitive appraisals, and coping. Participants with a high level of stigma evaluated it as threatening, and used self-blame and venting coping strategies, and showed higher stress responses. Conversely, participants who used positive reframing coping strategies exhibited lower stress responses. Based on this, effective strategies to address stigma and stress responses are necessitated.

Infertility is a health problem faced by an estimated 15% of women of childbearing age in Ghana. This study explores the coping strategies adopted by 615 women seeking infertility treatment in southern Ghana. Both closed and open-ended questions were used through a survey conducted using face-to-face interviews in three languages at three health sites - a hospital, a health centre and a private clinic. The findings suggest that the majority of the women preferred to keep issues of their fertility problems to themselves. The reason could be due to the associated stigma of infertility. Further, the majority of the women coped through drawing on their Christian faith. Others also coped through the support they received from their husbands, their occupation by way of achieving economic independence, and some avoided situations that reminded them of their infertility problem. The findings should have implications for health personnel as some strategies infertile women use may do more harm than good (Afr J Reprod Health 2009; 13[4]:81-93). La stérilité est un problème auquel font face environ 15% des femmes en âge d'avoir des enfants au Ghana. Cette étude explore les stratégies adoptées par 615 femmes qui recherchent un traitement de la stérilité au sud du Ghana pour faire face au problème. On s'est servi des questions de nature limitées et illimitées à travers une enquête menée à l'aide des interviews face à face en trois langues dans trois établissements de santé : un hôpital, un centre médicosocial et une clinique privée, les résultats ont montré que la plupart des femmes préfèrent garder tout ce qui concerne leurs problèmes de la stérilité à elles-mêmes. La raison pourrait être à cause de la stigmatisation liée à la stérilité. De plus, la plupart des femmes se sont débrouillées en s'appuyant sur leur foi chrétienne. Les autres se sont débrouillées à travers le soutien de la part de leurs maris, à travers leurs occupations quand elle accomplissent l'indépendance économique et certaines d'entre elles ont évité des situations qui leur rappelaient leur problème de stérilité. Les résultats devraient avoir des implications pour les membres du personnel médical puisque certaines stratégies adoptées par les femmes stériles peuvent être plus nuisibles que bénéfiques (Afr J Reprod Health 2009; 13[4]:81-93).

The study aims to propose and test a multi-dimensional infertility-related stress model including socio-demographic and fertility-related characteristics, infertility-related stress dimensions, coping strategies and couple’s dyadic adjustment dimensions as predictors of anxiety and depression among partners of couples undergoing infertility treatments. Both members of 250 infertile couples filled out a questionnaire consisting of Socio-demographics (Age; Educational level; Employment status), Fertility-related characteristics (Type of diagnosis; Duration of infertility), Fertility Problem Inventory-Short Form, Coping Orientations to Problem Experienced-New Italian Version, Dyadic Adjustment Scale, State-Trait Anxiety Inventory-Y and Edinburgh Depression Scale. Hierarchical Multiple Linear Regressions indicated that the proposed predictive models for anxiety and depression were significant and had good levels of fit with the data. Gender differences emerged in predictor variables. Findings provide valid predictive models that could be adopted to assess psychological health in infertile patients and to develop evidence-based and tailored counselling interventions at centres for assisted reproduction.

Psychological distress and social burdens associated with infertility among couples have been well-documented. However, little is known about the specific coping strategies employed by couples in low-middle-income countries such as Ghana, in the aftermath of unsuccessful infertility treatment attempts. In this qualitative study, we explored specific coping strategies patients adopt to address psychological distress related to unsuccessful treatment for infertility. A semi-structured interview approach was used to elicit qualitative responses from 18 fertility clients after unsuccessful treatment at four fertility clinics in Ghana. Thematic analysis (TA) was used to examine the coping strategies adopted by participants in response to psychological distress associated with infertility treatment failures. This allowed us to explore potential culturally specific coping strategies employed by participants in response to infertility-related psychological distress. The themes that emerged as coping strategies in response to infertility-related psychological distress were diversional activities, intrapersonal cognitive reframing, social isolation, familial support, religious coping, avoidance-focused coping strategies, seeking encouragement, and professional help. The findings from this study indicate that coping strategies that involve isolating oneself may not provide lasting emotional relief for individuals experiencing infertility. Relational activities contribute positively to coping. This is relevant in helping health professionals in the management of infertility treatment failures, which may include setting up support groups of similar experiences to draw strength from each. Furthermore, the results underscore the need to integrate psychological interventions into the counseling of couples following an unsuccessful infertility treatment. The clinical and research implications of these findings are discussed.

To examine the psychological impact of fertility treatment suspensions resulting from the COVID-19 pandemic and to clarify psychosocial predictors of better or worse mental health. 92 women from Canada and the United States (ages 20-45 years) whose fertility treatments had been cancelled were recruited via social media. Participants completed a battery of questionnaires assessing depressive symptoms, perceived mental health impact, and change in quality of life related to treatment suspensions. Potential predictors of psychological outcomes were also examined, including several personality traits, aspects of social support, illness cognitions, and coping strategies. 52% of respondents endorsed clinical levels of depressive symptoms. On a 7-point scale, participants endorsed a significant decline in overall quality of life (M(SD) = -1.3(1.3), p < .0001) as well as a significant decline in mental health related to treatment suspensions on a scale from -5 to +5 (M(SD) = -2.1(2.1), p < .001). Several psychosocial variables were found to positively influence these outcomes: lower levels of defensive pessimism (r = -.25, p < .05), greater infertility acceptance (r = .51, p < .0001), better quality social support (r = .31, p < .01), more social support seeking (r = .35, p < .001) and less avoidance of infertility reminders (r = -.23, p = .029). Fertility treatment suspensions have had a considerable negative impact on women's mental health and quality of life. However, these findings point to several protective psychosocial factors that can be fostered in the future to help women cope.

PurposeTo evaluate perceptions of delayed fertility care secondary to the COVID-19 pandemic.MethodsThis was a cross-sectional anonymous survey of N = 787/2,287 patients (response rate = 42.6%) from a single academic fertility center. Participants were randomized 1:1 to receive supplemental educational explaining the rationale behind recommendations to delay fertility treatments due to the COVID-19 pandemic. Assessment of well-being was conducted via the Personal Health Questionnaire Depression Scale, the Generalized Anxiety Disorder-7, the Ways of Coping-Revised, the Appraisal of Life Events Scale, and influence of supplemental education on agreement with ASRM COVID-19 Taskforce recommendations and associated distress.ResultsParticipants in the education v. no education groups were 35.51 (SD = 4.06) and 37.24 (SD = 5.34) years old, married (90.8% v. 89.8%), had a graduate degree (53.9% v. 55.4%), > 1 year of infertility (73.4% v. 74.4%), and were nulliparous (69.0% v. 72.6%), with moderate to high distress (64.9% v. 64.2%) (ns). Distress was related to age, duration of infertility, and engagement in social support seeking and avoidant coping strategies (P < 0.001). Agreement with recommendations was related to receipt of supplemental education, history of pregnancy loss, and use of cognitive coping (P = 0.001).ConclusionMost participants were distressed by the delay of treatments. Supplemental education increased acceptance of recommendations but did not decrease distress. Future treatment delays should include education related to and assessment of understanding of recommendations, and inclusion of mental health professionals in patient care.