Table 2.
Studies examining marital relationship in infertility
| Studies | Design | Sample characteristics/Country | Assessment | Key findings related to marital relationship |
|---|---|---|---|---|
| Ulbrich et al. (1990), (39) | Cross-sectional study | Convenient sampling: 103 married couples from Resolve and physicians. USA | Dyadic Adjustment Scale | Infertile couples are generally similar in the way of perceiving their marital adjustment, but they arrive at that view by different routes |
| Berg et al. (1991), (40) | Cross-sectional study | Convenient sampling:104 married couples from Resolve and clinic, with primary infertility currently involved in treatment. USA | Locke-Wallace Marital Adjustment Test | 1. Couples experienced normal levels of marital adjustment, and with no significant gender differences |
| 2. Couples experienced a stable marital adjustment in the pursuing treatment in year 1 and year 2, but deteriorated after the third year | ||||
| Pepe et al. (1991), (41) | Cross-sectional study | Convenient sampling: 40 female patients had been diagnosed with primary or secondary infertility. USA | Index of Marital Satisfaction | Infertility treatment was related to decreased marital satisfaction, but after the termination of treatment, the relationship returned to a level not significantly different from its pretreatment level |
| Benazon et al. (1992), (52) | A longitudinal study | Convenient sampling: During the 12 months of the study, all participants were categorized into two groups: 48 couples with pregnancy, 117 couples with nonpregnancy. Canada | Dyadic Adjustment Scale | 1, Significant decreases in marital functioning were experienced by subjects as the treatment investigation progressed |
| 2. Greater levels of marital distress were observed in couples that did not conceive. Significant gender differences were observed | ||||
| Slade et al. (1992), (54) | A longitudinal study | Convenient sampling: 28 couples with primary infertility. England | Dyadic Adjustment Scale | 1. For the infertile groups, marital adjustment tended to deteriorate over time, however, this was paralleled in the fertile groups |
| 2. Self-blame was correlated with marital difficulties in the females; self-blame and detachment were particularly linked with marital difficulties in the males | ||||
| Levin et al. (1997), (42) | Cross-sectional study | Convenient sampling: 46 couples undergoing different stages of infertility treatment. USA | Dyadic Adjustment Scale | Marital distress in the infertility population is impacted by the intra-couple coping methods |
| Leiblum et al. (1998), (53) | A longitudinal study | Convenient sampling: 75 infertile women were followed after the completion of infertility treatment, Group 1 (n = 41), successful IVF women; Group 2 (n = 16), unsuccessful IVF women who adopted; Group 3 (n = 18), unsuccessful IVF women who remained childless. USA | Locke-Wallace Marital Adjustment Test | 1. There were no significant differences between the three groups on the standardized measures of marital satisfaction |
| 2. Childless women reported that infertility had exerted a significantly greater negative impact on their marriages than that reported by the other two groups | ||||
| Markestad et al. (1998), (43) | Cross-sectional study | Convenient sampling: 20 infertile couples. USA | Dyadic Adjustment Scale | Length of time infertile couples have been seeking medical attention may not severely affect marital adjustment |
| Lee et al. (2000), (44) | Cross-sectional study | Convenient sampling: 59 infertile couples. Tai wan | Marital Satisfaction Questionnaire | The husbands’ marital satisfaction was higher than that of the wives |
| Lee et al. (2001), (45) | Cross-sectional study | Convenient sampling: 138 infertile couples. Tai wan | Marital Satisfaction Questionnaire | Infertility diagnosis is an important factor in assessing the marital satisfaction between husbands and wives |
| Verhaak et al. (2001), (55) | A longitudinal study | Convenient sampling: 207 infertile women. Netherlands | Maudsley Marital Questionnaire | Marital satisfaction changed in both pregnant and nonpregnant women after the first IVF and ICSI cycle |
| Peterson et al. (2003), (46) | Cross-sectional study | Convenient sampling: 525 infertile couples. USA | Dyadic Adjustment Scale | Both men and women in couples who perceived equal levels of social infertility stress reported higher levels of marital adjustment |
| Monga et al. (2004), (47) | Cross-sectional study | Not mentioned, Study group: 18 women being on infertility treatment; Control group: 12 women seeking elective sterilization. USA | Locke-Wallace Marital Adjustment Test | The Marital Adjustment Test scores for the women of the infertile couples were significantly lower than the scores of the controls |
| Peterson et al. (2006), (48) | Cross-sectional study | Convenient sampling: 506 infertile men, 520 infertile women. USA | Dyadic Adjustment Scale | No significant differences were reported between men and women for marital adjustment, but coping is related to marital adjustment |
| Reporaki et al. (2007), (56) | A longitudinal study | Convenient sampling. Study group: 367 couples with singleton IVF/ICSI pregnancies; Control group: 379 couples with spontaneous singleton pregnancies. Finland | Dyadic Adjustment Scale | Successful ART does not constitute a risk for marital adjustment. The shared stress of infertility may even stabilize marital relationships |
| Wang et al. (2007), (49) | cross-sectional study | Convenient sampling. Two groups of infertile women, 100 registered for IVF, and 100 registered for ICSI; A control group of 100 women attending a gynecology clinic, who had no known history of infertility. China | ENRICH (Evaluating & Nurturing Relationship Issues, Communication & Happiness) Marital Inventory | The stresses associated with infertility and IVF treatment had a negative impact on Chinese women's marital quality |
| Drosdzol et al. (2009), (50) | Cross-sectional study | Convenient sampling. Study group: 206 infertile couples; Control group: 190 fertile couples. Poland | Index of Marital Satisfaction | The risk factors of marital dissatisfaction in infertility include: female sex, age over 30, lower education level, diagnosis of male infertility, and infertility duration of 3-6 years |
| Smith et al. (2009), (51) | Cross-sectional study | Convenient sampling: 357 men in infertile couples. USA | Marital Impact Scale | No significant differences were seen between infertility groups in terms of Marital Impact scores |