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Hum. Reprod. Advance Access published online on July 8, 2005
Human Reproduction, doi:10.1093/humrep/dei193
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© The Author 2005. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved.
Received February 19, 2005
Revised April 27, 2005
Accepted June 9, 2005

Article

Communication and coping as predictors of fertility problem stress: cohort study of 816 participants who did not achieve a delivery after 12 months of fertility treatment

L. Schmidt 1*, B.E. Holstein 1, U. Christensen 1, and J. Boivin 2

1 Institute of Public Health, University of Copenhagen, Panum Institute, 3 Blegdamsvej, DK-2200 Copenhagen N, Denmark
2 School of Psychology, Cardiff University, Cardiff CF10 3AT, UK

* To whom correspondence should be addressed.
L. Schmidt, E-mail: L.Schmidt{at}pubhealth.ku.dk


  Abstract

BACKGROUND: We investigated coping strategies and communication strategies as predictors of fertility problem stress 12 months after start of fertility treatment. METHODS: We used a prospective, longitudinal cohort design including 2250 people beginning fertility treatment with a 12-month follow-up. Data were based on self-administered questionnaires measuring communication with partner and with other people, coping strategies: active-avoidance coping, active-confronting coping, passive-avoidance coping, meaning-based coping, and fertility problem stress. The study population included those participants (n = 816, men and women) who had not achieved pregnancy by assisted reproduction or delivery at follow-up. RESULTS: Among both men and women, difficulties in partner communication predicted high fertility problem stress (odds ratio for women, 3.47, 95% confidence interval 2.09-5.76; odds ratio for men, 3.69, 95% confidence interval 2.09-6.43). Active-avoidance coping (e.g. avoiding being with pregnant women or children, turning to work to take their mind off things) was a significant predictor of high fertility problem stress. Among men, high use of active-confronting coping (e.g. letting feelings out, asking other people for advice, seeking social support) predicted low fertility problem stress in the marital domain (odds ratio 0.53, 95% confidence interval 0.28-1.00). Among women, medium or high use of meaning-based coping significantly predicted low fertility problem stress in the personal and marital domain. CONCLUSION: The study provides information about where to intervene with fertility patients in order to reduce their stress after medically unsuccessful treatment.

Keywords: assisted reproduction/clinical epidemiology/coping/marital communication/stress.
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