Coping Mechanisms in Patients Presenting for in-Vitro-Fertilization

Abstract

Objectives:

The purpose of this study was to assess the coping mechanisms in patients presenting for in-vitro fertilization (IVF).

Methods:

We evaluated thirty consecutive couples presenting for in-vitro-fertilization. All couples were interviewed individually at first, and then together, using a semi- structured interview technique. Psychiatric diagnoses were made using the Diagnostic and Statistical Manual-IV (DSM-IV) criteria. Coping mechanisms used by the individuals were assessed using the Mechanisms of Coping Scale (MOCS). Other instruments used were Hamilton Depression Rating Scale (HAM-D-17), Hamilton Anxiety Rating Scale (HAM-A), Brief Psychiatric Rating Scale (BPRS), Self-Rating Symptom Scale (SRSS), and Eysenck Personality Inventory (EPI).

Results:

The mean age of the sixty patients was 32.3 ± 5.2 years. Fatalism was the commonest factor on the mechanisms of coping scale. Analysis of variance (ANOVA) across all factors of the MOCS for demographic factors showed that men used problem-solving mechanisms significantly more often than women (F = 3.0, df = 1, 58, p < 0.05). ANOVA across coping factors on stressors with post-hoc tests of significance revealed that individuals facing social stress used fatalism significantly more often than other coping mechanisms, while those facing career stress used problem-solving significantly more often than other coping mechanisms (F = 5.6, df = 1, 58, p < 0.05 and F = 3.04, df = 1,58, p < 0.01 respectively). ANOVA across coping factors on HAM-D-17 scores revealed that individuals who used fatalism had significantly higher HAM-D-17 scores compared to those who did not (F = 4.4, df = 1, 58, p < 0.05). ANOVA across coping factors on HAM-A scores revealed that individuals who used escape-avoidance had significantly lower HAM-A scores than those who did not (F = 4.3, df = 1, 58, p < 0.05). ANOVA across coping factors on SRSS scores revealed that individuals who used passivity or fatalistic coping mechanisms had significantly higher scores on SRSS than who did not (F = 4.6, df = 1, 58, p < 0.05 and F = 3.5, df = 1, 58, p < 0.05).

Conclusions:

Differential patterns of coping were found among the sixty individuals presenting for IVF and were associated with a variety of factors including gender, education, stressors, and levels of depression, anxiety, and overall psychopathology. Efforts to recognize and recruit the coping mechanisms of infertile individuals are likely to enhance their ability to participate effectively in treatment.

Keywords

coping in-vitro-fertilization stress depression anxiety

Get full access to this article

View all access options for this article.

References

Steptoe

Edwards

. Birth after the reimplantation of a human embryo. Lancet 1978;12:2:366.

Palermo

Joris

Devroey

Van Steirteghem

. Pregnancies after intracytoplasmic injection of single spermatozoan into an oocyte. Lancet 1992;340(8810):17–18.

Wood

Trounson

, editors. Clinical in-vitro fertilization, 2nd ed. New York: Springer-Verlag, 1989.

Cohen

Malter

Wright

Kort

Massey

Mitchell

. Partial zona dissection of human oocytes when failure of zona pellucida penetration is anticipated. Human Reproduction 1989;4:435–442.

Jones

Jr . In vitro fertilization. In Progress in Infertility, 3rd ed. In: Behrman

Kistner

Patton

Jr , editors. Boston: Little Brown and Company, 1988.

Asch

Balmaceda

Ellsworth

. Preliminary experiences with Gamete IntraFallopian Transfer (GIFT). Fertility and Sterility 1986;45:366–371.

Dodson

Young

Poindexter

Findley

Rossavick

Lipshultz

Gibbons

. A detailed program review of in vitro fertilization with a discussion and comparison of alternative approaches. Surgery Gynecology and Obstetrics 1986;162:189.

Parikh

Rathor

Kodwaney

Kamat

Parikh

. Successful human micromanipulation with subzonal sperm insemination and intracytoplasmic sperm injection. Journal of Obstetrics and Gynecology. India, 1994;44:458–463.

Connolly

Edelmann

Bartlett

Cooke

Lenton

Pike

. An evaluation of counseling for couples undergoing treatment for in-vitro fertilization. Human Reproduction 1993;8:1332–1338.

10.

Mazure

Greenfield

. Psychological studies of in-vitro fertilization/embryo transfer participants. Journal of In-Vitro Fertilization and Embryo-Transfer 1989;6:242–256.

11.

Stotland

. Social change and women's reproductive health care. New York: Praeger, 1988.

12.

Mazor

. Emotional reactions to infertility. In: Mazor

Simons

, editors. Infertility: Medical, emotional, and social considerations. New York: Human Sciences Press, 1984.

13.

Williams

. Psychology of women: Behavior in a biopsychosocial context. New York: WW Norton, 1983.

14.

Demyttenaere

Nijis

Evers

Koninckx

. Coping and the ineffectiveness of coping influence the outcome of in-vitro fertilization through stress responses. Psychoneuroendocrinology 1992;17:655–665.

15.

Aldwin

Revenson

. Does coping help? A re-examination of the relation between coping and mental health. Journal of Personality and Social Psychology 1987;53:337–348.

16.

Stone

Neale

. A new measure of daily coping: Development and preliminary results. Journal of Personality and Social Psychology 1984;46:892–906.

17.

Parkes

. Locus of control, cognitive appraisal and coping in stressful episodes. Journal of Personality and Social Psychology 1984;46:655–668.

18.

Lazarus

Averill

Option

Jr . The psychology of coping: Issues of research and assessment. In: Coelho

Hamburg

Adams

, editors. Coping and adaptation. New York: Basic Books, 1974:249–315.

19.

Demyttenaere

Bonte

Gheldof

Vervaeke

Meuleman

Vanderschuerem

D'Hooghe

. Coping style and depression level influence outcome in vitro fertilization. Fertility and Sterility 1998;69:1026–1033.

20.

Parikh

Quadros

D'Mello

. Mechanisms of coping and psychopathology following the Latur earthquake: The PROLIFE study. Archives of Indian Psychiatry, 1994.

21.

Folkman

Lazarus

. Manual for the Ways of Coping Questionnaire. California: Consulting Psychology Press. 1988:1–33.

22.

Stanton

Tennen

Affleck

. Cognitive appraisal and adjustment to infertility. Women's Health 1991;17:1.

23.

Newton

Mannon

. Gender differences in psychological response to infertility treatment. Infertility and reproductive clinics of North America, Vol. 4. Greenfeld

, (editor). Philadelphia, PA: Saunders WB, 1993.

24.

Nachtigall

Becker

Wozny

. The effects of gender-specific diagnosis on men's and women's response to infertility. Fertility and Sterility 1992;57:113–121.

25.

Hamilton

. A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry 1960;23:56–62.

26.

Hamilton

: The assessment of anxiety states by rating. British Journal of Psychiatry 1959;32:50–55.

27.

Overall

Gorham

. The Brief Psychiatric Rating Scale (BPRS): Recent developments in ascertainment and scaling. Psychopharmacology Bulletin 1988;24:97.

28.

Lipman

. Sensitivity of symptom and non symptom—Focused criteria of outpatient drug efficacy. American Journal of Psychiatry 1965;122:24–27.

29.

Eysenck

. Scores on three personality variables as a function of age, sex and social class. British Journal of Social Clinical Psychology 1969;8:69–76.

30.

Hollingshead

Redlich

. The index of social position in social class and mental illness. New York: Wiley, 1958:387–397.

31.

Cook

. Characteristics of the biopsychosocial crisis of infertility. Journal of Counseling Development 1987;65:465–469.

32.

Stanton

Dunkel-Schetter

. Psychological adjustment to infertility. In: Infertility: Perspectives from stress and coping research. New York: Plenum Press, 1991.

33.

Pepe

Bryne

. Women's perceptions of immediate and long-term effects of failed infertility treatment on marital and sexual satisfaction. Family Relations 1991;40:303.

34.

Burns

. Infertility as boundary ambiguity: One theoretical perspective. Family Process 1987;6:359.