Effects of gender and the representations about the importance of parenthood in the emotional adjustment in couples undergoing assisted reproductive technology (ART)

Infertility is defined as “the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse” [1]. The emotional adjustment of couples undergoing ART has been widely studied, evidencing the experience of infertility and its treatment have negative effects on the psychological well-being in many cases [2,3]. However, few studies were dedicated to study the role of the intrapersonal attributes of adjustment to infertility, such as attitudes toward parenthood, among this population. Therefore, this study aimed to explore the relationship between emotional adjustment and representations about the importance of parenthood (rejection of childfree lifestyle and need for parenthood) in men and women’s life undergoing ART in two different times: pre-treatment and treatment. A cross-sectional study was conducted with 241 heterosexual couples, attending Assisted Reproduction Unit at Hospital Universitari i Politecnic La Fe in Valencia (Spain) during March 2018- June 2019. Two self-report questionnaires were used to measure the representations about the importance of parenthood (Fertility Problem Inventory) and emotional distress (Questionnaire on Emotional Maladjustment and Adaptive Resources in infertility). Data were analysed using univariate and multivariate contrast tests. No statistically significant differences were found between pre-treatment and treatment groups in emotional maladjustment (p=.698) and representations about the importance of parenthood: rejection of childfree lifestyle (p=.304) and need for parenthood (p=.132). However, significant differences were found in emotional maladjustment between women and men considering both groups (p=.001). Women reported higher emotional difficulties than men. Moreover, a significant association (r=.12, p Our findings highlight gender differences among infertile couples in regard to emotional adjustments. In addition, the representations about the importance of parenthood in the individual’s life could affect the infertile patient’s emotional adjustment.These results contribute to a shift in the care provision of infertile couples, fostering the adoption of an integrated care approach to fertility in which psychological support is an essential pillar of care. Psychological intervention programs for infertile couples considering the gender differences should be implemented as part of integrated care. Furthermore, health professionals should also take into consideration the beliefs and cognitions regarding parenthood. The main limitation of this study is the lack of specification of fertility treatment status. All participants receiving fertility treatment were classified under the treatment group, regardless of the treatment cycle. Therefore, the treatment group was not analysed according to the duration and the stage of the process. For future research, a further study on infertile couples’ emotional impact at different moments of the treatment and how social pressure for parenthood can affect the need to achieve pregnancy is recommended.