Infertility Stress, Cortisol, Coping, and Quality of Life in U.S. Women Who Undergo Infertility Treatments.

Abstract Objective To examine relationships between infertility-related stress (IRS), coping, and quality of life (QOL) in U.S. women who undergo infertility treatments and to examine relationships among hair cortisol, IRS, coping, and QOL in a small subsample. Design Descriptive correlational cross-sectional survey. Setting Infertility-related Facebook support groups and Web pages. Participants A total of 230 U.S. women between 18 and 55 years old who underwent infertility treatments. We collected root hair samples for cortisol analysis from a subsample of 37 participants. Methods Participants completed the Copenhagen Multi-centre Psychosocial Infertility Fertility Problem Stress Scales (Personal, Marital, and Social), Copenhagen Multi-centre Psychosocial Infertility Coping Strategies Scales (Active-Avoidance, Passive-Avoidance, Active-Confronting, and Meaning-Based), Fertility Quality of Life scales (Emotional, Mind/Body, Relational, Social, and total QOL), and a demographic and supplemental infertility questionnaire. We used descriptive statistics, correlation, and hierarchic regression for data analysis. We mailed subsample participants instructions and materials to supply a 3-cm hair sample for cortisol analysis by an independent laboratory and a stamped envelope to return the materials. Results Higher stress scores were associated with more active-avoidance coping, less meaning-based coping, and lower QOL. Coping explained 40% of the variance in QOL. After controlling for coping strategies, stress explained another 20% of the variance in QOL. Hair cortisol levels for most participants were low and negatively correlated to stress, especially marital stress, and positively correlated to QOL. Conclusion Women with infertility with high levels of IRS tended to use active-avoidance coping and had lower QOL. Hypocortisolism was prevalent in the subsample and warrants further exploration.