4.2 Interpretation
The aim of this study was to determine the effect of the social emotional capacities of infertile individuals on their stress levels and their ability to cope with infertility stress. In this section, the relationships between average socio-demographic and clinical characteristics, infertility stress (individual, marital, social) averages, average scores of coping methods with infertility stress and social-emotional capacity load average scores are discussed. Turkey’s national data results show that the average age of infertile individuals from 2019 to 2022 is 32.3 ± 4.9 years, which is similar to the average age of the participants in our study.25 There are publications in the literature stating that women and men face the problem of infertility together and that men actively participate in the treatment process, as in our study results.4,26
Almost every couple wants to have children through fertility treatment, but some have difficulty having a baby.4,27 Contrary to popular perception, infertility treatment techniques do not guarantee success. Previous study findings have shown that 38% to 49% of couples who begin IVF treatment will remain childless even after undergoing up to six in vitro fertilization cycles.28 The couples who participated in our study also applied to the infertility center again due to treatment results that did not result in a live birth. Like the results of our study, about a quarter of the participants in the previous study had IUI and about half had IVF treatment, but less than half resulted in pregnancy.28,29 Almost all of these pregnancies ended in miscarriage and a few in ectopic pregnancy. Since the most frequent result of the treatments of these individuals was not live birth, the participants had received one of the reproductive health treatments on average four times before, and these findings are similar to the results of previous studies.25,28
Although the inability to have children affects both genders emotionally, it may cause women to experience more stress, anxiety, and depression problems than men in different areas of their lives.2,9,10 In our study, it was determined that women experienced more stress in their individual, marital, and social areas due to infertility than men; they had higher anxiety scores, and experienced a feeling of hopelessness more intensely. Studies have shown that infertile women experience high levels of stress in the individual and marital fields, moderate levels of stress in the social sphere,29 and high levels of anxiety and depression.9,10
According to the study results, regardless of the cause of infertility and who caused it, women are more negatively affected and feel more guilt and stress than men. Data from numerous studies have revealed that rates of psychological problems such as depression and anxiety are higher among infertile women.3,23,30 Lakatos et al.10 reported that women diagnosed with infertility experienced more anxiety and depression than men. This result may be because women are exposed to a large part of the treatments applied, even if infertility is of male origin, and femininity is directly related to childbearing in traditional societies.18,23,31
According to our study findings, couples use active avoidance, which includes thoughts such as avoiding being with pregnant women and women with children, at a similar rate as a method of coping with fertility stress. However, women use the passive avoidance method, which includes thoughts such as feeling that the only thing they can do is to wait, more than men. These women have higher infertility stress than men. In previous studies, it has been stated that the active avoidance coping method and the passive avoidance coping method are associated with an increase in infertility stress, while the active-confrontational coping method and the meaning-based coping method are associated with a decrease in infertility stress.1,20,32
In our study, we evaluated five risk factors (anxiety, depression, helplessness and acceptance, and lack of social support) with SCREENIVF to indicate the social, emotional, and psychological burden of couples diagnosed with infertility. We determined that women’s social, emotional, and psychological burden is greater than that of men. In addition to the fact that the anxiety level of men was lower than that of women, their mean score was below the cut-off point, which showed that men were not at risk for anxiety. Men are not at as much risk as women in terms of their social emotional capacities. A study by Lopes et al.33 (average score averages of the Anxiety, Social Support, Helplessness, Acceptance and Depression subscales of the SCREENIVF scale) supports our study results. Studies show that low familial and social support for infertile people leads to higher stress.34,35