Psychological adjustment of infertile women entering IVF treatment: differentiating aspects and influencing factors.

OBJECTIVE: To evaluate the psychological adjustment of infertile women compared with a control group of mothers and to determine which personal or marital factors influence the amount of emotional disorders in the infertile group. DESIGN: Cross-sectional questionnaire study with a group of infertile women and a group of mothers attending a routine gynecological examination. SETTING: Infertile women and mothers received the questionnaires after a psychological or medical examination respectively, at a Sterility Center in a Department of Obstetrics and Gynaecology. PARTICIPANTS: One hundred and twenty-two infertile women, entering an IVF program, and 57 mothers attending a routine care visit. MAIN OUTCOME MEASURES: Stressful events, self-esteem, job and marital satisfaction, care and control measures of intimate bond, state-trait anxiety, depression, psychophysiological symptoms and global emotional factor scores. RESULTS: The organic infertile group was higher than mothers on satisfaction with their relationship with their husbands, perception of care and state-anxiety. The emotional factor scores of infertile women, controlled for stressful events, were influenced by a) number of IVF-cycles and availability for adoption, b) job position, job satisfaction and self-esteem, c) personality dimensions. State and trait anxiety scores were influenced by the level of global marital satisfaction. CONCLUSIONS: Infertile women, entering an IVF treatment program, do not necessarily show signs of psychological maladjustment. Their level of state-anxiety can be considered a situational response to the treatment stress. The infertility condition and its treatment can be effectively dealt with by women having a good personality disposition, a high level of self-esteem, who are satisfied with their job and relationship with their husband, and who are willing to adopt a child as a last solution for their maternal need.