Emotional aspects and support in in vitro fertilization and embryo transfer programs

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Abstract
Little is known about the emotional demands upon women of the step-by-step procedures characteristic of involvement in an in vitro fertilization/embryo transfer (IVF-ET) program. In this study, 77 women provided their perceptions of the emotional demands of IVF-ET and explanations for failed attempts, as well as describing their coping strategies and sources of emotional support. Nominated as the two most difficult stages of IVF were the wait for a possible pregnancy after the procedure and the blood tests and injections prior to hospitalization. Women were overly optimistic with a first attempt, with 70% being moderately to highly optimistic about success. Levels of optimism, however, generally declined across attempts. About half of the women intended to stop after four attempts, and almost all would stop after six treatment cycles. Women attributed their lack of success to a wide range of factors, including the low success rate, being anxious or stressed, bad luck, or problems associated with their condition and the procedure. Asked how they coped with the program, the women reported that the major strategy was to adopt the attitude that they might be successful in the long term. Other coping strategies involved keeping busy, staying calm, and seeking the support of other IVF women and husbands. Husbands were listed as the major source of emotional support, followed by other infertile women and nurses, counselors, and doctors. Finally, the majority of women believed that although they would be less fulfilled if they did not have a child through IVF-ET, nevertheless there were alternative sources of satisfaction which they would pursue. For most, continued infertility was not seen as detrimental to the quality of their marriages.

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