Document Type : Research Paper

Authors

1 Social Welfare Department, Social Sciences Faculty, Yazd University, Yazd, Iran

2 Assistant Professor, Department of Counseling, Science and Arts University. Yazd, Iran

3 Assistant professor of sociology at faculty of social sciences at Yazd University

Abstract

This study examines the marital consequences of infertility in infertile women. It has been conducted, using a qualitative approach and contextual theory method. The target population has primary been infertile women between the age of 25 and 40 who face infertility problems and do meet the following criteria: at least 5 years of cohabitation experience, at least two years of infertility treatment, and at least one IowaF failure. Accordingly, through theoretical sampling twenty-one cases have been studied. The theoretical sampling has continued until data saturation. The data has been gathered through interviews, with data analysis being performed by open, axial, and selective coding methods. The findings show that the consequence of infertility in marital life are 8 main categories, namely transition from a main subject to marginal ones, objectification of the second wife, the victim role, agonized separation, transformation in the husband, the fantasy of love, infertility as a problematic platform, and existential loneliness. A core category has been identified as “victimizer victims”, a notion that refers to the idea that infertile women may, over time, experience their husband's remarriage or a desire to remarry as a result of their infertility, particularly cultural consequences. The findings generally indicated that infertile women are concerned about their husbands' remarriage and, in some cases, the wife's support for the husband's remarriage to have children only to divorce the second wife. Thus, infertile women are psychologically disturbed, as well as in their marital relationships.

Keywords

Main Subjects

[1] اسمعیلی، قاسم؛ افشانی، سیدعلیرضا؛ فلاح، محمدحسین و وزیری، سعید (1398). «کاوشی کیفی از علل و زمینه‌های شکل‌‌گیری چندهمسری مردان»، پژوهش‌های روانشناسی اجتماعی، 9 (34): 82-63.
[2] بزرگ‌نژاد، حسین؛ مسلمی‌زاده، نرگس و غلامی، فرشته (1388). «پیامدهای اجتماعی استفاده از تکنیک‌های کمک باروری (ART) در زنان تحت درمان مراجعه‌کننده به مرکز درمانی امام خمینی ساری در سال 1387». مجلۀ پژوهش اجتماعی، (2): 111-97.
[3] حریریان، حمیدرضا؛ محمدپور، یوسف؛ آقاجانلو، علی (1389). «بررسی فراوانی افسردگی در زنان نابارور مراجعه‌کننده به کلینیک ناباروری کوثر ارومیه». دوماهنامۀ زنان، مامایی و نازایی ایران، شمارۀ 28: 45-49.
[4] حسن پورازغدی، سیده بتول؛ سیم‌بر، معصومه؛ ودادهیر، ابوعلی و حسین رشیدی؛ بتول (۱۳۹۲). «تبیین اثرات روانی نازایی در زنان نابارور در جست‌وجوی درمان: یک مطالعه کیفی. پیشرفت در پرستاری و مامایی». نشریه علمی-پژوهشی دانشکده پرستاری و مامایی، ۲۳ (۸۳)، ۱-۸.
[5] دیرکوندمقدم، اشرف؛ دل‌پیشه، علی و سایه‌میری، کوروش (1395). «بررسی شیوع ناباروری در جهان به روش سیستماتیک». مجلۀ دانشگاه علوم پزشکی قم، دورۀ دهم، شمارۀ 1: 76-87.
[6] رضازاده، علی (1387). «بررسی عوامل اقتصادی، اجتماعی و فرهنگی بر چندهمسرگزینی مردان در منطقۀ باشت از تواب شهرستان گچساران». پایان‌نامۀ کارشناسی ارشد رشتۀ جامعه‌شناسی، دانشکدۀ علوم انسانی، دانشگاه پیام نور واحد شیراز.
[7] عباسی مولید، حسین؛ قمرانی، امیر و فاتحی‌زاده، مریم‌السادات (1390). «آسیب‌شناسی زوج‌های نابارور ایرانی»، مجلۀ طب و تزکیه، شمارۀ 72: 8-20.
[8]عرب، سعید؛ دانشمند، بدرالسادات؛ پودینه، زهرا؛ ثامنی، ناهید؛ میرگل، احمد؛ باباخانلو، اشرف؛ «بررسی میزان بهزیستی روانشناختی و سازگاری زناشویی و رضایت از زندگی در بین خانواده های تک همسری و چند همسری ». مشاوره و روان‌درمانی خانواده، 17: 96-80. 
[9] عنایت، حلیمه و قلیجی، گلاره (1399). «دلایل چند‌زنی در نظام معنایی زن دوم (مطالعه موردی شهرستان ملکشاهی استان ایلام)». جامعه‌شناسی فرهنگ و هنر، 2 (4): 108-89.
[10] فرهمند، مهناز. و رضوانی، زهرا (1398). «نقش ساختار خانواده بر عملکرد آن در خانواده‌های تک‌همسری و چندهمسری». جامعه‌شناسی کاربردی، مجلۀ پژوهشی علوم انسانی دانشگاه اصفهان، 30 (3 (پیاپی 75))، 134-154.
[11] فعال کلخوران، لیلا؛ بهرامی، هادی؛ فرخی، نورعلی؛ زراعتی، حجت؛ ترجمی، مجید (1390). «مقایسۀ اضطراب، افسردگی و رضایت زناشویی در دو گروه مختلف زنان نابارور و بارور در شهر تهران». باروری و ناباروری، شمارۀ 2: 163-157.
[12]معاونت درمان وزارت بهداشت، درمان و آموزش پزشکی (1398). دستورالعمل برنامۀ حمایت مالی زوج نابارور  مدیریت و توسعه خدمات درمان ناباروری.
[13]ملکی، امیر، بزرگ‌نژاد، سیده‌زهرا (1393). «بررسی جامعه‌شناختی رفتار بیماری زنان نابارور (مورد مطالعه: مراجعه‌کنندگان به مراکز ناباروری استان مازندران)». مجلۀ مطالعات اجتماعی ایران، (8): 166-141.
[14] Al-Krenawi, A. & Kanat-Maymon, Y. (2016) “Psychological Symptomatology, Self-Esteem and Life Satisfactions of Women from Polygamous and Monogamous Marriages in Syria.” International Social Work, 60 (1): 196–207. Doi: 10.1177/0020872814562478.
[15] Al-Krenawi, A. (2016). Polygamy and Mental Health: an International Perspective. EC Psychology and Psychiatry, 1 (1), 1-3 as a dyadic measure for stepcouples. Journal of family issues, Vol 37 (1): 1–19.
[16] Bakhtiyar, K., Beiranvand, R., Ardalan, A. et al. An investigation of the effects of infertility on Women’s quality of life: a case-control study. BMC Women's Health 19, 114 (2019).
[17] Balzarini, R. N., Dharma, C., Kohut, T., Campbell, L., Holmes, B. M., Lehmiller, J. J., & Harman, J. J. (2018a). Demographic comparison of American individuals in polyamorous and monogamous relationships.
[18] Balzarini, R.N., Dharma, C., Kohut, T. et al. Comparing Relationship Quality Across Different Types of Romantic Partners in Polyamorous and Monogamous Relationships. Arch Sex Behav 48, 1749–1767 (2019)
[19] Barker, M., & Langdridge, D. (2010). Whatever happened to nonmonogamies? Critical reflections on recent research and theory. Sexualities, 13, 748–772.
[20] Bokaie, M., Simbar, M., Ardekani, S.M., Majd, H.A., )2016(. Women’s beliefs about infertility and sexual behaviors: a qualitative study. Iranian J. Nursing Midwifery Res. 21 (4), 379–384.
[21] Burns, L. H. (2007). “Psychiatric effects of infertility and infertility treatments.” Psychiatric Clinics of North America.; 30: 689-716.
Burns, L. H. (2006). Parenting after infertility. In S. N. Covington & L. H. Burns (Eds.), Infertility counseling: A comprehensive handbook for clinicians (pp. 459–476). Cambridge University Press.
[22] Chachamovich JR, Chachamovich E, Ezer H, Fleck MP, Knauth D, Passos EP (2010). Investigating quality of life and health-related quality of life in infertility: a systematic review. Journal of Psychosomatic Obstetrics & Gynecology, 31: 101-110
[23] Chan, C. H, E. H., Chan, C. L., & Chan, T. H. (2006). Effectiveness of psychosocial group interventions for reducing anxiety in women undergoing in vitro fertilization: A randomized controlled study. Fertility & Sterility, 13, 339-349.
[24] Chelsea L. Garneau, Francesca Adler-Baeder, Brian Higginbotham. (2016). Validating the remarriage belief inventory
[25] Chow, K-M, Cheung, M-C, Cheung, IK. Psychosocial interventions for infertile couples: a critical review. J. Clin. Nurs. 2016; 25: 2101–2113. doi:10.1111/jocn.13361
[26] Claudia Massarotti, Giulia Gentile, Chiara Ferreccio, Paola Scaruffi, Valentino Remorgida & Paola Anserini (2019). Impact of infertility and infertility treatments on quality of life and levels of anxiety and depression in women undergoing in vitro fertilization, Gynecological Endocrinology, 35:6, 485-489, DOI: 10.1080/09513590.2018.1540575
[27] Clifton J, Parent J, Seehuus M, Worrall G, Forehand R, et al. (2020) An internet-based mind/body intervention to mitigate distress in women experiencing infertility: A randomized pilot trial. PLOS ONE 15(3): e0229379. https://doi.org/10.1371/journal.pone.0229379.
[28] Cousineau TM, Domar AD. Psychological impact of infertility. Best Pract Res Clin Obstet Gynecol. 2007;21 (2):293308.
[29] Edelmann, R.J., & Connolly, K. (2000). Gender differences in response to infertility and infertility investigations : Real or illusory. British Journal of Health Psychology, 5, 365-375
[30] Dural O, Yasa C, Keyif B, Celiksoy H, Demiral I, Ozgor BY. Effect of infertility on quality of life of women: a validation study of the Turkish FertiQoL. J human Fertility. 2016;19 (3):186–91.
[31] Getz, L. (2012). The Impact of Infertility. Social Work Today. 12 (6): 30-39/
[32] Greil AL, Slauson-Blevins K, McQuillan J, Lowry MH, Burch AR, Shreffler KM. (2018). Relationship Satisfaction Among Infertile Couples: Implications of Gender and Self-Identification. Journal of Family Issues. 39 (5): 1304-1325.
[33]Hasanpoor-Azghdy S B, Simbar M, Vedadhir A. The emotional-psychological consequences of infertility among infertile women seeking treatment: Results of a qualitative study. IJRM. 2014; 12 (2) :131-138
[34] Hess, R.F., Ross, R., Gililland Jr, J.L., )2018(. Infertility, psychological distress, and coping strategies among women in Mali, West Africa: a mixed-methods study. African J. Reprod. Health 22 (1), 60-72.
[35] Holter H, Anderheim L, Bergh C, Moller A. (2006). First IVF treatment--short-term impact on psychological well-being and the marital relationship. Human reproduction (Oxford, England).21 (12):3295-302. McCarthy MP. (2008). Women's lived experience of infertility after unsuccessful medical intervention. Journal of midwifery & women's health. 53 (4):319-24.
[36] Huppelschoten, Aleida & Duijnhoven, Noortje & Bommel, Peter & Kremer, Jan & Nelen, Willianne. (2012). Do infertile women and their partners have equal experiences with fertility care?. Fertility and sterility. 99. 10.1016/j.fertnstert.10-49.
[37] Holter H, Anderheim L, Bergh C, Moller A. (2006). First IVF treatment--short-term impact on psychological well-being and the marital relationship. Human reproduction (Oxford, England). 21 (12): 3295-3302.
[38] Liamputtong,p. Benza,p. (2019).Being able to bear a child’: Insights from Zimbabwean women in Melbourne, Women and Birth,Volume 32, Issue 2,
[39]Li, X., Ye, L., Tian, L. et al. (2020). Infertility-Related Stress and Life Satisfaction among Chinese Infertile Women: A Moderated Mediation Model of Marital Satisfaction and Resilience. Sex Roles 82, 44–52.
[40] Liamputtong, P., Benza, S., 2018. ‘Being able to bear a child’: insights from Zimbabwean women in Melbourne. Women Birth.
[41] Lotti, F, Maggi, M. (2018). Ultrasound of the male genital tract in relation to male reproductive health. Hum. Reprod. 21: 56–83. doi:10.1093/humupd/dmu042
[42] Marta Bornstein, Jessica D. Gipson, Gates Failing, Venson Banda, Alison Norris,
[43] McCarthy MP. (2008). Women's lived experience of infertility after unsuccessful medical intervention. Journal of midwifery & women's health. 53 (4):319-24.
[44] Meyers, Alison J. Domar, Alice D (2021). Research-supported mobile applications and internet-based technologies to mediate the psychological effects of infertility: a review. Journal of Reproductive BioMedicine Online. Volume 42, Issue 3, March, Pages 679-685
[45] Mindes, E. J., Ingram, K. M., Kliewer, W., & James, C. A. (2003). Longitudinal analyses of the relationship between unsupportive social interactions and psychological Adjustment among women with fertility problems. Social Science & Medicine, 8, 53, 216-221.
[46] Moors, A. C. (2016). Has the American public’s interest in information related to relationships beyond “the couple” increased over time?
[47] Nilforooshan, P, ahmasi,A, Aedi,M, Ahmadi,A. (2006) Studying the effect of cognitive-behavioral counseling based on interacting cognitive subsystems on depression of infertile couples. Middle East Fertility Society Journal, 11 (1): 43-47.
[48] Pasch, L. A., Dunkel-Schetter, C., & Christensen, A. (2002). Differences between husbands’ and wives’ approach to infertility affect marital communication and adjustment. Fertility and Sterility, 77, 1241-1247.
[49] Pasch, LA, Holley, SR, Bleil, ME, Shehab, D, Katz, PP, Adler, NE. (2016). Addressing the needs of fertility treatment patients and their partners: are they informed of and do they receive mental health services? Fertil. Steril; 106.
[50] Peterson, B. D., L. Gold and T. Feingold.T. (2007). “The experience and influence of infertility: considerations for couple counsellors.” The Family Journal;15 (3): 251-257.
[51] Peterson, B.O., Pirritano, M., Christensen, U, Schmidt, L. (2008). The Impact of Partner Coping in Couple Experiencing Infertility. Human Reproduction, 23: 1128-1137.
[52] Peterson BD, Gold L, Feingold T.(2007). The Experience and Influence of Infertility: Considerations for Couple Counselors. The Family Journal. 2007;15(3):251-257. doi:10.1177/1066480707301365.
[53] Peronace, L.A., Boivin, J., Schmidt, L.(2007). Patterns of suffering and social interactions in infertile men: 12 months after unsuccessful treatment. Journal of Psychosomatic Obstetrics & Gynecology. 28(2):105-14.
[54] Ramezanzadeh F, Aghssa M, Abedinia N, Zayeri F, Khanafshar N, Shariat M, et al. (2004). A survey of relationship between anxiety, depression and duration of infertility. BMC women's health. 4(1):9.
[55] Read, J. (1999). Sexual problems associated with infertility, pregnancy, and ageing. BMJ: British Medical Journal, 318 (7183), 587–589.
[56] Sejbaek, CS, Hageman, I, Pinborg, A, Hougaard, CO, Schmidt, L. Incidence of depression and influence of depression on the number of treatment cycles and births in a national cohort of 42 880 women treated with ART. Hum. Reprod. 2013; 28
[57] Slade P, O'Neill C, Simpson AJ, Lashen H. (2007). The relationship between perceived stigma, disclosure patterns, support and distress in new attendees at an infertility clinic. Human reproduction (Oxford, England);22 (8):2309-17.
[58] Social Science & Medicine,Volume 251, 2020,
[59] Thompson E, Woodward J, Stanton A. (2012). Dyadic Goal Appraisal During Treatment for Infertility: How Do Different Perspectives Relate to Partners' Adjustment? International Journal of Behavioral Medicine, 19: 252-259.
[60] Torez , B.L. (2010). Psychological stress of infertility. A conceptual analytic study. of the degree doctor of psychology. The California school of professional psychology. Alliant international university.
[61] Vander Borght, M, Wyns, C Fertility and infertility: Definition and epidemiology. Clin. Biochem. 2018; 62: 2–10. doi:10.1016/j. clinbiochem.2018.03.012
[62] Wischmann T, Stammer H, Scherg H, Gerhard I, Verres R. (2001) Psychosocial characteristics of infertile couples: a study by the ’Heidelberg Fertility Consultation Service’. Human Reproduction. 16 (8):1753–1761.
[63] Wirtberg I, Möller A, Hogström L, Tronstad SE, Lalos A. Life 20 years after unsuccessful infertility treatment. Hum Reprod. 2007 Feb;22(2):598-604. doi: 10.1093/humrep/del401. Epub 2006 Nov 23. PMID: 17124258.
[64] Woods NF, Olshansky E, Draye MA. (1991). Infertility: women's experiences. Health Care Women Int.12 (2):179-90.
[65] Yao, H., Chan, C.H.Y., Chan, C.L.W., )2018(. Childbearing importance: a qualitative study of women with infertility in China. Res. Nurs. Health 41 (1), 69–77.