Does childbirth after fertility treatment influence sense of coherence? A longitudinal study of 1,934 men and women

Abstract

Background. Infertility is a severe, stressful experience. Sense of coherence (SOC) is an individual attribute which reflects the ability to resist severe strain. According to Antonovsky, SOC is stable throughout adulthood, but there is little empirical evidence to support this. In a prospective study, we focused on 2 research questions: (i) Does childbirth after assisted reproductive technology (ART) result in high SOC? (ii) Does the level of SOC at baseline influence the association between childbirth after ART and SOC at 1-year follow-up? Methods. The study included a consecutive sample of patients in ART from a prospective, longitudinal survey in Denmark; baseline response rate 80.0%, 1-year follow-up 87.7% (n=1,934). The dependent variable was SOC at 1-year follow-up measured by Setterlind's 9-item scale. The independent variable was having achieved childbirth after ART. Data were analysed by logistic regression analysis adjusted for baseline SOC. Results. Having achieved childbirth after ART was associated with higher SOC at 1-year follow-up (women OR=1.81, 95% CI: 1.20-2.74; men OR=1.27, 95% CI: 0.88-1.86). Unexpectedly, the association between achieving childbirth after ART and high SOC at 1-year follow-up was significant among women who had low SOC at baseline. There was no association among participants with high SOC at baseline. Conclusions. The study indicated that SOC is not necessarily stable throughout adulthood, since a successful outcome of ART among women was associated with a significant increase in SOC. © 2007 Taylor & Francis.