Psychometry of stress in infertile couples

Abstract

The stress provoked by the difficulty in having children can lead to various emotional changes (anxiety, depression, somatization, aggressiveness etc.) The objective of the present study was to develop a program of psychological evaluation in an attempt to identify couples with a profile of the stressful type when they face the problem of infertility. In a total of 251 infertile couples were submitted to the program of psychological evaluation (PPE) of the Center for Human Reproduction, "Sinhá Junqueira" Maternity Foundation. The causes of infertility were male-related in 43.4% of cases, female-related in 46.6%, and both male- and female-related in 10%. Infertility was primary in 76% of cases and secondary in 24%. The mean age of the women was 34.5±5.2 years and the mean age of the men was 37.9±6.8 years. The psychometry of the infertile couples was evaluated using a questionnaire with 15 questions selected in order to detect emotional reactions caused by stress. The responses were assigned four grades with respect to frequency (1 = never or rarely; 2 = sometimes; 3 = many times, and 4 = always). The sum of the responses corresponded to a PPE score ranging from 15 to 60 points. A PPE score of < 30 points was defined as abnormal. Data were analyzed statistically by the Student t-test and the Mann-Whitney and Fisher tests, with the level of significance set at 5%. The reliability of the questionnaires was determined on the basis of the alpha coefficient of Cronbach. The mean PPE score for women (27±8) was significantly higher (p < 0.01, Mann-Whitney test) than the score for men (22±7). The alpha coefficient of Cronbach was 0.88, and was identical for the female and male questionnaires. The PPE score was considered to be abnormal for 31.2% of the women and for 12.3% of the men. In conclusion the data demonstrate that one of the characteristics of Brazilian infertile couples is that women are habitually more stressed by the situation of infertility than men. The PPE score is a simple and efficient tool for the identification of women and/or men with problems of stress caused by infertility. The team of the Center for Human Reproduction (employees, biologists, nurses, doctors etc.) has started to use the information provided by the PPE score in the daily routine, and patients with an abnormal PPE score are informed and counseled about the factors generating stress in infertility. Advice is provided (practicing sports, traveling, activating personal projects etc.) in order to help combat stress.