Identifying Modifiable Factors Associated with Psychological Health in Women Experiencing Infertility

Abstract

Infertility affects approximately 12.5% of U.S. women and is often accompanied by psychological distress. The following study aimed to assess the relationship of modifiable psychological factors on depression and anxiety symptoms and posttraumatic growth in women experiencing infertility. Women (n=457) in the U.S. completed an online survey containing demographic and clinical information as well as standardized self-report measures of mindfulness (FFMQ-24), self-compassion (SCS-SF), positive affect (mDES), intolerance of uncertainty (IUS-SF), relationship satisfaction (CSI-4), experiential avoidance (AAQ-II), depression (PROMIS Depression 8b), anxiety (PROMIS Anxiety 8a) and posttraumatic growth (PTGI). Efforts were made to recruit Black and Latina women who are less likely to seek medical treatment for infertility and are often underrepresented in infertility research. The final sample included women who identified as Non-LatinX White (65%), Non-LatinX Black (13%), LatinX (16%), Asian (2%) and Other (4%). Clinical and demographics characteristics (age, duration trying to conceive, history of miscarriage, and childlessness) did not significantly predict depression or anxiety. Positive affect and experiential avoidance predicted depression and anxiety, self-compassion predicted depression, and intolerance of uncertainty predicted anxiety. There were also indirect effects of mindfulness on anxiety and depression via these variables. Counter to expectations, posttraumatic growth was associated with higher intolerance of uncertainty and experiential avoidance. This suggests that, measured cross-sectionally, perceiving growth may act as a palliative strategy to reduce distress for women currently experiencing infertility. This cross-sectional study provides preliminary evidence that interventions targeting experiential avoidance and positive affect may help to address depressive and anxiety symptoms in women experiencing infertility. In addition, offering skills to promote mindfulness may have beneficial downstream effects on other key coping variables. These effects should be evaluated in further clinical research.