Une perspective dyadique chez les couples suivis en clinique de fertilité : le rôle de l’attachement et l’efficacité préliminaire d’une nouvelle intervention de groupe

A large body of research has shown that fertility treatment has a significant impact on individuals’ psychological and relational adjustment, as well as their quality of life. Nevertheless, studies in the context of infertility have a number of limitations, including the use of general rather than infertility-related measures of adjustment, the underrepresentation of men’s experiences with infertility, and the absence of a dyadic or couplelevel understanding of adjustment in couples seeking fertility treatment. Furthermore, despite numerous recommendations within the literature to include partners in group interventions for individuals undergoing fertility treatment, to our knowledge, no study to date has examined the effectiveness of a group intervention that includes both partners and uses the couple as a unit of analysis. As such, the general objective of this thesis was to use a dyadic perspective to examine the explanatory mechanisms of fertility-related quality of life and to evaluate the effectiveness of a group intervention designed to improve the wellbeing of couples undergoing fertility treatment. More specifically, the purpose of the first article was to examine in a dyadic approach (l) whether attachment insecurities were associated with fertility-related QoL in couples seeking fertility treatment and (2) whether infertility-specific emotion-focused coping strategies mediated these associations. Eighty-seven couples seeking fertility treatment completed a set of online questionnaires. Path analyses guided by the Actor- Partner Interdependence Model revealed that men and women’s attachment-related anxiety was associated with their own poorer QoL, through the use of social withdrawal, denial, self-blame, and poor acceptance. Men’s attachment-related avoidance was associated with their own poorer QoL. Two partner effects were also observed, indicating that attachmentv related avoidance in men and women was related to a decreased tendency to seek social support, which in turn was associated with their partners’ lower QoL. These findings contribute to our understanding of the role that adult attachment and infertility-specific coping strategies plays in the QoL of couples seeking fertility treatment. The aim of the second article was to test the acceptability and preliminary efficacy of a new psychoeducational and support group-based intervention for couples seeking fertility treatment. Twenty-night couples from the province of Quebec participated in the manualized cognitive-behavioral group intervention, which was comprised of six 90- minute bi-monthly sessions and included both partners. Participants also completed psychological, relational, and sexual outcome measures pre- and post-intervention on a web platform. Repeated-measures ANOVAs revealed significant improvements in terms of psychological and relational adjustment. Couples’ high participation rates and reported treatment satisfaction indicated good acceptability of the intervention. These results support the preliminary success of the intervention in reducing the psychological and relational burden for couples undergoing fertility treatment.

Keyphrases: couple, Infertility, Infertility treatment, Couples, Dyadic approach, Quality of life, Group intervention, Attachment, Coping strategies, Psychological and relational adjustment