Infertility-related stress and perceived social support as predictors of infertility self-efficacy among women in treatment for infertility
Authors:   , Nelson Alexandra Rose , Geller Pamela A 
Published: September 2022

Undertaking treatment for infertility using assisted reproductive technologies is a stressful experience marked by lengthy and invasive medical procedures, high financial cost, and relatively low success rates. Emotional distress during fertility treatment has been associated with high rates of treatment attrition. Women in treatment for infertility have been found to have high levels of general and infertility-related stress and distress. Such infertility-related stress has been demonstrated to have a strong, inverse relationship with confidence in the ability to cope with or manage the demands of treatment, referred to as "infertility self-efficacy." Additionally, stress has been associated with problems with social support, while adequacy of social support has been associated with greater psychological well-being. This study explores the interaction of infertility-related stress and perceived adequacy of social support as predictors of confidence in the ability to cope with treatment demands among women undergoing fertility treatment using assisted reproductive technologies. Eighty-four women undergoing fertility treatment were recruited from a fertility treatment clinic in the greater Philadelphia metropolitan area to participate in a cross-sectional survey study. Self-report measures included: a sociodemographic questionnaire assessing general and fertility-related descriptive characteristics; the Fertility Problem Inventory; the Multidimensional Scale of Perceived Social Support; the Infertility Self-Efficacy scale; and a visual analog scale assessing predicted willingness to repeat treatment in the event of an unsuccessful cycle. Primary hypotheses predicted that: 1) infertility-related stress would have an inverse relationship with infertility self-efficacy, with higher infertility-related stress associated with lower infertility self-efficacy; 2) perceived adequacy of social support would have a positive relationship with infertility self-efficacy, with greater satisfaction with social support associated with higher infertility self-efficacy; and 3) perceived adequacy of social support would moderate the relationship between infertility-related stress and infertility self-efficacy, with perceived adequacy of social support reducing the strength of the inverse relationship between infertility-related stress and infertility self-efficacy. Exploratory hypotheses predicted that: 1) each domain of perceived social support would have a positive relationship with infertility self-efficacy; and 2) infertility self-efficacy would have a positive relationship with ratings of willingness to repeat ART treatment in the event of an unsuccessful treatment attempt. Data were analyzed using multiple linear regression analyses. Results revealed support for Hypotheses 1 and 2, as infertility-related stress was found to have a significant, negative relationship with infertility self-efficacy (p > .001) and perceived adequacy of social support was found to have a significant, positive relationship with infertility self-efficacy (p > .05). Support was not found for Hypothesis 3, as social support did not significantly modify the relationship between infertility-related stress and infertility self-efficacy. Support was not found for exploratory Hypotheses 4 or 5, as no specific sub-domains of social support were found to have significant relationships with infertility self-efficacy, and infertility self-efficacy was not found to predict women's anticipated willingness to repeat treatment in the event of an unsuccessful cycle. Implications of these findings and future directions for research are discussed.