Infertility, affecting 8% to 12% of couples of reproductive age worldwide, represents more than just a medical challenge—it disrupts life plans and the dream of starting or expanding a family. While technological advancements in assisted reproduction offer hope, they often come with significant emotional and psychological strain for those involved. These treatments, which require considerable physical and emotional effort, sometimes fail to meet expectations, amplifying the emotional burden.
A study funded by FAPESP and conducted at the ABC Medical School in Santo André, São Paulo, has explored a new dimension of the infertility struggle: the work-family conflict faced by patients undergoing assisted reproductive treatments. The study, published in Psychology, Health & Medicine, shows that such conflicts are notably higher among male patients, while women face greater emotional stress during the process.
The research involved 242 couples undergoing treatment at the Ideia Fértil Institute in São Paulo’s Metropolitan Region. The median age of participants was 37, with a demographic profile of highly educated individuals—67% had a university degree—and most couples had been married for over five years.
Assisted reproductive treatments can be both financially and emotionally taxing. However, the impact on work-life balance is less discussed in existing literature. According to lead researcher, Professor Victor Zaia, these treatments can endanger patients’ jobs due to frequent medical appointments, often leading women to hide their fertility treatments from their employers to avoid stigma.
Patients also report significant challenges in productivity and concentration at work due to the side effects of treatment and the constant management of medical schedules. “Work-family conflict arises when individuals are under pressure to juggle their professional duties and personal responsibilities,” Zaia explains. This leads to stress, emotional exhaustion, and diminished job performance, often resulting in physical and psychological consequences.
To investigate these effects, the research team used several internationally validated assessment scales, including the Infertility-Related Stress Scale, the Connor-Davidson Resilience Scale, the Perceived Social Support Scale, and the Work-Family Conflict Scale. These scales evaluated factors such as emotional resilience, the support network from family and friends, and the extent to which work interfered with family life and vice versa.
The findings revealed that male participants exhibited higher resilience and lower stress levels compared to their female counterparts. However, men reported experiencing more interference from work in their family life. The study also noted that couples with higher incomes experienced more pronounced work-family conflicts.
On the other hand, women undergoing treatment had lower resilience and higher stress levels, likely due to societal pressures tied to motherhood, which remains a central expectation for many women. The study also found significant correlations between stress levels, resilience, and emotional support, suggesting that a lack of social support and resilience exacerbates work-family conflict.
Professor Zaia pointed out that stress alone doesn’t fully explain these conflicts. “A lack of resilience and social support can lead to heightened stress and, in turn, more conflict, creating a vicious cycle,” he said.
These findings are pivotal for clinical practice. They can help healthcare providers devise strategies to enhance couples’ resilience and support networks, aiming to alleviate the emotional burden and improve adaptation to infertility treatments. Zaia emphasizes that fostering open communication, emotional support, and stress management is essential for better patient outcomes.
From a practical perspective, improving resilience—defined as the ability to adapt to significant life changes—and ensuring strong social support are crucial. Resilience can mitigate the adverse effects of stress, while emotional and practical support can lessen the emotional toll of infertility, potentially easing the challenges of treatment.
Infertility, defined as the inability to conceive after one year of regular unprotected intercourse, affects many couples globally. Assisted reproductive treatments, though widely available, come with high financial costs and limited access through public healthcare systems. In Brazil, for example, only 11 out of 192 assisted reproduction clinics are publicly funded. A single round of in vitro fertilization (IVF) can cost anywhere from BRL 15,000 to BRL 100,000, with the cost varying based on location, the number of attempts, and the procedure used. For many, the financial burden remains a significant obstacle, despite the potential for hope and success in assisted reproduction.
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