This research paper analyzes multiple research articles to explain the effects that infertility has on relationship satisfaction.

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Infertility and Relationship Satisfaction
Elizabeth Rose Duignam
University of Georgia

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Introduction
Infertility, which is the inability of a couple to conceive children, is an extreme stressor
that contributes to the decreased relationship satisfaction of a couple. Infertility is prevalent in
10% to 15% of all couples living in western societies (Kiesswetter et al., 2020). In the context of
the research articles mentioned in this paper, infertility is a chronic condition, rather than an
acute issue. A chronic condition is one that is relatively stable and enduring (Bradbury &
Karney, 2019). Distress from infertility is negatively related to relationship satisfaction and can
cause many issues for a couple (Ussher & Perz, 2019). Multiple research articles go into depth
about why infertility negatively affects relationship satisfaction and resources that can be utilized
to decrease stress.
The Adverse Effects of Infertility on Relationship Satisfaction
Infertility is a chronic issue that affects intimate relationships in a stable manner
(Bradbury & Karney, 2019). According to Bronfenbrenner’s social ecological model, infertility
is described as a proximal issue (Bradbury & Karney, 2019). This means that it affects a couple
more directly than other stressors may (Bradbury & Karney, 2019). A study by Greil et al. (2018)
found that relationship satisfaction, as a whole, decreases when a couple finds out they are
infertile. However, the same study suggests that there are differences when it comes to males and
females (Greil et al., 2018). When neither partner identifies as having infertility issues, the
female feels higher relationship satisfaction than the male (Greil et al., 2018). This is because
when a couple finds out they are infertile, the female blames themself more and feels as though
infertility is part of their identity (Greil et al., 2018). If the male blames himself for the infertility,
he experiences a lower level of relationship satisfaction, but if the female blames herself, the
male experiences more anxiety and depression (Péloquin et al., 2017). Infertility has been found

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to lead to chronic stress and depression, which decreases relationship satisfaction (Keilek-Ratag
et al., 2020). A seven item report scale known as the Relationship Assessment Scale (RAS), was
tested on infertile Iranian couples to assess relationship dissatisfaction (Maroufizadeh et al.,
2018). Maroufizadeh et al. (2018) suggests that the longer the infertility duration, the lower the
score on the RAS. This finding was confirmed by Keilek-Ratag et al. (2020) that states the
longer the conflict with infertility and failed in vitro fertilization, the lower marital and
relationship satisfaction.
Connections to Theories
Attachment styles among individuals with infertility issues leads to varied relationship
satisfaction. John Bowlby was a psychologist and psychiatrist who studied attachment theory and
categorized intimate attachment into four groups based on anxiety and avoidance (Bradbury &
Karney, 2019). A study by Bayley et al. (2009) examined many individuals going through
infertility treatment and determined which attachment style they were. Individuals with anxious
attachment styles, known as preoccupied and fearful, were found to experience the lowest levels
of relationship satisfaction (Bayley et al., 2009). According to Bowlby, people with high levels
of anxiety tend to worry more in a relationship and have less self confidence (Bradbury &
Karney, 2019).
Elements that Increase Relationship Satisfaction
Although infertility is a huge source of psychological stress and decreased relationship
satisfaction, there are resources and factors that can mitigate the distress (Kiesswetter et al.,
2020). When couples communicate and are open in speaking about their infertility issues, their
relationship satisfaction increases (Keilek-Ratag et al., 2020). Keilek-Ratag et al. (2020)
conducted a study and found that when couples talk about being infertile, whether it be before or

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after finding out, it leads to higher marital and relationship satisfaction (Keilek-Ratag et al.,
2020). This is due to the fact that when couples dismiss a difficult topic of conversation, there is
underlying tension that can build up (Keilek-Ratag et al., 2020). Tension and uncommunicated
anger is a factor that leads to decreased relationship satisfaction.
The term social network is defined by Bradbury and Karney (2019) as the close family
and friends of an individual. When a couple experiences support from their social network
during the stressful time of infertility, there is a higher level of relationship satisfaction (Greil et
al., 2018). It is common for couples with strong social networks to have strong intimate
relationships according to Bradbury and Karney (2019), but this phenomenon transfers over to
when a couple is in a high stress environment.
Adequate resources are known to increase relationship satisfaction when a couple is
experiencing a difficult time (Bradbury & Karney, 2019). There are many resources that infertile
couples can utilize to alleviate this stressful situation. In vitro fertilization (IVF) is a treatment
that can lead to the possibility of an infertile couple conceiving a child. This is a great resource
for couples, however it is expensive and may not be available to all people. If a couple is able to
attempt IVF.
Conclusion
Relationship satisfaction invariably decreases when a couple finds out that they are
infertile (Ussher & Perz, 2019). Infertility is a stressor that leads to anxiety and depression, thus
making a relationship difficult to sustain (Kiesswetter et al., 2020). Differences in relationship
satisfaction vary as researchers study the four attachment styles, finding that more anxious
people tend to have the least satisfaction after finding out they are infertile (Bayley et al., 2009).

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However, there are multiple factors that alleviate the stress of infertility. Openness,
communication and resources like IVF are among a few (Keilek-Ratag et al., 2020).

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Resources
Bayley, T. M., Slade, P., & Lashen, H. (2009). Relationships between attachment, appraisal,
coping and adjustment in men and women experiencing infertility concerns. Human
Reproduction, 24(11), 2827-2837. https://doi.org/10.1093/humrep/dep235
Bradbury, T. N., & Karney B. R. (2019). Intimate Relationships (3rd. Ed.). New York: W.W.
Norton & Co.
Greil, A. L., Slauson-Blevins, K., McGuillan, J., Lowery, M. H., Burch, A. R., & Shreffler, K.
M. (2018). Relationships satisfaction among infertile couples: Implications of gender and
self-identification. Journal of Family Issues, 39(5), 1304-1325.
https://doi.org/10.1177/0192513X17699027
Kielek-Rataj, E., Wendolowska, A., Kalus, A., & Czyżowska, D. (2020). Openness and
communication effects on relationship satisfaction in women experiencing infertility or
misscariage: A dyadic approach. International Journal of Environmental Research and
Public Health, 17. https://doi.org/10.3390/ijerph17165721
Kiesswetter, M., Marsoner, H., Luehwink, A., Fistarol, M., Mahlknecht, A., & Duschek, S.
(2020). Impairments in life satisfaction in infertility: Associations with perceived stress,
affectivity, partnership quality, social support and the desire to have a child. Behavioral
Medicine, 46(2), 130-141. https://doi.org/10.1080/08964289.2018.1564897
Maroufizadeh, S., Omani-Samani, R., Almasi-Hashiani, A., Navid, B., Sobati, B., & Amini, P.
(2018). The relationship assessment scale (RAS) in infertile patients: A reliability and
validity study. Middle East Fertility Society Journal, 23(2018), 471-475.
https://doi.org/10.1016/j.mefs.2018.04.001
Péloquin, K., Brassard, A., Arpin, V., Sabourin, S., & Wright, J. (2017). Whose fault is it? Blame

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predicting psychological adjustment and couple satisfaction in couples seeking fertility
treatment. Journal of Psychosomatic Obstetrics & Gynecology, 39(1), 64-72.
https://doi.org/10.1080/0167482X.2017.1289369
Ussher, J. M. & Perz, J. (2019). Infertility-related distress following cancer for women and men:
A mixed method study. Psycho-Oncology, 28, 607-614. https://doi.org/10.1002/pon.4990