Both men and women experienced improved quality of life during ART treatment. The study found that men's quality of life improvement was influenced by their level of marital satisfaction at the beginning of treatment - men with higher marital satisfaction saw greater increases in quality of life. Neither infertility duration, partners' age, or partners' variables predicted changes in men's quality of life. The small sample size from a single clinic limits how broadly the results can be applied.

1. THE ROLE OF INFERTILITY CONCERNS
IN PREDICTING THE CHANGE IN MEN’S QUALITY OF LIFE
DURING ART TREATMENT IN COUPLES WITH A MALE INFERTILITY FACTOR
Z. Donarelli1, G. Lo Coco2, S. Gullo3, L. Salerno1, A. Volpes4, A. Allegra4
1ANDROS Day Surgery Clinic, Psychology Unit, Palermo, Italy
2University of Palermo, Department of Psychological, Pedagogical and Educational Sciences, Palermo, Italy
3ANDROS Day Surgery Clinic, Medical Statistic Unit, Palermo, Italy
4ANDROS Day Surgery Clinic, Reproductive Medicine Unit, Palermo, Italy
Table I – Descriptive statistics and differences between T1 and T2
ABSTRACT
The aim of this study was to examine psychosocial predictors relating to the improvement in men’s Quality of Life (QoL) during the course of ART
treatment, controlling for the duration of infertility, their partner’s age, their own and their partners marital satisfaction, need of parenthood and
sexual concerns.
Our findings show that both men and women’s QoL increased during the course of ART treatment and that men’s QoL improvement is only
influenced by their own marital satisfaction at the beginning of ART treatment. On the other hand, none of the women’s variables at the beginning of
ART predict men’s QoL variations.
DISCUSSION
Results of the current study show that men’s Quality of Life increases during an ART procedure and that this could be due to their involvement in
the couples’ process and to a positive marital relationship when facing with an infertility problem.
LIMITATIONS
There are two limitations in this study: firstly, data were obtained only from one clinical site; and secondly, the results of the study may be
influenced by the small sample size.
CLINICAL IMPLICATIONS OF THE FINDINGS
Due to the influence of men’s marital satisfaction on their own QoL change, couples’ relational domains may be identified by health professionals,
providing possible psychosocial counselling to infertile couples whose men show low marital satisfaction.
Figure 1 – Path Diagram for men’s Quality of Life variation.
REFERENCES
Boivin J, Takefman J, Braverman A. Development and preliminary validation of the fertility quality of life (FertiQoL) tool. Hum Reprod 2011a; 26, 2084–2091.
Boivin J, Takefman J, Braverman A. Development and preliminary validation of the fertility quality of life (FertiQoL) tool. Fertil Steril 2011b; 96, 409–415.
Chachamovich JLR, Chachamovich E, Ezer H, Cordova FP, Fleck MMP, Knauth DR, Passos EP. Psychological distress as predictor of quality of life in men experiencing infertility: a cross-sectional survey. Reprod
Health 2010; 7: 3-11.
Donarelli Z, Lo Coco G, Gullo S, Marino A, Volpes A, Allegra A. Are attachment dimensions associated with infertility-related stress in couples undergoing their first IVF treatment? A study on the individual and
cross-partner effect. Hum Reprod 2012; 27: 3215-3225.
Häcker M, Rösner S, Toth B, Strowitzki T, Wischmann T. Exploring involuntary childlessness in men: a qualitative study investigating men's experiences and perceptions in the process of diagnostic, fertility
treatment and quality of life. Hum Reprod 2014; 29 (Suppl. 1): i272.
Johansson M, Adolfsson A, Berg M, Francis J, Hogström L, Janson PO, Sogn J, Hellström AL. Gender perspective on quality of life, comparisons between groups 4–5.5 years after unsuccessful or successful IVF
treatment. Acta Obstet Gynecol Scand 2010; 89: 683–691.
Matthiesen SMS, Frederiksen Y, Ingerslev HJ, Zachariae R. Stress, distress and outcome of assisted reproductive technology (ART): A meta-analysis. Hum Reprod 2011; 26: 2763-2776.
RESULTS
Both men’s and women’s QoL increased during the course of ART
procedures (t = -3.38, p < .01 and t = -4.43, p < .001, respectively). No
significant differences regarding need of parenthood and marital
satisfaction between T1 and T2 were found.
The hypothesized model provided an adequate fit to the data (χ2 =
21.54; df = 21; χ2/df = 1.02; CFI = .96; RMSEA = .022), showing that
men’s QoL improvement was influenced by their own marital
satisfaction at T1 (β = .39; p < .05). Men with high marital satisfaction
at the beginning of ART treatment, therefore, displayed an increase of
QoL during the course of the treatment.
Finally, neither men’s need of parenthood and sexual concerns nor
their partner’s variables and control variables (female’s age and
duration of infertility) predicted men’s QoL variations.
MATERIALS AND METHODS
PARTICIPANTS
Both members of couples, whose men were the only cause of
infertility, were recruited at the ANDROS Clinic in Palermo (Italy).
Data were obtained from a group of 56 infertile men and their
partners (112 subjects), consecutively referred for IVF treatment
from February 2013 to December 2014. Mean age (±sd) was
32.98 (±4.53) and 35.55 (±4.77) for women and men,
respectively. Mean duration of primary infertility was 3.47 (±2.58)
years.
MEASURES
This longitudinal study comprises two repeated measurements: at
the beginning of the treatment (T1) and at the day of embryo
transfer (T2). Participants filled out the Fertility Quality of Life
Questionnaire (FertiQoL; Boivin et al., 2011a,b) the ENRICH
Marital Satisfaction (EMS) Scale, and two subscales of the
Fertility Problem Inventory (FPI-SEX: Sexual Concerns and FPI-
NEED: Need for Parenthood).
STATISTICAL ANALYSES
Descriptive statistics, independent sample t tests and Structural
Equation Modelling were used to analyze the data. Change in QoL
was analyzed by regressing QoL-T1 on QoL-T2.
T1 T2
t p
M sd M sd
QUALITY OF LIFE 82.50 13.77 86.35 10.65 -3.38 .001
NEED FOR PARENTHOOD 14.36 6.76 42.47 9.87 1.67 NS
SEXUAL CONCERNS 43.96 9.15 - - - -
MARITAL SATISFACTION 93.80 9.46 93.48 8.57 1.11 NS
QUALITY OF LIFE 79.29 12.98 83.76 12.01 -4.43 .000
NEED FOR PARENTHOOD 44.48 8.75 43.27 9.43 1.33 NS
SEXUAL CONCERNS 14.17 4.88 - - - -
MARITAL SATISFACTION 93.96 9.78 91.50 13.03 .27 NS
Note: Quality of Life = FertiQoL; Need for Parenthood = FPI-NEED; Sexual Concerns = FPI-
SEX; Marital Satisfaction = EMS; NS = not significant.
Contact: zairadn@gmail.com
-.17
.05
.12
-.13
.21
.05
-.16
.39
MALE SEXUAL CONCERNS
MALE NEED OF PARENTHOOD
MALE MARITAL SATISFACTION
YEARS OF INFERTILITY
FEMALE AGE
FEMALE SEXUAL CONCERNS
FEMALE NEED OF PARENTHOOD
FEMALE MARITAL SATISFACTION
MALE’S
IMPROVEMENT IN
QUALITY OF LIFE
Note: Significant standardized coefficients are presented in the diagram. Covariances’
coefficients are not shown in the diagram. No significant parameters are represented by
dashed lines.
BACKGROUND
Recent qualitative studies demonstrate that men’s involuntary childlessness is a major life crisis (Häcker et al., 2014). Confronting ART procedures
has been associated with high levels of chronic stress, associated with anxiety and psychological difficulties (e.g. Matthiesen et al., 2011). Infertile
men’s psychological conditions have a negative impact on their owns self-image, relational and psychological distress (e.g. Johansson et al., 2010)
and there is evidence that men’s psychological distress can predict low levels of QoL (Chachamovich et al., 2010). Moreover, previous studies have
suggested that infertility-related distress is a couples’ dyadic condition and partners’ effects were also studied (Donarelli et al., 2012). Quantitative
data on the influence of both partners’ couple relationship on men’s QoL during a ART treatment are lacking.
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