Skip to main content

Advertisement

SpringerLink
Log in

The Infertility Resilience Model: Assessing Individual, Couple, and External Predictive Factors

  • Original Paper
  • Published:
Contemporary Family Therapy Aims and scope Submit manuscript

Abstract

Resilience in couples experiencing infertility is critical to decrease the impact of infertility-related stress and sustain positive interactions and collective perceptions in couples. The Infertility Resilience Model (IRM) presented in this article provides a framework within which various individual, couple, and external factors that influence resilience can be understood. Although numerous approaches have been applied to infertility, few of them have examined resilience and the interconnections between individual, couple, and external influences. The concepts and connections within the model can be used by clinicians for assessment and interventions when working with couples facing infertility.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  • Amir, M., Horesh, N., & Lin-Stein, T. (1999). Infertility and adjustment in women: The effects of attachment style and social support. Journal of Clinical Psychology in Medical Settings, 6, 463. doi:10.1023/A:1026280017092.

    Article  Google Scholar 

  • Andrews, F. M., Abbey, A., & Halman, L. J. (1991). Stress from infertility, marriage factors, and subjective well-being of wives and husbands. Journal of Health and Social Behavior, 32(3), 238–253. doi:10.2307/2136806.

    Article  PubMed  Google Scholar 

  • Austenfeld, J. L., & Stanton, A. L. (2004). Coping through emotional approach: A new look at emotion, coping, and health-related outcomes. Journal of Personality, 72, 1335–1363. doi:10.1111/j.1467-6494.2004.00299.x.

    Article  PubMed  Google Scholar 

  • Becker, G. (1994). Metaphors in disrupted lives: Infertility and cultural constructions of continuity. Medical Anthropology Quarterly, 8(4), 383–410. doi:10.1525/maq.1994.8.4.02a00040.

    Article  Google Scholar 

  • Becker, G., Castrillo, M., Jackson, R., & Nachtigall, R. D. (2006). Infertility among low-income Latinos. Fertility and Sterility, 85, 882–887. doi:10.1016/j.fertnstert.2005.09.052.

    Article  PubMed  Google Scholar 

  • Benazon, N., Wright, J., & Sabourin, S. (1992). Stress, sexual satisfaction, and marital adjustment in infertile couples. Journal of Sex & Marital Therapy, 18(4), 273–284.

    Google Scholar 

  • Benyamini, Y., Gozlan, M., & Kokia, E. (2004). On the self-regulation of a health threat: Cognitions, coping, and emotions among women undergoing treatment for infertility. Cognitive Therapy and Research, 28(5), 577–592. doi:10.1023/B:COTR.0000045566.97966.22.

    Article  Google Scholar 

  • Berghuis, J. P., & Stanton, A. L. (2002). Adjustment to a dyadic stressor: A longitudinal study of coping and depressive symptoms in infertile couples over an insemination attempt. Journal of Consulting and Clinical Psychology, 70(2), 433–438. doi:10.1037/0022-006X.70.2.433.

    Article  PubMed  Google Scholar 

  • Boss, P. (2007). Loss, trauma, and resilience: Therapeutic work with ambiguous loss. New York: W·W. Norton.

    Google Scholar 

  • Brothers, S. C., & Maddux, J. E. (2003). The goal of biological parenthood and emotional distress from infertility: Linking parenthood to happiness. Journal of Applied Social Psychology, 33(2), 248–262. doi:10.1111/j.1559-1816.2003.tb01895.x.

    Article  Google Scholar 

  • Burns, L. H. (1987). Infertility as boundary ambiguity: One theoretical perspective. Family Process, 26, 359–372. doi:10.1111/j.1545-5300.1987.00359.x.

    Article  PubMed  Google Scholar 

  • Crosbie-Burnett, M., & Lewis, E. A. (1993). Use of African-American family structures and functioning to address the challenges of European-American postdivorce families. Family Relations, 42, 243–248. doi:10.2307/585552.

    Article  Google Scholar 

  • Day, R. D. (2005). Relationship stress in couples: Situations involving infidelity, infertility, and imprisonment. In P. C. McKenry & S. J. Price (Eds.), Families and change: Coping with stressful events and transitions (3rd ed., pp. 333–354). Thousand Oaks, CA: Sage.

    Google Scholar 

  • Diamond, R., Kezur, D., Meyers, M., Scharf, C. N., & Weinshel, M. (1999). Couple therapy for infertility (M. P. Nichols, Ed.). New York: The Guilford Press.

  • Domar, A. D., Clapp, D., & Slawsby, E. (2000). The impact of group psychological interventions on distress in infertile women. Health Psychology, 19(6), 568–575. doi:10.1037/0278-6133.19.6.568.

    Article  PubMed  Google Scholar 

  • Ferber, G. M. (1995). An empathy-supporting approach to the treatment of infertile women. Psychotherapy (Chicago, Ill.), 32(3), 437–442. doi:10.1037/0033-3204.32.3.437.

    Google Scholar 

  • Gerrity, D. A. (2001). A biopsychosocial theory of infertility. The Family Journal (Alexandria, Va.), 9(2), 151–158. doi:10.1177/1066480701092009.

    Article  Google Scholar 

  • Gibson, D. M., & Myers, J. E. (2000). Gender and infertility: A relational approach to counseling women. Journal of Counseling and Development, 78, 400–410.

    Google Scholar 

  • Greenbaum, M. (2005). Integrated reproductive healthcare: An object relational model for treatment and collaboration (Doctoral dissertation, Chicago School of Professional Psychology, 2004). Dissertation Abstracts International, 66(5-B), 2820–2887.

  • Greil, A. L. (1997). Infertility and psychological distress: A critical review of the literature. Social Science & Medicine, 45, 1679–1704. doi:10.1016/S0277-9536(97)00102-0.

    Article  Google Scholar 

  • Greil, A. L., Leitko, T. A., & Porter, K. L. (1988). Infertility: His and hers. Gender & Society, 2(2), 172–199. doi:10.1177/089124388002002004.

    Article  Google Scholar 

  • Hart, V. A. (2002). Infertility and the role of psychotherapy. Issues in Mental Health Nursing, 23(1), 31–41. doi:10.1080/01612840252825464.

    Article  PubMed  Google Scholar 

  • Higgins, E. T. (1987). Self-discrepancy: A theory relating self and affect. Psychological Review, 3, 319–340. doi:10.1037/0033-295X.94.3.319.

    Article  Google Scholar 

  • Higgins, B. S. (1990). Couple infertility: From the perspective of the close-relationship model. Family Relations, 39, 81–86. doi:10.2307/584953.

    Article  Google Scholar 

  • Hynie, M., & Burns, L. H. (2006). Cross-cultural issues in infertility counseling. In S. N. Covington & L. H. Burns (Eds.), Infertility counseling: A comprehensive handbook for clinicians (2nd ed., pp. 61–82). New York: Cambridge University Press.

    Google Scholar 

  • Jain, T. (2006). Socioeconomic and racial disparities among infertility patients seeking care. Fertility and Sterility, 85, 876–881. doi:10.1016/j.fertnstert.2005.07.1338.

    Article  PubMed  Google Scholar 

  • Jennings, S. E. (Ed.). (1995). Infertility counseling. Oxford: Blackwell Science Ltd.

    Google Scholar 

  • Jordan, C., & Revenson, T. A. (1999). Gender differences in coping with infertility: A meta-analysis. Journal of Behavioral Medicine, 22(4), 341–358. doi:10.1023/A:1018774019232.

    Article  PubMed  Google Scholar 

  • Kikendall, K. A. (1994). Self-discrepancy as an important factor in addressing women’s emotional reactions to infertility. Professional Psychology, Research and Practice, 25(3), 214–220. doi:10.1037/0735-7028.25.3.214.

    Article  Google Scholar 

  • Maillet, M. H. (2003). Infertility and marital adjustment; the influence of perception of social support, privacy preference and level of depression (Doctoral dissertation, Louisiana State University, 2002). Dissertation Abstracts International, 63(11-A), 4093.

  • McCubbin, H. I., & Patterson, J. M. (1982). Family adaptation to crisis. In H. I. McCubbin, A. E. Cauble, & J. M. Patterson (Eds.), Family stress, coping, and social support (pp. 26–47). Springfield, IL: Charles C. Thomas.

    Google Scholar 

  • McDaniel, S. H., Hepworth, J., & Doherty, W. (1992). Medical family therapy with couples facing infertility. The American Journal of Family Therapy, 20(2), 101–122. doi:10.1080/01926189208250882.

    Article  Google Scholar 

  • Meyer, D. F. (2005). Thawing out the unconscious: The use of countertransference in infertility counseling. Psychology of Women Quarterly, 29(4), 446–447. doi:10.1111/j.1471-6402.2005.00245_1.x.

    Article  Google Scholar 

  • Meyers, M., Diamond, R., Kezur, D., Scharf, C., Weinshel, M., & Rait, D. S. (1995a). An infertility primer for family therapists: I. Medical, social, and psychological dimensions. Family Process, 34, 219–229. doi:10.1111/j.1545-5300.1995.00219.x.

    Article  PubMed  Google Scholar 

  • Meyers, M., Weinshel, M., Scharf, C., Kezur, D., Diamond, R., & Rait, D. S. (1995b). An infertility primer for family therapists: II. Working with couples who struggle with infertility. Family Process, 34, 231–240. doi:10.1111/j.1545-5300.1995.00231.x.

    Article  PubMed  Google Scholar 

  • Mintle, L. M. (1995). The association between perceived family support and psychological well-being in infertile couples (Doctoral Dissertation, Old Dominion University, 1996). Dissertation Abstracts International, 56(8-B), 4235–4373.

  • Molock, S. D. (1999). Racial, cultural, and religious issues in infertility counseling. In L. H. Burns & S. N. Covington (Eds.), Infertility counseling: A comprehensive handbook for clinicians (pp. 249–265). New York: The Parthenon Publishing Group.

    Google Scholar 

  • Myers, L. B., & Wark, L. (1996). Psychotherapy for infertility: A cognitive-behavioral approach for couples. The American Journal of Family Therapy, 24(1), 9–20. doi:10.1080/01926189508251012.

    Article  Google Scholar 

  • Nachtigall, R. D., Becker, G., & Wozny, M. (1992). The effects of gender-specific diagnosis on men’s and women’s response to infertility. Fertility and Sterility, 57, 113–121.

    PubMed  Google Scholar 

  • Pasch, L. A., & Christensen, A. (2000). Couples facing fertility problems. In K. B. Schmaling & T. G. Sher (Eds.), The psychology of couples and illness: Theory, research, & practice (pp. 241–267). Washington DC: American Psychological Association.

    Chapter  Google Scholar 

  • Patterson, J. M. (2002). Integrating family resilience and family stress theory. Journal of Marriage and the Family, 64, 349–360. doi:10.1111/j.1741-3737.2002.00349.x.

    Article  Google Scholar 

  • Patterson, J. M., & Garwick, A. W. (1994). Levels of meaning in family stress theory. Family Process, 33, 287–304. doi:10.1111/j.1545-5300.1994.00287.x.

    Article  PubMed  Google Scholar 

  • Peterson, B. D., Feingold, T., & Gold, L. (2007a). The experience and influence of infertility: Considerations for mental health counselors. The Family Journal (Alexandria, Va.), 15, 251–257. doi:10.1177/1066480707301365.

    Article  Google Scholar 

  • Peterson, B. D., Newton, C. R., & Feingold, T. (2007b). Anxiety and sexual stress in men and women undergoing infertility treatment. Fertility and Sterility, 88, 911–914. doi:10.1016/j.fertnstert.2006.12.023.

    Article  PubMed  Google Scholar 

  • Peterson, B. D., Newton, C. R., & Rosen, K. H. (2003). Examining congruence between partners’ perceived infertility-related stress and its relationship to marital adjustment and depression in infertile couples. Family Process, 42(1), 59–70. doi:10.1111/j.1545-5300.2003.00059.x.

    Article  PubMed  Google Scholar 

  • Peterson, B. D., Newton, C. R., Rosen, K. H., & Schulman, R. S. (2006a). Coping processes of couples experiencing infertility. Family Relations: Interdisciplinary Journal of Applied Family Studies, 55(2), 227–239.

    Google Scholar 

  • Peterson, B. D., Newton, C. R., Rosen, K. H., & Skaggs, G. E. (2006b). Gender differences in how men and women referred with in vitro fertilization cope with infertility stress. Human Reproduction (Oxford, England), 21, 2443–2449. doi:10.1093/humrep/del145.

    Article  Google Scholar 

  • Peterson, B. D., Pirritano, M., Christensen, U., & Schmidt, L. (2008). The impact of partner coping in couples experiencing infertility. Human Reproduction (Oxford, England), 23, 1128–1137. doi:10.1093/humrep/den067.

    Article  Google Scholar 

  • Petok, W. D. (2006). The psychology of gender-specific infertility diagnosis. In S. N. Covington & L. H. Burns (Eds.), Infertility counseling: A comprehensive handbook for clinicians (2nd ed., pp. 37–60). New York: Cambridge University Press.

    Google Scholar 

  • Phipps, S. A. A. (1998). African-American couples’ lived experience of infertility. In H. I. McCubbin, E. A. Thompson, A. I. Thompson, & J. O. Futrell (Eds.), Resiliency in African-American families (pp. 245–258). Thousand Oaks, CA: Sage.

    Google Scholar 

  • Revenson, T. A., Schiaffino, K. M., Majerovitz, S. D., & Gibofsky, A. (1991). Social support as a double-edged sword: The relation of positive and problematic support to depression among rheumatoid arthritis patients. Social Science & Medicine, 33(7), 807–813. doi:10.1016/0277-9536(91)90385-P.

    Article  Google Scholar 

  • Schneider, M. G., & Forthofer, M. S. (2005). Associations of psychosocial factors with the stress of infertility treatment. Health & Social Work, 30(3), 183–191.

    Google Scholar 

  • Smith, J. A., & Smith, A. H. (2004). Treating faith-based infertile couples using cognitive-behavioral counseling strategies: A preliminary investigation. Counseling and Values, 49(1), 48–63.

    Google Scholar 

  • Spector, A. R. (2004). Psychological issues and interventions with infertile patients. Women & Therapy, 27(3–4), 91–105. doi:10.1300/J015v27n03_07.

    Article  Google Scholar 

  • Stammer, H., Wischmann, T., & Verres, R. (2002). Counseling and couple therapy for infertile couples. Family Process, 41(1), 111–122. doi:10.1111/j.1545-5300.2002.40102000111.x.

    Article  PubMed  Google Scholar 

  • Stanton, A., Tennen, H., Affleck, G., & Mendola, R. (1991). Cognitive appraisal and adjustment to infertility. Women & Health, 17, 1–15. doi:10.1300/J013v17n03_01.

    Article  Google Scholar 

  • Strauss, B. (Ed.). (2002). Involuntary childlessness: Psychological assessment, counseling, and psychotherapy. Seattle: Hogrefe & Huber Publishers.

    Google Scholar 

  • Walsh, F. (2002). A family resilience framework: Innovative practice applications. Family Relations, 51(2), 130–137. doi:10.1111/j.1741-3729.2002.00130.x.

    Article  Google Scholar 

  • Watkins, K. J., & Baldo, T. D. (2004). The infertility experience: Biopsychosocial effects and suggestions for counselors. Journal of Counseling and Development, 82(4), 394–420.

    Google Scholar 

  • Zucker, A. N. (1999). The psychological impact of reproductive difficulties on women’s lives. Sex Roles, 40(9/10), 767–786.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Brigham Young University, 722 Wymount Terrace, Provo, UT, 84604, USA

    Aaron F. Ridenour

  2. School of Family Life, Brigham Young University, 2079 JFSB, Provo, UT, 84602, USA

    Jeremy B. Yorgason

  3. Department of Psychology, Marriage and Family Therapy Program, Chapman University, One University Drive, Orange, CA, 92866, USA

    Brennan Peterson

Authors
  1. Aaron F. Ridenour
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jeremy B. Yorgason
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Brennan Peterson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Aaron F. Ridenour.

Appendix A

Appendix A

Sample assessment questionnaire based on the infertility resilience model

External influences:

1. Who do you talk to about your desire for a child and your treatment, and how does it help you?a

2. Do you feel under pressure when friends and acquaintances become pregnant?a

3. If you chose not to have children, how do you imagine it will affect your relationship with your family and friends?b

4. Sometimes infertility can lead a spouse to feel conflicting or torn loyalties between family-of-origin members and one’s spouse. How have your relationships with family-of-origin members changed or stayed the same since you have experienced infertility?d

5. Do you feel that becoming a parent represents a certain status within our society?d

Individualistic perceptions, interpretations, and coping strategies:

1. What have you done to help yourself handle the situation better?a

2. Is having a child a means of attaining status in your families and in society?b

3. Is it wise to make a decision if your partner still has reservations?b

4. How does each of you imagine your individual lives will be different if you had children?b

5. Are there times you still think about the infertility?b

6. What worries do each of you have about sharing your feelings about the infertility?b

7. Do you feel personally responsible for the infertility?d

8. Do you feel that having a child gives meaning to your life? Do you feel that having a child is a responsibility that you must fulfill?d

9. Does childbearing represent a crucial goal in your life?d

Collective interactions:

1. Has anything changed sexually with your partner since you have wanted a child?a

2. In what areas do you support each other and what do you still wish for in your relationship?a

3. When was the last time the two of you discussed the infertility?b

4. How do you see your relationship if you were unable to have children?c

5. How has the closeness between you and your spouse changed during this experience?d

Congruent couple perceptions:

1. Which of you feels more strongly about having children? How long are you willing to keep trying?b

2. Who is more eager to repeat the next procedure, you or your doctor?b

3. Who is more worried about putting your savings at risk?b

4. Which one of you is more inclined to speak about it with the other?b

5. Who is more interested in a life without children?b

6. If I asked your spouse what first attracted him to you, what do you think he would say?c

7. What has been the most difficult part of infertility for your spouse?d

8. Are you more concerned about your spouse’s well-being in response to infertility than your own?d

9. Do you feel that your spouse understands how you feel about the infertility? Do you understand how your spouse feels about the infertility?d

  1. aDenotes references taken from Strauss (2002, pp. 109, 131–133)
  2. bDenotes references taken from Diamond et al. (1999, pp. 64–65, 68, 89–90, 125, 130, 153, 183, and 205)
  3. cDenotes questions taken from Jennings (1995, p. 106)
  4. dDenotes questions developed by the authors of the current paper

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ridenour, A.F., Yorgason, J.B. & Peterson, B. The Infertility Resilience Model: Assessing Individual, Couple, and External Predictive Factors. Contemp Fam Ther 31, 34–51 (2009). https://doi.org/10.1007/s10591-008-9077-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10591-008-9077-z

Keywords

Search

Navigation