Infertility treatment decisions require people to balance multiple priorities. Within couples, partners must also negotiate priorities with one another. In this study, we assessed the family-building priorities of couples prior to their first consultations with a reproductive specialist.
Participants were couples who had upcoming first consultations with a reproductive specialist (N = 59 couples (59 women; 59 men)). Prior to the consultation, couples separately completed the Family-Building Priorities Tool, which tasked them with ranking from least to most important 10 factors associated with family building. We describe the highest (top three) and lowest (bottom three) priorities, the alignment of priorities within couples, and test for differences in prioritization between men and women within couples (Wilcoxon signed rank test).
Maintaining a close and satisfying relationship with one’s partner was ranked as a high priority by majorities of men and women, and in 25% of couples, both partners ranked this factor as their most important priority for family building. Majorities of men and women also ranked building a family in a way that does not make infertility obvious to others as a low priority, and in 27% of couples, both partners ranked this factor as the least important priority for family building. There were also differences within couples that involved either men or women ranking a particular goal more highly than their partners. More women ranked two factors higher than did their partners: 1) that I become a parent one way or another (p = 0.015) and 2) that I have a child in the next year or two (p < 0.001), whereas more men ranked 4 factors higher than their partners: 1) that our child has [woman’s] genes (p = 0.025), 2) that our child has [man’s] genes (p < 0.001), 3) that I maintain a close relationship with my partner (p = 0.034), and 4) that I avoid side effects from treatment (p < 0.001).
Clinicians who support patients in assessing available family-building paths should be aware that: (1) patients balance multiple priorities as a part of, or beside, becoming a parent; and (2) patients and their partners may not be aligned in their prioritization of achieving parenthood. For infertility patients who are in relationships, clinicians should encourage the active participation of both partners as well as frank discussions about each partner’s priorities for building their family.
RESOLVE: The National Infertility Association. Insurance coverage in your state. http://www.resolve.org/family-building-options/insurance_coverage/state-coverage.html. Accessed 7 Sept 2016.
American Society for Reproductive Medicine. State infertility insurance laws. ReproductiveFacts.org. http://www.reproductivefacts.org/resources/state-infertility-insurance-laws. Accessed 7 Sept 2016.
Manser M, Brown M. Marriage and household decision-making: a bargaining analysis. Int Econ Rev. 1980;21(1):31–44. CrossRef
Becker GS. A theory of marriage: part I. J Polit Econ. 1973;81(4):813–46. CrossRef
Becker GS. A theory of marriage: part II. J Polit Econ. 1974;82(2):S11–26. CrossRef
Gottman J, Notarius C, Markman H, Bank S, Yoppi B, Rubin ME. Behavior exchange theory and marital decision making. J Pers Soc Psychol. 1976;34(1):14–23. CrossRef
Godwin DD, Scanzoni J. Couple consensus during marital joint decision-making: a context, process, outcome model. J Marriage Fam. 1989;51(4):943–56. CrossRef
Shornack LL. Exchange theory and the family. Int Soc Sci Rev. 1986;61(2):51–60.
Rank MR, LeCroy CW. Toward a multiple perspective in family theory and practice: the case of social exchange theory, symbolic interactionism, and conflict theory. Fam Relat. 1983;32(3):441–8. CrossRef
Hill W, Scanzoni J. An approach for assessing marital decision-making processes. J Marriage Fam. 1982;44(4):927–41. CrossRef
McDonald GW. Structural exchange and marital interaction. J Marriage Fam. 1981;43(4):825–39. CrossRef
Challiol H, Mignonac K. Relocation decision‐making and couple relationships: a quantitative and qualitative study of dual‐earner couples. J Organ Behav. 2005;26(3):247–74. CrossRef
Davis HL. Decision making within the household. J Consum Res. 1976;2(4):241–60. CrossRef
Kulczycki A. Husband-wife agreement, power relations and contraceptive use in Turkey. Int Fam Plan Perspec. 2008;34(3):127–37. CrossRef
Langdridge D, Connolly K, Sheeran P. Reasons for wanting a child: a network analytic study. J Reprod Infant Psychol. 2000;18(4):321–38. CrossRef
Langdridge D, Sheeran P, Connolly K. Understanding the reasons for parenthood. J Reprod Infant Psychol. 2005;23(2):121–33. CrossRef
Cassidy T, Sintrovani P. Motives for parenthood, psychosocial factors and health in women undergoing IVF. J Reprod Infant Psychol. 2008;26(1):4–17. CrossRef
Ford M. Navigating the Land of IF. Berkeley: Seal Press; 2009.
Willis GB. Cognitive interviewing. Thousand Oaks: SAGE Publications; 2004.
Cella D, Riley W, Stone A, Rothrock N, Reeve B, Yount S, Amtmann D, Bode R, Buysse D, Choi S, Cook K, Devellis R, Dewalt D, Fries JF, Gershon R, Hahn EA, Lai JS, Pilkonis P, Revicki D, Rose M, Weinfurt K, Hays R. The patient-reported outcomes measurement information system (PROMIS) developed and tested its first wave of adult self-reported health outcome item banks: 2005–2008. J Clin Epidemiol. 2010;63(11):1179–94. CrossRefPubMedPubMedCentral
HealthMeasures.net. PROMIS: Interpret Scores. http://www.healthmeasures.net/score-and-interpret/interpret-scores/promis. Accessed 8 Mar 2017.
Pfeifer S, Butts S, Fossum G, Gracia C, La Barbera A, Mersereau J, Odem R, Paulson R, Penzias A, Pisarska M, Rebar R, Reindollar R, Rosen M, Sandlow J, Vernon M. Optimizing natural fertility: a committee opinion. Fertil Steril. 2017;107(1):52–8. CrossRef
- Priorities for family building among patients and partners seeking treatment for infertility
Elizabeth A. Duthie
Joseph B. Davis
Katherine D. Schoyer
Kathryn E. Flynn
- BioMed Central
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