Infertility Stress, Cortisol, Coping, and Quality of Life in U.S. Women Who Undergo Infertility Treatments.

Objective: To examine relationships between infertility-related stress (IRS), coping, and quality of life (QOL) in U.S. women who undergo infertility treatments and to examine relationships among hair cortisol, IRS, coping, and QOL in a small subsample.

Design: Descriptive correlational cross-sectional survey.

Setting: Infertility-related Facebook support groups and Web pages.

Participants: A total of 230 U.S. women between 18 and 55 years old who underwent infertility treatments. We collected root hair samples for cortisol analysis from a subsample of 37 participants.

Methods: Participants completed the Copenhagen Multi-centre Psychosocial Infertility Fertility Problem Stress Scales (Personal, Marital, and Social), Copenhagen Multi-centre Psychosocial Infertility Coping Strategies Scales (Active-Avoidance, Passive-Avoidance, Active-Confronting, and Meaning-Based), Fertility Quality of Life scales (Emotional, Mind/Body, Relational, Social, and total QOL), and a demographic and supplemental infertility questionnaire. We used descriptive statistics, correlation, and hierarchic regression for data analysis. We mailed subsample participants instructions and materials to supply a 3-cm hair sample for cortisol analysis by an independent laboratory and a stamped envelope to return the materials.

Results: Higher stress scores were associated with more active-avoidance coping, less meaning-based coping, and lower QOL. Coping explained 40% of the variance in QOL. After controlling for coping strategies, stress explained another 20% of the variance in QOL. Hair cortisol levels for most participants were low and negatively correlated to stress, especially marital stress, and positively correlated to QOL.

Conclusion: Women with infertility with high levels of IRS tended to use active-avoidance coping and had lower QOL. Hypocortisolism was prevalent in the subsample and warrants further exploration.