Transcript Couple satisfaction twelve years after conception via medical assistance

Couple satisfaction twelve years after conception via medical assistance
Jennifer Connor,
a
PhD ,
Martha A. Rueter,
b
PhD ,
Lauri
c
Pasch ,
Ascan F. Koerner,
d
PhD ,
Mark
e
Damario
a
Community Psychology, Counseling, and Family Therapy, St. Cloud State University, b Family Social Science, University of Minnesota,
c University of California, San Francisco, d Communication Studies, University of Minnesota, eObstetrics, Gynecology and Women’s Health, University of Minnesota
7
Background
Method
Author’s Name
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5.76
5.88
5.85
5.37
5.34
5.03
5
4.83
4
Relationship quality among couples during and following
infertility treatment is an important consideration given that
the couple hopes to raise children together. Some have
suggested that the increased stress couples endure during
infertility treatment can negatively affect the couple’s
relationship (Andrews, Abbey, & Halman, 1991; Gamiero,
Moura-Ramos, Canavarro, Santos, & Dattilio, 2009). Others
propose that couples who make it through treatment are more
resilient than the average couple (Drosdzol & Skrzypulec, 2009;
Repokari et al., 2007; Sydsjö, Wadsby, Kjellberg, & Sydsjö, 2002;
Sydsjö, Wadsby, Sydsjö, & Selling, 2008).
At the time of treatment, heterosexual couples with
diagnosed male infertility report lower couple satisfaction than
fertile couples (Drosdzol & Skrzypulec, 2009) and anticipate
lower relationship quality if they choose to utilize donor sperm
versus donor eggs (Eisenberg Smith, Millstein, Walsh, Breyer, &
Katz 2011). European studies undertaken after the birth of a
child report similar couple satisfaction across infertile couples
who conceived using donor insemination (DI), donor egg (DE),
and in-vitro fertilization (IVF; Blake, Casey, Javda, & Golombok,
2012; Golombok, 1995; Murray, MacCallum, & Golombok 2006;
Owen & Golombok, 2009). However, no studies of U.S. couples
have examined couple satisfaction following conception using
donor gametes.
Participants
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Study participants were recruited from a Midwestern U.S. university reproductive endocrinology clinic. Eligible participants had at least one child
conceived using IVF, ICSI, or IUI, born between 1998 and 2004 (M = 8.48 years, SD = 2.03, Min = 6.1, Max = 12.9). Of the eligible participants, 86%
were located, and n = 209 (82% response rate) agreed to study participation. The present study excluded couples who were single, divorced,
separated , or widowed, producing a final sample of n = 194. Participants were mostly heterosexual (96.4% heterosexual, 3.6% same-sex female
relationship) and mostly White (94.5%) with annual household incomes ranging from less than $10,000 to greater than $200,000 (median = $9099,000).
Procedures
This paper explores couple relationships six to twelve years
after successful conception, comparing those who used IVF
with own gametes, IVF with donor egg , and IVF or IUI with
donor sperm insemination.
Using university IRB approved procedures, letters were sent to eligible clinic patients introducing the study and asking a parent to complete an
online survey. The online survey included a consent form and demographic and marital satisfaction questionnaires. Letters were addressed to the
parent identified by the clinic as the patient, who was in all cases female; survey respondents were mostly female (98%). As compensation for
their time, participants received a $25 gift certificate.
Measures
Couple Satisfaction. Measured using the Huston Marital Opinion Questionnaire (Huston & Vangelisti, 1991). This measure consists of 11 semantic
differential-type items that being with “I would describe my relationships as…” and end with two opposing options scaled from 1 to 7. Responses
were reverse coded as necessary so that higher responses denoted greater couple satisfaction. Responses were summed and averaged (α = .96).
Child Donor Status. Donor status was coded as 1 for participants with at least one child conceived using donor egg, and/or donor sperm and 0 for
the participants whose children were conceived using the parents’ gametes.
Table 1. Descriptive Statistics for Study Covariates of Respondents
Nondonor
(n = 163)
Donor
(n = 30)
M(SE)
Range
M(SE)
Range
M(SE)
Range
Emotional
Disposition
Age at Birth
5.80 (.36)
0 - 36
5.73 (.39)
0 - 26
6.17 (1.03)
0 - 22
34.22 (.27)
25 - 44
33.78 (.27)
25 - 42
37.02 (.82)
27 - 44
Education
4.90 (.08)
2-7
4.92 (.09)
2-7
4.77 (.21)
2-6
Household
Income
9.96 (.17)
1 -13
10.09 (.18)
3 -13
9.23 (.53)
1 -13
All Sperm Donors
Same-Sex Sperm
Donor
Table 2. Statistics for Couple Satisfaction for the Full Sample and Donor and Nondonor Subgroups
Full Sample
N
194
Nondonor
163
All Donors
30
Egg Donor
12
18
7
Heterosexual Sperm
Donor
11
Couple Satisfaction
Mean (SE)
5.76 (.08)
5.85 (.09)ab
5.37 (.22)
5.88 (.25)
5.03 (.31)a
5.34 (.51)
4.83 (.40)ab
Range
2.35 – 7.00
2.35 – 7.00
3.20 – 7.00
3.80 – 7.00
3.20 – 7.00
3.40 – 6.85
3.20 – 7.00
aCouple
1
0
Couple Satisfaction
Full sample
Nondonor
Donor
Egg Donor
Sperm Donor
Same-Sex Sperm Donor
Hetersexual Sperm Donor
Full Sample
(n = 194)
Objective
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Satisfaction comparison across nondonor and sperm donor couples: F 1, 181) = 6.96, p = .01.
bCouple Satisfaction comparison across nondonor and heterosexual sperm donor couples: F(1, 173) = 5.60, p = .02.
Results
Few demographic differences were found across donor and
nondonor groups, with one exception (see Table 1). At the birth
of their oldest ART child, respondents who used donor gametes
were significantly older than nondonor respondents (Mnondonor =
33.78 years, Mdonor = 37.02 years, t = 3.76, p < .00). 94% of
couples remained together.
T-test comparisons across groups showed a statistically
significant difference in couple satisfaction (t = 2.21, p = .04).
General linear modeling showed that, after inclusion of study
covariates (see Table 1), couple satisfaction was not significantly
different across couples. The covariate respondent’s emotional
disposition was significantly associated with couple satisfaction.
F (1, 193)= 40.32, p = < .00, indicating respondents reporting
high levels of depressive or anxiety symptoms tended to feel
less satisfied with their partner.
Mean couple satisfaction by those who used donor egg and
donor sperm (see Table 2) showed egg donor respondents
reported couple satisfaction levels similar to those of
nondonors, but sperm donor respondents, F (1, 181) = 6.96, p =
.01, particularly heterosexual sperm donor respondents, F (1,
173) = 5.60, p = .02, reported significantly lower satisfaction
than nondonors. These findings account for the effect of all
covariates, of which significant associations occurred only for
emotional disposition (Nondonor vs. sperm donor: F (1, 181) =
31.35, p < .00, nondonor vs. heterosexual sperm donor: F (1,
181) = 27.57, p < .00).
Conclusions
Findings show the majority of couples remain together and
report high rates of relationship satisfaction. However, women
in heterosexual couples who used donor sperm are less
satisfied with their couple relationship than women who used
their husband’s sperm, even after accounting for the possible
biasing effect of emotional state. Future research should
investigate specific strains in these relationships.