The aim of this study was to recognize the interrelationships of the coping strategies and women’s psychological symptoms indices in couples who were under treatment of fertility assistance methods. Based on this, the relationship between the using of couples’ coping strategies and relationship between the using of couples’ coping strategies with women’s stress, anxiety and depression levels has been evaluated. The results showed that the couples’ coping strategies are interacted and the women’s stress, anxiety and depression levels of the women are raised by the using of the self-focused rumination and other blame strategies. These results suggest that the psychological symptoms in women are affected by interactions between couples’ coping strategies toward infertility.
The findings indicated that women use maladaptive coping strategies more than men. They also suffer from stress, anxiety and depression more than men. Women are under the pressure of society for infertility more than men [16–18]. And it can reduce their ability in controlling the conditions. It can be effective for their using of coping strategies, too.
The results showed an interrelation of coping strategies in the infertile couples with each other. The results of the research showed that men’s using of SB strategy was in a circular relationship with women’s using of OB and MD strategies. So that the men’s using of SB strategy depended on women’s using of OB strategy and the women whose husbands use SB strategy, OB more. Also, avoidance reactions of women were accompanied by more use of blame strategy by men and women’s using of this strategy depended on using SB strategy level by men.
This relation shows that women’s addressees for blaming the others are their husbands and the men facing this strategy and avoidance strategy assign the infertility problems to themselves and blame themselves more. This finding as well as the others’ findings representing dependence of women’s using level of SR strategy on men’s using of SB strategy, showed the importance of bilateral relationships between infertile couples in using adaptive coping strategies.
Despite the self-blame strategy which men and women use maladaptive strategies against; another finding shows that using EE coping strategy by the couples has interrelationship with each other. This finding, as one of the couples shares his/ her feelings about infertility, shows the other will present his/ her feelings. Moderating role of the couples’ relationship quality with each other has been known in expressing bilateral feelings [11] and this research shows that expressing feelings by the women makes the men share their own feelings more and use the maladaptive strategies less like other blame ones, too.
The negative psychological symptoms of women after use of SR strategy may be accompanied by men’s use of the same strategy and so that; the men attempt to take his thoughts away from infertility by using the strategy of GR strategy and avoidance.
Another finding showed that some types of coping strategies are determinant factors for stress, anxiety and depression changes in women. So that the results showed that negative psychological symptoms in women were increased by using the coping strategies of SR and OB. This finding is also the same as Kraaij et al report who showed using this strategy is accompanied by increasing depression level and anxiety [19]. Another study has also shown that using maladaptive coping strategies is accompanied by destroying the psychological health of infertile couples [20].
The inverse relation of women’s using of GR strategy with negative psychological symptoms and positive relation of men’s using of MD strategy with their anxiety level are the other findings of this research. These results are in direction of the other researches reports which have shown the positive effects of using this strategy in faced with the crisis in men and women [21, 22]. Also, the inverse effects of using avoidance strategies on psychological health of infertile couples have already been reported [12, 23], but despite these reports, in the present research there was no significant relationship between women’s using of avoidance strategy and their psychological health indices. However, there are also some studies which show that using the avoidance strategy will balance psychological reactions in the infertile couples [12, 24]. Anyway, it must be considered that the study target population was the couples under fertile assistance treatment and their entering into treatment process requires attempting for resolving infertility problems and persons, who often use the avoidance coping strategy, may try to treat the infertility less.
Although in this research, direct relationship between psychological health conditions and couples’ coping strategies hasn’t been observed, the interaction between the couples’ coping strategies may mediate the effect of the men’s coping strategies on their partner’s psychological health. These results consolidate the importance of increasing the skill for using coping strategies in the infertile couples.
Although this study has shown interrelationships between the couples’ coping strategies, its results must interpret according to the research limitations. The first research limitation was its cross sectional nature. Since in this research, the psychological conditions and quality of marital relationships and personal features which can impress their coping strategy need to be studied in future. Also, the figure process has effect on couples’ relationships, concluding from the research findings are accompanied by limitation. Therefore, because the study has been done on infertile couples under fertility assistance treatment, generalizing the results to the infertile couples who aren’t under fertility assistance treatments will be limited.