Gender differences in experiences with and adjustments to infertility: A literature review

Background: It has been widely recognized that infertility and its treatment affects a couple as a dyad. Given biomedical differences and differences in socialization processes and gender-role expectations, it is reasonable to suspect that females and males may experience and respond to infertility in different ways. Objective: To explore gender differences among infertile couples with regard to experiences with and adjustments to infertility. Design: A literature review. Data sources: A literature search was performed using the following databases: PubMed, CINAHL, PsycInfo, Web of Science, Scopus, and the China Academic Journal Full-text Database. Review methods: The studies that were included were those published in English or Chinese from the years 2000 to 2014. The references of all of the studies selected for this review were also searched. An author search was also performed to retrieve relevant articles. Experiences with and adjustments to infertility were explored from the perspective of gender. Results: A total of 33 studies were included in this review. The experiences with infertility can be grouped under the five domains of the biopsychosocial theory, namely: existential stressors, physical stressors, emotional stressors, interpersonal stressors, and the moderators of stress. In general, females had more negative experiences with infertility than men in most of the domains, including lower levels of identity, self-esteem, and physical health; and higher levels of depression, stress, anxiety, stigma, and shame. Infertile couples experienced stress in their married life, although there were no gender differences in the areas of marital adjustment, marital satisfaction, and sexual satisfaction. Females were likely to perceive themselves as being less confident than their partners in coping with infertility. For both men and women, partner support was found to be negatively related to stress due to infertility. Conclusions: This review revealed that while there were gender differences in the experience with infertility in many realms, both men and women were subject to a stressful married life. Partner support was an important element of coping with infertility. Therefore, a supportive intervention, focusing on enhancing a sense of partnership among infertile couples is a way of helping them to cope. (C) 2015 Elsevier Ltd. All rights reserved.