The role of self-stigmatization and marital adjustment in the effect of infertility-related stress on mental health in married couples

Infertility is defined as the inability to achieve pregnancy after at least 12 months of unprotected sexual intercourse and is a disease of the male or female reproductive system. When the prevalence of infertility is examined, it is understood to be an increasingly common public health issue. The evaluation, diagnosis, and treatment processes of infertility have an impact on couples from a biopsychosocial perspective. The aim of this study is to examine the relationship between infertility and mental health in couples undergoing infertility treatment, and the mediating role of infertility stress, stigma, and marital adjustment in this relationship. For this purpose, data was collected from individuals with infertility and their partners. Participants were 132 married couples who applied to a university hospital for treatment with assisted reproductive techniques. The research utilized data collection tools such as the 'Fertility Problem Inventory,' 'Infertility Stress Coping Scale,' 'Infertility Stigma Scale,' 'Couple Adjustment Scale,' and the 'Depression Anxiety Stress Scale,' along with a 'Sociodemographic Information and Infertility Status Inquiry Form.' The findings of the study show that the infertility stress of both the person with infertility and their partner is positively related to their own mental health issues. Regarding this relationship, the Actor-Partner Interdependence Model (APKM) test revealed that only the actor effect was significant, with no general partner effect. In the A-APKM test, it was found that the self-stigma of the person with infertility, social stigma, and their coping styles with infertility stress play a mediating role in the relationship between their infertility stress and mental health problems, while marital adjustment did not mediate this relationship. According to the results, none of these variables had a mediating effect in the relationship between the infertility stress and mental health problems of the partner of the person with infertility. Additionally, the passive coping style of the person with infertility and the active coping style of their partner were found to have a mediating role in the relationship between their infertility stress and mental health problems. The findings support previous studies on the psychosocial aspects of infertility, showing that the stigma and coping styles of the person with infertility affect the relationship between their infertility stress and mental health issues. Moreover, the coping styles of one partner in infertile couples affect the relationship between the other partner's infertility stress and mental health problems. In conclusion, the study highlights the importance of addressing infertility stress from individual, relational, and social perspectives and examining the relationship with mental health issues in terms of actor and partner dynamics, depending on the source of infertility. Based on the findings, recommendations are made for both future researchers and clinical psychology practices.