A Dyadic Mediation Study on Social Support, Coping, and Stress Among Couples Starting Fertility Treatment

This study adopted a dyadic approach to explore the associations between social support and stress as mediated by coping among infertile couples. All these variables were infertility-specific. A total of 201 couples starting their first assisted reproductive technology (ART) treatment completed self-reports of infertility-specific support from spouse and from social network, infertility-related coping with four strategies (active-avoidance, active-confronting, passive-avoidance, and meaning-based), and infertility stress. The actor-partner interdependence model was applied. Results indicated that dyadic associations between support and stress were either direct or mediated by individual or partner coping, with differences based on gender, source of support, and coping strategy. For both genders, greater support from spouse was associated with lower individual and partner stress directly and indirectly, through lower partner's use of active-avoidance coping. In men, the relationship between support from spouse and stress was also mediated by individual/partner avoidance coping strategies. As for support from social network, greater levels were directly associated with a lower partner stress in women and with higher individual stress in men. For both genders, the relationship between support from social network and stress was also mediated by active-confronting coping, which was associated with higher individual and partner stress. The findings suggest a potential protective role of support from spouse and an adverse effect of that from people outside the dyad. Interventions for couples starting ART treatment should focus on promoting infertility-related communication and support within the couple, which might help to reduce the use of infertility-specific maladaptive coping strategies.