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Objective: To determine which factors relate to satisfaction with infertility treatment., Design: A prospective structured interview research design was used., Setting: In-person and telephone interviews were conducted., Participants: Wives and husbands from 185 couples in southeastern Michigan with primary infertility were studied., Main Outcome Measures: There were two main outcome measures: how satisfied people were with the infertility treatment they received and why they were satisfied., Results: Both men and women were satisfied with the infertility treatment they had received. The most frequently mentioned reasons for satisfaction were the technical skills and the emotional support of infertility specialists. Both men and women advised infertility specialists to be compassionate and share information with their patients. Spouses' satisfaction with treatment was the greatest predictor for both men and women. For men, using escape as a coping skill was a negative predictor for treatment satisfaction. For women, personal control and the number of infertility treatments received were other predictors for treatment satisfaction., Conclusions: As hypothesized, a variety of psychosocial factors were related to treatment satisfaction. Contrary to expectation, treatment costs and how long respondents had been trying to have a child were not related to treatment satisfaction. This study's results suggest that physicians and their staff should pay particular attention to their patients' emotional needs, to their patients' understanding of procedures explained to them, to discussing adoption with their patients, to involving men more in the infertility treatment, and to assisting women to have more control over their course of treatment.

Objective: To compare the dynamics of fertility-problem stress experienced by wives and husbands in infertile couples with the dynamics of stress from other sources experienced by members of couples presumed to be fertile., Design: Relationships of stress to four marriage factors and four aspects of life quality (subjective well-being) are examined within a causal modeling framework using data from structured interviews., Setting: Face-to-face interviews were conducted in study participants' homes., Participants: Wives and husbands from 157 couples with primary infertility and from 82 presumed-fertile couples were studied., Main Outcome Measures: Final outcome measures were four multi-item scales assessing life quality with regard to the marriage, own self-efficacy, own health and appearance, and life as a whole. Intervening outcome scales measured four marriage factors: marital conflict, sexual self-esteem, sexual dissatisfaction, and frequency of intercourse., Results and Conclusions: Higher levels of stress, regardless of whether that stress was from attempting to solve a fertility problem or another problem, were related to reduced marital functioning and decreased life quality. For husbands, the strengths of the linkages did not depend on the source of the stress. For wives, however, the causal model suggested that fertility-problem stress had stronger negative impacts on sense of sexual identity and self-efficacy than did stress from other problems (P less than 0.05). Stress from any source had more impact on the lives of wives than of husbands, more impact on satisfaction with self and general well-being than on satisfaction with the marriage or health, and affected life quality mostly indirectly through its impacts on the marriage factors.

Objective: To determine which psychosocial, treatment, and demographic factors relate to the amount of perceived stress that infertile women and men experience., Design: A cross-sectional, structured interview research design was used., Setting: In-person interviews were conducted in study participants' homes., Participants: Wives and husbands from 185 couples in Southeastern Michigan with primary infertility were studied., Main Outcome Measures: A nine-item rating scale of perceived stress associated with infertility was the outcome measure., Results: For both women and men, stress was significantly positively correlated with treatment costs and number of tests and treatments received; stress was significantly negatively correlated with confidence that one will have a child and perceived control. For women only, attitudes about infertility treatments, importance of children, attributions of responsibility to physicians, and social support also significantly related to perceived stress. For men only, income, number of physicians seen, and self attributions of responsibility also significantly related to perceived stress., Conclusions: As hypothesized, a variety of treatment characteristics and psychosocial factors were related to experienced stress. Contrary to expectation, demographic factors such as age and number of years married were not related to experienced stress. This study's results suggest that attempts by health care providers to increase patients' sense of control, optimism (within realistic limits), and social support should reduce stress.