Stressful events and coping with infertility: factors determining pregnancy outcome among IVF couples in Jamaica

Objective: The goal of this study was to investigate infertility-coping patterns and pregnancy outcome among IVF participants who face stressful life events in addition to their infertility. Background: Many studies on stress and IVF-assisted pregnancy focus specifically on infertility-related stress without considering the role of other stressful events. Additionally, these studies seldom include the mediating influence of coping patterns. Methods: In a retrospective study, we reviewed the clinical records of 430 men and women who attended the sole fertility centre in Jamaica over a 10-year period. Using cross-sectional analyses, we examined exposure to past significant losses (death, intimate relationship, income) and current stressors (health, work, financial, personal relationships), as well as different coping patterns that emerged (problem-focused, emotion-focused, congruence between partner) with pregnancy outcome. Results: Univariate analyses and logistic regression revealed that participants exposed to multiple stressors were not at increased risk for a negative pregnancy outcome, but women who used problem-focused strategies to cope with their infertility were more likely to become pregnant than those who used emotion-focused strategies. Regardless of coping strategies, however, age was the only independent predictor of pregnancy outcome. Conclusions: Determinants of pregnancy outcome are identified, and the experience of general stress for IVF couples is discussed within the context of a developing country. Areas of future research are highlighted along with implications for psychosocial interventions.