Positive and negative adjustment in couples undergoing infertility treatment: The impact of support exchange

Background: Perceived social support relates to infertility-related distress in couples undergoing assisted reproductive technology (ART) treatment. Studies examining the effect of other support types on both positive and negative adjustment among infertile couples are scarce or non-existent. Therefore, this study investigated the effects of support receipt, provision, invisibility (the discrepancy between one partner’s received and the other partner’s provided support), and equity (the discrepancy between each partner’s received and provided support) on the positive (life purpose) and negative (depressive symptoms) indices of well-being in couples undergoing ART treatment. Methods: Depressive symptoms (CES-D), life purpose (PIL), and social support (BSSS) were assessed among 31 married couples (mean age 32.67 years) undergoing ART treatment. Data were analyzed by applying the Actor-Partner-Interdependence Model (APIM) using multilevel modeling. Findings: Both receiving and providing support had beneficial effects in women and men. However, sub-analysis showed differences according to gender and the support exchange effects. Women reported higher depression and lower life purpose but benefited more from support, and their well-being was more dependent on their own perception of support provision and receipt. Men demonstrated higher adjustment to infertility but benefited less from support, and their well-being was mostly correlated with supportive behaviors of their wives. Discussion: Adjustment mechanisms of women and men undergoing ART treatment vary considerably; thus, gender should be taken into consideration in interventions. Future studies should focus on costs/benefits and gender differences of visible and invisible support in infertility settings.