For many couples having a child is an integral part of their vision for their lives. When that vision is challenged by infertility, the damage to these couples marriage can be irreparable, according to new research.
A study of 47,500 Danish women found that those who don't have a child after treatment are three times more likely to divorce or end cohabitation with their partner than those who do.
"Our findings suggest that not having a child after fertility treatment may adversely affect the duration of a relationship for couples with fertility issues," said Dr. Trille Kjaer, of the Danish Cancer Society Research Center and the study's lead author, in a release.The researchers harnessed demographic and socioeconomic data from population-based registries which tracked women who had been referred to public hospitals or private fertility clinics. They also sourced relationship data on both marriage and cohabitation from a national database. They excluded partner-less women who visited fertility centers.
They traced women's fertility and cohabitation status from the first year of initial fertility evaluations, which began between 1990 and 2006 through 2007. The average study subject was followed for about seven years and averaged 32 years old at the onset of the evaluation.
Researchers found that more than one-quarter of the women, 26.7 percent, were either divorced or living alone by the last follow-up, as much as 12 years later. About one-third of these couples had not had any children.
"We already knew that having fertility problems is very stressful for couples but I was surprised that the effect lasted so long," Kjaer said in an email.
Kjaer stressed that researchers could not draw any conclusions about the quality of the relationship of the women who stayed with their partners because the study was based on registry data and not questionnaires.
"Further investigations that account for marital quality and relational wellbeing of couples with fertility problems are now needed," she said.
Previous research also conducted within a Danish sample has shown some conflicting results, namely that infertility problems can sometimes bring couples closer together "through a perception of joint hardship."
Brennan Peterson is a professor of psychology at the Crean School of Health and Life Sciences at Chapman University in Orange, Calif., and the author of one such study that showed this phenomenon was often stronger in the initial stages of treatment. However, there are a lot of losses along the way, he says. For some couples, this may mean the loss of their dreams and expectations of having a children. They may also face other challenges--stillborn births and miscarriages.
"A lot of times unresolved grief, if it's not worked through, can be very difficult on a relationship," says Peterson in an interview. "Sometimes the relationship is a reminder of that childlessness and so ending the relationship is less painful than staying in a relationship with a person that their life dreams have been kind of shattered."
Peterson says the study was well-designed and should be replicated in the U.S., although researchers in the U.S. do not have nearly the same level of access to population data.
"I think it is very important that couples with fertility problems and also the medical staff that work with these women are aware of the increased probability for divorce if treatment should fail so that proper intervention can be initiate," says Kjaer.
Peterson echoes,"If fertility clinics had ways to destigmatize counseling for their patients that could be a huge help."