Coping strategies and psychological interventions in women with infertility: a rapid review

Abstract

The aim of this study was to review the available scientific literature on the coping strategies employed by women with infertility, as well as the types of psychological interventions used in addressing their infertility-related difficulties. More specifically, it aims to (a) identify coping strategies used, (b) describe psychological interventions used to address primary and secondary infertility, and (c) make treatment recommendations specifically regarding infertile women in developing countries. A rapid review was conducted to obtain data to be able to address the research question. Keywords were identified during a general review of psychology journals and textbooks related to the topic. Boolean operators were matched with the keywords, their most common synonyms and the inclusion criteria to identify three search levels. EBSCO Discovery Services (EDS), a search engine that provides access to the resources of 73 international and national databases, was used as the search portal. The Joanna Briggs Institute (JBI) guidelines were used to identify relevant and high-quality scientific studies. From the initial 307 studies identified, only 23 met the selection criteria of the study. Most of the studies included were done in developing countries like Ghana, India, Iran, Israel, Mali, Mexico, South Africa, and Turkey. A thematic synthesis, based on Thomas and Harden’s approach (2008), was used to analyse the data. The main findings indicated that the experience of infertility is a personal challenge that interferes with important life goals or needs and requires effective coping. Similar to those found in other contexts, coping strategies as a response to infertility may promote or decrease psychological well-being. In confirmation of the general coping literature, active coping was particularly adaptive due to the utilisation of strategies like problem-solving, meaning, and acceptance. While the positive reappraisal of infertility seems to enable individuals to maintain or develop hope, as well as a more positive future outlook, and more effective problem-solving, appraising infertility only or primarily as a loss elicited avoidance coping strategies like fatalism and wishful thinking. Both positive religious and social coping seem to have been adaptive for infertile women. Positive religious coping provides a resource that addresses the personal nature of infertility and the identity challenge it often presents. Being socially accepted and able to rely on others is a deeply engrained human need – it is therefore no surprise that social support is such an important resource when individuals are confronted with infertility. It was further found that readiness for intervention (indicated by, for example, level of stress and perception of control, as well as the influence of cultural and religious beliefs) seems to be an important factor to take into account prior to and during counselling women with infertility. Psychological intervention available for addressing infertility primarily includes cognitive, problem-focused, emotion-focused, and mindfulness-based interventions. Different types of interventions addressed different consequences of infertility, but focused primarily on distress, depression, well-being, emotional regulation, and perception of control. It was recommended that further research needs to be done to better understand the psychological experience of infertility, the way society perceives infertility, and finally the extent to which counselling guidelines need to be tailored for specific cultural contexts. Key aspects have been identified that may improve the effectiveness of psychological interventions for infertile women and therefore improve their ability to cope.