Research on Dyadic Coping and Anxiety/Depression in Separated Couples with Infertility Undergoing IVF-ET Based on Actor-Partner Interdependence Model

doi:10.12280/gjszjk.20260039

Abstract

Abstract:

Objective: The psychological health status of infertile couples is affected by the dyadic coping. This study was designed to explore the impact patterns of dyadic coping on the anxiety and depression in non-cohabiting infertile couples undergoing in vitro fertilization-embryo transfer (IVF-ET), based on the actor-partner interdependence model (APIM). Methods: A total of 187 non-cohabiting infertile couples undergoing IVF-ET at the reproductive medicine department of our hospital from March to August 2024 were selected. Data on age, duration of infertility, self-rating anxiety scale (SAS), self-rating depression scale (SDS) and dyadic coping inventory (DCI) were collected. Correlation analysis and APIM were used to investigate the effects of dyadic coping on their negative emotions. Results: The prevalences of anxiety and depression were 19.25% (36/187) and 26.74% (50/187) in female partners, while 1.07% (2/187) and 15.51% (29/187) in male partners, respectively. In both male and female partners, the statistically significant differences were observed in SAS and SDS standard scores across different long-distance relationship duration groups, with the group of >5 years showing the highest scores (P<0.05). Standard scores of SAS and SDS in both spouses were negatively correlated with their own and their partners' total DCI scores (P<0.05). The APIM indicated that the negative emotions of the male partners were significantly influenced by both actor and partner effects (P<0.05). The negative emotions of female partners were only significantly influenced by their own actor effects (P<0.05), and the partner effects were not significant (P=0.128). Conclusions: Dyadic coping in non-cohabiting infertile couples exerts distinct actor and partner effects on the negative emotions, highlighting the need for tailored and evidence-based nursing interventions.

Key words: Fertilization in vitro, Embryo transfer, Anxiety, Depression, Dyadic coping, Actor-partner interdependence model

DU Chao, CHENG Xu, YU Xin-tong, SUN Kai-xuan, ZHANG Qian, ZHOU Jing. Research on Dyadic Coping and Anxiety/Depression in Separated Couples with Infertility Undergoing IVF-ET Based on Actor-Partner Interdependence Model[J]. Journal of International Reproductive Health/Family Planning, 2026, 45(3): 190-195.

Figures/Tables 6

References 22

[1]	Shingshetty L, Cameron NJ, Mclernon DJ, et al. Predictors of success after in vitro fertilization[J]. Fertil Steril, 2024, 121(5):742-751. doi: 10.1016/j.fertnstert.2024.03.003.
[2]	Braverman AM, Davoudian T, Levin IK, et al. Depression, anxiety, quality of life, and infertility: a global lens on the last decade of research[J]. Fertil Steril, 2024, 121(3):379-383. doi: 10.1016/j.fertnstert.2024.01.013.
[3]	Walker Z, Ernandez J, Lanes A, et al. The effects of male anxiety and depression on IVF outcomes[J]. Hum Reprod, 2023, 38(11):2119-2127. doi: 10.1093/humrep/dead179.
[4]	陈奕铭, 杨丽萍, 王燕侠, 等. 某市新型冠状病毒肺炎疫情期间孕妇焦虑抑郁对妊娠结局的影响[J]. 中国计划生育和妇产科, 2022, 14(12):27-31. doi: 10.3969/j.issn.1674-4020.2022.12.07.
[5]	马靖茹, 郝素芳, 谷向向, 等. 孕前焦虑和抑郁对妊娠期糖脂代谢指标水平、妊娠期并发症和妊娠结局的影响[J]. 广西医学, 2021, 43(22):2650-2653,2659. doi: 10.11675/j.issn.0253-4304.2021.22.03.
[6]	Eisenberg ML, Esteves SC, Lamb DJ, et al. Male infertility[J]. Nat Rev Dis Primers, 2023, 9(1):49. doi: 10.1038/s41572-023-00459-w. pmid: 37709866
[7]	张龙, 刘纪南, 冯玉慧. 部队官兵不孕不育问题分析与对策[J]. 海军医学杂志, 2016, 37(2):107-108,175. doi: 10.3969/j.issn.1009-0754.2016.02.005.
[8]	闫素文, 孟培, 孙延芝, 等. 关于两地生活探亲夫妇不孕症诊断标准的探讨[J]. 中国实用妇科与产科杂志, 2000, 16(12):755-756. doi: 10.3969/j.issn.1005-2216.2000.12.024.
[9]	Landolt SA, Weitkamp K, Roth M, et al. Dyadic coping and mental health in couples: A systematic review[J]. Clin Psychol Rev, 2023, 106:102344. doi: 10.1016/j.cpr.2023.102344.
[10]	Turcotte S, Robitaille H, Blair L, et al. The actor-partner interdependence model in shared decision-making: an illustrative example of its application to the physician-patient dyad in primary care consultations[J]. J Clin Epidemiol, 2019, 108:132-139. doi: 10.1016/j.jclinepi.2018.11.027. pmid: 30529006
[11]	Chaves C, Canavarro MC, Moura-Ramos M. The Role of Dyadic Coping on the Marital and Emotional Adjustment of Couples With Infertility[J]. Fam Process, 2019, 58(2):509-523. doi: 10.1111/famp.12364. pmid: 29709057
[12]	Song X, Zhao J, Xiao Z, et al. The actor-partner interdependence model of fertility stress and marital quality among couples undergoing in vitro fertilization and embryo transfer: The mediating role of dyadic coping[J]. Stress Health, 2024, 40(6):e3483. doi: 10.1002/smi.3483.
[13]	倪平, 陈京立, 刘娜. 护理研究中量性研究的样本量估计[J]. 中华护理杂志, 2010, 45(4):378-380. doi: 10.3761/j.issn.0254-1769.2010.04.037.
[14]	Zung WW. A rating instrument for anxiety disorders[J]. Psychosomatics, 1971, 12(6):371-379. doi: 10.1016/S0033-3182(71)71479-0. pmid: 5172928
[15]	Zung WW. A Self-Rating Depression Scale[J]. Arch Gen Psychiatry, 1965, 12:63-70. doi: 10.1001/archpsyc.1965.01720310065008. pmid: 14221692
[16]	Gmelch S, Bodenmann G, Meuwly N, et al. Dyadic Coping Inventory (DCI): A questionnaire assessing dyadic coping in couples[J]. Z Familienforsch, 2008, 20(2):185-202.
[17]	Xu F, Hilpert P, Randall AK, et al. Validation of the Dyadic Coping Inventory with Chinese couples: Factorial structure, measurement invariance, and construct validity[J]. Psychol Assess, 2016, 28(8):e127-140. doi: 10.1037/pas0000329.
[18]	Moutzouri M, Sarantaki A, Koulierakis G, et al. Coping Strategies Associated with Emotional Adjustment during the Dyadic Experience of Infertility and Its Treatment: A Systematic Review[J]. J Mother Child, 2024, 28(1):61-69. doi: 10.34763/jmotherandchild.20242801.d-24-00013. pmid: 39043203
[19]	Péloquin K, Boucher S, Benoit Z, et al. "We're in this together": Attachment insecurities, dyadic coping strategies, and relationship satisfaction in couples involved in medically assisted reproduction[J]. J Marital Fam Ther, 2023, 49(1):92-110. doi: 10.1111/jmft.12608.
[20]	Ye H, Zhao J, Zou Y, et al. Correlations among hope, fertility quality of life and negative emotions for couples undergoing their first in vitro fertilization-embryo transfer: a cross-sectional analysis[J]. Reprod Health, 2025, 22(1):10. doi: 10.1186/s12978-025-01954-x. pmid: 39876018
[21]	裴梦月. 不孕症夫妇二元应对与焦虑、抑郁的关系研究[D]. 兰州: 兰州大学, 2023. doi:10.27204/d.cnki.glzhu.2023.003555.
[22]	陈拓, 吴向然. 个体化与技术共谋:青年异地夫妻数字化亲密研究[J]. 东南学术, 2023, 25(4):186-196. doi: 10.13658/j.cnki.sar.2023.04.009.

特征	分组	男方	女方
年龄（岁）	<30	33	44
	30~35	110	108
	>35	44	35
学历	初高中	8	26
	大专或本科	166	140
	硕士及以上	13	21
职业	职员	0	87
	个体	0	13
	无业	0	75
	军人	187	12
婚姻状况	初婚	176	174
	再婚	11	13
收入（元/月）	<5 000	0	131
	5 000~10 000	54	40
	>10 000	133	16
DCI总分（分）	<111	20	38
	111~145	101	85
	>145	66	64
SAS标准分（分）	<50	185	151
	50~59	1	31
	60~69	1	3
	≥70	0	2
SDS标准分（分）	<53	158	137
	53~62	25	41
	63~72	4	7
	>72	0	2
异地时长（年）	<3	36
	3~5	119
	>5	32
见面频率（次/年）	<3	71
	3~5	52
	>5	64
沟通方式	电话	183
	视频	167
	信件	5
不孕时间（年）	<1	40
	1~3	83
	>3	64
不孕类型	原发性不孕	124
	继发性不孕	63
曾行IVF次数（次）	0	131
	1	30
	2	14
	≥3	12
治疗费用（元）	<10 000	84
	10 000~30 000	64
	>30 000	39

特征	分组	男方	女方
年龄（岁）	<30	33	44
	30~35	110	108
	>35	44	35
学历	初高中	8	26
	大专或本科	166	140
	硕士及以上	13	21
职业	职员	0	87
	个体	0	13
	无业	0	75
	军人	187	12
婚姻状况	初婚	176	174
	再婚	11	13
收入（元/月）	<5 000	0	131
	5 000~10 000	54	40
	>10 000	133	16
DCI总分（分）	<111	20	38
	111~145	101	85
	>145	66	64
SAS标准分（分）	<50	185	151
	50~59	1	31
	60~69	1	3
	≥70	0	2
SDS标准分（分）	<53	158	137
	53~62	25	41
	63~72	4	7
	>72	0	2
异地时长（年）	<3	36
	3~5	119
	>5	32
见面频率（次/年）	<3	71
	3~5	52
	>5	64
沟通方式	电话	183
	视频	167
	信件	5
不孕时间（年）	<1	40
	1~3	83
	>3	64
不孕类型	原发性不孕	124
	继发性不孕	63
曾行IVF次数（次）	0	131
	1	30
	2	14
	≥3	12
治疗费用（元）	<10 000	84
	10 000~30 000	64
	>30 000	39

组别	SAS			SDS
组别	标准分	F或t	P	标准分	F或t	P
年龄（岁）		0.348	0.706		3.242	0.041
<30	36.88±5.87			43.36±12.74
30~35	35.77±6.37			39.07±11.21
>35	35.91±8.08			36.86±9.83
学历		0.477	0.621		1.654	0.194
初高中	37.50±5.78			43.00±11.14
大专或本科	36.04±6.83			39.51±11.44
硕士及以上	34.62±5.65			34.46±9.06
收入（元/月）		3.548	<0.001		3.278	0.001
5 000~10 000	38.65±6.75			43.46±12.15
>10 000	34.92±6.40			37.62±10.56
异地时长（年）		4.323	0.015		4.483	0.013
<3	34.24±6.22			36.81±10.56
3~5	36.78±5.81			39.42±9.24
>5	37.76±6.34			43.06±9.33
见面频率（次/年）		0.767	0.534		0.292	0.253
<3	35.14±6.18			38.44±11.30
3~5	36.45±5.92			39.83±10.26
>5	35.95±6.55			39.08±11.01
不孕时间（年）		5.551	0.005		4.752	0.010
<1	33.74±6.64			36.07±10.94
1~3	37.64±6.71			41.99±11.01
>3	35.45±6.23			38.05±11.36
不孕类型		0.299	0.765		0.021	0.983
原发性不孕	36.10±6.44			39.32±11.01
继发性不孕	35.79±7.25			39.29±12.01
治疗费用（元）		1.352	0.261		0.012	0.988
<10 000	34.88±7.45			38.71±12.04
10 000~30 000	36.44±6.26			39.00±10.38
>30 000	36.72±5.97			38.85±10.98

组别	SAS			SDS
组别	标准分	F或t	P	标准分	F或t	P
年龄（岁）		0.348	0.706		3.242	0.041
<30	36.88±5.87			43.36±12.74
30~35	35.77±6.37			39.07±11.21
>35	35.91±8.08			36.86±9.83
学历		0.477	0.621		1.654	0.194
初高中	37.50±5.78			43.00±11.14
大专或本科	36.04±6.83			39.51±11.44
硕士及以上	34.62±5.65			34.46±9.06
收入（元/月）		3.548	<0.001		3.278	0.001
5 000~10 000	38.65±6.75			43.46±12.15
>10 000	34.92±6.40			37.62±10.56
异地时长（年）		4.323	0.015		4.483	0.013
<3	34.24±6.22			36.81±10.56
3~5	36.78±5.81			39.42±9.24
>5	37.76±6.34			43.06±9.33
见面频率（次/年）		0.767	0.534		0.292	0.253
<3	35.14±6.18			38.44±11.30
3~5	36.45±5.92			39.83±10.26
>5	35.95±6.55			39.08±11.01
不孕时间（年）		5.551	0.005		4.752	0.010
<1	33.74±6.64			36.07±10.94
1~3	37.64±6.71			41.99±11.01
>3	35.45±6.23			38.05±11.36
不孕类型		0.299	0.765		0.021	0.983
原发性不孕	36.10±6.44			39.32±11.01
继发性不孕	35.79±7.25			39.29±12.01
治疗费用（元）		1.352	0.261		0.012	0.988
<10 000	34.88±7.45			38.71±12.04
10 000~30 000	36.44±6.26			39.00±10.38
>30 000	36.72±5.97			38.85±10.98

组别	SAS			SDS
组别	标准分	F或t	P	标准分	F或t	P
年龄（岁）		1.025	0.361		0.894	0.411
<30	43.59±8.44			46.82±10.86
30~35	41.60±8.86			44.16±11.62
>35	41.09±8.88			44.09±12.51
学历		0.803	0.450		1.062	0.348
初高中	43.58±7.89			47.81±10.74
大专或本科	41.92±8.83			44.36±11.94
硕士及以上	40.33±9.46			43.71±10.23
收入（元/月）		3.080	0.048		2.769	0.065
<5 000	42.98±8.99			45.97±11.93
5 000~10 000	40.03±8.37			42.83±10.54
>10 000	38.63±6.26			39.81±10.05
异地时长（年）		5.024	0.008		6.324	0.002
<3	39.22±8.25			41.17±12.76
3~5	42.48±8.31			45.24±11.03
>5	45.46±7.99			48.37±11.28
见面频率（次/年）		1.785	0.171		0.292	0.253
<3	41.07±6.37			43.90±11.06
3~5	42.46±5.71			46.38±10.26
>5	43.81±6.49			39.08±11.01
不孕时间（年）		1.931	0.148		1.020	0.363
<1	39.91±9.38			42.37±12.31
1~3	42.23±8.85			45.29±11.55
>3	43.24±8.77			44.40±11.32
不孕类型		-2.168	0.031		-3.794	0.034
原发性不孕	40.99±8.26			43.49±11.60
继发性不孕	43.90±9.47			47.29±11.31
治疗费用（元）		2.436	0.090		1.971	0.142
<10 000	40.55±9.12			43.29±11.99
10 000~30 000	42.15±9.64			44.18±12.55
>30 000	43.74±7.66			47.06±10.77