Relationship status among lesbian and heterosexual couples 8–10 years after undergoing assisted reproductive treatment in Sweden
Abstract
Background: Infertility along with fertility treatments has been reported to have a devastating effect on the well-being of the individuals involved as well as their relationship. So far, the studies exploring the impact on the relationship have mainly focused on heterosexual couples facing infertility and undergoing treatment. There is, therefore, a lack of data on the potential role of sexual orientation, gamete origin, as well as treatment success on the risk of separation after fertility treatment. The purpose of this study was, thus, to explore whether sexual orientation, donation treatment, and fertility success affected the relationship well-being and to explore various separation-related aspects.
Methods: We have performed a prospective cohort study of heterosexual and homosexual couples undergoing fertility treatment with autologous and donated gametes in Sweden and followed them for up to 10 years after receiving fertility treatment. In the current follow-up study, 660 individuals have been included.
Results: Almost 39% of lesbian couples participating reported having separated as opposed to 11–17% of heterosexual couples undergoing treatment with own or donated gametes. Neither background factors nor treatment success protected against separation. By using the relationship satisfaction ENRICH tool, we were able to demonstrate that dissatisfaction of one of the lesbian spouses or heterosexual spouses undergoing oocyte donation increased significantly the risk of separation 8–10 years after treatment commencement.
Conclusion: The findings can be used by fertility clinics to provide relationship tools to the treated couples in order to help them nurture their relationship and decrease the risk of separation in the long run.
Downloads
References
2. World Health Organization (WHO). Fact sheets: infertility. 2016. Available from: https://www.who.int/news-room/fact-sheets/detail/infertility [cited 01 September 2023].
3. Pasch LA, Holley SR, Bleil ME, Shehab D, Katz PP, Adler NE. Addressing the needs of fertility treatment patients and their partners: are they informed of and do they receive mental health services? Fertil Steril. 2016;106:209–15 e2. https://doi.org/10.1016/j.fertnstert.2016.03.006
4. Peterson BD, Sejbaek CS, Pirritano M, Schmidt L. Are severe depressive symptoms associated with infertility-related distress in individuals and their partners? Hum Reprod. 2014;29:76–82. https://doi.org/10.1093/humrep/det412
5. Schanz S, Reimer T, Eichner M, Hautzinger M, Hafner HM, Fierlbeck G. Long-term life and partnership satisfaction in infertile patients: a 5-year longitudinal study. Fertil Steril. 2011;96:416–21. https://doi.org/10.1016/j.fertnstert.2011.05.064
6. Wang K, Li J, Zhang JX, Zhang L, Yu J, Jiang P. Psychological characteristics and marital quality of infertile women registered for in vitro fertilization-intracytoplasmic sperm injection in China. Fertil Steril. 2007;87:792–8. https://doi.org/10.1016/j.fertnstert.2006.07.1534
7. Tao P, Coates R, Maycock B. Investigating marital relationship in infertility: a systematic review of quantitative studies. J Reprod Infertil. 2012;13:71–80.
8. Kjaer T, Albieri V, Jensen A, Kjaer SK, Johansen C, Dalton SO. Divorce or end of cohabitation among Danish women evaluated for fertility problems. Acta Obstet Gynecol Scand. 2014;93:269–76. https://doi.org/10.1111/aogs.12317
9. Schanz S, Hafner HM, Ulmer A, Fierlbeck G. Quality of life in men with involuntary childlessness: long-term follow-up. Andrologia. 2014;46:731–7. https://doi.org/10.1111/and.12140
10. Sydsjö G, Lampic C, Bladh M, Skoog Svanberg A. Relationships in oocyte recipient couples – a Swedish national prospective follow-up study. Reprod Health. 2014;11:38. https://doi.org/10.1186/1742-4755-11-38
11. Sydsjö G, Svanberg AS, Bladh M, Lampic C. Relationships in couples treated with sperm donation – a national prospective follow-up study. Reprod Health. 2014;11:62. https://doi.org/10.1186/1742-4755-11-62
12. Borneskog C, Lampic C, Sydsjö G, Bladh M, Skoog Svanberg A. How do lesbian couples compare with heterosexual in vitro fertilization and spontaneously pregnant couples when it comes to parenting stress? Acta Paediatr. 2014;103:537–45. https://doi.org/10.1111/apa.12568
13. Borneskog C, Lampic C, Sydsjö G, Bladh M, Svanberg AS. Relationship satisfaction in lesbian and heterosexual couples before and after assisted reproduction: a longitudinal follow-up study. BMC Womens Health. 2014;14:154. https://doi.org/10.1186/s12905-014-0154-1
14. Blake L, Casey P, Jadva V, Golombok S. Marital stability and quality in families created by assisted reproduction techniques: a follow-up study. Reprod Biomed Online. 2012;25:678–83. https://doi.org/10.1016/j.rbmo.2012.09.006
15. Martins MV, Vassard D, Hougaard CO, Schmidt L. The impact of ART on union dissolution: a register-based study in Denmark 1994–2010. Hum Reprod. 2018;33:434–40. https://doi.org/10.1093/humrep/dey002
16. Elenis E, Skoog Svanberg A, Leandersson P, Lind J, Sydsjö G. Access to infertility evaluation and treatment in two public fertility clinics and the reasons for withholding it: a prospective survey cohort study of healthcare professionals. BMJ Open. 2020;10:e041538. https://doi.org/10.1136/bmjopen-2020-041538
17. Fournier DOD, Druckman J. EE. F, editor. Assessing marital and premarital relationships: the PREPARE/ENRICH inventories.Newsbury, CA: Sage; 1983.
18. Fowers BJ, Olson DH. Enrich marital inventory – a discriminant validity and cross-validation assessment. J Marital Fam Ther. 1989;15:65–79. https://doi.org/10.1111/j.1752-0606.1989.tb00777.x
19. Marteau B. Separation among cohabiting same-sex and different-sex couples. Population. 2019;74:521–49. https://doi.org/10.1111/j.1752-0606.1989.tb00777.x
20. Bennett NG. A reflection on the changing dynamics of union formation and dissolution. Demogr Res. 2017;36:371–90. https://doi.org/10.4054/DemRes.2017.36.12
21. Kalmijn M, Poortman AR. His or her divorce? The gendered nature of divorce and its determinants. Eur Sociol Rev. 2006;22:201–14. https://doi.org/10.1093/esr/jci052
22. ONS. Divorces in England and Wales: 2021. Statistics OfN, editor. London: Office for National Statistics (ONS). 2021.
23. Kolk M, Andersson G. Two decades of same-sex marriage in Sweden: a demographic account of developments in marriage, childbearing, and sivorce. Demography. 2020;57:147–69. https://doi.org/10.1007/s13524-019-00847-6
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors retain copyright of their work, with first publication rights granted to Upsala Medical Society. Read the full Copyright- and Licensing Statement.
