Date: 2018-10
Abstract:
BACKGROUND: Infertility remains a challenge for some couples globally. Recent evidence shows that one in every six couples will face fertility problem in their reproductive age. For the past four decades, Assisted Reproductive Technology (ART) has been an effective intervention for infertility. The complexities associated with the ART presents many challenges to couples including psychological, social, and emotional difficulties. These challenges underscore the relevance of coping particularly during the process of the ART. Objectives: This study therefore sought to understand the challenges associated with ART and the various coping strategies infertile couples adopt when seeking ART. Methods: The study employed convergent parallel mixed method design. Exploratory phenomenological approach and cross-sectional survey were used for the qualitative and the quantitative studies respectively. Overall, 12 women and 6 men participated in the qualitative study, whereas 211 women participated in the quantitative study. The qualitative study employed purposive sampling technique and the quantitative used convenience sampling technique to recruit the respondents. The qualitative data was collected using in-depth interviews and the Ways of Coping questionnaire was used to collect the quantitative data. Analysis of the quantitative data was done using content analysis technique whereas the quantitative data was analysed using the Stata version 14.0. Descriptive statistics such as the mean, frequencies were determined from the quantitative data. Inferential statistics such as Chi-square test of independence, Fishers exact test, one-way analysis of variance and Kruskal Wallis were used to determine association between each of the predictors of coping and levels of coping strategy. Results: The study revealed couples with infertility problems highly value biological children due to social stigmatization about childlessness. Some respondents indicated that they have suffered various forms of psychological, emotional, and social afflictions because of their inability to have their own children. Respondents utilised ART the best alternative solution to infertility problem. Factors such as advanced age of the woman, pressure from families, particularly mothers-in-law, and friends influenced respondents’ uptake of ART. Furthermore, various ART uptake challenges, identified included anxiety about treatment outcome, high cost of ART, and long distance to ART centres. The study respondents used different coping strategies to cope with ART. These included confrontational, distance, self-control, social support, acceptance responsibility, escape-avoidance, problem solving and positive reappraisal coping strategy. The most highly used coping strategy was positive-reappraisal (n = 104, 49.3%). Fertility centre and cause of infertility were the two covariates that were significantly related to overall coping strategy. None of the covariates were associated with the positive reappraisal coping strategy. Conclusions: Having children in marriage in the Ghanaian society is very crucial. Even though ART offers a better solution to infertility, it has its own associated challenges necessitating the adoption of various forms of coping strategies. Given the importance couples attach to biological children, evidence of infertility prevalence in Ghana, Government should consider integrating ART services into the existing obstetric and gynecological facilities to serve as an alternate solution to the challenges of infertility in Ghana. Again, the reproductive health unit of the Ghana Health Service should sensitise the general public about the availability of ART, its effectiveness as well as the associated benefits. This will reduce the negative consequences of childlessness in the Ghanaian society. Given the emotional and psychological challenges reported by the clients in this study, it is recommended that counseling units should be established in these centres to offer services to clients at every stage of the treatment.
Description:
PhD.
