Investigating the role of defense mechanisms on marital adjustment in infertile couples based on the cause of infertility: A cross-sectional study
Background: Infertility affects individual’s and couples’ adjustment. The defense mechanism and marital adjustment are mental processes that play a key role in infertile couples’ life.
Objective: This study aims to investigate the role of defense mechanisms on marital adjustment in infertile couples based on the cause of infertility.
Materials and Methods: This cross-sectional study was conducted on 400 infertile couples at Royan Institute (A referral center for infertility, Tehran, Iran). Infertile couples were divided into 4 groups based on the cause of infertility (female, male, both, and unknown). Demographic questionnaire, revised dyadic adjustment scale, and defense styles questionnaire were used for data collection.
Results: Results showed that the mean score of marital adjustment of men based on the cause of infertility (female, male, and both) was significantly higher in comparison with their wives (p = 0.04, p ≤ 0.001, p ≤ 0.001, respectively). However, no difference was observed between the mean score of women, men, and couples (women and husbands) in defense mechanisms. But marital adjustment has a significant positive correlation with mature defense mechanisms and a negative correlation with immature ones (p < 0.05).
Conclusion: The mean score of marital adjustment is higher in men than in their wives in all groups. So, counseling infertile couples in the field of marital adjustment and training in the use of mature defense mechanisms is recommended especially in women.
Key words: Defense mechanism, Marital relationship, Infertility.
 De D, Mukhopadhyay P, Roy PK. Experiences of infertile couples of West Bengal with male factor, female factor and unexplained infertility factor: A qualitative study. J Psychosexual Health 2020; 2: 152–157.
 Jaan U, Sultan A. Defence mechanisms of fertile and infertile women. J Psychiatry Ment Health 2017; 3: 1–4.
 Hamzehgardeshi Z, Shahhosseini Z, Rezaei M. [The role of counseling interventions on different dimensions of infertile couples’ health: A systematic review]. J Mazandaran Univ Med Sci 2019; 28: 225–236. (in Persian)
 Fallahzadeh H, Zareei Mahmood Abadi H, Momayyezi M, Malaki Moghadam H, Keyghobadi N. The comparison of depression and anxiety between fertile and infertile couples: A meta-analysis study. Int J Reprod BioMed 2019; 17: 153–162.
 Saffarieh E, Yousefi Saffarieh SR, Nasiri S, Aghaamoo Sh, Ziari A. [Evaluation of depression and anxiety in couples with infertility and related factors]. Tehran Univ Med J 2020; 78: 522–527. (in Persian)
 Kim JH, Shin HS, Yun EK. A dyadic approach to infertility stress, marital adjustment, and depression on quality of life in infertile couples. J Holist Nurs 2018; 36: 6–14.
 Amirian M, Mazloum SR, Laal Ahangar M. [Comparison of marital satisfaction in fertile and infertile couples and its relationship with sexual problems]. Iran J Obstet Gynecol Infertil 2015; 18: 1–10. (in Persian)
 Eftekhari M, Amanelahi A, Christopher Perry J, Rajabi Gh, Aslani Kh. Explaining the marital adjustment process in Iranian women: A grounded theory study. J Research Health 2021; 11: 77–86.
 Burgess CE, Cottrell L. Predicting success or failure in marriage. US: Prentice Hall, Inc.; 1939.
 Sahraian A, Bahmanipoor A, Amooee S, Mahmoodian H, Mani A. Marital maladjustment in infertile couples who referred to ghadir mother and child hospital, Shiraz. Women’s Health Bull 2016; 3: e30895.
 Abbaspour Khoshdast F, Jalali MR, Kakavand AR. Relationship between the personality traits, defense mechanisms and marital satisfaction of elementaryschool students’ parents. IIOAB J 2016; 7: 31–37.
 Podolska M, Bidzan M. Infertility as a psychological problem. Ginekol Pol 2011; 82: 44–49.
 Vaillant GE. Ego mechanisms of defense and personality psychopathology. J Abnorm Psychol 1994; 103: 44–50.
 Vaillant GE. The need for a uniform nomenclature for defenses. In: Vaillant GE, American Psychiatric Association. Ego mechanisms of defense: A guide for clinicians and researchers. Washington, DC: American Psychiatric Press; 1992.
 Katiraei Sh, Haghighat M, Bazmi N, Ramezanzadeh F, Bahrami H. The study of irrational beliefs, defense mechanisms and marital satisfaction in fertile and infertile women. J Family Reprod Health 2010; 3: 129–133.
 Broun P, Manavipour D, Sedaghati Fard M. [Investigate the relationship between proactive personality and work autonomy with job crafting]. J Analy-Cogn Psychol 2014; 5: 34–43. (in Persian)
 Busby DM, Christensen C, Crane RD, Larson JH. A revision of the dyadic adjustment scale for use with distressed and non-distressed couples: Construct hierarchy and multidimensional scales. J Marital Family Ther 1995; 21: 289–308.
 Hollist CS, Miller RB. Perceptions of attachment style and marital quality in midlife marriage. Family Relations 2005; 54: 46–57.
 Yousefi N. [Investigation of psychometric properties of the revised dyadic adjustment scales (RDAS)]. Res Clin Psychol Counseling 2012; 1: 183–200. (in Persian)
 Andrews G, Singh M, Bond M. The defense style questionnaire. J Nervous Mental Dis 1993; 181: 246–256.
 Yilmaz N, Gençöz T, Mehmet Ak. Psychometric properties of the defense style questionnaire: A reliability and validity study. Turk Psikiyatri Derg 2007; 18: 244–253.
 Shabanpour R, Zahiroddin AR, Janbozorgi M, Ghaeli P. Assessment of defense styles and mechanisms in Iranian patients suffering from obsessive compulsive or panic disorders versus normal controls using Persian version of Defense Style Questionnaire-40. Iran J Psychiatry 2012; 7: 31–35.
 Lee TY, Sun GH. Psychological response of Chinese infertile husbands and wives. Arch Androl 2000; 45: 143– 148.
 Tao P, Coates R, Maycock B. Investing marital relationship in infertility: A systematic review of quantitative studies. J Reprod Infertil 2012; 13: 71–80.
 Sahraian K, Jafarzadeh F, Poursamar SL. The relationship between social support and marital satisfaction in infertile women based on infertility factor. Nursing and Midwifery Journal 2015; 12: 1104–1109