Psychological factors in the aetiology of infertility: a prospective cohort study

The objectives were to identify and measure psychological factors characterizing the period following the cessation of contraception and to assess these psychological factors as predictors of the couples' fertility. A cohort of 63 couples with initially undetermined fertility status was prospectively studied, first shortly after the cessation of contraception, then 13 months later. The Child Project Questionnaire was constructed to assess psychological variations following the cessation of contraception. An Interspouse Difference Score was constructed to measure the difference between the spouses' responses. Three male and three female factors were derived from the questionnaire. The Interspouse Difference Score was significantly greater in infertile than in fertile couples. Two psychological factor scores were significantly higher in fertile subjects: the wives' level of positive expectations related to motherhood, and the husbands' quality of integration between the wish for a child and sexual relationships. Within the group of fertile couples, time to pregnancy was predicted by the husbands' above-cited factor and by the wives' frequency of thoughts and concerns related to the desired child. The results support the conclusion that in both women and men, psychological factors specifically related to the project of conceiving a child are significant predictors of the couple's fertility status.