title: Assessing infertility stress: re-examining the factor structure of the Fertility Problem Inventory.
abstract: BACKGROUND
  Research has documented that fertility problems can negatively affect the life of infertile patients, by imposing an obstacle to one important life goal: the achievement of parenthood. The Fertility Problem Inventory (FPI) proposes a comprehensive approach in assessing infertility stress, by measuring the impact on social, marital and sexual life dimensions and the importance of parenthood in infertile patients' life. This study examined the factor structure of the FPI, testing two alternative models using confirmatory factor analysis.
  
  
  METHODS
  A sample of 209 infertile patients was recruited in two public hospital departments of assisted reproduction technology. Measures included the FPI, the Brief Symptom Inventory and the ENRICH Marital Inventory.
  
  
  RESULTS
  Results confirmed the original measurement model of the instrument but suggested that the inclusion of an intermediate conceptual level resulted in a better fit to the model (χ²₈₄= 147.89, P< 0.001) i.e. the instrument assesses infertility stress by assessing two main conceptual domains: the impact of infertility in infertile patients' life and representations about the importance of parenthood. The instrument revealed measurement and structure invariance and construct validity by correlating with other measures assessing similar constructs.
  
  
  CONCLUSIONS
  This approach to the FPI has important contributions for research and clinical practice by distinguishing between the impact of infertility on different dimensions of a couple's' life and representations about the importance of parenthood, therefore extending the utility of the FPI in research and clinical practice.
authors.affiliation: Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, Apartado 6153, Coimbra 3001-802, Portugal. marianamr@fpce.uc.pt
authors.forename: M
authors.initials: M
authors.lastname: Moura-Ramos
authors.forename: S
authors.initials: S
authors.lastname: Gameiro
authors.forename: M C
authors.initials: MC
authors.lastname: Canavarro
authors.forename: I
authors.initials: I
authors.lastname: Soares
mesh_terms: D000328:Adult; D001294:Attitude to Health; D005260:Female; D006779:Hospitals, Public; D006801:Humans; D007246:Infertility / Q000523:psychology* / Q000628:therapy; D008297:Male; D008960:Models, Psychological; D010290:Parents / Q000523:psychology*; D011174:Portugal; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life / Q000523:psychology; D043762:Reproductive Behavior; D027724:Reproductive Techniques, Assisted / Q000009:adverse effects; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology