title: The impact of social relations among men and women in fertility treatment on the decision to terminate treatment.
abstract: OBJECTIVE
  Do social support and social strain from social relations have an impact on the decision to terminate fertility treatment among men and women after 1 year of unsuccessful treatment?
  
  
  CONCLUSIONS
  Several functional aspects of social relations show an impact on the probability to terminate treatment; social support from family significantly decreases the probability to terminate and experience of conflicts or problematic communication with the partner significantly increases the probability to terminate treatment.
  
  
  BACKGROUND
  Fertility patients can experience psychological, physical and economical strain as consequences of infertility and fertility treatment, and previous studies have shown that these pressures increase the probability of deciding to terminate treatment before the treatment options are exhausted. Some studies have indicated that social relations can also have an effect.
  
  
  METHODS
  This study is part of the prospective Infertility Cohort from the Copenhagen Multi-centre Psychosocial Infertility Research Programme. Baseline data were collected during January 2000-August 2001 among patients recruited at five Danish fertility clinics during their initial visit and follow-up data were collected after 1 year.
  
  
  METHODS
  The study group (n = 777; 427 women, 350 men) consisted of patients who did not achieve a live birth or an ongoing pregnancy during follow-up. Social support and strain from the patients' partner, family, family-in-law, friends and colleagues were measured at baseline and the decision to terminate treatment while treatment options were not yet exhausted was measured as the outcome at the 1-year follow-up.
  
  
  RESULTS
  At the 1-year follow-up, 23% of the study group had decided to terminate treatment. For women, low levels of family support, specifically with regard to infertility, were associated with the termination of treatment after 1 year [odds ratio (OR) 6.1, 95% confidence interval (CI) 2.2-16.8] and, for men, low levels of general family support had a similar impact (OR 2.6, 95% CI 1.0-7.0). For men, difficulties in communicating with their partner about the infertility increased the probability of terminating the treatment (OR 2.3, 95% CI 1.2-4.1) and, for women, frequent conflicts with their partner increased the probability of terminating the treatment (OR 12.4, 95% CI 2.9-54.1). For women, conflicts with friends were also a predictor of treatment termination (OR 2.2, 95% CI 1.2-4.2).
  
  
  CONCLUSIONS
  Functional aspects of social relations have an impact on the decision to terminate fertility treatment among men and women. The findings in this study provide new insights into how the close social environment can have implications for men and women going through fertility treatment.
  
  
  BACKGROUND
  This study has received support from the Danish Health Insurance Fund (J.nr. 11/097-97), the Else and Mogens Wedell-Wedellsborgs Fund, the manager E. Danielsens and Wife's Fund, the merchant L.F. Foghts Fund, the Jacob Madsen and Wife Olga Madsen's Fund, and the Engineer K.A. Rohde and Wife's Fund. The authors have no conflicts of interest to declare.
authors.affiliation: Department of Public Health, University of Copenhagen, 5 Oester Farimagsgade, Copenhagen K DK-1014, Denmark. dittev@gmail.com
authors.forename: Ditte
authors.initials: D
authors.lastname: Vassard
authors.forename: Rikke
authors.initials: R
authors.lastname: Lund
authors.forename: Anja
authors.initials: A
authors.lastname: Pinborg
authors.forename: Jacky
authors.initials: J
authors.lastname: Boivin
authors.forename: Lone
authors.initials: L
authors.lastname: Schmidt
mesh_terms: D000328:Adult; D003142:Communication; D003718:Denmark; D005190:Family; D005260:Female; D006801:Humans; D007246:Infertility / Q000523:psychology* / Q000628:therapy; D008297:Male; D011247:Pregnancy; D027724:Reproductive Techniques, Assisted / Q000191:economics / Q000523:psychology*; D012944:Social Support; D018454:Spouses; D016312:Treatment Refusal / Q000523:psychology*