Expectations and experiences of midlife intending mothers engaging with Assisted Reproductive Technology

Abstract

The age for optimal women's childbearing, with the best chance of delivering a healthy baby, is generally considered to be when aged in their 20s years. Some researchers propose that fertility declines occurs from 32 years of age. After this age women have a decreasing chance of conception attributed primarily to age-related chromosomal changes in their oocytes. Midlife intending mothers (women aged 35 and older) This research investigates perceptions of women's fertility decline and ART success from a group of women who had used ART, and from men and women in the community who may not have used ART. Women who had used ART and a community cohort were surveyed. Responses from these two groups were analysed separately and compared.Women who had used ART were asked about their experiences at their clinic, and if treatment had social or psychological repercussions. Participants asked about their perceptions of media portrayal of ART success for women aged 35 and older. The concept that ART has become commodified, where commodification is the transformation of services or entities into a commodity, is explored. Those who had used ART suggested recommendations for younger women about childbearing.A mixed-methods approach was utilised. Data were gathered from three cohorts of participants. Quantitative and qualitative data were gathered from an in-vitro fertilisation (IVF) support group (N = 68) and qualitative data from an interview group of IVF users (N=6) who had engaged with ART treatment either currently or recently. Some had conceived and some were still having treatment. The community group (N= 1243) comprised men and women over 18 years of age who participated in a Queensland-wide telephone survey. Quantitative data gathered from the support group and the community were analysed using SPSS. Qualitative data were explored via thematic analysis.Thematic findings from the interview group supported findings of the support group. Most women knew the benefits and risks of delaying childbearing and made an informed choice ii to use ART. Most were aware that fertility declined from the age of 35, yet this age group is the major consumer of ART. Most women younger than 40 years believed they would get pregnant and have a healthy baby. Only half of the women aged 40 years and older had that confidence. However, this insight may have been gained after using ART. Women found their experience physiologically and psychologically challenging and those who didn't conceive, found making the decision to stop treatment confronting. Some were confused on the published success rates, and expectations elevated from overall rather than age specific pregnancy not birth rates.Support group and interview participants felt delayed childbearing was mainly due to lack of a relationship partner whereas community members believed career or work aspirations. Both he support group and community group agreed that women's fertility declined from the age of 35 years but significantly more community members, and significantly more men th...

Extreme desire for motherhood: Analysis of narratives from women undergoing Assisted Reproductive Technology (ART)

“…The experience of infertility treatment has been described as a situation that engulfs patients and dominates their daily routine (Daniluk, 2001;Redshaw, Hockley, & Davidson, 2007). Furthermore, people who resort to ART often are not aware of the fertility decline related to the maternal age (especially after 35 years old), overestimating success rates of these techniques with unrealistic expectations (Hayward, 2016). In fact, many therapeutic attempts are often necessary before a child can be conceived, and, despite all the efforts, sometimes this does not even happen.…”

The need to restore generative identity in women undergoing assisted reproductive technology: Development and psychometric validation of the fertility reparation inventory

“…Within a psychodynamic perspective, it has been demonstrated instead that unconscious affective processes and emotional expectations, can affect patients' relationship with ART treatment and fertility staff (Langher et al, 2019). Nowadays, the scarce research exploring the therapeutic demand for ART by patients with infertility problems is derived, in fact, from indirect investigations, using fertility professionals and their experiences with patients as privileged information sources (Boivin et al, 2017; Fitzgerald et al, 2013; Leone et al, 2017; Hayward's, 2016). Therefore, standardized measures allowing a direct investigation of affective and motivational dimensions affecting the decision to resort to ART seem to be lacking.…”

“…Concerning the subjective experience of infertility, women resorting to ART are not always aware of their age‐related decline in fertility, the low success rates of ART, and all the efforts and fatigues required by the treatment (Hayward, 2016; Langher et al, 2019). In fact, several therapeutic attempts are often necessary to achieve a pregnancy and, despite all the efforts, giving birth to a child is an almost rare event.…”