Perception of Problems and Coping Strategies of Clients with Infertility

1.1 Introduction

Infertility, defined as the inability to conceive after one year of unprotected intercourse, is a global health issue that affects a significant number of individuals and couples. The World Health Organization (WHO) estimates that about 15% of reproductive-aged couples worldwide experience infertility, leading to emotional, psychological, and social distress (WHO, 2020). The perception of infertility varies across cultures and social groups, influencing how individuals cope with the condition. Studies show that the emotional toll of infertility can manifest as depression, anxiety, and feelings of inadequacy (Greil et al., 2018). In many societies, women bear the brunt of the blame, regardless of the actual medical cause of infertility.

Coping strategies adopted by individuals facing infertility are influenced by personal, social, and cultural factors. According to a study by Peterson et al. (2019), individuals often turn to both problem-focused and emotion-focused coping mechanisms. Problem-focused strategies include seeking medical advice and treatment, while emotion-focused strategies may involve seeking social support, engaging in distraction activities, or relying on spiritual beliefs.

As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Research hypothesis and questions, Limitation of the study and Definition of terms.

1.2 Background of Study

Over the past few decades, there has been increasing attention paid to how different cultures perceive infertility and the associated coping strategies. Studies show that cultural attitudes play a crucial role in shaping how individuals perceive infertility and manage the stress and challenges it brings (Fledderjohann, 2012). In many ancient societies, fertility was closely linked to societal survival and prosperity. As a result, infertility was often perceived as a personal failure or divine punishment, particularly for women. Historical records from ancient civilizations, including Mesopotamia, Egypt, and Greece, highlight that infertility was primarily viewed as a female issue, with women bearing the blame for the inability to produce offspring (Inhorn, 2003). Infertile women were often stigmatized and subjected to exclusion from social and religious activities.

The understanding and treatment of infertility began to evolve with the development of medical science in the 19th and 20th centuries. Advances in reproductive health, including the discovery of male infertility factors, shifted some of the societal blame away from women (Schmidt, 2006). However, cultural perceptions of infertility continued to influence the coping mechanisms adopted by those affected. During the 20th century, infertility treatments such as in vitro fertilization (IVF) and artificial insemination emerged, offering new hope for couples facing infertility. Despite these advancements, infertility remained a deeply personal and often stigmatized issue.

Research into the psychological and emotional dimensions of infertility gained momentum in the late 20th century, as healthcare professionals began to recognize that infertility was not just a medical issue, but also a significant emotional and social challenge. The introduction of counseling and psychological support for infertility patients has highlighted the complex nature of coping with infertility (Greil et al., 2010). Clients have been found to adopt a variety of coping strategies, ranging from seeking medical interventions to relying on social, emotional, and spiritual support.

Infertility is a multifaceted issue that impacts individuals and couples across the world, cutting across economic, social, and cultural lines. Defined as the failure to achieve pregnancy after 12 months of regular unprotected intercourse, infertility affects approximately 48.5 million couples globally, according to recent estimates from the World Health Organization (WHO, 2020). The causes of infertility are diverse, encompassing both male and female factors, including hormonal imbalances, ovulatory disorders, sperm abnormalities, and lifestyle factors such as stress, smoking, and diet (Mascarenhas et al., 2021).

The emotional and social burden of infertility can be profound, particularly in cultures where procreation is highly valued. In many societies, infertility is perceived as a personal failure, and women, in particular, often experience stigmatization, isolation, and marital stress (Amini et al., 2018). While medical advancements have improved the ability to diagnose and treat infertility, the psychological and emotional toll remains largely overlooked in many healthcare systems.

Research has shown that the coping strategies adopted by individuals facing infertility are influenced by their perceptions of the problem, cultural expectations, and the availability of social and medical support. According to Greil et al. (2018), individuals who perceive infertility as a temporary challenge are more likely to adopt active coping strategies, such as seeking medical treatment or engaging in problem-solving behaviors. Conversely, those who view infertility as a permanent or uncontrollable condition may resort to emotion-focused strategies, such as avoidance, denial, or seeking social and spiritual support (Peterson et al., 2019). Therefore, in Nigeria where the research was carried out, the activities that was conducted is to know the perception of problems and coping strategies of clients with infertility.

1.3 Statement of Problems

Investigation revealed that individuals experiencing infertility often perceive it as a personal failure, which results in heightened emotional distress and mental health problems such as depression, anxiety, and lowered self-esteem (Greil et al., 2018). Social stigma is another major problem associated with infertility. In many societies, women are disproportionately blamed for infertility, even when male factors are involved. This gendered perception leads to social isolation, marital tension, and even instances of divorce or abandonment (Amini et al., 2018).

Infertility treatment is often physically and emotionally draining, but another critical issue is that not all individuals have access to adequate medical and psychological support. Many clients dealing with infertility rely on alternative coping strategies, such as religious or traditional methods, in the absence of appropriate medical interventions (Peterson et al., 2019). This lack of comprehensive support exacerbates the psychological burden and leads to prolonged emotional suffering.

Additionally, there is a lack of awareness and education about infertility, which leads to misconceptions and myths. Many clients may not fully understand the causes or treatments available, which create feelings of hopelessness and helplessness. This misinformation further hinders their ability to cope effectively with the problem and often delays seeking proper medical assistance (Fledderjohann, 2012). It is against the backdrop that this study seeks to address these problems by evaluating the perception of problems and coping strategies of clients with infertility.

1.4 Aim and Objectives of Study

The aim of the study is to explore the perception of problems and coping strategies of clients with infertility. In achieving this aim, the following specific objectives were laid out as follows:

1. To assess how clients perceive infertility and the associated emotional and psychological problems.
2. To identify the key social and cultural factors influencing the perception of infertility.
3. To investigate the common coping strategies employed by individuals dealing with infertility.
4. To examine the role of healthcare systems in supporting clients with infertility-related challenges.
5. To explore the relationship between coping strategies and emotional well-being among clients facing infertility.

1.5 Research Questions

The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:

• How do clients perceive the emotional and psychological challenges associated with infertility?
• What are the key social and cultural factors that influence the perception of infertility among clients?
• What are the most common coping strategies employed by individuals experiencing infertility?
• How do healthcare systems and professionals support clients in managing the problems related to infertility?
• What is the relationship between the coping strategies used by clients and their emotional well-being?

1.6 Research Hypothesis

In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.

Hypothesis One

• H0: There is no significant relationship between clients' perception of infertility and the coping strategies they adopt.
• H1: There is a significant relationship between clients' perception of infertility and the coping strategies they adopt.

Hypothesis Two

• H0: Social and cultural factors do not significantly influence the perception of problems faced by clients with infertility.
• H1: Social and cultural factors significantly influence the perception of problems faced by clients with infertility.

1.7 Significance of Study

This study will help healthcare providers by offering insights into the psychological and emotional challenges that clients with infertility face, enabling them to provide more empathetic and comprehensive care. It will also benefit clients and patients by identifying effective coping strategies, which can improve their emotional well-being and provide them with practical tools for managing the stress associated with infertility.

Additionally, the study will inform policy makers by highlighting the social and cultural factors influencing infertility perceptions, aiding in the creation of policies and programs that better support individuals dealing with infertility.

Furthermore, counselors and therapists will gain a deeper understanding of the mental health challenges linked to infertility, allowing them to design targeted interventions that address the specific needs of this population. More so, researchers will benefit from the study's findings, as it will fill gaps in the literature and provide a foundation for future studies on infertility, coping strategies, and emotional well-being.

1.8 Scope of Study

The scope of the research is focused on the perception of problems and coping strategies of clients with infertility using Osi Local Government Area of Ekiti State as a case study.

1.9 Limitations of the Study

During the course of this study, there were some problems encountered which stood as limitations to the research work. Some of the limitations include:

1. Delays in Response from Respondents: Many clients faced challenges in providing timely responses due to their emotional states or scheduling conflicts, which resulted in incomplete data and potentially biased results.
2. Financial Constraint: Limiting the resources available for data collection and participant recruitment. This limitation affected the study's scope, as it restricted the ability to reach a larger sample size or conduct in-depth interviews.
3. Time Constraint: As the study was conducted within a fixed timeframe. This restriction affected the depth of exploration into the various aspects of clients' perceptions and coping strategies, potentially leading to a less comprehensive understanding of the issue.

1.10 Definition of Terms

Infertility: Infertility is defined as the inability to conceive after 12 months of regular unprotected sexual intercourse (World Health Organization, 2020). It encompasses both male and female factors and can be classified as primary infertility, which refers to individuals who have never achieved pregnancy, and secondary infertility, which pertains to those who have previously conceived but are unable to do so again.

Perception: Perception refers to the process by which individuals interpret and make sense of their experiences and the world around them. in the context of infertility, it involves how clients understand and internalize their infertility status, including the emotional and social implications it carries (Greil et al., 2010).

Coping Strategies: Coping strategies are defined as the cognitive and behavioral efforts that individuals employ to manage the internal and external demands of stressful situations. in the context of infertility, these strategies may include problem-focused coping (actively seeking solutions) and emotion-focused coping (managing emotions and seeking support) (Folkman & Moskowitz, 2004).

Emotional Well-being: Emotional well-being encompasses the overall emotional quality of an individual's experiences and includes feelings of happiness, contentment, and fulfillment. in the case of individuals facing infertility, emotional well-being is often negatively affected due to stress, anxiety, and feelings of inadequacy (Peterson et al., 2019).