Going through treatment for infertility does not increase couples' risk of breaking up, a large study has found. Researchers hope that this will provide much-needed reassurance to those who are considering in-vitro fertilisation (IVF).

In the past decades, a lot of studies looking at the psychological impact of infertility and its treatment have been published. Many have shown that undergoing IVF greatly increases couples' stress and anxiety levels, with some papers claiming that this puts intolerable strain on the marriage or the partnership.

In 2014, a large study based on data from a Danish register showed that couples who didn't succeed in having a child after treatment were more likely to separate. However, more research was needed to find out whether it was the stress associated with treatment or the failure to have a child which was to blame for the relationship breaking down.

The new study presented at the annual meeting of the European Society of Human Reproduction and Embryology is also based on Danish data. It suggests that treatment-related anxiety per se does not increase the risk of divorce or separation, but remaining childless after treatment does.

Stress and childlessness

The scientists, led by Dr Mariana Martins from the University of Porto, analysed the data of 42,845 women who had received assisted reproduction treatment (ART) in Denmark between 1994 and 2009. Their relationship status was monitored during the 16 years of follow-up. The results were compared with that of women from the general population, who acted as controls.

Throughout the study period, more than half of the couples ended up having a child. However, about a fifth of all couples broke up – a figure which was similar for controls after adjusting for other factors, including the partners' age and education.

Compared with controls, the risk of divorcing is not higher in people who receive ART. The findings suggest that childlessness after treatment has more influence on a couple's chances of separating than stress of treatment has.

That being said, patients who are most stressed at the beginning of treatment, seem to be more likely to break-up than those who are less stressed.

"We have previously found that subjects who divorce, repartner and come back to treatment are the ones that five years before had the most stress," Martins explained. "We also know that despite all the strain that this infertility can bring, going through ART can actually bring benefit to a couple's relationship, because it forces them to improve communication and coping strategies."

Today, most counselling interventions for infertile couples are aimed at reducing stress while treatment is on-going. However, more could be done to prepare people for the impact that treatment-related anxiety can have on their relationship - and to advise them on how to handle disappointment if treatment does not succeed.

"We believe that providing couples with appropriate knowledge and expectations about success rates and the burden that ART can bring to a marriage will make that treatment much easier for most couples," Martins said.