Exploring the psychological implications of infertility among IVF parents in Uganda using the transactional theory of stress and coping

INTRODUCTION: Infertility is on the rise among couples of reproductive age globally. In Uganda, while the prevalence of infertility has varied in recent studies due to differences in definitions and measures used, there is growing evidence for risks faced by those directly affected. The experiences and impact of involuntary infertility among the affected individuals and/or couples in Uganda have however not been extensively examined. This study examined the experiences of infertility before a decision to do In Vitro Fertilization (IVF) among individuals or couples who successfully had children through IVF treatment in Uganda. METHODS: In this qualitative phenomenological study, we conducted individual in-person or virtual audio-recorded in-depth interviews with eight participants (one couple and six spouses). Audio recordings were transcribed verbatim and transcripts thematically analyzed. RESULTS: Four themes emerged: (1) Personal and social expectations (2) Frustrations with seeking help, inconclusive medical tests and delays in diagnosis (3) Stigma from family, workplace and community and (4) Psychological and emotional effects of infertility. These themes show growing distress due to failure to have normal conception as per personal and societal expectations. Finding care and the delays in diagnosis were frustrating for participants. Participants' emotional and mental health problems resulted from a combination of factors such as unmet expectations of early conception; stigma and challenges with care and diagnosis. CONCLUSION: The stress that comes with delays in conception is exacerbated by a prolonged search for possible causes of ongoing infertility and diagnosis. A socio-cultural environment that espouses traditional beliefs and expectations about normality of conception increases risks of stigma and serious emotional and mental health problems among individuals facing infertility in Uganda. Public health campaigns on negative beliefs about infertility can reduce the psychological impact on affected individuals and couples.