Award Date

5-2010

Degree Type

Dissertation

Degree Name

Doctor of Philosophy in Nursing

Department

Nursing

First Committee Member

Yu Xu, Chair

Second Committee Member

Tish Smyer

Third Committee Member

Cheryl Bowles

Graduate Faculty Representative

LeAnn Putney

Number of Pages

285

Abstract

Infertility affects about 7.3 million women and their partners in the U.S., about 12% of the reproductive-age population. In vitro fertilization (IVF) has been used successfully in the United States since 1981. The number of women seeking artificial reproductive techniques (ART) has increased dramatically and the number of ART cycles performed in the United States has more than doubled, from 64,681 in 1996 to 134,260 in 2005 and 99% of these are IVF. Studies indicated that women rank waiting for the outcome of and IVF treatment and a negative pregnancy result as the most stressful events during their treatment. Although men and women report being satisfied with the medical care received during infertility treatment, they are less satisfied with their psychosocial care. One of the most frequent concerns reported in the literature regarding infertile couples' perceptions of their experiences was the lack of understanding and knowledge by health care providers, including nurses, who did not understand what the couples were experiencing and a lack of psychological support provided to. The literature indicates little is known about women's experiences during the 10-14 day window following embryo transfer prior to determination of pregnancy, and the meaning women ascribe to their non-implanted embryo(s) following embryo transfer. The American Psychological Association (APA) lists the "examination of risk factors for negative psychosocial outcomes in those who confront infertility is required, as is documentation of the efficacy of interventions designed to decrease psychological morbidity" as a research priority. Research to discover additional knowledge about the experiences of women who receive IVF was warranted to ensure that nurses, physicians, and other health care members provide appropriate education, support, and intervention to this already vulnerable population.

The purpose of this research was to: (a.) understand the experiences of women who receive IVF during the 10-14 day window following embryo transfer and prior to determination of a quantitative beta hCG pregnancy test, and (b.) discover the meanings women ascribe to their non-implanted embryo(s) following embryo transfer and prior to knowing their quantitative beta hCG pregnancy test result. The research question was: What are the lived experiences of women who receive in vitro fertilization during the period of time following embryo transfer and prior to knowing the outcome of their initial quantitative beta hCG pregnancy test? From a purposeful sample, a total of six women were interviewed. Methods for data collection include in-depth interviews and journal records. All data was coded and analyzed for emergent themes. Van Manen's (1997) phenomenological method and Four Existential Lifeworlds were used to guide the interpretation and discover the women's experiences. The essence of the phenomenon emerged as essential themes through the participant's vivid descriptions of their daily lives. The analysis revealed Waiting was the overarching essential theme and how the women waited was revealed as eight sub-themes: Hope, Awareness, Doubt, Anxiety, Isolation, Vulnerability, Despair, and Anticipation. The long-term objectives of this study are to (a) educate nurses and other healthcare workers, and the women who experience IVF including the families who support them; and (b) improve the level of health care received by women who experience IVF. Implications are addressed in the study and may lead to improvements in nursing education and the fertility care of women undergoing IVF treatments.

Keywords

Fertilization in vitro; Human psychological aspects; Human embryo transplantation; Infertility treatment psychological aspects; Women mental health

Disciplines

Mental and Social Health | Nursing | Obstetrics and Gynecology | Reproductive and Urinary Physiology

Language

English


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