Assessing infertility stress: Re-examining the factor structure of the Fertility Problem Inventory

Abstract

Background: Research has documented that fertility problems can negatively affect infertile patients life, by imposing an obstacle to one important life goal: the achievement of parenthood. The Fertility Problem Inventory (FPI) proposes a comprehensive approach in assessing infertility stress, by measuring the impact on social, marital and sexual life dimensions and the importance of parenthood in infertile patients’ life. This study examined the factor structure of the FPI, testing two alternative models. Method: A sample of 209 infertile patients was recruited in two public hospital departments of assisted reproductive technology. Measures included the FPI, the Brief Symptom Inventory, and the ENRICH Marital Inventory. Two higher-order factor models were tested using a confirmatory factor analysis. Results: Results confirmed the original measurement model of the instrument but suggested that the inclusion of an intermediate conceptual level resulted in a better fit to the model, i.e., the instrument assesses infertility related stress by assessing two main conceptual domains: the impact of infertility in infertile patients’ life and representations about the importance of parenthood in one’s life. The instrument revealed measurement and structure invariance. The FPI also revealed good construct validity by correlating with other measures assessing similar constructs. Conclusions: This approach to the FPI has important contributions for both research and clinical practice by distinguishing between the impact of infertility on different dimensions couples’ life and representations about the importance of parenthood in one’s life, therefore extending the utility of the FPI in research and clinical practice.