Psychosocial adjustment and the quality of the mother-child relationship at four months postpartum after conception by in vitro fertilization

Objective: To examine psychological adjustment to early motherhood at 4 months postpartum in mothers who conceived by IVF-ET. Design: Controlled clinical study. Setting: Healthy human volunteers in an academic research environment. Patient(s): Sixty-five primiparous women undergoing IVF-ET and 62 age-matched primiparous women with no history of infertility. Intervention(s): Completion of questionnaires, interviews, and videotaped interaction. Main Outcome Measure(s): Maternal self-reports of psychosocial adjustment and behavioral ratings of quality of mother-infant interaction based on a videotaped observation scored blind to IVF-ET status. Result(s): Mothers who conceived by IVF-ET did not differ from control mothers on measures of anxiety, postnatal depression, marital satisfaction, or use of support services. However, they reported lower self-esteem and lower maternal self-efficacy, and they rated their infants as more temperamentally difficult. (Ratings of temperament difficulty for the infants of mothers who conceived by IVF-ET are within the normal range when compared with Australian normative data for this age group.) The videotapes revealed no group differences in maternal behaviors, but the infants of mothers who conceived by IVF-ET displayed more negative behaviors in response to an interactive stress. Group differences were accounted for largely by those mothers who underwent more than one treatment cycle and by their infants. Conclusion(s): Overall, the results are reassuring for parents who conceive by IVF-ET. However, specific adjustment measures reveal some minor difficulties and suggest that mothers who conceive by IVF-ET may benefit from increased support in the early postpartum months.