Psychological adjustment of infertile couples in the postpartum period: the characteristics of parental mental representations and early parent-infant interactions

Clinical and empirical literature has recognized Assisted Reproductive Technology (ART) as a stressful condition that may impact on psychological transition to parenthood during pregnancy. However, poor attention has been paid to investigate parental adjustment in the postpartum period, a crucial moment for the parent-infant relationship. We therefore aimed to investigate transition to motherhood and fatherhood in the postnatal period, discussing an overview of recent studies on postnatal outcomes (parental representations and parent-infant interactions) of infertile couples after a successful ART treatment. The first study included a sample of 17 ART conceiving and 25 spontaneous conception (SC) couples; at 3 months postpartum all parents completed the Semantic Differential of IRMAG/IRPAG (Interview of Maternal/Paternal Representations During Pregnancy; Ammaniti et al., 1992, 1995, 2006), a self-report tool to evaluate domains of mental representations according to individual (Child, Self-as-womanman, and Partner) and parental (Self-as-parent, Own parent) characteristics. The second study aimed to assess the quality of a 5-minute free parent–infant interaction on 25 ART and 31 SC couples and their 3-month-old baby. Fathers, mothers and babies’ interactive patterns were coded using CARE-Index (Crittenden, 1994). Results on mental representations showed that both ART mothers and fathers had significantly higher positive representations of the Child than SC ones. The type of ART treatment (IVF/ICSI) showed a significant influence on the representation of Self-as-woman/man, with higher positive scores in IVF parents compared to ICSI ones. Regarding parent-infant interactions, both ART mothers and fathers showed more frequently “inept” and “at-risk” interactive patterns, compared to SC ones. ART variables significantly influenced interactive behaviours: infants conceived at first ART cycle showed lower scores at Difficulty scale than those conceived after more attempts; ICSI babies got lower scores at Compulsivity and higher at Passivity compared to IVF ones. These findings support the clinical relevance of exploring parents’ psychological adjustment after successful ART treatments, to improve the understanding of the transition to parenthood in infertile couples and to target more specific interventions when needed.