Experiences of involuntary childlessness and treatment in the UK: what has changed in 20 years?

Article


Payne, N., Seenan, S. and van den Akker, O. 2021. Experiences of involuntary childlessness and treatment in the UK: what has changed in 20 years? Human Fertility. 24 (5), pp. 333-340. https://doi.org/10.1080/14647273.2019.1687946
TypeArticle
TitleExperiences of involuntary childlessness and treatment in the UK: what has changed in 20 years?
AuthorsPayne, N., Seenan, S. and van den Akker, O.
Abstract

This study examined the financial, emotional and relationship impacts of involuntary childlessness and treatment, and satisfaction with support from professionals. 796 participants in the UK completed an online survey based on a survey conducted in 1997. 55% of participants had to pay for at least part of their treatment. High levels of distress were experienced and 42% experienced suicidal feelings at least occasionally. Those most at risk of suffering distress and suicidal feelings at some point had only experienced unsuccessful treatment outcomes, spent longer trying to conceive and experienced some relationship strains. 75% would like to have counselling if it were free but 45% received counselling and 54% of these had to fund some of it themselves. Thus although advances have been made in the availability of funded treatment and psychological support, involuntary childlessness and treatment continue to have financial, emotional and relationship consequences for many people. While counselling was generally reported to be useful, a whole clinic approach involving all fertility clinic staff in the psychosocial care of clients is advisable.

KeywordsInvoluntary childlessness; fertility treatment; distress; counselling; support; funding
Research GroupApplied Health Psychology group
PublisherTaylor and Francis
JournalHuman Fertility
ISSN1464-7273
Electronic1742-8149
Publication dates
Online11 Nov 2019
Print20 Oct 2021
Publication process dates
Deposited08 Jul 2019
Accepted04 Jul 2019
Submitted25 Jul 2017
Output statusPublished
Accepted author manuscript
Copyright Statement

This is an Accepted Manuscript of an article published by Taylor & Francis in Human Fertility on 11/11/2019, available online: http://www.tandfonline.com/10.1080/14647273.2019.1687946

Digital Object Identifier (DOI)https://doi.org/10.1080/14647273.2019.1687946
Web of Science identifierWOS:000495524400001
LanguageEnglish
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Payne, N. 2006. Learning, teaching and assessment in health psychology. Health Psychology Update. 15 (2), pp. 4-5.
Family based behavioural management of childhood obesity: Service evaluation of a group programme run in a community setting in the UK.
Murdoch, M., Payne, N., Samani-Radia, D., Rosen-Webb, J., Walker, L., Howe, M. and Lewis, P. 2011. Family based behavioural management of childhood obesity: Service evaluation of a group programme run in a community setting in the UK. European Journal of Clinical Nutrition. 65 (6), pp. 764-767. https://doi.org/10.1038/ejcn.2011.23
Alcohol and fertility
van den Akker, O. 2008. Alcohol and fertility. in: Martin, C. (ed.) Identification and Treatment of Alcohol Dependency M&K Publishers. pp. 349-363
Maternal mental health and wellbeing
Redshaw, M. and van den Akker, O. 2007. Maternal mental health and wellbeing. Journal of Reproductive and Infant Psychology. 25 (4), pp. 253-254. https://doi.org/10.1080/02646830701669497
The contextual challenges of successfully becoming a parent - from inception to completion
van den Akker, O. and Redshaw, M. 2008. The contextual challenges of successfully becoming a parent - from inception to completion. Journal of Reproductive and Infant Psychology. 26 (1), pp. 1-3. https://doi.org/10.1080/02646830701810257
Understanding factors which can influence the experience of pregnancy and childbirth
Redshaw, M. and van den Akker, O. 2008. Understanding factors which can influence the experience of pregnancy and childbirth. Journal of Reproductive and Infant Psychology. 26 (2), pp. 71-73. https://doi.org/10.1080/02646830802016036
Nature and nurture: what do theory and research tell us?
van den Akker, O. 2010. Nature and nurture: what do theory and research tell us? in: Crawshaw, M. and Balen, R. (ed.) Adopting after Infertility: Messages from Practice, Research and Personal Experience Jessica Kingsley Publishers. pp. 164-179
Surrogate mothers
van den Akker, O. 2010. Surrogate mothers. in: Tyano, S., Keren, M., Herrman, H. and Cox, J. (ed.) Parenthood and Mental Health: a Bridge Between Infant and Adult Psychiatry WileyBlackwell. pp. 39-49
How do we view alternative families?
van den Akker, O. 2007. How do we view alternative families? BioNews.
Learning, teaching and assessment of Health Psychology MSc courses: results from a survey.
Payne, N. 2008. Learning, teaching and assessment of Health Psychology MSc courses: results from a survey. Health Psychology Update. 17 (2), pp. 34-40.
Surrogate motherhood: a critical perspective
van den Akker, O. 2010. Surrogate motherhood: a critical perspective. Expert Review of Obstetrics & Gynecology. 5 (1), pp. 5-7. https://doi.org/10.1586/eog.09.69
The complete guide to infertility: diagnosis, treatment, options
van den Akker, O. 2002. The complete guide to infertility: diagnosis, treatment, options. Free Association Books.
A study of the effect of message framing on oocyte donation
Purewal, S. and van den Akker, O. 2009. A study of the effect of message framing on oocyte donation. Human Reproduction. 24 (12), pp. 3136-3143. https://doi.org/10.1093/humrep/dep342
I feel like they were mine and I should be looking after them: an exploration of non-patient women's attitudes towards oocyte donation
Purewal, S. and van den Akker, O. 2009. I feel like they were mine and I should be looking after them: an exploration of non-patient women's attitudes towards oocyte donation. Journal of Psychosomatic Obstetrics and Gynecology. 30 (4), pp. 215-222. https://doi.org/10.3109/01674820903348732
Evaluation of an intervention to help students avoid unintentional plagiarism by improving their authorial identity
Elander, J., Pittam, G., Lusher, J., Fox, P. and Payne, N. 2010. Evaluation of an intervention to help students avoid unintentional plagiarism by improving their authorial identity. Assessment & Evaluation in Higher Education. 35 (2), pp. 157-171. https://doi.org/10.1080/02602930802687745
A daily diary investigation of the impact of work stress on exercise intention realisation: Can planning overcome the disruptive influence of work?
Payne, N., Jones, F. and Harris, P. 2010. A daily diary investigation of the impact of work stress on exercise intention realisation: Can planning overcome the disruptive influence of work? Psychology & Health. 25 (1), pp. 111-129. https://doi.org/10.1080/08870440903337622
Attitudes and intention to donate oocytes for research
Purewal, S. and van den Akker, O. 2010. Attitudes and intention to donate oocytes for research. Fertility and Sterility. 93 (4), pp. 1080-1087. https://doi.org/10.1016/j.fertnstert.2008.11.021
Beliefs and attitudes during pregnancy and post natally [Editorial]
Redshaw, M. and van den Akker, O. 2008. Beliefs and attitudes during pregnancy and post natally [Editorial]. Journal of Reproductive and Infant Psychology. 26 (3), pp. 155-156. https://doi.org/10.1080/02646830802224432
The nature of relationships: maltreatment, mothering and migration [Editorial]
Redshaw, M. and van den Akker, O. 2006. The nature of relationships: maltreatment, mothering and migration [Editorial]. Journal of Reproductive and Infant Psychology. 24 (3), pp. 183-185. https://doi.org/10.1080/02646830600821215
Pregnancy and postnatal states and support: the effects of the partner [Editorial]
Redshaw, M. and van den Akker, O. 2007. Pregnancy and postnatal states and support: the effects of the partner [Editorial]. Journal of Reproductive and Infant Psychology. 25 (3), pp. 171-172. https://doi.org/10.1080/02646830701470243
Factors influencing attitudes towards potential oocyte donation for research
Purewal, S. and van den Akker, O. 2008. Factors influencing attitudes towards potential oocyte donation for research. Annual Conference of the British Psychological Society.. The Royal Dublin Society, Ireland.
Contribution of generalized negative affect to elevated menstrual cycle symptom reporting
van den Akker, O., Sharifian, N., Packer, A. and Eves, F. 1995. Contribution of generalized negative affect to elevated menstrual cycle symptom reporting. Health Care for Women International. 16 (3), pp. 263-272. https://doi.org/10.1080/07399339509516177
British women's attitudes towards oocyte donation: ethnic differences and altruism
Purewal, S. and van den Akker, O. 2006. British women's attitudes towards oocyte donation: ethnic differences and altruism. Patient Education and Counseling. 64 (1), pp. 43-49. https://doi.org/10.1016/j.pec.2005.11.007
The feasibility of nursing patients with sickle cell crisis at home
Smith-Wynter, L. and van den Akker, O. 1999. The feasibility of nursing patients with sickle cell crisis at home. British Journal of Community Nursing. 4 (10), pp. 531-537.
Patient perceptions of crisis pain management in sickle cell disease: a cross-cultural study
Smith-Wynter, L. and van den Akker, O. 2000. Patient perceptions of crisis pain management in sickle cell disease: a cross-cultural study. Nursing Times Research. 5 (3), pp. 204-213. https://doi.org/10.1177/136140960000500307
A review of psychosocial and family functioning following assisted reproductive treatment
Segev, J. and van den Akker, O. 2006. A review of psychosocial and family functioning following assisted reproductive treatment. Clinical Effectiveness in Nursing. 9 (Supple), pp. e162-e170. https://doi.org/10.1016/j.cein.2006.08.002
Psychological adaptation and symptom distress in bone marrow transplant recipients
Molassiotis, A., van den Akker, O., Milligan, D., Goldman, J. and Boughton, B. 1996. Psychological adaptation and symptom distress in bone marrow transplant recipients. Psycho-Oncology. 5 (1), pp. 9-22. https://doi.org/10.1002/(SICI)1099-1611(199603)5:1<9::AID-PON198>3.0.CO;2-4
Psychological trait and state characteristics, social support and attitudes to the surrogate pregnancy and baby
van den Akker, O. 2007. Psychological trait and state characteristics, social support and attitudes to the surrogate pregnancy and baby. Human Reproduction. 22 (8), pp. 2287-2295. https://doi.org/10.1093/humrep/dem155
Organizational selection and assessment of women entering a surrogacy agreement in the UK
van den Akker, O. 1999. Organizational selection and assessment of women entering a surrogacy agreement in the UK. Human Reproduction. 14 (1), pp. 262-266. https://doi.org/10.1093/humrep/14.1.262
Genetic and environmental factors in premenstrual symptom reporting and its relationship to depression and a general neuroticism trait
van den Akker, O., Eves, F., Stein, G. and Murray, R. 1995. Genetic and environmental factors in premenstrual symptom reporting and its relationship to depression and a general neuroticism trait. Journal of Psychosomatic Research. 39 (4), pp. 477-487. https://doi.org/10.1016/0022-3999(94)00152-U
Coping, quality of life and psychological symptoms in three groups of sub-fertile women
van den Akker, O. 2005. Coping, quality of life and psychological symptoms in three groups of sub-fertile women. Patient Education and Counseling. 57 (2), pp. 183-189. https://doi.org/10.1016/j.pec.2004.05.012
A longitudinal pre-pregnancy to post-delivery comparison of genetic and gestational surrogate and intended mothers: confidence and genealogy
van den Akker, O. 2005. A longitudinal pre-pregnancy to post-delivery comparison of genetic and gestational surrogate and intended mothers: confidence and genealogy. Journal of Psychosomatic Obstetrics and Gynecology. 26 (4), pp. 277-284. https://doi.org/10.1080/01674820500165745
Genetic and gestational surrogate mothers' experience of surrogacy
van den Akker, O. 2003. Genetic and gestational surrogate mothers' experience of surrogacy. Journal of Reproductive and Infant Psychology. 21 (2), pp. 145-161. https://doi.org/10.1080/0264683031000124091
The acceptable face of parenthood: the relative status of biological and cultural interpretations of offspring in infertility treatment
van den Akker, O. 2001. The acceptable face of parenthood: the relative status of biological and cultural interpretations of offspring in infertility treatment. Psychology, Evolution & Gender. 3 (2), pp. 137-153. https://doi.org/10.1080/14616660110067366
Leisure activities and adolescent sexual behaviour
van den Akker, O. and Lees, S. 2001. Leisure activities and adolescent sexual behaviour. Sex Education. 1 (2), pp. 137-147. https://doi.org/10.1080/14681810120052560
Adoption in the age of reproductive technology
van den Akker, O. 2001. Adoption in the age of reproductive technology. Journal of Reproductive and Infant Psychology. 19 (2), pp. 147-159. https://doi.org/10.1080/02646830125231
A review of family donor constructs: current research and future directions
van den Akker, O. 2006. A review of family donor constructs: current research and future directions. Human Reproduction Update. 12 (2), pp. 91-101. https://doi.org/10.1093/humupd/dmi038
The importance of a genetic link in mothers commissioning a surrogate baby in the UK
van den Akker, O. 2000. The importance of a genetic link in mothers commissioning a surrogate baby in the UK. Human Reproduction. 15 (8), pp. 1849-1855. https://doi.org/10.1093/humrep/15.8.1849
Surrogate motherhood: demystifying the controversies
van den Akker, O. 1998. Surrogate motherhood: demystifying the controversies. British Journal of Midwifery. 6 (12), pp. 768-770.
Functions and responsibilities of organizations dealing with surrogate motherhood in the UK
van den Akker, O. 1998. Functions and responsibilities of organizations dealing with surrogate motherhood in the UK. Human Fertility. 1 (1), pp. 10-13. https://doi.org/10.1080/1464727982000198031
Adolescent sexual behaviour and knowledge
van den Akker, O., Andre, J., Lees, S. and Murphy, T. 1999. Adolescent sexual behaviour and knowledge. British Journal of Midwifery. 7 (12), pp. 765-769.
Psychosocial aspects of surrogate motherhood
van den Akker, O. 2007. Psychosocial aspects of surrogate motherhood. Human Reproduction Update. 13 (1), pp. 53-62. https://doi.org/10.1093/humupd/dml039
Something old, something new, something borrowed, and something taboo
van den Akker, O. 1994. Something old, something new, something borrowed, and something taboo. Journal of Reproductive and Infant Psychology. 12 (3), pp. 179-188. https://doi.org/10.1080/02646839408408884
Psychophysiological responses in women reporting severe premenstrual symptoms
van den Akker, O. and Steptoe, A. 1989. Psychophysiological responses in women reporting severe premenstrual symptoms. Psychosomatic Medicine: Journal of Biobehavioral Medicine. 51 (3), pp. 319-328.
Menstrual cycle symptom reporting in three British ethnic groups
van den Akker, O., Eves, F., Service, S. and Lennon, B. 1995. Menstrual cycle symptom reporting in three British ethnic groups. Social Science & Medicine. 40 (10), pp. 1417-1423. https://doi.org/10.1016/0277-9536(94)00265-U
The retrospective diagnosis of postnatal depression by questionnaire
Stein, G. and van den Akker, O. 1992. The retrospective diagnosis of postnatal depression by questionnaire. Journal of Psychosomatic Research. 36 (1), pp. 67-75. https://doi.org/10.1016/0022-3999(92)90115-I
Comparison of the overall quality of life in 50 long-term survivors of autologous and allogeneic bone marrow transplantation
Molassiotis, A., Boughton, B., Burgoyne, T. and van den Akker, O. 1995. Comparison of the overall quality of life in 50 long-term survivors of autologous and allogeneic bone marrow transplantation. Journal of Advanced Nursing. 22 (3), pp. 509-516. https://doi.org/10.1046/j.1365-2648.1995.22030509.x
Symptom distress, coping style and biological variables as predictors of survival after bone marrow transplantation
Molassiotis, A., van den Akker, O., Milligan, D. and Goldman, J. 1997. Symptom distress, coping style and biological variables as predictors of survival after bone marrow transplantation. Journal of Psychosomatic Research. 42 (3), pp. 275-285. https://doi.org/10.1016/S0022-3999(96)00298-X
Perceived social support, family environment and psychosocial recovery in bone marrow transplant long-term survivors
Molassiotis, A., van den Akker, O. and Boughton, B. 1997. Perceived social support, family environment and psychosocial recovery in bone marrow transplant long-term survivors. Social Science & Medicine. 44 (3), pp. 317-325. https://doi.org/10.1016/S0277-9536(96)00101-3
The quality of life of renal dialysis patients: trying to find the missing measurement
Killingworth, A. and van den Akker, O. 1996. The quality of life of renal dialysis patients: trying to find the missing measurement. International Journal of Nursing Studies. 33 (1), pp. 107-120. https://doi.org/10.1016/0020-7489(95)00040-2
Dysmenorrhoea, mental attitude and GP consultation
Hewison, A. and van den Akker, O. 1996. Dysmenorrhoea, mental attitude and GP consultation. British Journal of Nursing. 5 (8), pp. 480-484.
Service provision for sickle-cell disease: school-based education
Eboh, W. and van den Akker, O. 1996. Service provision for sickle-cell disease: school-based education. British Journal of Nursing. 5 (1), pp. 30-33.
eHealth as a challenge to ‘expert’ power: a focus group study of internet use for health information and management
Donnelly, L., Shaw, R. and van den Akker, O. 2008. eHealth as a challenge to ‘expert’ power: a focus group study of internet use for health information and management. Journal of the Royal Society of Medicine. 101 (10), pp. 501-506. https://doi.org/10.1258/jrsm.2008.080156
Developing a Year 9 safe-sun programme: adolescents form a particularly high-risk group, in need of specific skin-protective information and advice
Colley, K. and van den Akker, O. 1998. Developing a Year 9 safe-sun programme: adolescents form a particularly high-risk group, in need of specific skin-protective information and advice. Education and Health. 16 (3), pp. 42-47.
Disclosing donor information: a new code of silence?
Blyth, E., Crawshaw, M. and van den Akker, O. 2009. Disclosing donor information: a new code of silence? BioNews.
Attitudes and intentions towards volunteer oocyte donation
Purewal, S. and van den Akker, O. 2009. Attitudes and intentions towards volunteer oocyte donation. Reproductive BioMedicine Online. 19, pp. 19-26. https://doi.org/10.1016/S1472-6483(10)60059-4
Systematic review of oocyte donation: investigating attitudes, motivations and experiences
Purewal, S. and van den Akker, O. 2009. Systematic review of oocyte donation: investigating attitudes, motivations and experiences. Human Reproduction Update. 15 (5), pp. 499-515. https://doi.org/10.1093/humupd/dmp018
The socio-cultural and biological meaning of parenthood
Purewal, S. and van den Akker, O. 2007. The socio-cultural and biological meaning of parenthood. Journal of Psychosomatic Obstetrics and Gynecology. 28 (2), pp. 79-86.
The impact of job strain on the predictive validity of the theory of planned behaviour: an investigation of exercise and healthy eating
Payne, N., Jones, F. and Harris, P. 2005. The impact of job strain on the predictive validity of the theory of planned behaviour: an investigation of exercise and healthy eating. British Journal of Health Psychology. 10 (1), pp. 115-131. https://doi.org/10.1348/135910704X14636
Occupational stressors and coping as determinants of burnout in female hospice nurses
Payne, N. 2001. Occupational stressors and coping as determinants of burnout in female hospice nurses. Journal of Advanced Nursing. 33 (3), pp. 396-405. https://doi.org/10.1046/j.1365-2648.2001.01677.x
Student beliefs and attitudes about authorial identity in academic writing
Pittam, G., Elander, J., Lusher, J., Fox, P. and Payne, N. 2009. Student beliefs and attitudes about authorial identity in academic writing. Studies in Higher Education. 34 (2), pp. 153-170. https://doi.org/10.1080/03075070802528270
Work stress and health behaviour: daily diary methodology and multilevel modelling
Payne, N. and Jones, F. 2007. Work stress and health behaviour: daily diary methodology and multilevel modelling. Health Psychology Update. 16 (3), pp. 13-20. https://doi.org/10.53841/bpshpu.2007.16.3.13
Work stress and health behaviours: a work—life balance issue
Jones, F., Kinman, G. and Payne, N. 2006. Work stress and health behaviours: a work—life balance issue. in: Jones, F., Burke, R. and Westman, M. (ed.) Work-life balance: a psychological perspective Psychology Press. pp. 185-216
The role of perceived need within the theory of planned behaviour: a comparison of exercise and healthy eating
Payne, N., Jones, F. and Harris, P. 2004. The role of perceived need within the theory of planned behaviour: a comparison of exercise and healthy eating. British Journal of Health Psychology. 9 (4), pp. 489-504. https://doi.org/10.1348/1359107042304524
The impact of working life on health behavior: the effect of job strain on the cognitive predictors of exercise
Payne, N., Jones, F. and Harris, P. 2002. The impact of working life on health behavior: the effect of job strain on the cognitive predictors of exercise. Journal of Occupational Health Psychology. 7 (4), pp. 342-353. https://doi.org/10.1037/1076-8998.7.4.342
The pattern and prevalence of symptoms during the menstrual cycle
van den Akker, O. and Steptoe, A. 1985. The pattern and prevalence of symptoms during the menstrual cycle. The British Journal of Psychiatry. 147 (2), pp. 164-169. https://doi.org/10.1192/bjp.147.2.164