دلبستگی، سازگاری و اضطراب در زنان باردار به روش لقاح خارج از رحم: مقایسه با گروه کنترل

زهرا   پیرحسنی; لیلا خبیر; الناز  فتحی کلجاهی

Authors

Zahra Pirhasani Master of Science, Department of Psychology, Shi.C., Islamic Azad University, Shiraz, Iran Author https://orcid.org/0009-0001-1334-6276
Leila Khabir Assistant Professor, Department of Psychology, Shi.C., Islamic Azad University, Shiraz, Iran. https://orcid.org/0000-0003-4068-9749
Elnaz Fathi Kaljahi Obstetrician and Gynecologist, Shiraz University of Medical Sciences, Iran Author https://orcid.org/0009-0000-5418-0690

Keywords:

In Vitro Fertilization (IVF), Maternal, Fetal Attachment, Pregnancy Anxiety, Prenatal Self, Evaluation, Pregnancy

Abstract

Introduction and Aim: Pregnancy achieved through in vitro fertilization (IVF) may be associated with distinct psychological experiences because of previous infertility, prolonged treatment, uncertainty regarding treatment outcomes, and concerns about pregnancy maintenance. This study aimed to compare maternal-fetal attachment, prenatal maternal adjustment, and pregnancy anxiety between women who conceived through IVF and women with natural pregnancies.

Methodology: This applied study employed a descriptive causal-comparative (ex post facto) design. The study population comprised pregnant women attending the Thamar Infertility and Recurrent Miscarriage Clinic in Shiraz, Iran, during June 2025. Using matched purposive sampling, 60 pregnant women were recruited and allocated to two independent groups of 30 women with IVF pregnancies and 30 women with natural pregnancies. The groups were matched on major demographic and background characteristics. Data were collected using Cranley’s Maternal-Fetal Attachment Scale, Lederman’s Prenatal Self-Evaluation Questionnaire, and Vandenberg’s Pregnancy-Related Anxiety Questionnaire. Chi-square, Fisher’s exact test, one-way analysis of variance (ANOVA), and multivariate analysis of variance (MANOVA) were performed using SPSS version 27, with statistical significance set at p<0.05.

Findings: MANOVA demonstrated a significant overall difference between the two groups across the combined dependent variables (Wilks’ λ=0.57, F(3,56)=13.92, p<0.001, Partial η²=0.43). Subsequent univariate analyses indicated that women with IVF pregnancies had significantly greater maternal-fetal attachment than women with natural pregnancies (F(1,58)=28.45, p<0.001, Partial η²=0.33). Prenatal adjustment was also significantly higher in the IVF group (F(1,58)=5.12, p=0.027, Partial η²=0.08). In addition, women who conceived through IVF experienced significantly greater pregnancy anxiety than those with natural pregnancies (F(1,58)=10.28, p=0.002, Partial η²=0.15).

Conclusion: IVF pregnancy appears to be characterized by a dual psychological pattern in which stronger maternal-fetal attachment and greater prenatal adjustment coexist with elevated pregnancy anxiety. Integrating routine psychological assessment with targeted counseling and supportive interventions into prenatal care may therefore be particularly important for women who conceive through assisted reproductive technologies.

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