Past Issue

Volume 13, Number 1, Apr-Jun 2019 Pages: 66-71

The Relationship between Perceived Stress and Marital Satisfaction in Couples with Infertility: Actor-Partner Interdependence Model

Saman Maroufizadeh, M.Sc, 1, Mostafa Hosseini, Ph.D, 1, *, Abbas Rahimi Foroushani, Ph.D, 1, Reza Omani-Samani, M.D, 2, Payam Amini, Ph.D, 2,
Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
*Corresponding Address: P.O.Box: 14155-6446 Department of Epidemiology and Biostatistics School of Public Health Tehran University of Medical Sciences Tehran Iran



Infertility, one of life’s great stressors, may adversely affect marital satisfaction. No studies have in- vestigated the relationship between perceived stress and marital satisfaction at the dyadic level. The current study assessed the actor and partner effects of perceived stress on marital satisfaction in husband-wife dyads using an in- novative dyadic analysis approach, the Actor-Partner Interdependence Model (APIM).

Materials and Methods

In this cross-sectional study, we recruited a total of 141 infertile couples. Marital satisfac- tion and stress were assessed using the ENRICH Marital Satisfaction Scale (EMS Scale) and Perceived Stress Scale-4 Item (PSS-4), respectively. Dyadic data have been analysed by the APIM approach, with distinguishable dyads. In this approach, actor effect is the impact of a person᾽s perceived stress on his/her own marital satisfaction. Partner effect is the impact of a person's perceived stress on the partner᾽s marital satisfaction.


Both men and women’s perceived stress exhibited an actor effect on their marital satisfaction (β=-0.312, P<0.001, β=-0.405, P<0.001, respectively). Women’s perceived stress had a negative relationship to the marital satis- faction of their partner (β=-0.174, P=0.040). Although the partner effect of men’s perceived stress on woman’s marital satisfaction was not significant (β=-0.138, P=0.096), women whose husbands had higher levels of stress were more likely to have poorer marital satisfaction. Both actor and partner effects of perceived stress on marital satisfaction were similar among men and their wives.


The findings of this study have highlighted that marital satisfaction in patients with infertility was in- fluenced by not only their own perceived stress, but also their spouses’ perceived stresses. Therefore, psychological interventions that target a reduction in perceived stress and enhancement of marital satisfaction in the context of infer- tility should treat the couple as a unit.