The Comparison of Family Function and Related Factors in First-Child Infertile Women and Second-Child Infertile Women after “Two-Child” Policy in China

Abstract Background: The rising prevalence of infertility rates worldwide has had a significant impact on individuals, couples, and families. This study examines how infertility affects family functions in China under the newly implemented two-child policy. We compared family function in first-child infertile (FI) and second-child infertile (SI) women. Methods: This study included 572 infertile women of childbearing age, composed of 337 first-child infertile women and 235 second-child infertile women in a reproductive medical center in Chongqing, China, between Feb 2016 and Dec 2018. The Family Assessment Device (FAD) and Family Cohesion And Adaptability Evaluation Scale II (FACES II) scores were used to assess family perception. The Patient Health Questionnaire-9 was used to assess depression (PHQ-9). Results: The demographic statistics of our sample showed the age of FI was 33.26±3.46, while the SI was 36.68±5.01. 46% of FI women are the only child, while 23.8% of SI women are the only child ( P ＜ 0.001 ). FI women had higher levels of education than SI women ( P ＜ 0.001 ). FI women made higher incomes than SI did ( P ＜ 0.001 ). The psychiatric diagnostics showed that 170(50.4%) of FI families and 157(66.8%) of SI families had a poor family function ( P ＜ 0.001 ). We found that infertility women with lower levels of education and family income are more likely to have an unhealthy family function ( P ＜0.05) based on the correlation analysis ( P ＜ 0.05 ). The total score of PHQ-9 is related to the family function ( P ＜ 0.05 ). Conclusions: The socio-demographical statistics show SI women have lower family monthly income and lower education levels than FI individuals. SI women obtained worse scores and more family dysfunction rates regarding family functioning. The study indicated that infertile families generally have higher risks in family functioning, family cohesion, and family adaptability. Counselors and psychologists can be deployed in infertility centers to screen people with family problem risks from the beginning and perform early interventions to improve family problems.