Marital Adjustment as a Mediator Between Emotional Suppression and Self-Compassion in Women Aged 35+ Undergoing In Vitro Fertilization-Embryo Transfer: A Cross-Sectional Observational Study

Abstract

Objective: This study aimed to investigate the pathways of emotional suppression among women aged 35 years and older undergoing in vitro fertilization-embryo transfer (IVF-ET) and to provide a theoretical basis for developing personalized programs to reduce emotional suppression.

Methods: A convenience sample of 225 women aged ≥35 years undergoing IVF-ET at a reproductive centre between May 1st and September 30th, 2023, was selected. The participants completed a self-designed general information questionnaire, the Emotional Inhibition Scale (EIS), the Locke-Wallace Marriage Adjustment Test (MAT), and the Self-Compassion Scale (SCS). Data were analysed using SPSS 27.0 and AMOS 24.0. Normality and homogeneity of variance were assessed, with normally distributed data described as mean ± standard deviation (SD). Pearson correlation, structural equation modeling (SEM), and bootstrap resampling (5000 iterations, 95% confidence intervals [CIs]) were employed to test the mediation effects, with a bootstrap analysis used to assess the stability and significance of indirect effects through repeated sampling.

Results: The cohort comprised predominantly Han Chinese (82.2%), first-married (60.9%), urban-dwelling (60.4%) women with secondary infertility (68.0%). Over 40.0% of the total held a tertiary educational level, and 67.1% reported per capita monthly income of the family (3001–10,000 RMB). The mean emotional suppression score was 28.65 ± 6.74. Emotional suppression was negatively correlated with marital adjustment (r = −0.442, p  < 0.01) and self-compassion (r = −0.393, p  < 0.01). SEM with bootstrap validation demonstrated that marital adjustment mediated the relationship between emotional suppression and self-compassion (mediating effect proportion: 24.89%, 95% CI: −0.115 to −0.027).

Conclusion: Marital adjustment mediates emotional suppression and self-compassion in women aged ≥35 years undergoing IVF-ET. Fostering positive marital dynamics may alleviate emotional suppression and enhance self-compassion, promoting psychological resilience during treatment. These findings support targeted interventions to improve patient satisfaction and treatment success rates.