THE ATTITUDE TO INFERTILITY BY COUPLES AND ITS EFFECT ON MARRIAGE STABILITY CHAPTER ONE 1.0 1.

1 INTRODUCTION Background to Study

Marriage institution is found in all societies and has been an age long affair that started from Adam. The origin of marriage therefore is traced back to the Biblical story of Gods creation story in the book of Genesis.

According to Ponzetti (2003), in the United States and other western nations, marriage means a stabilized pattern of norms and roles associated with the mutual relationship between husband and wife. In almost all societies, it entails a legal

contract (written or verbal) and this contract varies in the degree to which it can be broken. Olayinka (1987) defined marriage as a social institution for the union of a man and his wife in body and soul. It fosters the coming together of two totally different

individuals with their personality traits as husband and wife to plan for their future and set up their own family.

We have different types of marriages as practiced in the world; Africa and Nigeria in particular. These include monogamy the practice of having one wife at a time; polygamy - marrying of more than one wife; Polyandry when a woman has more than one husband and Bigamy the custom where a man or woman marries another person while his or her marriage is still in existence. In Nigeria marriages can be contracted traditionally, by the customary laws. It can also be contracted in the court

registry known as the ordinance or statutory marriage. Lastly, marriages can be contracted in the church, which is known as Christian marriage or in the mosque, known as Islamic marriage. Osarenren (2005) observed that of all the types of marriages explained above, the customary and Islamic marriages are potentially polygamous while marriages contracted at the registry are absolutely monogamous. Marriages are contracted also for different reasons and from different backgrounds. Weiten, Lloyd & Lashley (1991) noted that a great variety of motivational factors propel people into marriage. The first among them is the desire to participate in a socially sanctioned mutually rewarding intimate relationship. Another key factor is the social pressure exerted on the single adults to marry. The third reason is the popular view of people falling in love with each other. Ponzetti (2003) on the

other hand, outlined his findings to also include that marriages are formed to produce children as well as for economic security. In summary, a multitude of motivational factors are involved in the decision to marry. Some of them are considered as ideal and others not ideal. Osarenren (2005) noted that many people marry for wrong reasons and as such have wrong attitudes toward marriage. These people tend to see marriage as something they can do away with if it becomes inconvenient.

Marriages are meant to last till death, or for life. It is meant to be for better for worse, richer and poorer, in sickness and in health, until death do us part. But in practice, the situation is different, as many marriages are breaking up. Marital instability could be caused by a number of factors which include lack of respect, tolerance and understanding between couples, poor

communication, third party interference, sexual incompatibility, financial difficulties, issues of religion and cultural practices and infertility. These issues make marriage to be full of stresses and strains and can lead to break up if not well managed.

Researchers have confirmed that the attitude of couples towards marriage is very central to stable and happy marriage (Osarenren

2005). Attitude, therefore, is a major issue with regards to marriage stability.

Attitude has been defined by Anastasi in Okoli (2000) as a tendency to react favourably or unfavourably towards a

designated class of stimuli such as national or ethnic group, a custom or an institution. Attitude could be appropriate or

inappropriate. Appropriate attitudes promote effective behaviour and feelings of satisfaction, enjoyment and happiness.

Inappropriate attitude promotes self-defeating behaviour and feelings of depression, anger, anxiety, shame and guilt (Okoli 2001). Appropriate (positive) or Inappropriate (negative) attitude therefore has implication to marriage stability. Positive attitude

leads to a stable marriage, while poor attitude leads to marital instability. The climax of marital instability is separation and divorce. In

Africa and Nigeria in particular other manifestations of marital instability include polygamy. It is quite common for the Nigerian man to marry another wife or wives when he is faced with some serious marital challenges that tend to undermine his

achievements or progress. One of such major issues is infertility,

which is fast becoming a trend among couples in Nigeria and other parts of the world.

Zanden (1989) described infertility as the term employed by the medical profession to refer to a condition in which a couple fails to achieve pregnancy after one year of having engaged in sexual relations with a normal frequency of about three or four times a week and without contraception. It is of two types - primary and secondary. Primary infertility is when a pregnancy has never

occurred. Secondary infertility is when there has been a previous pregnancy but a couple is unable to conceive again after one full year. Whichever, the case, both types of infertility can be devastating to a marriage. Infertility therefore has become a major challenge to the marriage institution.

The burden of Infertility is seen to affect every aspect of a couples life. It is physical, psychological, emotional, financial and spiritual. The very thought of childlessness alone leaves the

couple with an associated feelings of rage, depression, self doubt, guilt and blame. These negative feelings can also lead to

inappropriate attitudes towards each other, which can also be

extended to the people in their environment - relatives, in-laws, friends etc.

Inappropriate attitudes could lead to couples suspecting and apportioning blames to each other, or if medically, the person having the problem has been detected, the okay couple could begin to lay blames and put unhealthy pressure on the partner. It could lead to disrespect for each other, depression and isolation on the part of either of the couple. These may in turn lead to poor communication, which is a major key to a successful marriage.

On

the

other

hand,

appropriate

attitude

of

co-operation,

understanding, patience, faith etc, between the couples will always lead to peace. As observed in the society, some couples are able to survive infertility challenges while others seem unable to do so. Attitude therefore seems to be a major determinant

factor in infertility and marriage stability.

1.2. Statement of Problem Infertility is today a palpable problem in many families in Nigeria. Its negative impact on the peace and stability of the affected families is becoming conspicuously increasing everyday. This is

evidenced by Andrew, Abbey and Halman (1993), who did not only observe that the effects of infertility on families vary from divorce, separation, quarreling and fighting to infidelity, etc, but also noted that the management of these infertility attendant problems by couples to ensure a happy stable marriage is a function of their attitude to infertility. On this same note, Osarenren (2005) opined that couples attitude to infertility as well as their marriage stability is dependent on their purpose of coming together in marriage, which is basically procreation.

Given the above diverse opinions, this study attempts to examine the attitude of couples to infertility and the effect of this attitude of theirs to marriage stability.

1.3. Purpose of the Study The objective of this study is to determine the extent to which marriage stability is influenced by: (i) Couples attitude to infertility (ii) Couples perceptions of infertility (iii) Couples behaviour to each other during infertility.

1.4.

Research Questions

The following research questions are raised to guide the study. (i) Is marriage stability influenced by couples attitude to infertility? (ii) Does the couples perception of infertility affect

marriage stability? (iii) Is marriage stability influenced by the behaviour of the couples facing infertility challenges? (iv) Do couples differ in their attitude to infertility?

1.5.

Research Hypotheses

(i) Marriage stability is not significantly influenced by couples attitude to infertility (ii) Couples perception of infertility does not have significant effect on marriage stability (iii) Marriage stability is not significantly affected by the behaviour of the couples facing infertility challenges. (iv) There is no significant gender difference in couples attitude to infertility.

1.6. Significance of the study The findings from this study are expected to:

1. help affected couples maintain the right attitude to infertility challenges. 2. encourage the relations and friends of affected couples to maintain positive attitude towards them. 3. create more awareness on the counseling needs of such couples. 4. encourage the general public and society at large to appreciate the challenges of such couples and to sympathize with them by maintaining the right attitude.

1.7. Scope of the Study. This study is limited to establishing the effect of attitude of couples to infertility on marriage stability. It is not concerned

with determining the causes of infertility and does not intend to go into details on the cures or solution to infertility. 1.8 Operational Definition of Terms

The terms below are defined in accordance to the context and way in which they are used in the study. Marriage This refers to the relationship between two people who are statutorily, religiously or traditionally joined as husband and wife.

Stability This refers to the condition whereby the couples psychological expectations for intimacy, understanding, communication and love are consistently met to a large extent in a marriage.

Attitude This refers to the feeling of couples about infertility, which involves a tendency to behave in a certain way.

Couples This refers to two people who are involved in a marriage relationship. Infertility- This refers to the inability of a couple to achieve pregnancy after twelve months of regular, unprotected sexual intercourse.

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CHAPTER TWO REVIEW OF RELATED LITERATURE 2.0 Introduction This study is designed to look at the attitude to infertility by couples and its effect on marriage stability. The review of related literature will focus on the following: 2.1 2.2 2.3 2.4 2.5 Concept of attitude Concept of infertility Concept of marriage stability Effect of infertility on marriage stability. Summary

2.1 Concept of attitude There are various definitions of attitude by psychologists. The Wikipedia encyclopedia described attitude as a hypothetical construct that represents an individuals likes and dislikes for an

11

item. It talks about attitude being positive, negative or neutral views of an attitude object i.e. a person, behaviour or event. People can be ambivalent towards a target, meaning that they simultaneously possess a positive and a negative bias towards the attitude in question. Scholl (2002) defined attitudes as a mental predisposition to act that is expressed by evaluating a particular entity with some degree of favour or disfavour. He noted that individuals generally have attitudes that focus on objects people or institutions. Jung (1921) defined attitude as readiness of the psyche to act or react in a certain way. According to him attitude very often come in pairs, one conscious and the other unconscious. He defines several attitudes and attitude dualities to include the following: consciousness and unconsciousness, extraversion and

introversion, rational and irrational, individual and social and the abstract attitude. Travers in Magnal (2007) defined attitude as a readiness to respond in such a way that behaviour is given a certain direction. By this definition, attitude is responsible for behaving in a particular and definite way. When one keeps a positive attitude

12

towards an object he will be attracted to it, admire it and achieve it, whereas a negative attitude will make one avoid it. For Meckeache and Doyle in Magnal (2007) attitude is seen as an organization of concepts, beliefs, habits and motives, associated with a particular object. This definition takes into account all the concepts, belief, habit and motives associated with the object. These concepts and belief are referred to as the cognitive components. For Sorenson in Magnal (2007) attitude is seen as a particular feeling about something which involves a tendency to behave in a certain way towards situations, persons, ideas and objects. For him, it is partially rational and emotional and is acquired, not inherited in an individual. Whitttaker in Magnal (2007) defined attitude as a predisposition or readiness to respond in a pre-determined manner to relevant stimuli. Johnson in Okoli (2000) on his part defined attitude as a combination of concepts, information and emotions that result in a predisposition to respond favourably or unfavourably toward a particular people, group, ideas, events or objects.

13

Silverman in Okoli (2000) views attitudes as a well established mental set that predisposes a person to evaluate something favourably or unfavourably. In conclusion, from these definitions, attitude to a great extent is responsible for a particular behaviour of a person towards an object, idea, or person. This does not mean that ones behaviour is an absolute function of ones attitude. Behaviour by all means is a function of both characteristics of the person and the situations, which he behaves (Magnal, 2007). Hence one may hold a strong attitude and yet under certain circumstances may behave in quite contradiction to those attitudes. 2.1.1 Characteristics of attitudes

Magnal (2007) outlined the nature and characteristic of attitude to include: first, attitudes are learned they are not innate or inherent in an individual. Secondly, attitudes have a subject and object relationship because they involve the relation of an individual with specific objects, persons, groups, institutions and value or norms related to his environment. Thirdly, attitudes are re-actively enduring states of readiness to respond to certain stimulus. Fourthly, attitudes have motivational affective characteristics. Also attitudes are as numerous and varied as the stimulus to

14

which they respond. Finally, attitudes range from strongly positive to strongly negative. It involves direction as well as magnitude. Okoli (2000) noted that not only are attitudes learned but are continually open to modification and change and that learning and modification of attitudes have their origins in interaction with other people which can be direct or indirect.

2.1.2

Components of attitudes

Reily & Lewis (1983) outlined three components of attitude the feeling components, the cognitive component and the action component. The wikipedia encyclopedia referred to it as the ABC model of affect, behavioural change and cognition. Scholl (2002) on the other hand, added the fourth component as the evaluation component. These four components are; (1) Cognitions: refers to our beliefs, theories, expectancies, causes and effect, perceptions, relative to the focal object. (2) Affect: this refers to our feeling with respect to the focal object such as fear, liking or anger.
15

(3)

Behavioural intentions: these are our goals, aspirations and our expected responses to the attitude object.

(4)

Evaluation: this is the central component of attitudes. It consists of the imputation of some of goodness or badness to an attitude object. Evaluation components of attitude are referred to when we speak of a positive and negative attitude toward an object. Evaluations are functions of cognitive, affect and behavioural intentions of the object. Evaluation is what is often stored in the memory without the corresponding cognitions and affects that were responsible for its formations.

2.1.3

Formation of attitudes

Formation of attitudes has been a question for investigation to the psychologist (Magnal 2007). According to him, based on the opinion of Allport, Stagner has suggested that attitudes are formed under one of the following four conditions which are integration of experiences, differentiation to experiences, trauma of dramatic experiences and adaptation of the available attitudes. Attitudes therefore are unquestionably acquired dispositions and therefore conditioned by learning or acquisition of experiences. Psychologists believe that heredity factor does not play any role in

16

the formation or development of attitudes. It is the environmental force that helps an individual to form and develop various attitudes so it is essentially a product of the interaction of ones self with ones environment. Magnal (2007) outlines the factors that influence the formation of attitudes to be both from within the individual himself and from within the individuals environment. The factors within the individual include, physical growth and development, ethical and moral development, intellectual development, emotional

development and social development. Environmental factors refer to the home and family setting and also social setting. 2.1.4 Expression of attitudes

According to Okoli (2000) attitudes are expressed in three ways: firstly, by spontaneous verbal remarks and comments about people, ideas and objects, secondly, by using questions to elicit attitudes from other people and thirdly, they can be manifested in ones behaviour. 2.1.5 Measurement of attitude

The techniques for measuring attitudes according to Magnal (2007) are both direct and indirect method. The direct method includes the use of questionnaire, interviews checklists and

17

attitude scales. The indirect method has to do with interpretations of attitude from the unsaturated or indirect responses. 2.1.6 Theories of attitudes

There are numerous theories of attitude and attitude change, which include (1) Consistency theory (dissonance reduction theory by Leon festings and balance theory of Fritz Heider. (2) (3) Self perception theory associated with Daryl Bem Meta programs associated with neuro linguistic

programming (4) Elaboration likelihood model associated with Richard Petry and the Heuristic systematic model of shelly chaiken (5) Social judgment theory etc

2.2 Concept of infertility Zanden (1989) defined infertility as a medical term that refers to a condition in which a couple fails to achieve pregnancy after one year of having engaged in sexual relations with normal frequency (about three or four times a week) and without contraception. It is therefore the inability of a couple to achieve pregnancy after

18

twelve

months

of

regular,

unprotected

sexual

intercourse.

Metzger (2003), on the other hand defined infertility as the inability to conceive after twelve months of regular, unprotected intercourse or the inability to carry a pregnancy to live birth. Infertility is classified into two primary and secondary. Primary infertility refers to a situation where a pregnancy has never occurred while secondary infertility is when there has been a previous pregnancy but the couple is unable to conceive again after one full year. 2.2.1 Causes of fertility

In contrast to the popular belief that infertility is womens problem, medical studies show that 40 percent of recorded infertility cases are due to male factor, another 40 percent due to female factor and the remaining percentage of cases can be either a combined factor (that is the couple has infertility problems) or the cause of infertility is unexplained (Blakes lee, 1987, LiebmanSmith, 1987). Infertility therefore, is of two types male infertility and female infertility. As such, the causes of infertility in men and women differ. 2.2.2 Male infertility

19

Shur (2006) outlined top causes of male factor infertility which account for the majority of cases of infertility in men to include (1) Blockage of sperm this results if the vas deferens that carries sperm from the testicles to the penis is blocked due to prior vasectomy, injury, infection or physical anomaly. (2) Infections many types of infections might cause sterility or low sperm count in men. These infections can be recent or from childhood and include mumps and certain types of sexually transmitted infections (STI). (3) Chronic disease these diseases can effect hormonal controls and sperm production when not controlled. They include diabetes, hypertension. (4) Erectile dysfunction (ED) these are problems that revolve around getting or maintaining an erection which results in difficulties in getting sperm out. (5) Failure to produce sperm the body may not produce sperm due to hormonal issues of testicular failure or from treatment for certain illnesses and cancer, like

chemotherapy and radiation therapy.

20

(6)

Exposure to harmful substances this may result from environmental or work hazards.

(7)

Injury injury to the testicles will lead to issues with sperm production.

(8)

Varicocele this refers to varicosity or varicose vein in the testicle. This damages the flow of blood to the testes, slowing or stopping sperm production.

Reyes-Hughes (2007) gave a run-down of male factor infertility as (1) Semen this was referred to as the most common cause of male infertility. According to them, abnormal semen accounts for 75% of male infertility cases and the cause of abnormal semen is often unknown. Reasons for abnormal semen are (a) decreased number of sperm (low sperm count or no sperm at all) (b) decreased sperm mobility difficulty for sperm to swim to the egg. (c) abnormal sperm this is in terms of shape and can make it difficult for it to move and fertilize an egg. (2) Testicles the testicles are responsible for producing and storing sperm. If they are damaged, it can seriously affect
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the quality of semen. It may occur due to an infection of the testicles, testicular cancer or testicular surgery. (3) Ejaculation disorders this refers to some conditions that make it difficult for some men to ejaculate. For example, retrograde ejaculation causes one to ejaculate semen into ones bladder. Also, the ejaculatory ducts can sometimes become blocked or obstructed, and this can make it difficult to ejaculate normally. (4) Medicines and drugs these include sulfabalazine,

anabolic steroids and chemotherapy. These medicines can decrease number of sperm or sperm count, sperm mobility and sperm production. In addition, Zanden (1989) noted that among other factors, exposure to environmental toxins and to industrial chemicals like lead, cadmium and some pesticides in the workplace could contribute to infertility condition in men. So also can the use of marijuana, heavy cigarette smoking and alcohol abuse. 2.2.3 Female infertility

Hyde (1990) enumerated the most common causes of female infertility to be failure to ovulate, blockage of the fallopian tubes and cervical mucus called hostile mucus that does not permit the

22

passage of sperm. He also mentions age as a factor. According to him, fertility declines in women after 35 years of age and the decline is especially sharp after age 40. Shur (2006) grouped the top causes of female infertility under structural issues, mechanical issues, ovulatory issues and multiple or unknown factors. According to him, structural issues account for 15% female factors and refers to the anatomy of the woman. It may be blockage of the fallopian tube, a fibroid in the uterus or a problem with the opening of the cervix. Some of these factors may be caused by previous meditations or surgeries. Mechanical issues according to Shur(2006), account for 25 40% female factor. This refers to problems such as scar tissue that blocks the fallopian tubes or the uterus. It can also be caused by pelvic inflammatory disease (PID) or endometriosis. Ovulatory issues account for about 30% female factor and maybe complete ovarian failure due to hormonal issues. It could be merely a problem with timing or detection of ovulation. Finally, multiple or unknown factors, for Shur (2006), accounts for 10% of female infertility and refers to unexplainable factors of infertility and the fact that a woman can have infertility problem resulting from more than one factor. Ryes-Hughes (2007) outlined female factors of infertility as
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(1) Ovulation disorders This refer to problems with the monthly release of an egg which may stop the release of eggs at all or cause the eggs to be released during some cycles, but not others. These problems may be caused by premature ovarian failure (when the ovaries stop working before the age of 40); polycystic ovary syndrome (PCOS) a condition which makes it difficult for the ovaries to produce an egg; thyroid problems an overactive or under active thyroid can prevent ovulation; and chronic conditions such as cancer, AIDS etc which can prevent the ovaries from releasing eggs. (2) Womb and fallopian tubes If the womb or fallopian tubes become damaged or stop working, then it may be difficult to conceive naturally. It can occur following a number of procedures or conditions like: (a) pelvic surgery- can cause damage or scar to the fallopian tubes; (b) cervical surgery- can cause scarring or shorten the cervix (neck of the womb); (c) sub mucosal fibroids these are benignly (not cancerous) tumors that develop in the muscle underneath the lining of the womb and may prevent implantation

24

(d)

endometriosis - a condition where cells, normally found in the womb lining, start growing on other organs. This can cause adhesions in the pelvis and limit the movement of the fimbria tubes, which direct the egg into the tube

(e)

previous sterilization - involves willful blocking of the fallopian tubes (tubal ligation) or prevent egg from traveling to the womb. This process is rarely reversible.

(3) Medicines and drugs The side effect of some medications and drugs can affect fertility. They include: (a) non-steroidal anti-inflammatory drugs (NSAIDS) long term use or high dosage use of NSAIDS like ibuprofen or aspirin can make it difficult to conceive (b) chemotherapy the medicines used for chemotherapy can sometimes permanent; (c) illegal drugs such as marijuana and cocaine can seriously affect functioning of the fallopian tubes and can also make it difficult to ovulate. (4) Age
25

cause

ovarian

failure

which

can

be

Infertility in women is also linked to age. Women in their early twenties are about twice as fertile as women in their thirties. The biggest decrease in fertility begins during the mid thirties. In tune with this, Silver (2007) attributed the recent increase in cases of infertility to the fact that many marriages are occurring at latter ages than they used to. Zanden (1989), also noted that researchers (Dercherney and Berkowitz, 1982) has reported a sharp drop in a womans fertility after the age of thirty. Nouriani (2006) in the national womens health information center (U.S.) opined that more and more women are waiting until their 30s and 40s to have children. According to them, in the United States, 20% of women have their first child at the age of 35. As a result, age is an increasingly common cause of infertility problem. Ageing decreases a womans fertility in the following ways: (1) The ability of a womans ovaries to release eggs ready for fertilization decline with age. (2) (3) The health of a womans eggs decline with age As a woman ages she is likely to have health problems that can interfere with fertility.

26

(4)

As a woman ages her risk of having a miscarriage increases.

In contrast to the age factor for the women, the effect of aging on male fertility is not clear. According to Barness (2007) one earlier study suggested that sperm number and quality do not decline until beyond age 64 but a subsequent 2000 trial reported a reduction in sperm count and quality between the second and fifth decade of life. Another study reported that fertilization rates during fertility treatments were over 60% for men under 39 but fell to slightly over half after age 40. Genetic defects in sperm have also been observed to increase with advancing age although the implications for fertility are unclear. A 2002 study indicated that when men with genital infections were not considered there was no difference in fertility rates between older and younger men. 2.2.4 Causes of infertility in both men and women

Reyes-Hughes (2007) outlined the factors, which can affect infertility in both men and women as: (1) Weight being overweight, or obese reduces both male and female fertility. In women, it can affect ovulation. Being underweight can also impact on fertility,

27

particularly for women, who will not ovulate if they are severely underweight. (2) Sexually transmitted infections (STIs) some STIs can cause infertility, the commonest is Chlamydia, which can damage the fallopian tubes in women and cause swelling and tenderness of the scrotum in men. (3) Smoking this affects ones general and long term health and can cause infertility. (4) Occupational and environmental factors like exposure to certain pesticides, metals and solvents, in both men and women. (5) Stress if either or both partners are stressed, it may affect their relationship. Stress can reduce libido (sexual desire/therefore reducing the frequency of sexual

intercourse. Severe stress can affect female ovulation and limit sperm count. 2.2.5 Treatment of infertility

Nouriani (2006), Strawn (2005) and Reyes-Hughes (2007), all agree that the problem of infertility can treated in three main ways: (1) By medicines to assist fertility
28

(2) (3)

By surgical procedures and By assisted conception [artificial insemination or assisted reproductive technology].

However, doctors recommend specific treatments for infertility based on test results, how long the couples has been trying to get pregnant, the age of both the man and woman, the overall health of the partners and preference of the partners. Metzger (2003) outlined the two different philosophies for infertility as (1) find out whats wrong and fix it or (2) nonspecifically enhance fertility by increasing the chances that the sperm and egg will get together. According to her, successful treatment relies on a combination of the two approaches. (i) Medicines to assist fertility

These include the following: (1) Clomifene helps to encourage ovulation in women with irregular or no ovulation. They are taken by mouth (2) Metformin also helps the body to ovulate and

particularly beneficial to women with polycystic ovary syndrome (PCOS) or who have insulin resistance. They are usually taken by mouth.

29

(3)

Gonadoraphins these are hormone releasing drugs used to stimulate ovulation. They are usually injected or given with a nasal spray.

(4)

Bromosciptine this medicine is used for women with ovulation problems due to high level of prolactin hormone that causes milk production.

(5)

Follicle stimulating hormone or FSH causes the ovaries to begin the process of ovulation. They are usually injected.

(6)

Human menopausal gonadotropin or LMG acts directly on the ovaries to stimulate ovulation. It is injected.

Many fertility drugs increase a womans chance of having twins, triplets or other multiples (Neuriani, 2006). (ii) Surgical procedures

Surgical procedures include (1) Fallopian tube surgery blocked or scarred fallopian tubes require surgery to help repair tubes and make it easier for eggs to pass along it. (2) Laparoscopic surgery involves having a small cut (incision) made in the abdomen. This procedure is used to

30

look at internal organs, take samples and perform small operations. (3) Epididymal blockage this type of procedure is used to repair epididymins (a coil like structure in the testicles which help to store and transport sperm). Blockage of the (4) epididymes does not allow normal ejaculation of sperm.

(iii) Assisted conception These include the following: (1) Intrauterine insemination (IUI) also known as artificial insemination. In this procedure, the woman is injected with specially prepared sperm, during her ovulation. Sometimes the woman is also treated with medicines that stimulate ovulation before IUI. It is used to treat mild male infertility, women who have problem with their cervical mucus and couples with unexplained infertility. (2) In vitro fertilization (IVF) this is the most effective method of assisted reproductive technology. It means fertilization outside the body. The female takes fertility medication to encourage the ovaries to produce more eggs than normal. Eggs are then removed from her ovaries and fertilized with sperm in a laboratory dish. The

31

fertilized embryos are then put back inside the womans body. It is often used when a womans fallopian tubes are blocked or when a man produces too few sperm. Fertility treatment with donor eggs and sperms are normally carried out using IVF. Other forms of assisted conception include (1) Blastocycst transfer used for women who are able to make good quality embryos which fail to implant in the womb. Here, the embroyo are allowed to develop for five to six days after fertilization and then put back in the womb. (2) Assisted hatching here the doctor helps the embryo to hatch by making the shell of the embryo thinner or making a small hole in its shell. (3) Egg and sperm donation here a couple with infertility problem, which deal with sperm or egg production could receive eggs or sperms from a donor to help them get pregnant. 2.2.6 Couples attitude to infertility

Attitude formation according to Magnal (2007) is influenced by factors both within the individual himself and within the

32

individuals environment. These factors are all encompassing but exclude genetic or inherited factors, pointing more to the family and social settings of the person involved, because attitudes are formed or acquired. This means that attitude to infertility may not be divorced from the personal and social perception and

understanding of infertility. The environmental belief, theories, expectations, cause and effect, beliefs to fertility/infertility, therefore, plays a role in the attitude to infertility especially in African countries and Nigeria specifically. Okonofuaa et al (1995) based on their research on the social meaning of infertility in southwest Nigeria noted that the community members accord great significance to child bearing but they have incorrect knowledge of the causes and appropriate treatment of infertility. Giwa-Osagie (2006) noted that there are distinct cultures and practices that affect the perception of fertility and inheritance. The child is valued as the embodiment of the family genes into the future. As he grows into adulthood he is expected to carry responsibilities of his gender and family. The womans roles relates to the vital roles of ensuring continuation of the family tribe and race through procreation. Inability to fulfill these roles spells problem for the couple.
33

Osarenren (2005) also opined that marriages are basically contracted for procreation purposes and that delay up to one year will cause eyebrows to be raised from all quarters and pressures are mounted on the couple. In the same vein, Miller (1987) relates that in most societies, marriages are formed to produce children. According to him in some societies the connection between marriage and reproduction is so strong that if conception does not occur a divorce is permissible and often is automatic. In others, a marriage does not take place until after pregnancy occurs and fertility proven. All these explain the premium put on fertility in the most societies and informs the attitude or behaviour to infertility. However, in most developed countries of the world, knowledge and practices has advanced beyond marriage for procreation. In most developed countries of the world instances abound of couples opting for childlessness. Rowland in Ponzetti (2003) discussed the option of childlessness as one aspect of the diversity inherent in contemporary

experiences of marriage and the family. According to him, with this greater diversity the once common pressure for child bearing have given way to greater social acceptance of remaining single or married without children.
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This, of course, is not the case in most African societies where there is strong attachment to family lineages and perpetuation of family names, through procreation. Okonofuaa et al (2003) outlined different conception of causes and treatment of infertility in southwest, Nigeria to include that infertility results from supernatural causes like witches and wizards, curses placed on either or both of the couples, vows by some women not to bear children based on the concept of reincarnation and ogbanje or abiku. Other causes of infertility as perceived in the southwest Nigeria and outlined by Okonofuaa and others are hotness of blood or womb, abortions and promiscuity or waywardness of youths. There is also the belief that the infertile people had simply used themselves up and damaged their organs through early sexual activity and promiscuity. On the part of the male, Okonofuaa et al (2003) record and that it is believed that watery sperm, weak sperm, impotence, size of penis, weak organs can cause infertility. According to them, there is a misconception than an erection and sexual intercourse meant that the male would be fertile. Another cause put under spiritual is the usage of sperm for ritual, to get rich. All these refer to some social beliefs and perception of infertility and reflect the attitude of people to infertility. This explains the
35

consequences

of

infertility as recorded

in different

African

countries and in Nigeria. Okonofuaa et al (1995) noted that women are more likely to suffer the social consequences of infertility, which include physical and mental abuse, neglect, abandonment economic deprivation, social ostracism and

stigmatization etc as a result of their infertility status. According to Giwa Osagie (2006) it is quite common in sub Saharan Africa, for the male partner to confuse sexual potency with normal male fertility, which can result in him refusing further investigation of himself or his wife if the practitioner insists on him being properly investigated. This shows that the males seem to have an upper hand in the decision and management of infertility, leaving the female with further problems. Widge (2002) talks about the huge stigma attached to being infertile/childless in India. According to him, childlessness has negative implications in Indian society, especially for the woman. Fertility defines womanhood and womanhood is defined by a womans capacity to mother as a result of this, even if the man is infertile, the woman bears the social and psychological consequences. There are also threats of divorce or debarment from property. He concluded that the experience of infertility is usually marked by anxiety and fear; societal pressures to

36

conceive and social stigmatizations and various trials of various treatment. All these reflect the influence of the environmental or social perception on infertility, which also determines the attitude of people and couples in African countries. Okonofuaa et al (1995) however pointed out that there is a correlation between general level of education and the accuracy of responses of people in their research. They opined that the educated ones with some medical knowledge gave biologically correct explanations of the causes and approaches to the treatment of infertility than the less educated ones. This means that a change occurs in attitude based on the level of general awareness of people and couples in particular. Appropriate perception leads to appropriate evaluation and

behaviour to infertility. Conway (2007) noted that most couples experience the struggle of infertility in much the same way and it is related to the traditional ways men and women have been trained to think feel and act. Their environment and level of awareness on the causes and treatment of infertility therefore, influence Couples attitude to infertility. According to him the women in infertility often try to protect their husbands from their own pain and feelings of failure by taking much of the responsibility for the treatment upon them.
37

This reason is not far fetched, as it is general for women, being the one that bears children to feel like a failure during infertility. Being that the male and female roles are defined in the society also, while the woman feels inadequate, the man also feels that his masculinity or virility is in question (Hyde, 1990). This makes couples approach infertility challenges with the attitude of helplessness, devastation, fear and powerlessness.

2.3. Concept of marriage stability The institution of marriage is found in all societies and as Ogionwo and Otite (1979) put it, to define marriage is difficult because of the diversities in the system throughout the world. It is such that although marriage is known to have some common qualities it varies from one culture group to another. In tune with this opinion, Kottak in Ponzetti (2003) opined that because marriage as an institution may differ in structure, function, dynamics and meaning from one culture to another, no all-encompassing definition of marriage is possible. However, attempts have been made to define marriage.

38

Olayinka (1987) define marriage as the union, sanctioned by the society, of a man and women as husband and wife with social obligations being recognized and accepted by both partners. Weiten, Lloyd and Lashley (1991) defined marriage as the legally and socially sanctioned union of sexually intimate adults.

According to them, marital relationship brings about economic inter-dependence, common residence, sexual fidelity and shared responsibility for children. Osarenren (2005) defined marriage as the union between two consenting adults. According to her, it is about two individuals who are willing and able to accept the responsibility and obligations attached to marital status. The Wikipedia encyclopedia defined marriage as an inter-personal relationship with governmental, social or religious recognition, usually intimate and sexual and often created as a contract or through civil process. According to them, the reason people marry vary but usually include one or more of the following: legal, social and economic stability; the formation of a family unit pro-creation and the education and nurturing of children; legitimizing sexual relations; public declaration of love. It also talks about the act of marriage, which usually creates obligations between the

individuals involved and in many societies, the extended families.

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2.3.1

Marriage stability

In all societies, marriage is viewed as a relatively permanent bond so much so that in some societies, it is virtually irrevocable. The stability is provided by a life-long mutual commitment on the part of the couple involved. Most marriages therefore are contracted to last until death. This according to Ogionwo and Otite (1979) is as true of societies in Europe and America as it is of Africa and Asian societies. However, in practice, not all marriages last that long, as some end up in divorce. Research indicates that in most societies the family scene has been hunted by marriage instability. In United States of America, researches noted that the overall divorce rate remains close to fifty percent of all marriage (Popense and Whitehead, 2004). Blackenhorn (2003) noted that over the course of three decades, from the mid 1900s through at least the mid 1990s, marriage as a social institution got steadily and dramatically weaker.

According to him, during these years American adults become significantly less likely to get married and stay married. The annual number of marriages per 1,000 unmarried women dropped substantially as did the proportion of all American adults who were married. And if they were married, they were less likely to describe their marriage as a
40

very

happy.

Over

these

approximately three decades, according to him, married couples families became less able to carry out their basic social functions, which include maintaining the population level, regulating adult sexual behaviour and socializing children, and in other ways caring for family members. According to Onyemerekeya (1997) in most societies, conflicts, stresses and even divorce has characterized the family scene. Mbaezue in Onyemerekeya (1997) reports that the world health organization put divorce rate, world wide at a growing rate of 2.05% annually. He also noted that here in Nigeria marital crises, separation and divorces between 1980 1990 were estimated at 80,000. Blankenhorn (2003) opined that scholar and other world leaders view the weakening of marriage as a genuine societal crisis. According to him, James Wilson recently described the weakening of marriage as the most important domestic problem in the country. It drives or sustains a diversity of social problems such as child poverty, weapons related violence, educational failure, teen suicide, child and adolescent mental health problems, teen pregnancy and many others. Marriage is seen as the foundation for a successful society. as such marriage stability is crucial for the progress and success of
41

any society. Some writers have tried to explain what marriage stability is. Onyemerekeya (1997) opined that stable marriage could be viewed as one in which the couples psychological expectations for intimacy, understanding, communication and love are consistently met to a large extent. The healthy marriage initiative (HMI) U.S. department of Health and Human Services described a healthy marriage as a mutually satisfying relationship that is beneficial to the husband, wife and children (if present). It is a relationship that is committed to the ongoing growth, the use of effective communication skills and use of successful conflict management skills. It is also a relationship where both spouses have a deep respect for each other. 2.3.2 Factors affecting marriage stability

Various factors are responsible for the instability recorded in various homes. (i) Financial issues and home management

Economic security is one of the motivations for marriage. A failure in this regard can have far reaching consequences. Although researchers indicates that neither financial stability nor wealth can ensure marital satisfaction they are however of the opinion that poverty can produce serious consequences. Even when financial

42

resources are plentiful, money can still be a source of marital strain. The issue of how the money is spent becomes a potentially damaging front. Hicks and Plat in Nwobi (1996) concluded that although the husbands economic performance has important marital consequences, it also has importance for the organization of marital roles.

In modern marriages there is a great emphasis on equality of husband and wife as far as marital roles in the home is concerned. The man is still viewed as the one who is primarily responsible for the provision of the finance for the upkeep of the family. On the other hand the woman cooks and cleans much more than the man. She takes more care of other services such as child care and house work. Her opinion is usually incorporated in decisions bothering on the home and children. However, when either partner fails to assume his or her obligation or role, the marriage looses a significant force for cohesion, which could destabilize the relationship. Even when unforeseen

circumstances forces roles switch such as the woman becoming the main breadwinner, the resultant effect is added marital stress.

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(ii)

Communication

Nwobi (1996) opines that communication is the means by which family member develop collective views and values. If

communication is not functional, inevitable rigid barriers or boundaries could surface in the couples relationship. This could promote deep-seated underlying differences in values and

attitudes. When communication is excessive but unheard, it becomes noise in the system. Inefficient communication has therefore, important marital consequences. (iii) Infertility Ponzetti (2003) noted that there is a connection between marriage and reproduction, which in some societies is so strong that if conception does not occur, a divorce is permissible and often is automatic. In others according to Miller (1987) marriage does not occur until after pregnancy occurs and fertility proven. Since a marriage is an institutionalized structured for satisfying both individuals expectations and that of the society, the inability to conceive usually throws most marriages off balance. (iv) Conflict Management Many couples do not know how to deal with conflicts

constructively. Finkestein (2007) noted that the inability to

44

wrestle effectively with conflicts contribute to the growing marital disharmony in marriages. Every marriage has attendant

challenges such as arriving at acceptable role compromise, paying bills and raising family. Couples ability to handle their problem is therefore a major contributor to marriage stability. (v) Motivation to marry

Weiten et al (1991) outlined the variety motivational factors that propel people into marriage to include (a) To fulfill societys expectation of being involved in intimate relationship. (b) (c) (d) (e) (f) To escape the social pressure to marry. To fulfill sexual urge To escape unsatisfactory home situation To enjoy economic security provided by the union Physical attraction and emotional attachment

Couples vary greatly in the strength of their motivation to marry. While some of the motivations are great building blocks to stable marriage, others would rather constitute a very weak base to build a marriage on gaps in expectation about marital roles, unrealistic expectations may give rise to marital instability.

45

(vi) Family Background According to Weiten, Lloyd and Lashley (1991), the marital adjustment of parents is correlated with the marital satisfaction of their children. People whose parents were unhappily married are more likely than others to have an unsatisfactory marriage. For a number of reasons, marital instability appears to run in families (Teachman, Polonko and Scanzoni, 1987). (vii) Sexual Problems Olayinka (1987) sexual intercourse is an important factor by which a couple expresses love and affection. Sexual problems therefore tend to cause marital instability. Such problem therefore tend to cause marital instability such problems are often

intertwined with other marital problems. Sexual problems range from sexual incompatibility, sexual deprivation, and sexual

gratification to unwanted pregnancies and infidelity.

2.4. Effect of infertility on marriage stability The burden of infertility is said to be physical, psychological, emotional and financial. Several researches have been carried out to evaluate the claim that infertility may result in a decrease in

46

quality of life and an increase in marital discord and sexual dysfunction. Ganiats, et al (2004) reported that the marital adjustment test scores from their research shows that scores for women with infertility problem was significantly lower than that of the control group, but no difference was found in that of men; trend towards lower quality of life was noted in women but not in the men of infertile couples. No significant impact on sexual functioning in women was noted. However, the men in the infertile couples had lower international index of erectile function scores and

intercourse satisfaction scores. Silver (2007) examined how infertility affects a marriage and noted that it can be devastating to a marriage such that some marriages do not survive it. According to her infertility affects a marriage differently from couple to couple but there is this general feelings of anger, guilt, powerlessness at their inability to make their dreams come true accompanied with turmoil and heartache. For some couples, they can grow and have a stronger marriage whereas with some other couples, infertility can

ultimately be the end of a marriage. Zanden (1989) notes that infertility is a problem that causes a good many couples profound anguish. They view parenthood as
47

an integral part of their development as adults a credential of adulthood. Consequently the prospect that they may be sterile confronts them with a sense of helplessness at loosing control of their life plans. Many feel that their bodies are damaged and otherwise defective. Women speak of feeling hollow or empty, men speak of feeling like castrates or say that they shoot blanks. And some are troubled by their place in the flow of generations. Associated feelings of range, depression, self doubt, guilt and blame can have devastating consequences for the marital relationship (Bouton 1982, Brozan, 1982, McEven Costello and Taylor 1987). Metzger (2003) opined that the stress of infertility on a marriage can manifest itself in a variety of ways. According to her couples with otherwise good relationship may develop signs of marital discord and those with normal sexual function prior to their infertility problem may develop decreased frequency of

intercourse, orgasmic dysfunction, mid-cycle male impotence, or vaginisms (involuntary tightening of the vaginal muscles).

Because conception and infertility diagnostic testing may require precise timing of intercourse, many couples can experience loss of sexual spontaneity. Intercourse becomes a chore. As a result, there may be discomfort during intercourse due to decreased

48

lubrication in the woman or impotence in the man. According to her, an occasional episode of impotence or lack of desire is common for couples experiencing infertility. All of these have implications on marital relationships. Fworth (2007) opined that the effect of infertility affects men and women in different levels. Women are generally perceived as more emotional than men because of their ability to freely express what they feel. In most infertility causes women tend to feel responsible for the situation regardless of who among the couple is infertile. This makes them suffer greatly on the emotional effects of infertility. Also, pressure to conceive often results to emotional pain, anger, fear which eventually lead to desperation. Some women experience anxiety and depression and crave for their husbands attention more than they normally do while others emotionally distance themselves from their partners due to fear of rejection because they feel they have failed. Russelburg noted that emotional challenges due to infertility may be compared to a roller coaster ride because the couple is constantly coping with sorrows, yet trying to maintain hope month after month of attempting to conceive. Widge (2002) notes that infertility is a major problem in the context of social domains of social life such as kingship,
49

inheritance, marriage and divorce patterns. According to him, it is a threat to a womans identity, status and economic insecurity, to a mans procreativity and to lineage, familial and community continuity. Infertility he further said had very often been compared to bereavement and can be a wrecking experience for both the woman and the man. It may lead to identity dilemma, lowered self-esteem, frustration and a sense of powerlessness. Andrews, Abbey and Halman (1991) conducted a research on stress from infertility, marriage factors and subjective well being of wives and husbands. A causal model of their research suggest that fertility problem stress ha direct effects that increase marital conflict and decrease sexual self esteem, satisfaction with own sexual performance and frequency of intercourse. Also if reported that fertility problem stress has both direct and indirect effects that decrease evaluations of life as a whole, self-efficiency, marriage intimacy and health. The negative effects on life quality are stronger for wives than husbands. All these are linked to the emotional and psychological effect of infertility on the couple and capable of tearing the couple apart, if not well managed. Infertility is also seen as a condition that taxes the couple physically and financially. This is why medical solutions are sought
50

and given, but the financial cost on the treatment of infertility can be burden some and capable of grounding the life of the couple to a halt. 2.5 Summary This chapter looked at related literature on attitudes definitions of attitude, components of attitude, formation, expression and measurement of attitudes. It highlights the fact that attitudes comprise of cognitions, affects, behavioural intentions and

evaluation. Attitude, therefore, to a great extent, is responsible for particular behavoiur of a person towards an object, idea or person. They are acquired dispositions that are conditioned by learning or acquisition of experiences. Their acquisitions are influenced by the factors both within the individual himself and within his environment home family setting and social setting. The concept, causes and treatment of infertility was also examined and discussed in this chapter. Infertility is seen as a medical condition of inability of a couple to conceive or carry a pregnancy to full term after one year of unprotected regular intercourse. It is a condition that may result from male factor causes, female factor causes or by both couples or unexplained causes. It is not the problem of the woman only.

51

The concept of marriage stability was also examined and discussed. It is seen as a relationship that is committed to ongoing growth the use of effective communication skills and the use of successful conflict management skills. It is a mutually satisfying relationship that is beneficial to the husband, wife and children (if any). Marriage instability speaks the opposite of these qualities. The attitude of couples to infertility was looked at and discussed. It was discovered that couples attitude to infertility is influenced by the social perception of infertility. Many societies regard fertility with great importance and as such infertility problem tends to leave the couples with a feeling of worthlessness and frustration, which affects their life. African society views infertility as a major problem with a level of stigma attached to it and this affects the way couples look at infertility as a big challenges. The effect of infertility on the couples marriage was also reviewed. Most studies reveal that infertility is capable of tearing the couple apart due to the attendant and prevalent negative feelings of anger, guilt depression, loneliness and others, which if not properly handled can have consequence on the marriage.

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CHAPTER THREE RESEARCH METHODOLOGY

3.0 Introduction This chapter presents the methods and procedures adopted in conducting this study. 3.1 Research Design The research design adopted for this study was the ex-post facto research design. This design was considered appropriate for this study as the variables involved in the study were not to be manipulated but studied retrospectively in the way they occur naturally. 3.2 Population of the Study The population of this study covered all the couples having infertility problem in Lagos State. 3.3 Samples and Sampling Procedure The sample used for this study comprised of one hundred and twenty (120) subjects selected from the population identified above using the simple random sampling method. Out of the

53

twenty (20) local government areas in Lagos State, Lagos Mainland was purposively selected for the study consequent upon time and financial constraints as well as the researchers wider knowledge of the area.

3.4 Research Instrument The instrument used for data collection was a self-developed questionnaire. It was divided into two parts. The first part contained questions on the demographic characteristics of the respondents while the second part contained questions on the study variables designed in relation of the research questions raised in the study. 3.5 Validation of Instrument The validation of instrument was based on the vetting, corrections and modifications of the instrument by the supervisor 3.6 Reliability of Instrument To determine the reliability of the questionnaire, a pilot study was conducted by the researcher using twenty (20) respondents that were not involved in the main study. The split-half statistical method was adopted to analyze the data from the pilot test and a reliability co-efficient of 0.87 was obtained indicating the reliability of the instrument. 3.7 Procedure for Data Collection

54

The researcher visited some clinics and churches as well as some identified couples on some streets and homes in Lagos Mainland Local Government Area and administered the questionnaire. The subjects were given enough time to respond to the questionnaires before retrieval.

3.8 Method of Data Analysis Data collected on the demographic features of the respondents were analyzed and presented in percentage tables. The one-way analysis of variance (ANOVA) and the Independent Sample T-test statistical tools were used in analyzing the hypotheses raised in the study

55

CHAPTER FOUR DATA ANALYSIS, PRESENTATION OF RESULTS,

DISCUSSION AND SUMMARY OF FINDINGS 4.0 Introduction This chapter presents the analysis of the data collected from the study, presentation of results, discussion and summary of findings. 4.1 Presentation of respondents bio data TABLE 1: Gender distribution of Responses Gender Male Female Total Frequency 53 67 120 % 44.2 55.8 100

Table one shows that 44.2% of the subjects that were involved in the study were male and 55.8% were female. TABLE 2: Age distribution of respondents Age < 30 years Frequency 23 % 19.2

56

30-39 years > 40 years Total

38 59 120

31.7 49.1 100

Table two shows that 19.2% of the respondents that participated in the study were less than thirty years old; 31.7% of them were between the ages of thirty and thirty-nine and 49.1% were forty years old or above

Table

3:

Distribution

of

Respondents

by

Educational

Background Educational Background Primary education Secondary educational Tertiary education Total Frequency 4 29 87 120 % 3.3 24.2 72.5 100

Table three shows that 3.3% of the respondents that took part in the study had only primary education; 24.2% of them had up to secondary education; and 72.5% had up to tertiary education

4.2 Test of Hypothesis and Presentation of results

Ho1: Marriage stability is not significantly influenced by couples attitude to infertility.

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Table

4:

Result

of

one-way

analysis

of

variance

on

influence of couples attitude to infertility on marriage stability

Sources of Sum of Degrees Mean ofF-ratio variance Between Groups (Treatment) 209.07 Within Groups (Error) Total 3642.6 3857.67 238 239 15.31 13.66 0.05 6.76 Significant 1 209.07 square of s freedom squares calculated Prob. Fratio critical Decision

Table four shows that the calculated f-value of 13.66 is greater than the critical f-value of 6.76 given 1 and 238 degrees of freedom, at 5% level of significance. Hence, the hypothesis is rejected in favour of its alternative, thereby confirming that marriage stability is significantly influenced by couples attitude to infertility.

Ho2: Couples perception of infertility does not have significant effect on marriage stability

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Table 5: Result of one-way analysis of variance on the influence of couples perception of infertility on marriage stability
Sources of Sum of Degrees Mean ofF-ratio variance Between Groups (Treatment) 64.07 Within Groups (Error) Total 593.6 657.67 238 239 2.49 25.69 0.05 6.76 Significant 1 64.07 square of s freedom squares calculated Prob. Fratio critical Decision

Table five shows that the calculated F-value of 25.69 is greater than the critical f-value of 6.76 given 1 and 238 degrees of freedom, at 5% level of significance. This result approves the rejection of null hypothesis and acceptance of its alternative, thereby confirming that marriage stability is significantly affected by couples perception of infertility.

Ho3: Marriage stability is not significantly affected by the behaviour of the couples facing infertility challenges.

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Table 6: Result of one-way analysis of variance on the influences of the behaviour of couples facing infertility on marriage stability
Sources of Sum of Degrees Mean of F-ratio variance Between Groups (Treatment) 4463.44 Within Groups (Error) Total 8150.8 238 239 34.25 130.33 0.05 6.76Significant 1 4463.44 square of s freedom squares calculated Prob. Fratio critical Decision

Table six shows that the critical f-value of 6.76 is less than the calculated f-value of 130.33 given 1 and 238 degree of freedom at 5% level significance. The result endorses the rejection of null hypothesis three and acceptance of its alternative, thereby indicating that marriage stability is significantly influenced by the behaviour of couples facing infertility challenges.

Ho4; There is no significant gender difference in couples attitude to infertility.

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Table 7: Result of the independent sample t-test of gender difference in attitude to infertility
Gender N mean SD DF(N-2) Female 67 19.71 0.23 118 Male 53 19.42 2.44 0.05 1.02 1.98 not significant Prob t-cal t-crit decision

Table seven shows that the calculated t-value of 1.02 is less than the critical t-value of 1.98 given 118 degree of freedom at 0.05 alpha levels. This result approves the acceptance of null

hypothesis four, thereby confirming that there is no gender bias in couples attitude to infertility.

4.3 Summary of findings Based on the data analysis and tests of the hypothesis raised in this study, the following findings were made: In hypothesis one (Table 4), it was found that couples attitude to infertility has significant influence on marriage stability. The null hypothesis was therefore rejected because the calculated f-value

61

of 13.66 was greater than the critical f-value of 6.76 given 1 and 238 degrees of freedom, at a 0.05 level of significance.

In hypothesis two (table 5), it was found that the way couples perceive infertility has significant effect on marriage stability. The null hypothesis was also rejected because the calculated f-value of 25.69 was greater the critical f-value of 6.76, given 1 and 238 degrees of freedom, at a 0.05 level of significance.

In hypothesis three (table 6); it was found that the behaviour of couples in infertility has significant influence on marriage stability. The null hypothesis here was also rejected based on the calculated f-value of 130.33 being greater than the critical f-value of 6.76 given 1 and 238 degrees of freedom, at 0.05 level of significance.

In hypothesis four (Table 7) it was found that there is no significant gender difference in couples attitude to infertility. This null hypothesis was retained based on the calculated t-value of 1.02, which was less than the critical t-value of 1.98 given 118 degree of freedom at 5% level of significance.

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4.4 Discussion of findings Hypothesis One The result of finding shows that couples attitude to infertility has significant influence on marriage stability. This means that the stability of marriage is susceptible to the attitude of couples to infertility.

This result of findings is in line with Hydes (1990) findings, which concluded that infertility leaves the couples with feelings of inadequacy that makes the man feel his masculinity or virility is in question and the woman feels like a failure because of their inability to bear children. Silver (2007) also noted that the effect of infertility on couples could be devastating to a marriage such that marriages do not survive it because of the general feelings of anger, guilt, and powerlessness at their inability to make their dreams come true, which goes with much turmoil and heart ache. Furthermore Widge (2002) confirmed this by observing that infertility leads the couple to identity dilemmas, lowered selfesteem, frustration and a sense of powerlessness. These negative emotions have impact on couples attitude, because emotion is the affective component of attitude.

Okonofuaa et al (1995) confirmed that beliefs and perceptions,

63

theories, expectations goals and aspirations affect the attitude of couples to infertility. According to the findings of Andrews et all (1991) and Metzer (2003) stress from infertility is a major issue because the burden of infertility is physical, emotional,

psychological and financial. These have strong implication to the attitude of couples during infertility. It definitely exerts some level of pressure on the couples relationship. The researcher therefore agrees with this finding because the couples have a lot of factors to contend with.

Hypothesis Two In hypothesis two, it was found that the way couples perceive infertility has significant effect on their marriage stability. This means that the stability of the marriage of couples is a function of their views about infertility.

Couples perception of infertility is greatly influenced by the societal beliefs and perceptions of infertility, which are based on a lot of misconceptions as noted by Okonofuaa et al (1995) in their study on the social meaning of infertility in South-west Nigeria. Widge (2002) further confirms this in his own findings. According to him infertility is a threat to a womans identity, status and

64

economic insecurity, to a mans procreativity and lineage familial and community continuity. It is usually marked by social stigmatization. Conway (2007) also related that couples

experience of infertility is connected to the traditional ways men and women have been trained to think, feel and act.

The reason for this finding is not detached from what is obtainable in the Nigerian and African societies at large, where infertility is almost seen as a curse and runs counter to the tradition and purpose of marriage. Couples with this perception would consider their marriage fruitless and worthless. Nevertheless since the environmental beliefs and practices influence the perception of couples, it then follows that with the re-orientation of the public, couples could begin to perceive infertility problems differently. As Okonofuaa et al (1995) pointed out, there is a correlation between general level of education and beliefs on infertility. The researcher agrees with this because, in the society today, people with strong religious inclinations seem to view infertility differently, as a test of their faith and so seem to have more stable marriages than those that are not religiously inclined. Hence couples perception of infertility could determine stability of marriages.

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Hypothesis Three This hypothesis states that marriage stability is not significantly influenced by the behaviour of couples facing infertility challenge. The research finding shows that marriage stability is significantly influenced by the behaviour of couples facing infertility challenge. This finding is in line with the conclusions of Miller and Miller (1973) that talks about the high premium put on fertility in most African countries, as having strong connection with marriage.

This connection is so strong that in some societies if conceptions do not take place divorce is permissible and often automatic. Osarenren (2005) also supported this. According to her marriages in Nigeria are basically contracted for procreation purposes and any delay up to one year will cause eyebrows to be raised from all quarters and pressures are mounted on the couple. These pressures and societal expectations affect and shape couples behaviour and also marriage stability.

The researcher agrees with this finding. However since medical advances have shown that most cases of infertility are treatable, this knowledge should encourage positive behaviour which will enhance marriage stability.

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Hypothesis Four The hypothesis states that there is no significant gender

difference in couples attitude to infertility. The research finding shows that this null hypothesis was retained implying that there is no significant gender difference in couples attitude to infertility.

This agrees with Zandens (1989) conclusion that while women speak of feeling hallow or empty, men speak of feeling like castrates or say they shoot blanks. This implies that both men and women approach infertility as a huge challenge with little or no differences. Furthermore, Fworth (2007) opined that the effects of infertility affect men and women in different levels. According to him, the woman is generally perceived as more emotional than the men, but the man is more likely to conceal his emotions. This does not mean lack of emotions. On the other hand the concealed emotions could bring adverse psychological problems that would affect couples relationships. Widge (2002) further reiterates this finding when he compared infertility to bereavement, which according to him can be a wrecking

experience for both the woman and the man.

67

The researcher agrees with this finding because both the men and women observed in infertility seem to put up more of defensive attitude in trying to brace up to the challenge of infertility. However, their sense of powerlessness, helplessness and

emptiness is felt.

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CHAPTER FIVE SUMMARY, CONCLUSION AND RECOMMENDATIONS 5.0 Introduction This chapter presents the summary of this study; conclusion and recommendations. 5.1 Summary of the Study This study examined couples attitude to infertility and its effects on marriage stability in Lagos State. The ex-post facto research design was adopted for the study. This is because the variables studied were not manipulated by the researcher but studied retrospectively in the way they occur naturally. The studys population covered the entire couples having infertility problem in Lagos State. Out of twenty Local Government Areas in Lagos State, Lagos Mainland was purposively selected for the study. A sample of hundred and twenty (120) respondents was selected using simple random sampling technique. The instrument used to collect data for this study was a thirty item self-structured questionnaire. The questionnaire was divided into two parts. The first part contained questions on the demographic characteristics of the respondents; while the second part contained questions on the studys variables designed in line with the research questions raised in the study towards attaining the objectives of the study.
69

Four hypotheses were formulated and tested during the study using one way analysis of variance (ANOVA) and independent ttest. The findings of the study shows that marriage stability is significantly affected by couples attitude to infertility; couples perception of infertility and couples behaviour to each other during infertility. Further finding showed that there is no gender bias in attitude to infertility.

5.2 Conclusion From the findings of this study, the following conclusions were reached: i. Marriage stability is affected by the attitude of couples facing infertility challenges. ii. The way couples perceive infertility affects the stability of their marriage during infertility iii. The behaviour of couples to each other affects the stability of their marriage iv. There is no gender bias in the attitude of couples to infertility

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5. 3 Recommendations Based on the findings of this study, the following

recommendations are made: 1. Counselors would need to focus attention on couples attitude during infertility. They should be assisted to cultivate and maintain positive attitude, which has

implication to marriage stability. 2. Public enlightenment campaign should be carried out by the media, NGOs and religious bodies, on the impact of perceptions of infertility on marriage stability. Efforts should also be focused on correcting the poor societal perception and misconceptions of infertility problems. 3. The Public enlighten campaign should also focus on

countering the general stigmatization of couples facing infertility which affects their behaviour. Efforts must be made to foster positive behaviour among couples with infertility challenge. 4. Infertility affects the couples and so equal attention would need to be given to both the male and female counter-part as against the lobe-sided focus on the woman during infertility. Infertility treatment and counseling centers would

71

need to promote publications that fully carter for the needs of both gender.

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REFERENCES Andrews, F. M., Abbey, A., and Halman, L. J. (1991), Stress from infertility, marriage factors and subjective well being of wives and husbands. http://www.ncbi.nlm.nlh.gov/sites Blackenhorn, D. (2003), The Marriage Problem.
http://www.americanexperiment.org/uploaded/files/aeqv6n1blakenhorn.pdf

Conway S. (2007). The emotional effect of infertility on the couples relationship. http://www.ivf.com/emotion.htm Finkelstein J.M (2007), Models for Marriage in the 21 st Century, http://www.asbee.net/marriage.htm Fworth, J. A. (2007). Effect of infertility on couples http://www.puppaw.com Ganiats, T., Mogaa, M., Alexandrescu, B., Katz, S. E., Steim, M. (2004). Impact of infertility on quality of life, marital adjustment and sexual function, http://www.sciencedirect.com
(13/9/07)

Giwa-Osagie O.F. (2002). Social ethical aspects of assisted conception in Anglophone sub-Saharan Africa http://www.who.int/reproductive-health/infertility/9.pdf Hyde J.S. (1990). Understanding human sexuality USA McGraw-Hill Inc. Library on congress cataloguing in Publication Jung C.G. (1921). Psychological types collected works, volume 6, Princeton N.T, Princeton University Press Magnal S.K (2007). Essentials of Educational Psychology, New Delhi Prentice Hall of India Private limited Metzger, D. A. programme. (2003), Helena womens healthfertility

http://www.harmoneywomenshealth.com/web/Articles/HwhfertilityProgramme.htm

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