Acceptance and mindfulness in couples dealing with infertility

survey image
Project title: Acceptance and mindfulness in couples dealing with infertility
Project protocol number: RO 1951


You are invited to participate in research investigating couples’ experiences of infertility.

This research is being conducted by Anastasiia Kuliapina, a Masters student in Clinical Psychology, under the supervision of Dr. Lisa Marie Abel from the School of Psychology at Bond University. 

The aim of this research is to gain a better understanding about the extent to which acceptance and mindfulness contribute to couples’ coping and adjustment within the context of infertility. It is hoped that the results of this research may contribute to the development of appropriate psychological support programs for couples facing fertility difficulties.

Both partners are invited to participate in the research. The research questionnaire takes approximately 45 minutes. Participation is voluntary and responses will remain completely confidential.

Given the nature of the research project, some of the questions may trigger sad thoughts or memories; please know that you are free to withdraw from the study at any time. If you experience any distress, please contact any of the following support services:

In Australia: Relationships Australia 1300 364 277 or Lifeline Counseling 13 11 14.

In UK: Infertility Network UK Support Line 0121 323 5025 or Relate 0300 100 1234

In USA: Resolve 866 668 2566 or Your Life Your Voice 1800 448 3000

In recognition of your participation, your name will go into a draw to win a gift card valued at $100US. The draw for this will take place at the completion of data collection.

Should you have any complaints concerning the manner in which this research (RO 1951) is conducted, please do not hesitate to contact Bond University Research Ethics Committee at the following address:

Senior Research Ethics Officer


Bond University Human Research Ethics Committee

Bond University

Gold Coast QLD 4229

Telephone: (07)55954194; Fax: (07)55951120


If you would like to know more about the research or receive a summary of the research findings please contact Anastasiia Kuliapina at Thank you very much for taking the time to participate in this study, it is appreciated.

I have read and understood Explanatory Statement, and consent to the research it describes to me.

A "participant code" is required. This is simply the female partner's maiden name, date of wedding/relationship anniversary,
and 'M' or 'F' for participant gender e.g., SMITH3008M or SMITH3008F (N.B. 3008 indicates that the wedding anniversary
is the 30th August). Anniversary months should be recorded as follows: 01, 02, 03, 04, 05, 06, 07, 08, 09, 10, 11, 12 i.e.,
the month should be a two digit code. The actual date of your anniversary should also be a two-digit code i.e. 01-31.
Please enter your participant code below.

Age (in years)


How would you describe your sexuality?

Length of relationship in years

Have you or your partner ever received a diagnosis of a mental health disorder?

If yes, please list the appropriate diagnoses and who they apply to

(1000 characters remaining)
Marital Status

In which country were you born?

Where do you currently live?

What is the highest level of education you have completed?

What is your household's total annual income for the most recent calendar year?

Would you describe yourself as someone who is spiritual?

What religion are you?

Fertility medical history

So that we can gain a better understanding of your unique experiences, questions 15 to 25 focus on you and your partner's fertility history.

For how long (in months) did you and your partner try to conceive before seeking medical fertility assistance?

How long ago (in months) were you and/or your partner diagnosed as infertile?

What did the medical professional identify as the primary cause for the infertility diagnosis?

Have you or your partner undergone (or currently undergoing) medical treatment for infertility?

If you and/or your partner are currently obtaining medical fertility assistance, please select the treatment you and/or your partner are undertaking:

Have you ever sought psychotherapeutic support for your fertility related concerns?

What type of psychotherapy did you undertake regarding your fertility related concerns?

Do you and your partner share any living, biological children?

How many times have you been pregnant?

How many times have you undergone IVF treatment?

How many IVF attempts were unsuccessful?

How many miscarriages have you and your partner had?

For each question, check the response that is closest to your current thoughts and feelings

How would you rate your health?

Are you satisfied with your quality of life?

Are your attention and concentration impaired by thoughts of infertility?

Do you think you cannot move ahead with other life goals and plans because of fertility problems?

Do you feel drained or worn out because of fertility problems?

Do you feel able to cope with your fertility problems?

Are you satisfied with the support you receive from friends with regard to your fertility problems?

Are you satisfied with your sexual relationship even though you have fertility problems?

Do your fertility problems cause feelings of jealousy and resentment?

Do you experience grief and/or feelings of loss about not being able to have a child (or more children)?

Do you fluctuate between hope and despair because of fertility problems?

Are you socially isolated because of fertility problems?

Are you and your partner affectionate with each other even though you have fertility problems?

Do your fertility problems interfere with your day-to-day work or obligations?

Do you feel uncomfortable attending social situations like holidays and celebrations because of your fertility problems?

Do you feel your family can understand what you are going through?

Have fertility problems strengthened your commitment to your partner?

Do you feel sad and depressed about your fertility problems?

Do your fertility problems make you inferior to people with children?

Continue ONLY when finished. You will be unable to return or change your answers.