B Navid - Reproductive Epidemiology Research Center, Royan Institute For Reproductive Biomedicine, ACECR, Tehran, Iran.
F Malekzadeh - Reproductive Epidemiology Research Center, Royan Institute For Reproductive Biomedicine, ACECR, Tehran, Iran.. Department of Endocrynology and Femail Infertility, Reproduc-tive Epidemiology Research Center, Royan Institute for Reproduc-tive Biomedicine, A
M Mohammadi - Reproductive Epidemiology Research Center, Royan Institute For Reproductive Biomedicine, ACECR, Tehran, Iran.
R Omani-Samani - Department of Medical Ethics and Law, Reproductive Biomedi-cine Research Center, Royan Institute for Reproductive Biomedi-cine, ACECR, Tehran, Iran

Background: Infertility could have a negative impact on vari-ous aspects of women’s lives. The defense mechanisms are mental processes in the structure of the personality which has an impact on psychological coping mechanisms. Self –esteem and marital adjustment play key role in infertile women’s men-tal-social health. So, the aim of this study was to investigate the role of defense mechanisms, self-esteem and marital adjust-ment based on the cause of infertility.Materials and Methods: In this cross-sectional study, 400 infertile couples referred to infertility center in Tehran, Iran. Data gathering tool in this study was Demographic questionnaire, Revised Dyadic Adjustment Scale (RDAS), Rosenberg Self-Esteem Scale and Defense Styles Ques - tionnaire (DSQ). Data were analyzed (SPSS 18 software) using paired t -test for comparison between the groups ac - cording to the cause of infertility using regression analyses and Kruskal Wallis tests.Results: The results of this study showed that marital ad - justment was significantly higher in women with unknown factor than in other groups (P <0.07). Also in couples with female factor, male factor, and both factor, husbands ap - peared significantly higher mean score for marital adjust - ment in comparison with wives (P <0.07). When the cause of infertility was unknown, the women expressed greater self- esteem compared to other groups (P <0.029). In men with female factor, self –esteem was significantly higher than other groups (P <0.049). In couples, husbands with female and male factor showed more self- esteem than their wives (P< 0.001, P <0.008, respectively). In defense mech - anisms, there was no difference between women, men, and couples (women with husbands). Self- esteem has a signifi - cant positive correlation with marital adjustment and ma - ture defense mechanism and also has a significant negative correlation with the immature and neurotic defense mecha - nisms (P <0.05).Conclusion: The findings of this study showed that women had higher levels of vulnerability than their husbands even when they were not the cause of infertility. Perhaps becoming preg-nant is a feminine process and associated with feminine identity and these women are responsible for this matter. Also, there was a relation between defense mechanisms, self-esteem, and mari-tal adjustment in infertile couples.

Defense Mechanism, Infertility, Marital Adjustment, Self-Esteem