Influence of Couple Communication and Relational Autonomy on Assisted Reproductive Technology Utilisation among Fertility Clients in Port Harcourt, Nigeria

Abstract

Infertility remains a significant reproductive health concern for couples, particularly in settings where childbearing is closely linked with marriage, family continuity, and social recognition. Although assisted reproductive technology (ART) provides important clinical options for couples experiencing infertility, its utilisation may be influenced by partner communication, relational autonomy, treatment cost, emotional readiness, and social pressure. This study examined the influence of couple communication and relational autonomy on ART utilisation among fertility clinic clients in Port Harcourt. A descriptive quantitative design was adopted. The population comprised married and cohabiting couples seeking or receiving ART services in selected private fertility clinics in Port Harcourt, Rivers State. A total of 209 valid responses were analysed after incomplete responses were excluded. Respondents were selected through a multi-stage sampling technique. Data were collected using a structured questionnaire validated through expert review. Reliability testing produced Cronbach's alpha coefficients of 0.83 for communication pattern, 0.86 for relational autonomy, and 0.74 for ART utilisation. Data were analysed using SPSS version 27. Frequencies, percentages, mean, standard deviation, Pearson correlation, and multiple linear regression were used. Findings showed that couples reported open and frequent communication on fertility treatment decisions. Relational autonomy was also strongly reflected in joint reproductive decision-making. Communication pattern had a positive relationship with ART utilisation (r = .63, p < .05), while relational autonomy had a stronger positive relationship with ART utilisation (r = .68, p < .05). The regression model showed that communication pattern and relational autonomy jointly predicted ART utilisation and explained 54% of its variation. The study concludes that ART utilisation is strengthened when couples communicate openly, make joint decisions, respect each partner's views, and avoid coercion.