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Ni Y, Tong C, Huang L, Zhou W, Zhang A. The analysis of fertility quality of life and the influencing factors of patients with repeated implantation failure. Health Qual Life Outcomes 2021; 19:32. [PMID: 33494768 PMCID: PMC7831164 DOI: 10.1186/s12955-021-01666-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 01/01/2021] [Indexed: 01/29/2023] Open
Abstract
Background The objective of this study was to investigate the current status of fertility quality of life (QoL) and explore the influencing factors for infertile women with repeated implantation failure (RIF). Methods The sample consisted of 137 infertile women with RIF who were under treatment from January 2019 to December 2019 in the Reproductive Medical Center of Ruijin Hospital, affiliated with Shanghai Jiaotong University School of Medicine in China. A general information questionnaire, FertiQoL scale, perceived social support scale (PSSS), self-rating anxiety scale (SAS), and self-rating depression scale (SDS) were used to analyse the fertility QoL and related factors of RIF patients.
Results The total fertility QoL score of RIF patients was 60.44 ± 11.60. The results of multivariate regression analysis showed that residence, financial difficulties, male infertility, BMI index, depression, and family social support were the main factors that influenced the fertility QoL of RIF patients (adjusted R2 = 0.762). Conclusion Based on the results of this study, RIF patients’ psychological status must be addressed. Corresponding interventions such as building a sound family and social support system, creating a good medical environment and offering diverse health education should be provided to improve the fertility QoL of RIF patients.
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Affiliation(s)
- Ying Ni
- Nursing Department of Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China
| | - Chenye Tong
- Nursing Department of Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China
| | - Limin Huang
- Nursing Department of Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China
| | - Wenjie Zhou
- Reproductive Medical Center of Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China
| | - Aijun Zhang
- Reproductive Medical Center of Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China.
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Ngai FW, Loke AY. Relationships between infertility-related stress, family sense of coherence and quality of life of couples with infertility. HUM FERTIL 2021; 25:540-547. [PMID: 33432870 DOI: 10.1080/14647273.2021.1871781] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
This is a cross-sectional study with the objective to examine the relationships between infertility-related stress, family sense of coherence and quality of life of Chinese couples with infertility in Hong Kong. A convenience sample of 135 Chinese couples were recruited at the subfertility clinics of the Family Planning Association of Hong Kong. Data were collected using the Fertility Problem Inventory, Family Sense of Coherence Scale and Fertility Quality of Life. Path analysis was used for data analysis. The results showed that infertility-related stress had a negative association with the quality of life of infertile couples and family sense of coherence mediated the effect of infertility-related stress on quality of life for both partners. The infertility-related stress of women had a negative association with their husbands' quality of life. Infertile women had more infertility-related stress and a lower quality of life than their husbands. The findings provide new insights into the importance of family sense of coherence in facilitating couples' adjustment to infertility. Culturally competent heath care interventions should be developed to strengthen family sense of coherence among Chinese couples with infertility and help them reduce their infertility-related stress, thus improving their quality of life.
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Affiliation(s)
- Fei-Wan Ngai
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Alice Yuen Loke
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
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Zurlo MC, Cattaneo Della Volta MF, Vallone F. Re-examining the Role of Coping Strategies in the Associations Between Infertility-Related Stress Dimensions and State-Anxiety: Implications for Clinical Interventions With Infertile Couples. Front Psychol 2020; 11:614887. [PMID: 33414752 PMCID: PMC7782436 DOI: 10.3389/fpsyg.2020.614887] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 11/18/2020] [Indexed: 12/22/2022] Open
Abstract
Research has shown a direct relationship between infertility-related stress and anxiety in infertile patients. The present study goes into this relationship in depth, testing the moderating role of coping strategies (Seeking Social Support, Avoidant, Positive Attitude, Problem-Solving, Turning to Religion) in the associations between specific infertility-related stress dimensions (Social Concern, Need for Parenthood, Rejection of Childfree Lifestyle, Couple’s Relationship Concern) and State-Anxiety among male and female partners of infertile couples. Gender differences were also explored. Both members of 254 infertile couples completed a questionnaire consisting of Socio-demographics, Fertility Problem Inventory–Short Form (FPI-SF), Coping Orientation to Problem Experienced–New Italian Version (COPE-NIV), and State-Trait Anxiety Inventory-Y (STAI-Y). The results revealed that Social Concern and Couple’s Relationship Concern, in both partners, and Need for Parenthood, in female partners, had positive correlations with State-Anxiety. Seeking Social Support and Avoidant coping were related to increasing levels of State-Anxiety in both partners, whereas Positive Attitude coping strategies were related to lower levels of State-Anxiety in female partners. Problem-Solving and Avoidant coping played moderating roles between specific infertility-related stress dimensions and State-Anxiety in unexpected directions. Problem-Solving exacerbated the negative effects of Social Concern, whereas Avoidant coping buffered the negative effects of several infertility-related stress dimensions in both partners. Interventions to improve stress management and psychological health in infertile couples should consider that the adequacy of coping strategies is inherently situation specific. It therefore follows that patient-centered clinical interventions should consider the potential inadequacy of promoting Problem-Solving strategies, and that even Avoidance can be an efficient strategy for dealing with specific infertility-related stress dimensions.
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Affiliation(s)
- Maria Clelia Zurlo
- Dynamic Psychology Laboratory, Department of Political Science, University of Naples Federico II, Naples, Italy
| | - Maria Francesca Cattaneo Della Volta
- Dynamic Psychology Laboratory, Department of Political Science, University of Naples Federico II, Naples, Italy.,Department of Humanities, University of Naples Federico II, Naples, Italy
| | - Federica Vallone
- Dynamic Psychology Laboratory, Department of Political Science, University of Naples Federico II, Naples, Italy.,Department of Humanities, University of Naples Federico II, Naples, Italy
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Facchin F, Leone D, Tamanza G, Costa M, Sulpizio P, Canzi E, Vegni E. Working With Infertile Couples Seeking Assisted Reproduction: An Interpretative Phenomenological Study With Infertility Care Providers. Front Psychol 2020; 11:586873. [PMID: 33391106 PMCID: PMC7773748 DOI: 10.3389/fpsyg.2020.586873] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 11/26/2020] [Indexed: 11/13/2022] Open
Abstract
Although most studies investigated the impact of infertility and its treatment on the couple, a small body of evidence suggested that infertility care providers may experience different sources of stress related for instance to excessive workload, the complexity of the technique, and relational difficulties with patients. The current study aimed at providing further insight into the understanding of the subjective experience of infertility care providers by highlighting their feelings and emotions, personal meanings, challenges, and opportunities. Following the methodological guidelines of Interpretative Phenomenological Analysis, we conducted individual semi-structured interviews with 23 members of two different fertility units. Interviews were audiotaped and transcribed verbatim. Textual analysis was then conducted to identify emerging dominant themes and subthemes. Three main themes were extracted: (i) dealing with infertile patients and their specificities, (ii) performing assisted reproductive technology (ART), (iii) being part of a team. These themes related to participants experiencing: (i) difficulties in establishing an empathic connection and communicating with couples, such that women were sometimes perceived as "particular patients" and men as poorly involved in the process; (ii) difficulties in dealing with a complex procedure in which errors are not allowed (as reported by embryologists), with a growing number of women aged > 40 seeking assisted reproduction, despite the risks for their health; (iii) being part of a team as a resource, although the huge amount of time spent together can involve conflicts and organizational problems. These findings suggested that patients' overpersistence (rather than just dropout) represents an important source of stress for infertility care providers. At the same time, the concept of particular or difficult patient derives from the combination of multiple factors, including providers' own history and subjective experience. The presence of mental health professionals in fertility units is essential to help providers improve the quality of doctor-patient communication and relieve the stress related to organizational issues and conflicts.
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Affiliation(s)
- Federica Facchin
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Daniela Leone
- Unit of Clinical Psychology, San Paolo University Hospital, Asst-Santi Paolo e Carlo, Milan, Italy
| | - Giancarlo Tamanza
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Mauro Costa
- Reproductive Medicine Unit, Ospedale Evangelico Internazionale, Genoa, Italy
| | - Patrizia Sulpizio
- Reproductive Medicine Unit, San Paolo University Hospital, Asst-Santi Paolo e Carlo, Milan, Italy
| | - Elena Canzi
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Elena Vegni
- Unit of Clinical Psychology, San Paolo University Hospital, Asst-Santi Paolo e Carlo, Milan, Italy.,Department of Health Sciences, University of Milan, Milan, Italy
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Aimagambetova G, Issanov A, Terzic S, Bapayeva G, Ukybassova T, Baikoshkarova S, Aldiyarova A, Shauyen F, Terzic M. The effect of psychological distress on IVF outcomes: Reality or speculations? PLoS One 2020; 15:e0242024. [PMID: 33315878 PMCID: PMC7735622 DOI: 10.1371/journal.pone.0242024] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 10/26/2020] [Indexed: 02/03/2023] Open
Abstract
Introduction Infertility is a problem that affects millions of people worldwide. The aim of this study was to assess the effect of stress, depression and anxiety on the IVF outcomes in Kazakhstan. Methods The prospective cohort study was performed using questionnaires to assess psychological distress in 304 infertile female in three different cities in Kazakhstan. Results The average age of participants was 33.7 years with infertility duration of 5.9 years. Regarding stress, depression and anxiety we found that more than 80% of all respondents had CES-D score higher than 16, indicating that they are at risk of developing clinical depression. On average, FPI subscales’ scores, global stress score and anxiety scale (STAI-S and STAI-T) scores were statistically significantly higher among not pregnant women than pregnant women. Similarly, in simple logistic regression analysis all FPI subscales scores, global stress scale score and anxiety scales’ scores were negatively associated with clinical pregnancy. Conclusion Rates of stress, anxiety and depression among IVF patients are higher than in general population. If the level of infertility-related stress is higher, IVF success rate is lower. Findings of our study indicate the need for the specific psychological interventions for all infertility women, to improve IVF success rate.
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Affiliation(s)
- Gulzhanat Aimagambetova
- Department of Biomedical Sciences, Nazarbayev University School of Medicine, Nur-Sultan, Kazakhstan
- * E-mail:
| | - Alpamys Issanov
- Department of Medicine, Nazarbayev University School of Medicine, Nur-Sultan, Kazakhstan
| | - Sanja Terzic
- Department of Medicine, Nazarbayev University School of Medicine, Nur-Sultan, Kazakhstan
| | - Gauri Bapayeva
- Clinical Academic Department of Women’s Health, National Research Center of Mother and Child Health, University Medical Center, Nur-Sultan, Kazakhstan
| | - Talshyn Ukybassova
- Clinical Academic Department of Women’s Health, National Research Center of Mother and Child Health, University Medical Center, Nur-Sultan, Kazakhstan
| | | | - Aidana Aldiyarova
- Clinical Academic Department of Women’s Health, National Research Center of Mother and Child Health, University Medical Center, Nur-Sultan, Kazakhstan
| | - Fariza Shauyen
- Clinical Academic Department of Women’s Health, National Research Center of Mother and Child Health, University Medical Center, Nur-Sultan, Kazakhstan
| | - Milan Terzic
- Department of Medicine, Nazarbayev University School of Medicine, Nur-Sultan, Kazakhstan
- Clinical Academic Department of Women’s Health, National Research Center of Mother and Child Health, University Medical Center, Nur-Sultan, Kazakhstan
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America
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Abstract
OBJECTIVE We aimed to compare the depression levels between primary and secondary infertile couples and to investigate the related factors that may affect depression. STUDY DESIGN Two hundred and fifty primary and secondary infertile couples, who admitted to Gynecology and Infertility Clinics of Pendik Teaching and Research Hospital affiliated with Marmara University were enrolled in this study. Sixty-four BMI-matched fertile female patients who applied to the General Gynecology Clinic and their husbands were taken as the control group. Beck Depression Inventory (BDI) form was filled by the infertile couples to evaluate the depression status before they started their cycles. RESULTS The mean total BDI scores were alike between groups among women. Mild depression was found to be higher in the primary infertile women and moderate depression was higher in women of the control group. Women had statistically higher depression scores than male partners. Primary infertile, secondary infertile, and fertile women had higher depression scores than their male partners in the corresponding groups. There was no significant difference in mean total BDI scores among males between the groups. The percentage of distribution of male partners in each level of depression was similar between the groups. CONCLUSIONS Only a weak positive correlation between the mean total BDI score and the number of previous treatment cycles was found. Psychiatric support before and during the upcoming fertility treatment might reduce the perception of the probable treatment failure.
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Affiliation(s)
- Tevfik Yoldemir
- School of Medicine, Obstetrics and Gynecology, Marmara University, Istanbul, Turkey
| | - Mahmut Yassa
- Diyarbakir Selahaddin Eyyubi State Hospital, Diyarbakir, Turkey
| | - Kemal Atasayan
- School of Medicine, Maltepe University, Istanbul, Turkey
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Bhamani SS, Zahid N, Zahid W, Farooq S, Sachwani S, Chapman M, Asad N. Association of depression and resilience with fertility quality of life among patients presenting to the infertility centre for treatment in Karachi, Pakistan. BMC Public Health 2020; 20:1607. [PMID: 33097027 PMCID: PMC7585180 DOI: 10.1186/s12889-020-09706-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 10/14/2020] [Indexed: 12/21/2022] Open
Abstract
Background In Pakistan there is a dire need to explore the quality of life in infertile males and females and its undesirable psychological outcomes. This, study aimed to compare the quality of life (QoL) of males and females visiting an infertility centre for treatment and to assess its association with resilience, depression, and other socio-demographic factors. Methods An Analytical Cross-Sectional study was conducted amongst infertile males and females at the Australian Concept Infertility Medical Centre (ACIMC), Karachi, Pakistan. The non-probability (purposive) sampling strategy was used to recruit the participants. The sample size was 668. Data was analysed using STATA version 12. FertiQoL tool, Beck II Depression Inventory Tool and Resilience Scale 14 (RS-14) were used for assessing the quality of life, depression and resilience respectively of infertile patients. Results Total 668 infertile patients, 334 males and 334 females participated in the study. The mean age was 35.53 ± 6.72, among males, and 30.87 ± 6.12 among females. The mean resilience scores were significantly higher among males, (77.64 ± 8.56), as compared to females (76.19 ± 8.69) (95% CI; − 2.757, − 0.1347). However, a significantly higher proportion of females were depressed (13.8%) as compared to males (6%). The mean QoL scores for the general health domain, emotional domain, mind and body domain, and relational domain, and the total QoL were significantly higher in males as compared to females (p value< 0.001); however, QoL for the social domain was not significantly different in both the groups. On multivariable linear regression resilience and depression among males had a significant association with QoL, after adjusting for the covariates educational status, monthly income, and number of friends. Similar association was observed among females after adjusting for the covariate monthly income only. Conclusion Fertility related QoL of men and women has a significant association with no formal education, number of friends, income, depression and resilience. Therefore, health care professionals in the field of infertility must be adequately trained to respond to the needs of individuals going through these psychological problems.
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Affiliation(s)
| | - Nida Zahid
- Department of Surgery, Aga Khan University, Stadium Road, Karachi, 74800, Pakistan.
| | - Wajeeha Zahid
- Community Health Sciences Department Aga Khan University, Karachi, Pakistan
| | - Salima Farooq
- School of Nursing and Midwifery, Aga Khan University, Karachi, Pakistan
| | - Saima Sachwani
- School of Nursing and Midwifery, Aga Khan University, Karachi, Pakistan
| | | | - Nargis Asad
- Department of Psychiatry, Aga Khan University, Karachi, Pakistan
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YILDIZ S, UĞUR K, SARIDOĞAN E, YAĞIN F, AKKUŞ M. İnfertilite tanılı kadın hastalarda mizaç özellikleri, aleksitimi, psikiyatrik belirtiler ve yaşam kalitesinin değerlendirilmesi. CUKUROVA MEDICAL JOURNAL 2020. [DOI: 10.17826/cumj.692985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Szigeti F J, Grevenstein D, Wischmann T, Lakatos E, Balog P, Sexty R. Quality of life and related constructs in a group of infertile Hungarian women: a validation study of the FertiQoL. HUM FERTIL 2020; 25:456-469. [PMID: 32985277 DOI: 10.1080/14647273.2020.1824079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Quality-of-life measurement is a basic prerequisite for psychologically sensitive fertility care and the FertiQoL is a psychometrically sound outcome measure in this field. The aim of the present research was to investigate the reliability and validity of the Hungarian Core FertiQoL. Two independent samples of infertile women were merged (n = 320). While the model fit of the four-factor Confirmatory Factor Analysis was under the level of acceptability (χ2(246) = 626.36, p < 0.001, RMSEA = 0.070 [CI90 = 0.063-0.076], CFI = 0.878, SRMR = 0.071), the four-factor Exploratory Structural Equation Model showed much improved model fit (χ2(186) = 395.63, p < 0.001, RMSEA = 0.059 [CI90 = 0.051-0.067], CFI = 0.933, SRMR = 0.035). Good internal consistency (Cronbach's Alphas 0.77-0.92) and construct reliability (0.75-0.95) were found for both factor structures. Depression correlated negatively with fertility-specific quality of life. Almost a quarter of the sample suffered from moderate-to-severe depression. Multivariate analysis of variance indicated that Beck Depression Inventory categories (mild, moderate etc.) co-occurred with significantly distinct FertiQoL score ranges, leading to a possible, clinically meaningful threshold on the Core FertiQoL. Pearson coefficients showed secondary infertility, rural residency and pre-treatment status to be associated with better fertility quality of life.
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Affiliation(s)
- Judit Szigeti F
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | | | - Tewes Wischmann
- Institute of Medical Psychology, University Hospital Heidelberg, Heidelberg, Germany
| | - Enikő Lakatos
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | - Piroska Balog
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | - Réka Sexty
- Department of Neonatology, Children's Hospital, University Hospital Bonn, Bonn, Germany
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Molgora S, Baldini MP, Tamanza G, Somigliana E, Saita E. Individual and Relational Well-Being at the Start of an ART Treatment: A Focus on Partners' Gender Differences. Front Psychol 2020; 11:2027. [PMID: 33117204 PMCID: PMC7549400 DOI: 10.3389/fpsyg.2020.02027] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 07/21/2020] [Indexed: 12/17/2022] Open
Abstract
Infertility and ART treatments represent stressful experiences for the couples, impacting on the overall psychological well-being of partners as well as on their couple adjustment. Several variables were analyzed as risk factors for infertility-related distress. The impact of these experiences has been well-documented in both women and men, reporting important gender differences. The aim of this study was to assess gender differences in individual and relational well-being in infertile couples. Gender differences for psychological and medical variables predicting psychological distress were investigated. Two hundred and thirty couples who entered an ART program at a public hospital in Milan were recruited. Each partner completed the following scales: ScreenIVF, Dyadic Adjustment Scale, and Experience in Close Relationship Questionnaire. Findings revealed several gender differences with women reporting higher levels of both anxiety and depressive symptoms, anxiety and avoidance attachment, and helplessness, but lower levels of acceptance than men. Differences emerged also in factors predicting well-being: poor support predicted anxiety in men and depression in women. Furthermore, individual well-being was predicted only for men by attachment anxiety and previous treatment. Finally, in the women subsample, couple's adjustment was predicted by anxiety attachment, while in men predictors were helplessness and type of diagnosis. These results suggest the importance of implementing support interventions for couples which take into consideration the specific needs and fragility of each partner as well as focusing on enhancing a sense of partnership.
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Affiliation(s)
- Sara Molgora
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
| | - Maria Pia Baldini
- IRCCS Ca’Granda Foundation Maggiore Policlinico Hospital, Milan, Italy
| | | | | | - Emanuela Saita
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
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61
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Fang M, Li G, Kang X, Hou F, Lv G, Xu X, Kong L, Li P. The role of gender and self-esteem as moderators of the relationship between stigma and psychological distress among infertile couples. PSYCHOL HEALTH MED 2020; 26:1181-1194. [PMID: 32804542 DOI: 10.1080/13548506.2020.1808233] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
To determine if perceived stigma is positively associated with psychological distress, and examine if self-esteem has a moderating effect on the relationship between stigma and psychological distress among infertile Chinese couples. 369 infertile couples completed questionnaires including socio-demographic and clinical characteristics, stigma, self-esteem, and psychological distress. Stigma had a significant, positive association with psychological distress (r = 0.461, P < 0.01). Self-esteem moderated the association between stigma and psychological distress differently for men compared to women. Stigma had a positive, moderate association with psychological distress in men with high self-esteem compared to men with low self-esteem (t = 3.232, P < 0.01). However, there was no significant difference in the relationship between stigma and psychological distress between women with high and low self-esteem, tests of the simple slopes showed that non-significant difference of slopes between the two groups (t = -0.017, P = 0.987). The results indicate that self-esteem buffers the net effect of stigma on psychological distress in men but not women. Future research should focus on interventions that use self-esteem as a way to decrease the negative association of stigma with psychological distress, especially among men who are infertile and have low self-esteem.
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Affiliation(s)
- Mei Fang
- Center for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, People's Republic of China
| | - Guopeng Li
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, People's Republic of China
| | - Xiaofei Kang
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, People's Republic of China
| | - Fangyan Hou
- School of Nursing, Shandong University, Shandong, People's Republic of China
| | - Gaorong Lv
- School of Nursing, Shandong University, Shandong, People's Republic of China
| | - Xiaofang Xu
- School of Nursing, Shandong University, Shandong, People's Republic of China
| | - Linghua Kong
- School of Nursing, Shandong University, Shandong, People's Republic of China
| | - Ping Li
- School of Nursing, Shandong University, Shandong, People's Republic of China
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62
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Zhao J, Hong X, Zhang H, Dai Q, Huang K, Zhang X, Liu Y, Wu J, Wang Q, Shen H, Xu Z, Zhang Y, Yan D, Qi D, Yang X, Zhang Y, Wang B, Ma X. Pre-pregnancy maternal fasting plasma glucose levels in relation to time to pregnancy among the couples attempting first pregnancy. Hum Reprod 2020; 34:1325-1333. [PMID: 31216361 PMCID: PMC6613343 DOI: 10.1093/humrep/dez069] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 04/09/2019] [Accepted: 04/18/2019] [Indexed: 12/29/2022] Open
Abstract
STUDY QUESTION What is the relationship between pre-pregnancy maternal glucose levels and fecundability in Chinese couples? SUMMARY ANSWER Elevated pre-pregnancy maternal glucose levels were associated with fecundability, as reflected by prolonged time to pregnancy (TTP) among the couples with no prior gravidity. STUDY DESIGN, SIZE, DURATION Based on the National Free Pre-conception Check-up Projects supported by the Chinese government, 2 226 048 eligible couples attempting first pregnancy and participating in the project from 2015 to 2016 were included. They were followed-up for 1 year or until they reported pregnancy. PARTICIPANTS/MATERIALS, SETTINGS, METHODS The Kaplan–Meier method was used to estimate the cumulative pregnancy rate in each menstrual cycle, and the discrete-time analogue of the Cox models was used to estimate the fecundability odds ratios (FORs) and 95% CIs by different pre-pregnancy maternal glucose levels (impaired fasting glucose (IFG) or diabetes as compared to normal). MAIN RESULTS AND THE ROLE OF CHANCE The cumulative pregnancy rate for 12 cycles of the normal fasting plasma glucose (FPG) level group was 42.29%, significantly higher than that of the IFG (35.52%) and diabetes groups (31.52%). After adjusting for confounding factors, the FORs were 0.82 (95% CI: 0.81–0.83) and 0.74 (95% CI: 0.72–0.76) for the IFG and diabetes groups, respectively, as compared to the normal group. The association between pre-pregnancy maternal FPG levels and the FORs was non-linear, and the optimal FPG level for greatest fecundability (shortest TTP) was 3.90–4.89 mmol/L. LIMITATIONS, REASONS FOR CAUTION The findings from this register-based cohort study require cautious interpretation given that information bias would be inevitable for single FPG measurements and for TTP calculations that were based on telephone follow-up information. Additionally, because couples who achieved pregnancy during their first menstrual cycle in the study were excluded, the pregnancy rates reported were low and possibly biased. WIDER IMPLICATIONS OF THE FINDINGS The current report suggests that elevated pre-pregnancy maternal glucose levels were associated with prolonged TTP. Early evaluation and preventive treatment for female partners with IFG or diabetes in a pre-pregnancy examination are necessary. STUDY FUNDING/COMPETING INTEREST(S) Funding was provided by the National Key Research and Development Program of China (grants No. 2016YFC1000300 and 2016YFC1000307), the National Natural Science Foundation of China (grant No. 81872634), the CAMS Innovation Fund for Medical Sciences (grant No. 2018-I2M-1-004), the National Human Genetic Resources Sharing Service Platform (grant No. 2005DKA21300) and the National Population and Reproductive Health Science Data Center (grant No. 2005DKA32408), People’s Republic of China. The authors have no conflicts of interest to declare. TRIAL REGISTRATION NUMBER N/A
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Affiliation(s)
- Jun Zhao
- National Research Institute for Family Planning, Beijing, China.,National Human Genetic Resources Center, Beijing, China
| | - Xiang Hong
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Epidemiology and Statistics, School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Hongguang Zhang
- National Research Institute for Family Planning, Beijing, China.,National Human Genetic Resources Center, Beijing, China
| | - Qiaoyun Dai
- National Research Institute for Family Planning, Beijing, China.,National Human Genetic Resources Center, Beijing, China
| | - Kaiping Huang
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Epidemiology and Statistics, School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Xu Zhang
- Department of Medical Record Management, The Affiliated YanAn Hospital of Kunming Medical University, Yunnan, China
| | - Yuxiang Liu
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Epidemiology and Statistics, School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Jingwei Wu
- Department of Epidemiology and Biostatistics, College of Public Health, Temple University, Philadelphia, PA, USA
| | - Qiaomei Wang
- Department of Maternal and Child Health, National Health Commission of the People's Republic of China, Beijing, China
| | - Haiping Shen
- Department of Maternal and Child Health, National Health Commission of the People's Republic of China, Beijing, China
| | - Zongyu Xu
- Department of Maternal and Child Health, National Health Commission of the People's Republic of China, Beijing, China
| | - Yiping Zhang
- Department of Maternal and Child Health, National Health Commission of the People's Republic of China, Beijing, China
| | - Donghai Yan
- Department of Maternal and Child Health, National Health Commission of the People's Republic of China, Beijing, China
| | - Daxun Qi
- National Research Institute for Family Planning, Beijing, China.,National Human Genetic Resources Center, Beijing, China
| | - Xueying Yang
- National Research Institute for Family Planning, Beijing, China.,National Human Genetic Resources Center, Beijing, China
| | - Yue Zhang
- National Research Institute for Family Planning, Beijing, China.,Graduate School of Peking Union Medical College, Beijing, China
| | - Bei Wang
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Epidemiology and Statistics, School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Xu Ma
- National Research Institute for Family Planning, Beijing, China.,National Human Genetic Resources Center, Beijing, China.,Graduate School of Peking Union Medical College, Beijing, China
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Lasheras G, Mestre-Bach G, Clua E, Rodríguez I, Farré-Sender B. Cross-Border Reproductive Care: Psychological Distress in A Sample of Women Undergoing In Vitro Fertilization Treatment with and without Oocyte Donation. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2020; 14:129-135. [PMID: 32681625 PMCID: PMC7382677 DOI: 10.22074/ijfs.2020.5997] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 10/13/2019] [Indexed: 12/05/2022]
Abstract
Background Cross-border reproductive care (CBRC) refers to the movement of patients to foreign countries
for fertility treatment. Limited evidence indicates that this phenomenon is associated with a risk of psychologi-
cal distress, but few studies on the psychological impact of CBRC are currently available. The aim of this study
was to compare the anxiety and depression levels of a group of cross-border patients with a local Spanish patient
group, both of which underwent in vitro fertilization (IVF) treatment. We also sought to explore the clinical,
sociodemographic and personality profiles of the CBRC group and local women. Materials and Methods This present cross-sectional study was conducted on 161 infertile females (71 CBRC
patients and 90 local women) who were undergoing IVF treatment. The following questionnaires were used to
collect data: Spielberger State Anxiety Inventory (STAI-S), the Beck Depression Inventory-II (BDI-II) and the
Zuckerman-Kuhlman Personality Questionnaire (ZKPQ). Sociodemographic, clinical, reproductive and CBRC
variables were also recorded. Results CBRC patients, specifically CBRC oocyte recipients, showed higher levels of anxiety compared to lo-
cal women. However, no significant differences in depression scores were found between both groups. Finally,
when analysing personality, the Activity scale scores of the ZKPQ were found to be higher in CBRC oocyte
recipients, which indicated a greater tendency for general activity and higher energy levels. Conclusion CBRC oocyte recipient women may have greater vulnerability to anxiety than local women prior
to infertility treatment. Screening and psychological support protocols for anxiety in this population should be
considered.
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Affiliation(s)
- Gracia Lasheras
- Department of Psychiatry, Psychology and Psychosomatics, Dexeus University Hospital, Barcelona, Spain. Electronic Address:
| | - Gemma Mestre-Bach
- Department of Psychiatry, Psychology and Psychosomatics, Dexeus University Hospital, Barcelona, Spain.,Facultad de Ciencias de la Salud. Universidad Internacional de La Rioja, La Rioja, Spain
| | - Elisabet Clua
- Department of Obstetrics, Gynaecology and Reproduction, Dexeus University Hospital, Barcelona, Spain
| | - Ignacio Rodríguez
- Department of Obstetrics, Gynaecology and Reproduction, Dexeus University Hospital, Barcelona, Spain
| | - Borja Farré-Sender
- Department of Psychiatry, Psychology and Psychosomatics, Dexeus University Hospital, Barcelona, Spain
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Nikolaeva M, Arefieva A, Babayan A, Chagovets V, Kitsilovskaya N, Starodubtseva N, Frankevich V, Kalinina E, Krechetova L, Sukhikh G. Immunoendocrine Markers of Stress in Seminal Plasma at IVF/ICSI Failure: a Preliminary Study. Reprod Sci 2020; 28:144-158. [PMID: 32638280 DOI: 10.1007/s43032-020-00253-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 05/28/2020] [Accepted: 06/30/2020] [Indexed: 11/25/2022]
Abstract
We have previously shown that high level of seminal interleukin (IL)-18 is positively associated with a greater risk of pregnancy failure in women exposed to their partners' seminal plasma (SP) during the in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycle. Since IL-18 and IL-1β considered to be the key immune markers of stress, here we ask whether their increase in SP may be due to the stress experienced by men engaged in the IVF programs. Therefore, we correlated seminal IL-18 with IL-1β and both cytokines with the seminal steroids, whose increase indicates the activation of neuroendocrine stress response systems. Retrospective analysis of stored seminal samples was performed. Based on previously identified cutoff level for content of IL-18 per ejaculate, samples with high IL-18 content from IVF failure group (n = 9), as well as samples with low IL-18 content from IVF success group (n = 7), were included in the study. Seminal cytokines were evaluated using FlowCytomix™ technology. A set of 16 biologically active steroids in SP was quantified by liquid chromatography coupled with mass spectrometry. Concentrations and total amounts per ejaculate of cytokines and steroids were determined. A positive significant correlation was found between the levels of IL-18 and IL-1β. There was also a positive correlation between IL-18 or IL-1β and 17-α-hydroxypregnenolone, 17-α-hydroxyprogesterone, dehydroepiandrosterone (DHEA), DHEA sulfate (DHEAS), androstenedione, testosterone, dihydrotestosterone, progesterone, corticosterone, 11-deoxycorticosterone, and the ratio of DHEAS/cortisol. We suggested that stress-related overexpression of immune and hormonal factors in SP may be the key link between male stress and embryo implantation failure.
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Affiliation(s)
- Marina Nikolaeva
- Laboratory of Clinical Immunology, National Medical Research Center for Obstetrics, Gynecology and Perinatology of Ministry of Healthcare of Russian Federation, Oparina str. 4, Moscow, Russia, 117997.
| | - Alla Arefieva
- Laboratory of Clinical Immunology, National Medical Research Center for Obstetrics, Gynecology and Perinatology of Ministry of Healthcare of Russian Federation, Oparina str. 4, Moscow, Russia, 117997
| | - Alina Babayan
- Department of Assisted Technologies in Treatment of Infertility, National Medical Research Center for Obstetrics, Gynecology and Perinatology of Ministry of Healthcare of Russian Federation, Oparina str. 4, Moscow, Russia, 117997
| | - Vitaliy Chagovets
- Department of Systems Biology, National Medical Research Center for Obstetrics, Gynecology and Perinatology of Ministry of Healthcare of Russian Federation, Oparina str. 4, Moscow, Russia, 117997
| | - Natalia Kitsilovskaya
- Department of Systems Biology, National Medical Research Center for Obstetrics, Gynecology and Perinatology of Ministry of Healthcare of Russian Federation, Oparina str. 4, Moscow, Russia, 117997
| | - Natalia Starodubtseva
- Department of Systems Biology, National Medical Research Center for Obstetrics, Gynecology and Perinatology of Ministry of Healthcare of Russian Federation, Oparina str. 4, Moscow, Russia, 117997.,Moscow Institute of Physics and Technology, Institutskiy per. 9, Dolgoprudny, Moscow, Russia, 141701
| | - Vladimir Frankevich
- Department of Systems Biology, National Medical Research Center for Obstetrics, Gynecology and Perinatology of Ministry of Healthcare of Russian Federation, Oparina str. 4, Moscow, Russia, 117997
| | - Elena Kalinina
- Department of Assisted Technologies in Treatment of Infertility, National Medical Research Center for Obstetrics, Gynecology and Perinatology of Ministry of Healthcare of Russian Federation, Oparina str. 4, Moscow, Russia, 117997
| | - Lubov Krechetova
- Laboratory of Clinical Immunology, National Medical Research Center for Obstetrics, Gynecology and Perinatology of Ministry of Healthcare of Russian Federation, Oparina str. 4, Moscow, Russia, 117997
| | - Gennady Sukhikh
- Laboratory of Clinical Immunology, National Medical Research Center for Obstetrics, Gynecology and Perinatology of Ministry of Healthcare of Russian Federation, Oparina str. 4, Moscow, Russia, 117997.,First Moscow State Medical University named after I.M. Sechenov, Trubetskaya str. 8-2, Moscow, Russia, 119991
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65
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Lorzadeh N, Kazemirad N, Kazemirad Y. Human immunodeficiency: Extragonadal comorbidities of infertility in women. IMMUNITY INFLAMMATION AND DISEASE 2020; 8:447-457. [PMID: 32621331 PMCID: PMC7416027 DOI: 10.1002/iid3.327] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 06/21/2020] [Indexed: 12/12/2022]
Abstract
Introduction Infertility is mediated by several changes system‐wide. These changes are likely to cause other systems‐related pathologies, such as changes in systemic immune response, particularly inflammatory response can lead to cardiovascular diseases and breast cancer. Methods These morbidities can exist immediately or years after the diagnosis of infertility. Therefore, understanding the mechanism is important to move toward therapeutic interventions. Results Several extragonadal pathologies are reported due to infertility, as well as, how these might also contribute to reproductive disabilities. Detailed evidence are still not present that can give stronger result. Conclusion This review highlights some of the most frequent comorbidities that are seen in infertile women, hence requiring a need for complete clinical screening and care, as well as diagnosis and treatment in early stages.
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Affiliation(s)
- Nahid Lorzadeh
- Department of Obstetrics and Gynecology, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Nastaran Kazemirad
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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66
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Fertility under uncertainty: exploring differences in fertility-related concerns and psychosocial aspects between breast cancer survivors and non-cancer infertile women. Breast Cancer 2020; 27:1177-1186. [DOI: 10.1007/s12282-020-01124-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 06/14/2020] [Indexed: 12/27/2022]
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67
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Cui Y, Li D, Zhou B, Lin Y, Zeng Y. Mediating role of social support between sleep quality, anxiety and depressive symptoms in Chinese women undergoing in vitro fertilization treatment. SAGE Open Med 2020; 8:2050312120930163. [PMID: 32566228 PMCID: PMC7288797 DOI: 10.1177/2050312120930163] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 05/07/2020] [Indexed: 11/28/2022] Open
Abstract
Introduction: Infertility is a significant health problem, and the prevalence of infertility among women is increasing in developing countries. This study aims to explore whether social support plays a mediating role in the links between exogenous variables, sleep quality, anxiety, and depressive symptoms in Chinese women undergoing in vitro fertilization. Methods: This is a cross-sectional study comprising a sample of Chinese women undergoing in vitro fertilization treatment at a tertiary reproductive medicine center located in South China. Results: The final testing model showed good fit, with normed χ2 = 39.317, p = 0.055, comparative fit index = 0.948, Tucker–Lewis index = 0.902, incremental fit index = 0.951, normed fit index = 0.906, root mean square error of approximation = 0.046). The final path model supported the proposed model: partner relationship, a woman’s age, financial strain, duration of infertility, and cycles of in vitro fertilization were exogenous variables for depressive symptoms, while social support was a significant mediator between sleep quality, anxiety, and depressive symptoms. Conclusion: The empirical support from this study could facilitate the development of appropriate interventions to reduce depressive symptoms, and to promote the mental health of Chinese women undergoing in vitro fertilization treatment.
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Affiliation(s)
- Ying Cui
- Department of Psychiatry, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Danian Li
- Department of Brain Disease, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Borong Zhou
- Department of Psychiatry, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yanshan Lin
- Reproductive Medicine Center, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yingchun Zeng
- Research Institute of Gynecology and Obstetrics, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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68
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Adachi T, Endo M, Ohashi K. Regret over the delay in childbearing decision negatively associates with life satisfaction among Japanese women and men seeking fertility treatment: a cross-sectional study. BMC Public Health 2020; 20:886. [PMID: 32513145 PMCID: PMC7282077 DOI: 10.1186/s12889-020-09025-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 06/01/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Currently, in developed countries, increasing numbers of women and men are delaying childbearing but begin seeking fertility treatment later in life. Some women undergoing infertility treatment develop negative feelings such as depression associated with low life satisfaction and regret over the delay in childbearing. We therefore examine the association of life satisfaction with regret over the delay in childbearing decision and infertility-related factors among Japanese women and men seeking fertility treatment. METHODS This cross-sectional study included 253 women and 196 men referred to fertility facilities in Japan from July to December 2018. Participants completed a questionnaire on life satisfaction, regret over the delay in childbearing decision, infertility-related factors and sociodemographic characteristics. Life satisfaction was measured using the Satisfaction with Life Scale (SWLS), and the degree of regret over delay in childbearing decision was measured on a 7-point Likert scale. Multiple linear regressions, conducted separately by sex, were used to analyze the association of life satisfaction with regret over the delay in childbearing decision and infertility-related factors. RESULTS Of the 253 women and 196 men, 102 (40.3%) women and 43 (21.9%) men answered "strongly agree" regarding their regret over the delay in childbearing decision. Among women, life satisfaction was negatively associated with regret (β = - 0.155, 95% CI [- 0.938, - 0.093], p = 0.017), use of assisted reproduction technology (ART) (β = - 0.135, 95% CI [- 2.977, - 0.020], p = 0.047). In contrast, previous live birth was positively associated with life satisfaction (β = 0.134, 95% CI [0.122, 3.739], p = 0.037). In men, we found no significant association of life satisfaction with regret over the delay in childbearing decision and infertility-related factors. CONCLUSIONS Regret over the delay in childbearing decision is negatively associated with life satisfaction among Japanese women seeking fertility treatment. It may be important for women to make better informed decision regarding the timing of childbearing to not regret later in life. Health professionals should address regret over the delay in childbearing decision during fertility treatment and explore ways to spread information on fertility awareness.
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Affiliation(s)
- Tomoko Adachi
- Division of Health Science, Graduate School of Medicine, Osaka University, 1-7, Suita, Osaka, 565-0871, Japan.
| | - Masayuki Endo
- Division of Health Science, Graduate School of Medicine, Osaka University, 1-7, Suita, Osaka, 565-0871, Japan
| | - Kazutomo Ohashi
- Division of Health Science, Graduate School of Medicine, Osaka University, 1-7, Suita, Osaka, 565-0871, Japan
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Adelosoye AA, Fasipe OJ, Medunoye EI, Adelosoye OC, Sunday EO. Assessment of family function impact on depression severity among infertile women attending a teaching hospital in South-South Nigeria. Future Sci OA 2020; 6:FSO595. [PMID: 32983563 PMCID: PMC7491040 DOI: 10.2144/fsoa-2020-0033] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 05/07/2020] [Indexed: 11/23/2022] Open
Abstract
AIM Family function and husband support can impact depression severity in women with infertility disorder. The aim of this study was to assess the impact of family function and husband support on depression severity among women with infertility disorder at the fertility clinics of a University Teaching Hospital, South-South, Nigeria. METHODOLOGY A cross-sectional descriptive study was carried out among 341 female respondents attending the University of Benin Teaching Hospital fertility clinics over a 3-month period, using a semistructured interviewer administered questionnaire. Data obtained were analyzed. RESULT Respondents mean age was 36 ± 5.3 years. The overall prevalence for depression in this study was 42.5% with a breakdown of 64.2%, 30.4% and 5.4% of these depressed participants having mild, moderate and severe depression, respectively. Family dysfunction had a statistically significant relationship with severity of depression in women with infertility (p < 0.001). A statistically significant relationship was established between poor husband support and the severity of depression (p < 0.001). CONCLUSION Depression is highly prevalent among women with infertility disorder, severe depression was associated with family dysfunction. Good family function would reduce the severity of depression.
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Affiliation(s)
- Alex A Adelosoye
- Department of Family Medicine, University of Medical Sciences Teaching Hospital Complex, Ondo City, Ondo State, Nigeria
| | - Olumuyiwa J Fasipe
- Department of Clinical Pharmacology & Therapeutics, Faculty of Basic Clinical Sciences, University of Medical Sciences, Ondo City, Ondo State, Nigeria
| | - Elihu I Medunoye
- Department of Family Medicine, University of Medical Sciences Teaching Hospital Complex, Ondo City, Ondo State, Nigeria
| | - Onyekachukwu C Adelosoye
- Department of Anaesthesiology, Delta State University Teaching Hospital, Oghara, Delta State, Nigeria
| | - Elisha O Sunday
- Department of Clinical Pharmacology & Therapeutics, Faculty of Basic Clinical Sciences, University of Medical Sciences, Ondo City, Ondo State, Nigeria
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Dumbala S, Bhargav H, Satyanarayana V, Arasappa R, Varambally S, Desai G, Bangalore GN. Effect of Yoga on Psychological Distress among Women Receiving Treatment for Infertility. Int J Yoga 2020; 13:115-119. [PMID: 32669765 PMCID: PMC7336944 DOI: 10.4103/ijoy.ijoy_34_19] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Revised: 06/20/2019] [Accepted: 09/11/2019] [Indexed: 12/18/2022] Open
Abstract
Background Infertility among women has been associated with significant psychological distress, anxiety, and depression. yoga therapy has been found to be useful in the management of anxiety, depression and psychological distress. Aim To review studies on the effectiveness of yoga in reducing psychological distress and improving clinical outcomes among women receiving treatment for infertility. Methodology PubMed, ScienceDirect, and Google Scholar databases were searched for studies using the following inclusion criteria: studies published in English, those published between 2000 and 2018, published in peer-reviewed journals, and those with Yoga as an intervention. Review articles, studies without any yoga interventions for infertility, and male infertility were excluded. The keywords included for the literature search were: Yoga, Mindfulness, Relaxation technique, Stress, Distress, Anxiety, Infertility, In Vitro Fertilization (IVF), and Assisted Reproductive Technology (ART). Results Three studies satisfied the selection criteria. Two studies involved Hatha yoga intervention and one study used structured yoga program. The variables assessed in these studies were: (1) anxiety, (2) depression, (3) emotional distress, and (4) fertility-related quality of life. All the studies reported an improvement in the anxiety scores after yoga intervention. Conclusion Yoga therapy may be potentially useful in improving anxiety scores among women suffering from infertility. More studies are needed in this area to establish role of yoga as an adjuvant during the treatment of infertility.
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Affiliation(s)
| | - Hemant Bhargav
- Department of Psychiatry, NIMHANS, Bengaluru, Karnataka, India
| | | | - Rashmi Arasappa
- Department of Psychiatry, NIMHANS, Bengaluru, Karnataka, India
| | | | - Geetha Desai
- Department of Psychiatry, NIMHANS, Bengaluru, Karnataka, India
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Kiani Z, Simbar M, Hajian S, Zayeri F, Shahidi M, Saei Ghare Naz M, Ghasemi V. The prevalence of anxiety symptoms in infertile women: a systematic review and meta-analysis. FERTILITY RESEARCH AND PRACTICE 2020; 6:7. [PMID: 32313665 PMCID: PMC7157980 DOI: 10.1186/s40738-020-00076-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 03/31/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Infertile women are exposed more frequently to anxiety risk than are infertile men, thereby adversely affecting the procedures with which they are treated and the quality of their lives. Yet, this problem is often disregarded. This study accordingly determined the prevalence of anxiety symptoms among infertile women. METHODS All Persian and English studies published from the early 2000s to May 2019 were searched in international (i.e., PubMed, the Cochrane Library, Web of Science, Scopus, Embase, and PsycINFO) and national (i.e., SID, Magiran) databases as well as through Google Scholar. After the titles and abstracts of the articles were reviewed, their quality was evaluated, and relevant works for examination were selected in consideration of established inclusion and exclusion criteria. The risk of biases of individual studies according to Newcastle - Ottawa Scale was assessed. The heterogeneity of the studies was assessed using the I2 statistic, and indicators of publication bias were ascertained using Egger's test. Stata (version 14) was employed in analyzing the findings. RESULTS Thirteen studies having a collective sample size of 5055 infertile women were subjected to meta-analysis, with study heterogeneity incorporated into a random effects model. The findings indicated that 36% of the infertile women involved in the evaluated studies self-reported their experience with anxiety. The pooled prevalence of the condition among the subjects was 36.17% [95% confidence interval (CI): 22.47-49.87]. The pooled prevalence levels in low- and middle-income countries and high-income countries were 54.24% (95% CI: 31.86-78.62) and 25.05% (95% CI: 15.76-34.34), respectively. The results revealed no evidence of publication bias (P Egger's test = 0.406). CONCLUSION Considering the prevalence of anxiety in infertile women and its effects on health processes and quality of life, this problem requires serious consideration and planning for effective intervention, especially in low- and middle-income nations.
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Affiliation(s)
- Zahra Kiani
- Student Research Committee, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoumeh Simbar
- Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sepideh Hajian
- Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farid Zayeri
- Proteomics Research Center and Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Shahidi
- Department of Biochemistry and Biophysics, Mazandaran University of Medical Sciences, Sari, Iran
- Hazrat-e Maryam Fertility Center, Sari, Iran
| | - Marzieh Saei Ghare Naz
- Student Research Committee, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Vida Ghasemi
- Student Research Committee, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Stress and the impact on the outcome of medically assisted reproduction. Eur J Obstet Gynecol Reprod Biol 2020; 248:187-192. [PMID: 32240891 DOI: 10.1016/j.ejogrb.2020.03.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 03/03/2020] [Accepted: 03/05/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVES There is evidence to suggest that high perceived stress in early pregnancy is associated with increased rates of miscarriage. Our objective was to determine if psychological stressors have an impact on medically assisted reproduction (MAR) cycle outcomes including miscarriage rates. STUDY DESIGN A survey-based study of women recruited prior to commencing MAR treatment and followed prospectively for treatment outcome (negative/positive pregnancy test, miscarriage) during the study period 2013-2015. The survey focused on perceived stress, emotional well-being, maternal social support and outlook. The women were asked to grade their responses according to a specified scale. RESULTS 320 women responded to the survey (response rate 64 %, 320/498). 290 (90 %, 290/320) women proceeded to MAR of which 58 % (n = 167/290) conceived. Analysis of stressful life events in the preceding 12 months, including job stress or serious financial problems did not reveal significance in terms of conception. A small number had experienced serious illness in the preceding 12 months which demonstrated significance in terms of not achieving pregnancy. Overall, there were high rates of emotional wellbeing, very high rates of maternal support and medium to low levels of perceived stress and this did not differ amongst those who conceived and failed to conceive. The data were further analysed according to livebirth and miscarriage (biochemical pregnancy and miscarriage). Analysis of stressful life events revealed a higher rate of miscarriage amongst those who reported a stressful/demanding job (p < 0.05). A number of women reported non-specified stressful life events and separation/divorce in higher numbers amongst the miscarriage group, reaching statistical significance, however the numbers are small thus limiting interpretation. Psychological factors had no impact on the risk of miscarriage amongst the group. CONCLUSION This study suggests that stressors do not impact greatly on conception rates from MAR but may negatively impact on miscarriage rates. Job-related stress, in particular, is associated with higher risk of miscarriage. This suggests that there may be a role for stress management in early pregnancy.
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Szatmári A, Helembai K, Zádori J, Dudás IE, Fejes Z, Drótos G, Rafael B. Adaptive coping strategies in male infertility, paramedical counselling as a way of support. J Reprod Infant Psychol 2020; 39:457-474. [PMID: 32043383 DOI: 10.1080/02646838.2020.1724918] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Aims: In the last decades, the number of infertile males increased worldwide which gained more focus. The extent to which a person or a couple is able to cope adaptively with the problem of infertility depends on the combined effect of several variables. Our aim was to apply counselling among males suffering from infertility problems. During the therapy - besides providing information - we aim to elaborate the effects of the treatment and experiences, to process information, to develop adaptive coping strategies against stress and to indirectly or directly change health behaviours influencing reproduction.Methods: Only patients with male factor infertility were involved. They were divided into an observed group (n = 57) and a control (n = 51) group after a thorough physical examination and assessment of their reactions to, and awareness of, the disease.Results: The group that received the interventions had an intense awareness of the diagnosis and aims and nature of the indicated treatment. They employed purposeful problem-solving coping strategies, reported being satisfied with the infertility treatment.Conclusions: The counselling of clients with infertility problems a more favourable mental well-being can be established by the active participation of professional helpers. Patients might receive effective, targeted and problem-specific help.Abbreviations: ART: Assisted Reproductive Technology.
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Affiliation(s)
- Angelika Szatmári
- Faculty of Health Sciences and Social Studies, University of Szeged, Szeged, Hungary
| | - Kornélia Helembai
- Faculty of Health Sciences and Social Studies, University of Szeged, Szeged, Hungary
| | - János Zádori
- Center for Assisted Reproduction, Kaáli Institute, Szeged, Hungary
| | - Ilona Eva Dudás
- Faculty of Medicine, Department of Psychiatry, University of Szeged, Szeged, Hungary
| | - Zsuzsanna Fejes
- Faculty of Medicine, Department of Radiology, University of Szeged, Szeged, Hungary
| | - Gergely Drótos
- Institute of Psychology, University of Szeged, Budapest, Hungary
| | - Beatrix Rafael
- Institute of Psychology, University of Szeged, Szeged, Hungary.,Department of Medical Rehabilitation and Physical Medicine, University of Szeged, Szeged, Hungary
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74
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Abdishahshahani M, Torabi M, Kazemi A. Investigating related factors to psychological symptoms of infertile couples undergoing assisted reproductive treatment. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2020; 9:21. [PMID: 32154316 PMCID: PMC7034165 DOI: 10.4103/jehp.jehp_412_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 11/24/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND The impact of infertility and assisted reproductive treatment on the mental health of infertile couples is documented, and the identification of its predictor factors can be helpful in identifying susceptible individuals. Therefore, the aim of this study was to identify the factors associated with psychological symptoms of infertile couples undergoing assisted reproductive treatment. MATERIALS AND METHODS Using convenience sampling method, this cross-sectional study was conducted on 212 couples undergoing assisted reproductive treatments. The levels of mental disorders (depression, anxiety, and stress) of the couples undergoing assisted reproductive treatments were assessed via self-report questionnaire of Depression, Anxiety, and Stress Scales. Data analysis was performed using paired t-test, independent t-test, Wilcoxon signed-rank test, Pearson correlation coefficient, Spearman correlation, and multivariate linear regression. RESULTS The mean scores of stress, anxiety, and depression in women (14, 9.93, and 10.7) were significantly higher than that in men (9, 5.51, and 6.6). Correlation coefficient of stress, anxiety, and depression scores in women was inversely correlated with their age. Moreover, stress, anxiety, and depression scores in men were significantly correlated with the duration of infertility. In both men and women, stress, anxiety, and depression scores were inversely correlated with the level of education and economic situation. CONCLUSION The results showed that during assisted reproductive treatment, women are more likely to experience psychological problems than their spouses. In addition, underlying factors such as age, duration of infertility, and educational level do not similarly cause of lower mental health in men and women.
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Affiliation(s)
- Mahshid Abdishahshahani
- Department of Midwifery, Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Marjan Torabi
- Department of Midwifery and Reproductive Health, Student Research Committee, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ashraf Kazemi
- Department of Reproductive Health, Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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75
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Aynaoglu Yildiz G, Yildiz D, Yapca OE, Suleyman B, Arslan YK, Kurt N, Suleyman H. Effect of diazepam, sertraline and melatonin on the stress-induced reproductive disorders and intrauterine growth restriction in female rats. J Matern Fetal Neonatal Med 2019; 34:4103-4109. [PMID: 31875735 DOI: 10.1080/14767058.2019.1706469] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: Psychological stress is an important factor triggering depression and anxiety. Infertility is known to cause stress; however, it is not clearly known whether stress causes infertility as well. In addition, there are different opinions accounting for the relation of stress-induced oxidative stress to infertility and intrauterine growth restriction. The aim of the study is to examine the effect of sertraline, diazepam and melatonin on the infertility, intrauterine growth restriction and oxidative stress that can be caused by forced immobilization stress management (FISM) in female rats.Materials and methods: Wistar rats were grouped as healthy rats (HG) applied distilled water, stress treated control group (SC), and 20 mg/kg sertraline + stress (SS), 2 mg/kg diazepam + stress (DS) and 10 mg/kg melatonin + stress (MS) treated rats. The medicines were administered orally once a day for 30 days. At the end of this period, oxidant/antioxidant parameters were measured through the blood samples collected from the tail veins of all rats. Then the rats were kept in a suitable environment for 2 months for breeding.Results: FISM caused oxidative stress in blood serum of animals, infertility and intrauterine growth restriction (decrease in birth weight of the baby). Best medicines to suppress FISM-related oxidative stress are melatonin > diazepam > sertraline respectively, while sertraline > diazepam > melatonin were most successful in terms of preventing infertility. The best medicines preventing the FISM-caused intrauterine growth restriction were found to be melatonin > diazepam > sertraline, respectively.Conclusion: FISM causes oxidative stress in animals. Oxidative stress is understood to affect the intrauterine growth negatively although it is not a major component in the pathogenesis of infertility. While melatonin is only effective in preventing the oxidative stress-related intrauterine growth restriction, antidepressants and anxiolytic treatment were found to be helpful in preventing both infertility and intrauterine growth restriction.
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Affiliation(s)
- Gulsah Aynaoglu Yildiz
- Department of Gynecology and Obstetrics, Faculty of Medicine, Atatürk University, Erzurum, Turkey
| | - Duran Yildiz
- Division of Neonatology, Department of Pediatrics, Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Omer Erkan Yapca
- Department of Gynecology and Obstetrics, Faculty of Medicine, Atatürk University, Erzurum, Turkey
| | - Bahadir Suleyman
- Department of Pharmacology, Faculty of Medicine, Erzincan Binali Yildirim University, Erzincan, Turkey
| | - Yusuf Kemal Arslan
- Department of Biostatistics, Faculty of Medicine, Erzincan Binali Yildirim University, Erzincan, Turkey
| | - Nezahat Kurt
- Department of Biochemistry, Faculty of Medicine, Atatürk University, Erzurum, Turkey
| | - Halis Suleyman
- Department of Pharmacology, Faculty of Medicine, Erzincan Binali Yildirim University, Erzincan, Turkey
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76
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Sarafraz Yazdi M, Nasiri R, Gharaei Jomei M, Sarafraz Yazdi S. Quality of Life and General Health in Pregnant Women Conceived with Assisted Reproductive Technology: A Case-Control Study. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2019; 13:271-276. [PMID: 31710186 PMCID: PMC6875863 DOI: 10.22074/ijfs.2020.5684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 04/10/2019] [Indexed: 11/04/2022]
Abstract
Background Infertility affects different aspects of life including the quality of life (QOL) in infertile couples. Many infertile couples conceive via using assisted reproductive technology (ART). However, the effect of pregnancy and childbearing on QOL is not known in these couples. This study aimed to evaluate QOL and general health during pregnancy and after successful treatment of infertility, in women conceived with ART. Materials and Methods In this case-control study, QOL and general heath were evaluated in 40 women conceived with ART and 40 women who conceived spontaneously and served as the control group. WHO quality of life- BREF (WHOQOL-BREF) inventory was used to evaluate QOL and General Health Questionnaire-28 (GHQ-28) was applied to evaluate general health. These two questionnaires were completed in the first and second trimester of pregnancy and results were compared between the two groups. Results Mean age of women was 29.4 ± 4.4 and 29.6 ± 5 years in ART and control group, respectively. QOL in women conceived with ART was similar to QOL in the control group in the first and second trimester of pregnancy while general health score (distress level) in women conceived with ART was significantly higher than that of the control group in both trimesters. Although distress level decreased in the second trimester in ART group, but yet, it was higher than that recorded for the control group. Conclusion After pregnancy, QOL in women conceived with ART is similar to women conceived spontaneously. However, these women experience higher distress level in the first and second trimester of pregnancy compared to women conceived spontaneously.
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Affiliation(s)
| | - Roya Nasiri
- Department of Obstetrics and Gynecology, Islamic Azad University, Mashhad Branch, Mashhad, Iran.Electronic Address:
| | - Masoud Gharaei Jomei
- Department of Obstetrics and Gynecology, Islamic Azad University, Mashhad Branch, Mashhad, Iran
| | - Saman Sarafraz Yazdi
- Department of Obstetrics and Gynecology, Islamic Azad University, Mashhad Branch, Mashhad, Iran
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77
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Kong L, Shao Y, Xia J, Han J, Zhan Y, Liu G, Wang X. Quantitative and Qualitative Analyses of Psychological Experience and Adjustment of In Vitro Fertilization-Embryo Transfer Patients. Med Sci Monit 2019; 25:8069-8077. [PMID: 31656309 PMCID: PMC6836641 DOI: 10.12659/msm.916627] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The aim of this study was to quantitatively analyze the psychosocial characteristics of in vitro fertilization-embryo transfer (IVF-ET) couples and normal couples, and to identify the influencing factors of psychological characteristics and pregnancy outcomes. MATERIAL AND METHODS There were 260 infertile couples undergoing IVF-ET and 277 healthy couples of childbearing age in Shengjing Hospital of China Medical University recruited into 2 groups. Psychosocial characteristics were compared to analyze the influencing factors of pregnancy outcomes after IVF-ET. In-depth interviews (n=11) and infertility-related forum posts (n=12) were adopted to obtain the data related to the psychological experience and adjustment. Nvivo 11 software was utilized to collect and analyze the data. RESULTS The levels of anxiety and depression in the IVF-ET group were significantly higher (both P<0.01), the total scores of marital quality scale and social support scale were significantly lower (both P<0.05), immature defense mechanism score was significantly higher (P<0.05), and mature defense mechanism score (P<0.05) was significantly lower than those in the control group. Bod mass index (BMI), family's rural residence, marital quality, and immature and mature defense mechanisms were influencing factors of depression in IVF-ET female patients (all P<0.05). Marital quality, mature and immature defense mechanisms, concealment factors, and Harm Avoidance (HA) score were influencing factors of depression in IVF-ET males (all P<0.05). The age of the female patient was an independent influencing factor of IVF-ET pregnancy success rate (P<0.01). CONCLUSIONS The mental health levels of IVF-ET patients were worse than those of fertile couples. The younger the female infertile patient, the higher pregnancy rate of IVF-ET.
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Affiliation(s)
- Lin Kong
- Department of Obstetrics and Gynecology, Assisted Reproduction Center, Shengjing Hospital Affiliated to China Medical University, Shenyang, Liaoning, China (mainland)
| | - Yun Shao
- Department of Clinical Psychology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China (mainland)
| | - Jing Xia
- Department of Clinical Psychology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China (mainland)
| | - Jiyang Han
- Department of Clinical Psychology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China (mainland)
| | - Yuhua Zhan
- Department of Clinical Psychology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China (mainland)
| | - Guo Liu
- Department of Clinical Psychology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China (mainland)
| | - Xumei Wang
- Department of Clinical Psychology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China (mainland)
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78
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Bai CF, Sun JW, Li J, Jing WH, Zhang XK, Zhang X, Ma LL, Yue R, Cao FL. Gender differences in factors associated with depression in infertility patients. J Adv Nurs 2019; 75:3515-3524. [PMID: 31410867 DOI: 10.1111/jan.14171] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 06/09/2019] [Accepted: 08/06/2019] [Indexed: 12/25/2022]
Abstract
AIMS To clarify gender differences in the demographic variables and infertility problems associated with depression among men and women undergoing infertility treatment. DESIGN A cross-sectional study. METHODS We surveyed 380 women and 360 men undergoing infertility treatment at the reproductive medicine center of a hospital in China's Ningxia Province from March - September 2016. RESULTS For women, ethnicity, the number of clinic visits, social concern, and sexual concern were factors linked with depression symptoms. For men, treatment cost pressure and social concern were significantly associated with depression symptoms. CONCLUSION Psychological counseling and intervention programs should be integrated into in-vitro fertilization treatments and interventions should be targeted based on gender differences. IMPACT The provision of treatment-related sexual knowledge by nurses is indispensable for infertile participants. Mental health policies should be developed to facilitate the implementation of psychological services. Psychological counseling and intervention programs should be integrated into in vitro fertilization treatment to help men and women with infertility cope with psychological distress.
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Affiliation(s)
- Cai-Feng Bai
- School of Nursing, Shandong University, Jinan, P.R. China.,School of Nursing, Ningxia Medical University, Yinchuan, China
| | - Ji-Wei Sun
- School of Nursing, Shandong University, Jinan, P.R. China
| | - Jie Li
- School of Nursing, Shandong University, Jinan, P.R. China
| | - Wan-Hong Jing
- Reproductive Medicine Center, General Hospital of Ningxia Medical University, Yinchuan, P.R. China
| | - Xue-Kun Zhang
- School of Nursing, Soochow University, Suzhou, P.R. China
| | - Xuan Zhang
- School of Nursing, Shandong University, Jinan, P.R. China
| | - Li-Li Ma
- Reproductive Medicine Center, General Hospital of Ningxia Medical University, Yinchuan, P.R. China
| | - Rong Yue
- Reproductive Medicine Center, General Hospital of Ningxia Medical University, Yinchuan, P.R. China
| | - Feng-Lin Cao
- School of Nursing, Shandong University, Jinan, P.R. China
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79
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Becker MA, Chandy A, Mayer JLW, Sachdeva J, Albertini ES, Sham C, Worley LLM. Psychiatric Aspects of Infertility. Am J Psychiatry 2019; 176:765-766. [PMID: 31474128 DOI: 10.1176/appi.ajp.2019.176702] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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80
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Psychometrics of the SCL-90-R and Development and Testing of Brief Versions SCL-45 and SCL-9 in Infertile Couples. Nurs Res 2019; 68:E1-E10. [DOI: 10.1097/nnr.0000000000000363] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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81
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Yeung EH, Kim K, Purdue-Smithe A, Bell G, Zolton J, Ghassabian A, Vafai Y, Robinson SL, Mumford SL. Child Health: Is It Really Assisted Reproductive Technology that We Need to Be Concerned About? Semin Reprod Med 2019; 36:183-194. [PMID: 30866005 DOI: 10.1055/s-0038-1675778] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Concerns remain about the health of children conceived by infertility treatment. Studies to date have predominantly not identified substantial long-term health effects after accounting for plurality, which is reassuring given the increasing numbers of children conceived by infertility treatment worldwide. However, as technological advances in treatment arise, ongoing studies remain critical for monitoring health effects. To study whether the techniques used in infertility treatment cause health differences, however, remains challenging due to identification of an appropriate comparison group, heterogeneous treatment, and confounding by the underlying causes of infertility. In fact, the factors that are associated with underlying infertility, including parental obesity and other specific male and female factors, may be important independent factors to consider. This review will summarize key methodological considerations in studying children conceived by infertility treatment including the evidence of associations between underlying infertility factors and child health.
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Affiliation(s)
| | | | | | | | | | - Akhgar Ghassabian
- Department of Pediatrics, New York University School of Medicine, New York.,Department of Environmental Medicine, New York University School of Medicine, New York, New York.,Department of Population Health, New York University School of Medicine, New York, New York
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82
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Li Y, Zhang X, Shi M, Guo S, Wang L. Resilience acts as a moderator in the relationship between infertility-related stress and fertility quality of life among women with infertility: a cross-sectional study. Health Qual Life Outcomes 2019; 17:38. [PMID: 30770738 PMCID: PMC6377764 DOI: 10.1186/s12955-019-1099-8] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 01/24/2019] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Infertility-related stress can seriously impact the fertility quality of life (QoL) of infertile women. Resilience, as a coping resource, can effectively combat psychological stress. This study aimed to evaluate the fertility QoL of infertile women and to examine whether resilience moderates the association of infertility-related stress with fertility QoL. METHODS This cross-sectional study was conducted in northeast of China from December 2017 to February 2018. Out of 559 women outpatients with infertility, 498 (89.1%) completed self-reported questionnaires including the FertiQoL Scale, Fertility Problem Inventory (FPI) and Connor-Davidson Resilience Scale (CD-RISC). Hierarchical multiple regression analysis and simple slope analysis were applied to explore the influencing factors related to fertility QoL as well as to examine the moderating effect of resilience on the association of infertility-related stress with fertility QoL. RESULTS The mean FertiQoL score was 64.54 ± 16.90 among the participants. Household monthly income and causes of infertility were significantly related to fertility QoL. In addition, infertility-related stress was negatively related to fertility QoL, and resilience was positively associated with fertility QoL, explaining 36.3% of the variance. Resilience moderated the association of infertility-related stress with fertility QoL. Specifically, the effect of infertility-related stress on fertility QoL varied by low(1 SD below the mean, B = - 0.496, β = - 0.714, P < 0.001), mean (B = - 0.293, β = - 0.422, P < 0.001) and high (1 SD above the mean, B = - 0.090, β = - 0.130, P < 0.001) levels of resilience. The higher resilience was, the weaker the effect of infertility-related stress on fertility QoL was. CONCLUSIONS Overall, women with infertility in China had relatively low FertiQoL scores. Resilience influenced the association of infertility-related stress with fertility QoL. Infertile patients' psychological status must be addressed and adequate resilience-based interventions such as mindfulness-based skills should be provided to improve fertility QoL of women with infertility.
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Affiliation(s)
- Yifei Li
- Department of Social Medicine, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122 China
| | - Xin Zhang
- Department of Social Medicine, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122 China
| | - Meng Shi
- English Department, School of Fundamental Sciences, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122 China
| | - Shuaishuai Guo
- Reproductive Medicine Center, Shenyang Women’s and Children’s Hospital, No.87 Danan Road, Shenhe Area, Shenyang, 110000 China
| | - Lie Wang
- Department of Social Medicine, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122 China
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83
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Abstract
The relationship between stress and infertility has been debated for years. Women with infertility report elevated levels of anxiety and depression, so it is clear that infertility causes stress. What is less clear, however, is whether or not stress causes infertility. The impact of distress on treatment outcome is difficult to investigate for a number of factors, including inaccurate self-report measures and feelings of increased optimism at treatment onset. However, the most recent research has documented the efficacy of psychological interventions in lowering psychological distress as well as being associated with significant increases in pregnancy rates. A cognitive-behavioral group approach may be the most efficient way to achieve both goals. Given the distress levels reported by many infertile women, it is vital to expand the availability of these programs.
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Affiliation(s)
| | - Alice D Domar
- Boston IVF, Waltham, Massachusetts USA; Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, Massachusetts, USA; Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston Massachusetts, USA
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84
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Abstract
Reproduction is fundamental for the survival of all species and requires meticulous synchronisation of a diverse complement of neural, endocrine and related behaviours. The reproductive hormone kisspeptin (encoded by the KISS1/Kiss1 gene) is now a well-established orchestrator of reproductive hormones, acting upstream of gonadotrophin-releasing hormone (GnRH) at the apex of the hypothalamic–pituitary–gonadal (HPG) reproductive axis. Beyond the hypothalamus, kisspeptin is also expressed in limbic and paralimbic brain regions, which are areas of the neurobiological network implicated in sexual and emotional behaviours. We are now forming a more comprehensive appreciation of extra-hypothalamic kisspeptin signalling and the complex role of kisspeptin as an upstream mediator of reproductive behaviours, including olfactory-driven partner preference, copulatory behaviour, audition, mood and emotion. An increasing body of research from zebrafish to humans has implicated kisspeptin in the integration of reproductive hormones with an overall positive influence on these reproductive behaviours. In this review, we critically appraise the current literature regarding kisspeptin and its control of reproductive behaviour. Collectively, these data significantly enhance our understanding of the integration of reproductive hormones and behaviour and provide the foundation for kisspeptin-based therapies to treat related disorders of body and mind.
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Affiliation(s)
- Edouard G A Mills
- Section of Endocrinology and Investigative Medicine, Imperial College London, Hammersmith Hospital, London, UK
| | - Waljit S Dhillo
- Section of Endocrinology and Investigative Medicine, Imperial College London, Hammersmith Hospital, London, UK
| | - Alexander N Comninos
- Section of Endocrinology and Investigative Medicine, Imperial College London, Hammersmith Hospital, London, UK
- Department of Endocrinology, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK
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85
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Rooney KL, Domar AD. The relationship between stress and infertility. DIALOGUES IN CLINICAL NEUROSCIENCE 2018; 20:41-47. [PMID: 29946210 PMCID: PMC6016043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 09/27/2023]
Abstract
The relationship between stress and infertility has been debated for years. Women with infertility report elevated levels of anxiety and depression, so it is clear that infertility causes stress. What is less clear, however, is whether or not stress causes infertility. The impact of distress on treatment outcome is difficult to investigate for a number of factors, including inaccurate self-report measures and feelings of increased optimism at treatment onset. However, the most recent research has documented the efficacy of psychological interventions in lowering psychological distress as well as being associated with significant increases in pregnancy rates. A cognitive-behavioral group approach may be the most efficient way to achieve both goals. Given the distress levels reported by many infertile women, it is vital to expand the availability of these programs.
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Affiliation(s)
| | - Alice D Domar
- Boston IVF, Waltham, Massachusetts USA; Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, Massachusetts, USA; Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston Massachusetts, USA
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