151
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Apers S, Dancet EA, Aarts JW, Kluivers KB, D'Hooghe TM, Nelen WL. The association between experiences with patient-centred care and health-related quality of life in women with endometriosis. Reprod Biomed Online 2018; 36:197-205. [DOI: 10.1016/j.rbmo.2017.10.106] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 08/02/2017] [Accepted: 10/13/2017] [Indexed: 01/24/2023]
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152
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Zurlo MC, Cattaneo Della Volta MF, Vallone F. Predictors of quality of life and psychological health in infertile couples: the moderating role of duration of infertility. Qual Life Res 2018; 27:945-954. [PMID: 29307056 DOI: 10.1007/s11136-017-1781-4] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2017] [Indexed: 11/24/2022]
Abstract
PURPOSE To investigate the influence of individual characteristics (age, gender, educational level, coping strategies), perceived couple's Dyadic Adjustment, type of diagnosis and duration of infertility on self-reported quality of life (QoL) and psychological health in infertile couples, examining the potential moderating role of duration of infertility. METHODS A questionnaire composed by socio-demographics, Coping Orientations to Problem Experienced, Dyadic Adjustment Scale, FertiQoL, State-Trait Anxiety Inventory and Edinburgh Depression Scale was submitted to 206 couples undergoing infertility treatments. RESULTS Female patients perceived significantly lower levels of QoL and higher levels of Anxiety and Depression. High Educational level and Social Support Coping strategy were associated with higher QoL and psychological health only in female patients. Problem Solving Coping strategy was associated with higher QoL and psychological health only in male patients. Positive Attitude and Avoidance/Distancing Coping strategies and perceived couple's Dyadic Adjustment were associated with higher QoL and psychological health in both male and female patients. Duration of infertility > 3 years was associated with a reduction of protective effects of all coping strategies but did not affect protective effects of Educational level and couple's Dyadic Adjustment. CONCLUSIONS Both positive/active and avoiding/distancing coping strategies are effective to promote QoL and psychological health in infertile couples, but they are all compromised by a long duration of infertility. Conversely, positive effects of educational level and couple's Dyadic Adjustment persist and should be emphasised in the definition of interventions to promote well-being in couples undergoing long-term treatments.
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Affiliation(s)
- Maria Clelia Zurlo
- Department of Political Sciences, University of Naples Federico II, Via L. Rodinò 22, 80138, Naples, Italy.
| | | | - Federica Vallone
- Department of Political Sciences, University of Naples Federico II, Via L. Rodinò 22, 80138, Naples, Italy
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153
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Abstract
SummaryThe World Health Organization (WHO) has indicated that 8–12% of couples worldwide experience infertility, and in recent years the number seeking treatment has dramatically increased. The diagnosis and therapy put a heavy psychological and physical burden on most patients, female and male. The incidence of depression in couples presenting for infertility treatment is significantly higher than in comparable fertile couples. Anxiety is significantly higher in infertile couples than in the general population. Professionals have become aware of the importance of providing educational interventions to address patients' fears and concerns, and to better prepare patients for the demands of treatment. Health professionals should follow a patient-centred approach to provide for the specific needs of the couple. Women in general have a positive attitude to seeking psychological help in the form of cognitive-behavioural therapy, couples counselling and infertility counselling.Learning Objectives•Learn about the incidence rates of infertility and its impact on the mental health of the couple.•Know about infertility treatment and its psychological impact.•Learn about the different management strategies that can be helpful in the treatment of mental illness associated with infertility.
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154
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Asazawa K, Jitsuzaki M, Mori A, Ichikawa T, Shinozaki K, Yoshida A, Kawanami M, Kamiyama H. Validity and Reliability of the Japanese Version of the Fertility Quality of Life (FertiQoL) Tool for Couples Undergoing Fertility Treatment. ACTA ACUST UNITED AC 2018. [DOI: 10.4236/ojn.2018.89046] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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155
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Quality of life and psychosocial and physical well-being among 1,023 women during their first assisted reproductive technology treatment: secondary outcome to a randomized controlled trial comparing gonadotropin-releasing hormone (GnRH) antagonist and GnRH agonist protocols. Fertil Steril 2017; 109:154-164. [PMID: 29175067 DOI: 10.1016/j.fertnstert.2017.09.020] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 09/12/2017] [Accepted: 09/18/2017] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To compare self-reported quality of life, psychosocial well-being, and physical well-being during assisted reproductive technology (ART) treatment in 1,023 women allocated to either a short GnRH antagonist or long GnRH agonist protocol. DESIGN Secondary outcome of a prospective phase 4, open-label, randomized controlled trial. Four times during treatment a questionnaire on self-reported physical well-being was completed. Further, a questionnaire on self-reported quality of life and psychosocial well-being was completed at the day of hCG testing. SETTING Fertility clinics at university hospitals. PATIENT(S) Women referred for their first ART treatment were randomized in a 1:1 ratio and started standardized ART protocols. INTERVENTION(S) Gonadotropin-releasing hormone analogue; 528 women allocated to a short GnRH antagonist protocol and 495 women allocated to a long GnRH agonist protocol. MAIN OUTCOME MEASURE(S) Self-reported quality of life, psychosocial well-being, and physical well-being based on questionnaires developed for women receiving ART treatment. RESULT(S) Baseline characteristics were similar, and response rates were 79.4% and 74.3% in the GnRH antagonist and GnRH agonist groups, respectively. Self-reported quality of life during ART treatment was rated similar and slightly below normal in both groups. However, women in the GnRH antagonist group felt less emotional (adjusted odds ratio [AOR] 0.69), less limited in their everyday life (AOR 0.74), experienced less unexpected crying (AOR 0.71), and rated quality of sleep better (AOR 1.55). Further, women receiving GnRH agonist treatment felt worse physically. CONCLUSION(S) Women in a short GnRH antagonist protocol rated psychosocial and physical well-being during first ART treatment better than did women in a long GnRH agonist protocol. However, the one item on self-reported general quality of life was rated similarly. CLINICAL TRIAL REGISTRATION NUMBER NCT00756028.
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156
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Namavar Jahromi B, Mansouri M, Forouhari S, Poordast T, Salehi A. Quality of Life and Its Influencing Factors of Couples Referred to An Infertility Center in Shiraz, Iran. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2017; 11:293-297. [PMID: 29043705 PMCID: PMC5641461 DOI: 10.22074/ijfs.2018.5123] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 04/29/2017] [Indexed: 11/11/2022]
Abstract
Background Infertility adversely affects quality of life (QoL). The present study aims to evaluate QoL and its associated factors among infertile couples. Materials and Methods In this cross-sectional study, the Fertility QoL (FertiQoL) instrument was used to measure
QoL among 501 volunteer couples who attended the Infertility Clinic at the Mother and Child Hospital, Shiraz, Iran.
We used an additional questionnaire to assess participants’ demographic and clinical characteristics. The relationship
between the scores of QoL to the sociodemographic and treatment data was analysed. Results The subjects with lower income levels had lower relational, mind/body, emotional, and total core scores. Female participants without academic education had lower scores in the emotional subscale, while the male participants
showed lower scores in emotional, mind/body, relational, social, and total QoL domains. Subjects who had undergone
any type of treatment, including pharmacological treatment, intrauterine insemination (IUI), intra-cytoplasmic sperm
injection (ICSI), and in vitro fertilization (IVF) showed significantly lower scores in the environmental domain. Participants with lower infertility duration obtained significantly greater QoL scores. Finally, tolerability, emotional, and
environmental domains were significantly more desirable when the infertility problem was related to a male factor. Conclusion Infertile couples with shorter duration of infertility and male etiology have higher QoL. Lower academic
education, lower income levels, or prior unsuccessful treatments are associated with lower QoL.
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Affiliation(s)
- Bahia Namavar Jahromi
- Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Obstetrics and Gynecology, Shiraz School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahsa Mansouri
- Student Research Center, Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sedighe Forouhari
- Shahid Sadoughi University of Medical Sciences, Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Tahere Poordast
- Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Obstetrics and Gynecology, Shiraz School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Salehi
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
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157
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Agostini F, Monti F, Andrei F, Paterlini M, Palomba S, La Sala GB. Assisted reproductive technology treatments and quality of life: a longitudinal study among subfertile women and men. J Assist Reprod Genet 2017; 34:1307-1315. [PMID: 28733802 PMCID: PMC5633563 DOI: 10.1007/s10815-017-1000-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 07/12/2017] [Indexed: 10/19/2022] Open
Abstract
PURPOSE Quality of life (QoL) may represent a comprehensive indicator for the assessment of the psychological impact of complex clinical conditions, such as infertility. Infertile women have a worse QoL compared to both infertile men and non-infertile controls. However, the initial phases of infertility treatments have been frequently investigated using cross-sectional study designs. This prospective longitudinal study aimed at assessing the health-related QoL change across different phases of assisted reproductive technology (ART) treatments in subfertile women and men. METHODS Eighty-five subfertile women and men undergoing ART cycles were assessed at the beginning of the ovarian stimulation, during oocyte retrieval before discharging, and around 14 days after the embryo transfer. QoL was assessed through the Short Form 36. RESULTS Irrespective of the cause of infertility, work status, and age, QoL levels decreased from the first to the third assessment, and women scored significantly lower than men to each QoL indicator. Additionally, a higher number of previous ART failures had a negative impact on QoL, irrespective of gender and the phase of treatment. ART outcome marginally affected women's QoL across time. CONCLUSION Infertile women have a worse QoL throughout all phases of ARTs compared to men, and this difference increases in infertile patients with more than one previous ART failure.
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Affiliation(s)
- Francesca Agostini
- Department of Psychology, University of Bologna, Viale Berti Pichat 5, 40127, Bologna, Italy.
| | - Fiorella Monti
- Department of Psychology, University of Bologna, Viale Berti Pichat 5, 40127, Bologna, Italy
| | - Federica Andrei
- Department of Psychology, University of Bologna, Viale Berti Pichat 5, 40127, Bologna, Italy
| | - Marcella Paterlini
- Unit of Obstetrics and Gynecology, IRCCS - ASMN of Reggio Emilia, Reggio Emilia, Italy
| | - Stefano Palomba
- Unit of Obstetrics and Gynecology, IRCCS - ASMN of Reggio Emilia, Reggio Emilia, Italy
| | - Giovanni Battista La Sala
- Unit of Obstetrics and Gynecology, IRCCS - ASMN of Reggio Emilia, Reggio Emilia, Italy
- University of Modena and Reggio Emilia, Modena, Italy
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158
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Hasson J, Tulandi T, Shavit T, Shaulov T, Seccareccia E, Takefman J. Quality of life of immigrant and non-immigrant infertile patients in a publicly funded in vitro fertilisation program: a cross-sectional study. BJOG 2017; 124:1841-1847. [DOI: 10.1111/1471-0528.14709] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2017] [Indexed: 11/26/2022]
Affiliation(s)
- J Hasson
- Department of Obstetrics & Gynecology; McGill University Health Center; Montreal QC Canada
| | - T Tulandi
- Department of Obstetrics & Gynecology; McGill University Health Center; Montreal QC Canada
| | - T Shavit
- Department of Obstetrics & Gynecology; McGill University Health Center; Montreal QC Canada
- Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - T Shaulov
- Department of Obstetrics & Gynecology; McGill University Health Center; Montreal QC Canada
| | - E Seccareccia
- Department of Obstetrics & Gynecology; McGill University Health Center; Montreal QC Canada
| | - J Takefman
- Department of Obstetrics & Gynecology; McGill University Health Center; Montreal QC Canada
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159
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Bruneau M, Colombel A, Mirallié S, Fréour T, Hardouin JB, Barrière P, Grall-Bronnec M. Desire for a child and eating disorders in women seeking infertility treatment. PLoS One 2017; 12:e0178848. [PMID: 28586392 PMCID: PMC5460847 DOI: 10.1371/journal.pone.0178848] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 05/21/2017] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES The purpose of this study was to evaluate the prevalence of EDs in women seeking treatment for infertility, and to better characterize their clinical profile. STUDY DESIGN Sixty participants completed self-report measures that assessed EDs, desire for a child, body preoccupations, quality of life, anxiety and depression. RESULTS Ten patients (17%) met criteria for a past or current ED. We showed a significant association between greater body dissatisfaction and a more ambivalent desire for a child. Furthermore, an ED was associated with (i) a lower quality of life, and (ii) more anxiety disorders. CONCLUSION Screening for a history of ED in infertile women is recommended to plan for adapted care regarding infertility but also regarding ED and psychiatric comorbidities. Therefore, the assessment has to take into account the desire for a child and the body satisfaction, that are essential parts of the ED process on the one hand and infertility process on the other. This could help with the infertility treatment and the prevention of negative maternal and fetal outcomes.
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Affiliation(s)
- Mélanie Bruneau
- CHU Nantes, Department of Addictology and Psychiatry, Nantes, France
- Université Nantes, EA 4275 SPHERE "bioStatistics, Pharmacoepidemiology and Human sciEnces Research tEam", Faculties of Medicine and Pharmaceutical Sciences, Nantes, France
| | - Agnès Colombel
- CHU Nantes, Department of Reproductive Medicine, Nantes, France
| | - Sophie Mirallié
- CHU Nantes, Department of Reproductive Medicine, Nantes, France
| | - Thomas Fréour
- CHU Nantes, Department of Reproductive Medicine, Nantes, France
| | - Jean-Benoit Hardouin
- Université Nantes, EA 4275 SPHERE "bioStatistics, Pharmacoepidemiology and Human sciEnces Research tEam", Faculties of Medicine and Pharmaceutical Sciences, Nantes, France
- CHU Nantes, Unit of Methodology and Biostatistics, Nantes, France
| | - Paul Barrière
- CHU Nantes, Department of Reproductive Medicine, Nantes, France
| | - Marie Grall-Bronnec
- CHU Nantes, Department of Addictology and Psychiatry, Nantes, France
- Université Nantes, EA 4275 SPHERE "bioStatistics, Pharmacoepidemiology and Human sciEnces Research tEam", Faculties of Medicine and Pharmaceutical Sciences, Nantes, France
- * E-mail:
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160
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Kitchen H, Aldhouse N, Trigg A, Palencia R, Mitchell S. A review of patient-reported outcome measures to assess female infertility-related quality of life. Health Qual Life Outcomes 2017. [PMID: 28449717 DOI: 10.1186/s12955-017-0666-0.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Infertility has a negative impact on quality of life (QoL) and well-being of affected individuals and couples. A variety of patient-reported outcome (PRO) measures to assess infertility-related QoL are available; however, there is a concern regarding potential issues with their development methodology, validation and use. This review aimed to i) identify PRO measures used in infertility interventional studies ii) assess validation evidence to identify a reliable, valid PRO measure to assess changes in QoL or treatment satisfaction in clinical studies with female patients following treatment with novel therapies iii) identify potential gaps in evidence for validity. METHODS A structured literature search of Medline, Embase, and the Cochrane Library (accessed in September 2015) was conducted using pre-defined search terms. The identified publications were reviewed applying eligibility criteria to select interventional female infertility studies using PROs. Infertility-specific PRO measures assessing QoL, treatment satisfaction or psychiatric health, and included in studies by ≥2 research groups were selected and critically reviewed in light of scientific and regulatory guidance (e.g. FDA PRO Guidance for Industry) for evidence of content validity, psychometric strength, and patient acceptability. RESULTS The literature search and hand-searching yielded 122 publications; 78 unique PRO measures assessing QoL, treatment satisfaction or psychiatric health were identified. Five PRO measures met the selection criteria for detailed review: Fertility Quality of Life (FertiQoL); Fertility Problem Inventory (FPI); Fertility Problem Stress (FPS); Infertility Questionnaire (IFQ); Illness Cognitions Questionnaire adapted for Infertility (ICQ-I). None of the PRO measures met all validation criteria. The FertiQoL was the most widely used infertility-specific PRO measure to assess QoL in interventional studies, with reasonable evidence for adequate content validity, psychometric strength, and linguistic validation. However, gaps in evidence remain including test-retest reliability and thresholds for interpreting clinically important changes. While the FPI demonstrated reasonable evidence for content and psychometric validity, its utility as an outcome measure is limited by a lack of recall period. CONCLUSION The FertiQoL and the FPI are potentially useful measures of infertility-related QoL in interventional studies. Further research is recommended to address gaps in evidence and confirm both PRO measures as reliable assessments of patient outcomes.
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161
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Kitchen H, Aldhouse N, Trigg A, Palencia R, Mitchell S. A review of patient-reported outcome measures to assess female infertility-related quality of life. Health Qual Life Outcomes 2017; 15:86. [PMID: 28449717 PMCID: PMC5408488 DOI: 10.1186/s12955-017-0666-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 04/21/2017] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Infertility has a negative impact on quality of life (QoL) and well-being of affected individuals and couples. A variety of patient-reported outcome (PRO) measures to assess infertility-related QoL are available; however, there is a concern regarding potential issues with their development methodology, validation and use. This review aimed to i) identify PRO measures used in infertility interventional studies ii) assess validation evidence to identify a reliable, valid PRO measure to assess changes in QoL or treatment satisfaction in clinical studies with female patients following treatment with novel therapies iii) identify potential gaps in evidence for validity. METHODS A structured literature search of Medline, Embase, and the Cochrane Library (accessed in September 2015) was conducted using pre-defined search terms. The identified publications were reviewed applying eligibility criteria to select interventional female infertility studies using PROs. Infertility-specific PRO measures assessing QoL, treatment satisfaction or psychiatric health, and included in studies by ≥2 research groups were selected and critically reviewed in light of scientific and regulatory guidance (e.g. FDA PRO Guidance for Industry) for evidence of content validity, psychometric strength, and patient acceptability. RESULTS The literature search and hand-searching yielded 122 publications; 78 unique PRO measures assessing QoL, treatment satisfaction or psychiatric health were identified. Five PRO measures met the selection criteria for detailed review: Fertility Quality of Life (FertiQoL); Fertility Problem Inventory (FPI); Fertility Problem Stress (FPS); Infertility Questionnaire (IFQ); Illness Cognitions Questionnaire adapted for Infertility (ICQ-I). None of the PRO measures met all validation criteria. The FertiQoL was the most widely used infertility-specific PRO measure to assess QoL in interventional studies, with reasonable evidence for adequate content validity, psychometric strength, and linguistic validation. However, gaps in evidence remain including test-retest reliability and thresholds for interpreting clinically important changes. While the FPI demonstrated reasonable evidence for content and psychometric validity, its utility as an outcome measure is limited by a lack of recall period. CONCLUSION The FertiQoL and the FPI are potentially useful measures of infertility-related QoL in interventional studies. Further research is recommended to address gaps in evidence and confirm both PRO measures as reliable assessments of patient outcomes.
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162
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Xiaoli S, Mei L, Junjun B, Shu D, Zhaolian W, Jin W, Ju Q, Wanli S, Huali Z, Li J, Dong L, Li P, Xiaojin H. Assessing the quality of life of infertile Chinese women: a cross-sectional study. Taiwan J Obstet Gynecol 2017; 55:244-50. [PMID: 27125409 DOI: 10.1016/j.tjog.2015.06.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2015] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To assess QoL of infertile Chinese women and determine the specific factors adversely affecting QoL for improving the care and treatment compliance of infertile women. MATERIALS AND METHODS We conducted a cross-sectional study on a randomized, demographically matched, controlled population of infertile married Chinese women to determine their demographic, menstrual, family stress, and infertility characteristics and then applied the World Health Organization QoL Instrument (WHOQOL-100) to determine which factors would be associated with significant QoL differences between infertile women and their demographically matched fertile controls. RESULTS Infertile women showed lower QoL scores in the facets of spirituality/religion/personal beliefs, self-esteem, financial resources, and accessibility to and quality of health and social care, as well as increased pain and discomfort, while also experiencing positive QoL adjustments in terms of mobility, daily living activities, work capacity, sexual activity, freedom, physical safety, security, and transport. CONCLUSION Married infertile Chinese women had significantly lower overall and comprehensive QoL scores, as well as higher anxiety scores, compared with fertile controls.
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Affiliation(s)
- Su Xiaoli
- Endoscopy Center, The First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China
| | - Li Mei
- Endoscopy Center, The First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China
| | - Bao Junjun
- Endoscopy Center, The First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China.
| | - Ding Shu
- Department of Economics, Hefei University of Technology, Hefei, Anhui, China
| | - Wei Zhaolian
- Department of Obstetrics and Gynecology, the First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China
| | - Wang Jin
- Endoscopy Center, The First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China
| | - Quan Ju
- Endoscopy Center, The First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China
| | - Sun Wanli
- Endoscopy Center, The First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China
| | - Zhao Huali
- Endoscopy Center, The First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China
| | - Jin Li
- Endoscopy Center, The First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China
| | - Li Dong
- Endoscopy Center, The First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China
| | - Pan Li
- Endoscopy Center, The First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China
| | - He Xiaojin
- Department of Obstetrics and Gynecology, the First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China
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Porat-Katz A, Paltiel O, Kahane A, Eldar-Geva T. The effect of using complementary medicine on the infertility-specific quality of life of women undergoing in vitro fertilization. Int J Gynaecol Obstet 2016; 135:163-167. [DOI: 10.1016/j.ijgo.2016.05.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 05/15/2016] [Accepted: 07/29/2016] [Indexed: 11/17/2022]
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164
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Pedro J, Frederiksen Y, Schmidt L, Ingerslev HJ, Zachariae R, Martins MV. Comparison of three infertility-specific measures in men and women going through assisted reproductive technology treatment. J Health Psychol 2016; 24:738-749. [PMID: 27881623 DOI: 10.1177/1359105316678669] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
We compared the psychometric properties of COMPI Fertility Problem Stress Scales, Fertility Problem Inventory, and Fertility Quality of Life Tool in 293 patients enrolled for assisted reproductive technology. COMPI Fertility Problem Stress Scales and Fertility Problem Inventory subscales presented higher internal consistency. COMPI Fertility Problem Stress Scales differentiated best between its domains. Fertility Problem Inventory revealed better concurrent validity. Fertility Quality of Life Tool presented better fit. While discrimination for depression was similar between measures, Fertility Quality of Life Tool was better at discriminating anxiety. Results suggest that while all compared measures are reliable and valid in assessing the psychosocial adjustment to infertility, the choice of measure should be based according to the assessment goals.
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165
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Kim JH, Shin HS, Yun EK. A Dyadic Approach to Infertility Stress, Marital Adjustment, and Depression on Quality of Life in Infertile Couples. J Holist Nurs 2016; 36:6-14. [DOI: 10.1177/0898010116675987] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose: This study was conducted to examine the level of infertility stress, marital adjustment, depression, and quality of life in infertile couples and assess the actor and partner effects in these areas using the actor–partner interdependence model. Design: Cross-sectional study. Method: Participants were 121 infertile couples. After pilot study, data were collected from November 2012 to March 2013 using the following questionnaires: the Fertility Quality of Life, Fertility Problem Inventory, Revised Dyadic Adjustment Scale, and Beck Depression Inventory. Findings: There was a gender difference in infertility stress, depression, and quality of life. Infertility stress had actor and partner effects on the quality of life. Marital adjustment had an actor effect on the quality of life for the wives. Depression had actor and partner effects on quality of life for the wives, but only an actor effect for the husbands. Conclusion: This study found that there were actor and partner effects of infertility stress, marital adjustment, and depression on the quality of life in infertile couples. These findings may help nurses be aware of such effects and can be used as a baseline data in the development of nursing interventions for infertile couples.
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166
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Lo SST, Kok WM. Sexual functioning and quality of life of Hong Kong Chinese women with infertility problem. HUM FERTIL 2016; 19:268-274. [PMID: 27706954 DOI: 10.1080/14647273.2016.1238516] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Infertility is estimated to affect 10-15% of couples in industrialized countries and many of them are under tremendous stress. Stress can lead to poor quality of life and sexual dysfunction in general, but little is known about their prevalence in infertile women. We, therefore, conducted this cross-sectional survey in two primary care subfertility clinics between August 2012 and April 2013. A total of 159 women completed two validated Chinese questionnaires: Female Sexual Function Index and core Fertility Quality of Life. The overall Female Sexual Function Index score (mean ± SD) of the whole group was 24.99 ± 4.22. Using the urban Chinese cut-off, the prevalence of female sexual dysfunction, low desire, arousal disorder, lubrication disorder, orgasmic disorder and sexual pain were 32.5%, 15.7%, 19.3%, 22.3%, 33.1% and 15.1%. The core Fertility Quality of Life score of the whole group was 59.76 ± 13.59 and the subgroup of infertile women with sexual dysfunction (n = 50) had significantly lower mean core Fertility Quality of Life score than those without sexual dysfunction (n = 109) (55.03 versus 61.88) (p = 0.005). Among the subscales, the relational score had the strongest correlation with sexual dysfunction. Infertile women with sexual dysfunction had significantly worse quality of life especially in the relational aspect.
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Affiliation(s)
- Sue Seen-Tsing Lo
- a Health Services Division, The Family Planning Association of Hong Kong , Wanchai, Hong Kong SAR
| | - Wai-Ming Kok
- a Health Services Division, The Family Planning Association of Hong Kong , Wanchai, Hong Kong SAR
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Karaca N, Karabulut A, Ozkan S, Aktun H, Orengul F, Yilmaz R, Ates S, Batmaz G. Effect of IVF failure on quality of life and emotional status in infertile couples. Eur J Obstet Gynecol Reprod Biol 2016; 206:158-163. [PMID: 27693938 DOI: 10.1016/j.ejogrb.2016.09.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 09/09/2016] [Accepted: 09/13/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To investigate the effect of a previous IVF failure on the quality of life and emotional distress, in couples undergoing IVF treatment. Experiencing IVF failure might cause differences on the anxiety-depression and quality of life scores of the couples, compared to the ones who were undergoing IVF treatment for the first time. STUDY DESIGN This study included 64 couples who had previously experienced at least one IVF failure (Group 1) and 56 couples without history of IVF failure (Group 2) in a private Assisted Reproductive Center, Istanbul, Turkey. A sociodemographic data form, the FertiQoL International and Hospital Anxiety (HAD-A) and Depression scale (HAD-D) for evaluating the status of distress, were administered for the study. RESULT(S) FertiQoL scores were compared between the groups, the environment scale of the quality of life in treatment section was found to be significantly higher in Group 1 compared with Group 2 (p=0.009). The HAD-A and HAD-D scores did not differ significantly between the groups. Group-variables were investigated using multilevel analysis, the infertility duration and income level were found to have an effect on the subscales of quality of life (p=0.009 and p=0.001 respectively) in Group 2. Depression scores were higher in couples with infertility duration of below five years in Group 1 and Group 2 compared to couples with infertility duration of five years or above (MANOVA analysis). The level of education was found to affect the scores of HAD-D in Group 2, but not in Group 1 (p=0.011). The score of HAD-D was significantly affected by the family type only in Group 2 (p=0.009); the depression score of the couples living with a nuclear family was found to be higher compared with the couples living in a traditional family (p=0.021). CONCLUSION(S) Fertility-specific quality of life scores reveals better results regarding the orientation to the treatment environment in the couples with a previous IVF failure, compared to first IVF cycle couples. Treatment failure does not elevate the level of anxiety, while the effect on depression scores changes according to duration of infertility.
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Affiliation(s)
- Nilay Karaca
- Bezmialem Vakif University, School of Medicine, Department of Obstetric and Gynecology, Istanbul, Turkey.
| | - Aysun Karabulut
- Pamukkale University, School of Medicine, Department of Obstetric and Gynecology, Denizli, Turkey
| | - Sevgi Ozkan
- Pamukkale University, Denizli Health Services Vocational College, Denizli, Turkey
| | - Hale Aktun
- Medipol University, School of Medicine, Department of Obstetric and Gynecology, Istanbul, Turkey
| | | | - Rabiye Yilmaz
- Bezmialem Vakif University, School of Medicine, Department of Obstetric and Gynecology, Istanbul, Turkey
| | - Seda Ates
- Bezmialem Vakif University, School of Medicine, Department of Obstetric and Gynecology, Istanbul, Turkey
| | - Gonca Batmaz
- Bezmialem Vakif University, School of Medicine, Department of Obstetric and Gynecology, Istanbul, Turkey
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Donarelli Z, Lo Coco G, Gullo S, Salerno L, Marino A, Sammartano F, Allegra A. The Fertility Quality of Life Questionnaire (FertiQoL) Relational subscale: psychometric properties and discriminant validity across gender. Hum Reprod 2016; 31:2061-71. [PMID: 27343271 DOI: 10.1093/humrep/dew168] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 06/06/2016] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION Is the Fertility Quality of Life Questionnaire (FertiQoL)-Relational Scale a valid measure to assess the relational domain regarding quality of life in women and men undergoing infertility treatment? SUMMARY ANSWER The FertiQoL-Relational scale (FertiQoL-REL) showed good psychometric properties and captured core aspects of couple relationships. WHAT IS KNOWN ALREADY FertiQoL has become a gold standard for the assessment of infertility-related quality of life in patients undergoing assisted reproduction treatment (ART). Despite its growing importance, no previous studies have examined the convergent validity of the FertiQoL-REL and its discriminant validity across gender. STUDY DESIGN, SIZE, DURATION Baseline cross-sectional data as part of a longitudinal study of infertile couples undergoing an ART between February 2013 and January 2015. PARTICIPANTS/MATERIALS, SETTING, METHODS Five hundred and eighty-nine patients (301 females and 288 males), prior to starting an ART in a private clinic, filled in the Fertility Quality of Life Questionnaire (FertiQoL) and several measures of the marital relationship (Dyadic Adjustment Scale, Marital Commitment Inventory and ENRICH Marital Satisfaction Scale) and infertility-related distress (Fertility Problem Inventory). MAIN RESULTS AND THE ROLE OF CHANCE Confirmatory factor analysis showed that the FertiQoL four-factor solution provided a good fit for the observed data. Reliability of the FertiQoL-REL was higher for women than men. Significant correlations between the FertiQoL-REL scores and all the other measures of marital relationship were found for both women and men. FertiQoL-REL scores did not differ significantly in women and men. The FertiQoL-REL was able to differentiate subjects as regards the Dyadic Adjustment Scale and ENRICH Marital Satisfaction Scale threshold. LIMITATIONS, REASONS FOR CAUTION Findings are limited because the data were obtained from only one Italian private clinic. WIDER IMPLICATIONS OF THE FINDINGS FertiQoL-REL threshold scores are useful for identifying those patients undergoing ART who are more likely to report poor or good relationship quality. Clinicians should tailor their counselling strategies to the positive qualities in a couple's relationship, so as to reinforce the overall quality of life, especially among women, and to support patients in tackling the psychological burden, so that they can either continue treatment or choose discontinuation. STUDY FUNDING/COMPETING INTERESTS This research was supported by funds provided by Centro Andros S.r.l., Palermo, Italy. The authors declare no financial or commercial conflicts of interest in this study. TRIAL REGISTRATION NUMBER Not necessary.
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Affiliation(s)
- Z Donarelli
- ANDROS Day Surgery Clinic, Psychology Unit, Palermo, Italy
| | - G Lo Coco
- Department of Psychology and Educational Sciences, University of Palermo, Palermo, Italy
| | - S Gullo
- ANDROS Day Surgery Clinic, Medical Statistics Unit, Palermo, Italy
| | - L Salerno
- ANDROS Day Surgery Clinic, Psychology Unit, Palermo, Italy
| | - A Marino
- ANDROS Day Surgery Clinic, Reproductive Medicine Unit, Palermo, Italy
| | - F Sammartano
- ANDROS Day Surgery Clinic, Reproductive Medicine Unit, Palermo, Italy
| | - A Allegra
- ANDROS Day Surgery Clinic, Reproductive Medicine Unit, Palermo, Italy
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169
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Bechoua S, Hamamah S, Scalici E. Male infertility: an obstacle to sexuality? Andrology 2016; 4:395-403. [PMID: 27061770 DOI: 10.1111/andr.12160] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 11/26/2015] [Accepted: 12/18/2015] [Indexed: 11/28/2022]
Abstract
Interactions between infertility and sexuality are numerous and complex. Infertile men may suffer from sexual dysfunction (SD) when undergoing an assisted reproductive technology programme. We undertook a review both in French and English of the available data on male SD when being diagnosed with a fertility problem with a specific focus on azoospermic men. The review was performed over a 30-year time period using PubMed/Medline. The sexual concerns and needs of infertile/sterile men for whom potential parenting can be compromised were evaluated. When diagnosed with infertility, men usually go through a crisis that can have a deleterious effect on their sexuality with sometimes a feeling of sexual inadequacy. Infertile men will feel stigmatized because they are perceived as being deficient in a specific component of their masculinity. Hence, subsequent SD may occur that can impact the couple sexuality and the infertility management. However, little is known on how the announcement of azoospermia may affect male on a sexual and psychological point of view. The present review suggests that a global management through a healthcare network (biologist, andrologist, sexologist and psychologist) is required which will allow to consider infertility and its subsequent sexual disorders as a whole and not as dichotomized issues.
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Affiliation(s)
- S Bechoua
- UFR Sciences de Santé de Dijon, Université de Bourgogne, Dijon, France.,Centre Hospitalier Universitaire de Dijon, Dijon, France
| | - S Hamamah
- ART-PGD Department, INSERM U1203, Arnaud de Villeneuve Hospital, CHU Montpellier, Montpellier, France
| | - E Scalici
- ART-PGD Department, INSERM U1203, Arnaud de Villeneuve Hospital, CHU Montpellier, Montpellier, France
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170
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Santulli P, Bourdon M, Presse M, Gayet V, Marcellin L, Prunet C, de Ziegler D, Chapron C. Endometriosis-related infertility: assisted reproductive technology has no adverse impact on pain or quality-of-life scores. Fertil Steril 2016; 105:978-987.e4. [DOI: 10.1016/j.fertnstert.2015.12.006] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 11/27/2015] [Accepted: 12/03/2015] [Indexed: 01/24/2023]
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Verkuijlen J, Verhaak C, Nelen WLDM, Wilkinson J, Farquhar C. Psychological and educational interventions for subfertile men and women. Cochrane Database Syst Rev 2016; 3:CD011034. [PMID: 27031818 PMCID: PMC7104661 DOI: 10.1002/14651858.cd011034.pub2] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Approximately one-fifth of all subfertile couples seeking fertility treatment show clinically relevant levels of anxiety, depression, or distress. Psychological and educational interventions are frequently offered to subfertile couples, but their effectiveness, both in improving mental health and pregnancy rates, is unclear. OBJECTIVES To assess the effectiveness of psychological and educational interventions for subfertile couples on psychological and fertility treatment outcomes. SEARCH METHODS We searched (from inception to 2 April 2015) the Cochrane Gynaecology and Fertility Group Specialised Register of Controlled Trials, the Cochrane Central Register of Controlled Trials (CENTRAL; Issue 2, 2015), MEDLINE, EMBASE, PsycINFO, EBSCO CINAHL, DARE, Web of Science, OpenGrey, LILACS, PubMed, and ongoing trials registers. We handsearched reference lists and contacted experts in the field. SELECTION CRITERIA We included published and unpublished randomised controlled trials (RCTs), cluster randomised trials, and cross-over trials (first phase) evaluating the effectiveness of psychological and educational interventions on psychological and fertility treatment outcomes in subfertile couples. DATA COLLECTION AND ANALYSIS Two review authors independently assessed trial risk of bias and extracted data. We contacted study authors for additional information. Our primary outcomes were psychological measures (anxiety and depression) and fertility rates (live birth or ongoing pregnancy). We assessed the overall quality of the evidence using GRADE criteria.As we did not consider the included studies to be sufficiently similar to permit meaningful pooling, we summarised the results of the individual studies by presenting the median and interquartile range (IQR) of effects as well as the minimum and maximum values. We calculated standardised mean differences (SMDs) for continuous variables and odds ratios (ORs) for dichotomous outcomes. MAIN RESULTS We included 39 studies involving 4925 participants undergoing assisted reproductive technology. Studies were heterogeneous with respect to a number of factors, including nature and duration of interventions, participants, and comparator groups. As a result, we judged that pooling results would not result in a clinically meaningful estimate of a treatment effect. There were substantial methodological weaknesses in the studies, all of which were judged to be at high risk of bias for one or more quality assessment domains. There was concern about attrition bias (24 studies), performance bias for psychological outcomes (27 studies) and fertility outcomes (18 studies), and detection bias for psychological outcomes (26 studies). We therefore considered study-specific estimates of intervention effects to be unreliable. Thirty-three studies reported the outcome mental health. Only two studies reported the outcome live birth, and both of these had substantial attrition. One study reported ongoing pregnancy, again with substantial attrition. We have combined live birth and ongoing pregnancy in one outcome. Psychological outcomesStudies utilised a variety of measures of anxiety and depression. In all cases a low score denoted benefit from the intervention.SMDs for anxiety were as follows: psychological interventions versus attentional control or usual care: median (IQR) = -0.30 (-0.84 to 0.00), minimum value -5.13; maximum value 0.84, 17 RCTs, 2042 participants; educational interventions versus attentional control or usual care: median = 0.03, minimum value -0.38; maximum value 0.23, 4 RCTs, 330 participants.SMDs for depression were as follows: psychological interventions versus attentional control or usual care: median (IQR) = -0.45 (-0.68 to -0.08), minimum value -3.01; maximum value 1.23, 12 RCTs, 1160 participants; educational interventions versus attentional control or usual care: median = -0.33, minimum value -0.46; maximum value 0.17, 3 RCTs, 304 participants. Fertility outcomesWhen psychological interventions were compared with attentional control or usual care, ORs for live birth or ongoing pregnancy ranged from minimum value 1.13 to maximum value 10.05. No studies of educational interventions reported this outcome. AUTHORS' CONCLUSIONS The effects of psychological and educational interventions on mental health including distress, and live birth or ongoing pregnancy rates is uncertain due to the very low quality of the evidence. Existing trials of psychological and educational interventions for subfertility were generally poorly designed and executed, resulting in very serious risk of bias and serious inconsistency in study findings. There is a need for studies employing appropriate methodological techniques to investigate the benefits of these treatments for this population. In particular, attentional control groups should be employed, that is groups receiving a treatment that mimics the amount of time and attention received by the treatment group but is not thought to have a specific effect upon the participants, in order to distinguish between therapeutic and non-specific effects of interventions. Where attrition cannot be minimised, appropriate statistical techniques for handling drop-out must be applied. Failure to address these issues in study design has resulted in studies that do not provide a valid basis for answering questions about the effectiveness of these interventions.
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Affiliation(s)
- Jolijn Verkuijlen
- Radboud University Nijmegen Medical CentreGeert Grooteplein 10NijmegenNetherlands6525 GA
| | - Christianne Verhaak
- Radboud University Medical CenterMedical psychologistPO Box 9101NijmegenNetherlands6500 HB
| | - Willianne LDM Nelen
- Radboud University Nijmegen Medical CentreGeert Grooteplein 10NijmegenNetherlands6525 GA
| | - Jack Wilkinson
- University of Manchester, Manchester Academic Health Science CentreBiostatistics, Institute of Population HealthClinical Sciences Building Salford Royal NHS Foundation Trust HospitalStott Lane, SalfordManchesterUKM6 8HD
| | - Cindy Farquhar
- University of AucklandDepartment of Obstetrics and GynaecologyFMHS Park RoadGraftonAucklandNew Zealand1003
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172
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Addressing the emotional barriers to access to reproductive care. Fertil Steril 2016; 105:1124-1127. [PMID: 27054306 DOI: 10.1016/j.fertnstert.2016.02.017] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 02/09/2016] [Accepted: 02/10/2016] [Indexed: 11/22/2022]
Abstract
Health care professionals make the medical care of infertility patients a priority, with the goal of achieving a singleton pregnancy for each. Patients who never seek out care, who do not return for treatment after the diagnostic workup, or who drop out of treatment are rarely noticed. Yet this is the outcome for the majority of patients, and the primary reason after financial for treatment termination is the emotional aspect. Attending to the psychological needs of our patients must become a higher priority, to provide all patients true access to care.
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173
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de Vries M, Emons WHM, Plantinga A, Pietersma S, van den Hout WB, Stiggelbout AM, van den Akker-van Marle ME. Comprehensively Measuring Health-Related Subjective Well-Being: Dimensionality Analysis for Improved Outcome Assessment in Health Economics. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2016; 19:167-75. [PMID: 27021750 DOI: 10.1016/j.jval.2015.11.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Revised: 11/07/2015] [Accepted: 11/25/2015] [Indexed: 05/15/2023]
Abstract
BACKGROUND Allocation of inevitably limited financial resources for health care requires assessment of an intervention's effectiveness. Interventions likely affect quality of life (QOL) more broadly than is measurable with commonly used health-related QOL utility scales. In line with the World Health Organization's definition of health, a recent Delphi procedure showed that assessment needs to put more emphasis on mental and social dimensions. OBJECTIVE To identify the core dimensions of health-related subjective well-being (HR-SWB) for a new, more comprehensive outcome measure. METHODS We formulated items for each domain of an initial Delphi-based set of 21 domains of HR-SWB. We tested these items in a large sample (N = 1143) and used dimensionality analyses to find a smaller number of latent factors. RESULTS Exploratory factor analysis suggested a five-factor model, which explained 65% of the total variance. Factors related to physical independence, positive affect, negative affect, autonomy, and personal growth. Correlations between the factors ranged from 0.19 to 0.59. A closer inspection of the factors revealed an overlap between the newly identified core dimensions of HR-SWB and the validation scales, but the dimensions of HR-SWB also seemed to reflect additional aspects. This shows that the dimensions of HR-SWB we identified go beyond the existing health-related QOL instruments. CONCLUSIONS We identified a set of five key dimensions to be included in a new, comprehensive measure of HR-SWB that reliably captures these dimensions and fills in the gaps of the existent measures used in economic evaluations.
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Affiliation(s)
- Marieke de Vries
- Department of Social Psychology, Tilburg Institute for Behavioral Economics Research, Tilburg University, Tilburg, The Netherlands; Radboud University, Institute for Computing and Information Sciences (iCIS), Data Science Department, Nijmegen, The Netherlands
| | - Wilco H M Emons
- Faculty of Social and Behavioural Sciences, Department of Methodology and Statistics, Tilburg University, Tilburg, The Netherlands
| | - Arnoud Plantinga
- Department of Social Psychology, Tilburg Institute for Behavioral Economics Research, Tilburg University, Tilburg, The Netherlands
| | - Suzanne Pietersma
- Department of Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands
| | - Wilbert B van den Hout
- Department of Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands
| | - Anne M Stiggelbout
- Department of Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands
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174
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Testicular biopsy and cryopreservation for fertility preservation of prepubertal boys with Klinefelter syndrome: a pro/con debate. Fertil Steril 2015; 105:249-55. [PMID: 26748226 DOI: 10.1016/j.fertnstert.2015.12.011] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Revised: 12/08/2015] [Accepted: 12/15/2015] [Indexed: 12/28/2022]
Abstract
In about one-half of adult Klinefelter syndrome (KS) patients, spermatozoa can be retrieved by means of testicular biopsy (TESE). Given the expected increase in the number of diagnosed KS patients owing to the use of noninvasive prenatal testing, the probable questions of young KS patients and their parents regarding future fertility, and the fact that widespread apoptosis of spermatogonia occurs at onset of puberty, an attempt to increase the retrieval rates at TESE above those found in adult KS men by undertaking preservation techniques peripubertally has been initiated. To date, however, only a limited number of KS adolescents have been examined, demonstrating no increases in the chances of finding sperm. Furthermore, spermatogonial stem cell and testicular tissue freezing techniques, as well as in vitro maturation strategies, require further validation. Given these controversies, banking testicular tissue from prepubertal KS boys should be performed only in a research framework.
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175
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Li J, Long L, Liu Y, He W, Li M. Effects of a mindfulness-based intervention on fertility quality of life and pregnancy rates among women subjected to first in vitro fertilization treatment. Behav Res Ther 2015; 77:96-104. [PMID: 26742022 DOI: 10.1016/j.brat.2015.12.010] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Revised: 12/15/2015] [Accepted: 12/16/2015] [Indexed: 12/20/2022]
Abstract
Generally, undergoing an in vitro fertilization (IVF) treatment is an emotional and physical burden for the infertile woman, which may negatively influence the treatment outcome. We conducted a study to investigate the effectiveness of a mindfulness-based intervention (MBI) among women subjected to first IVF treatment at a fertility medical center in China. Among infertile women registered for their first IVF treatment, 58 completed the intervention, and 50 were assigned to a control group using a non-randomized controlled study. Standardized measures of mindfulness, self-compassion, emotion regulation difficulties, infertility-related coping strategies and fertility quality of life (FertiQoL) were endorsed pre- and post-MBI, and measure of pregnancy rates at the sixth months after the intervention. Both groups were shown to be equivalent at baseline. By the end of the intervention, women who attended the intervention revealed a significant increase in mindfulness, self-compassion, meaning-based coping strategies and all FertiQoL domains. Inversely, they presented a significant decrease in emotion regulation difficulties, active- and passive-avoidance coping strategies. Women in the control group did not present significant changes in any of the psychological measures. Moreover, there were statistically significant differences between participants in the pregnancy rates, the experiment group higher than the control group. Being fully aware of the present moment without the lens of judgment, seems to help women relate to their infertility and IVF treatment in new ways. This is beneficial for promoting their self-compassion, adaptive emotion regulation and infertility-related coping strategies, which, in turn, may influence the FertiQoL and pregnancy rates. The brief and nonpharmaceutical nature of this intervention makes it a promising candidate for women' use during first IVF treatment.
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Affiliation(s)
- Jing Li
- Department of Military Psychology, College of Psychology, Third Military Medical University, Chongqing 400038, China
| | - Ling Long
- Reproductive Medical Center, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Yu Liu
- Department of Laboratory Medicine, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Wei He
- Reproductive Medical Center, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Min Li
- Department of Military Psychology, College of Psychology, Third Military Medical University, Chongqing 400038, China.
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176
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Duval K, Langlois MF, Carranza-Mamane B, Pesant MH, Hivert MF, Poder TG, Lavoie HB, Ainmelk Y, St-Cyr Tribble D, Laredo S, Greenblatt E, Sagle M, Waddell G, Belisle S, Riverin D, Jean-Denis F, Belan M, Baillargeon JP. The Obesity-Fertility Protocol: a randomized controlled trial assessing clinical outcomes and costs of a transferable interdisciplinary lifestyle intervention, before and during pregnancy, in obese infertile women. BMC OBESITY 2015; 2:47. [PMID: 26635965 PMCID: PMC4666156 DOI: 10.1186/s40608-015-0077-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2015] [Accepted: 11/20/2015] [Indexed: 11/10/2022]
Abstract
BACKGROUND Obesity in infertile women increases the costs of fertility treatments, reduces their effectiveness and increases significantly the risks of many complications of pregnancy and for the newborn. Studies suggest that even a modest loss of 5-10 % of body weight can restore ovulation. However, there are gaps in knowledge regarding the benefits and cost-effectiveness of a lifestyle modification program targeting obese infertile women and integrated into the fertility clinics. This study will evaluate clinical outcomes and costs of a transferable interdisciplinary lifestyle intervention, before and during pregnancy, in obese infertile women. We hypothesize that the intervention will: 1) improve fertility, efficacy of fertility treatments, and health of mothers and their children; and 2) reduce the cost per live birth, including costs of fertility treatments and pregnancy outcomes. METHODS/DESIGN Obese infertile women (age: 18-40 years; BMI ≥30 kg/m(2) or ≥27 kg/m(2) with polycystic ovary syndrome) will be randomised to either a lifestyle intervention followed by standard fertility treatments after 6 months if no conception has been achieved (intervention group) or standard fertility treatments only (control group). The intervention and/or follow-up will last for a maximum of 18 months or up to the end of pregnancy. Evaluation visits will be planned every 6 months where different outcome measures will be assessed. The primary outcome will be live-birth rates at 18 months. The secondary outcomes will be sub-divided into four categories: lifestyle and anthropometric, fertility, pregnancy complications, and neonatal outcomes. Outcomes and costs will be also compared to similar women seen in three fertility clinics across Canada. Qualitative data will also be collected from both professionals and obese infertile women. DISCUSSION This study will generate new knowledge about the implementation, impacts and costs of a lifestyle management program in obese infertile women. This information will be relevant for decision-makers and health care professionals, and should be generalizable to North American fertility clinics. TRIAL REGISTRATION ClinicalTrials.gov NCT01483612. Registered 25 November 2011.
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Affiliation(s)
- Karine Duval
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec Canada ; Division of Endocrinology, Department of medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001-12e Avenue Nord, Sherbrooke, Québec J1H 5N4 Canada
| | - Marie-France Langlois
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec Canada ; Division of Endocrinology, Department of medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001-12e Avenue Nord, Sherbrooke, Québec J1H 5N4 Canada
| | - Belina Carranza-Mamane
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec Canada ; Department of Obstetrics and Gynecology, Université de Sherbrooke, Sherbrooke, Québec Canada ; Procrea Cliniques, Montréal, Québec Canada
| | - Marie-Hélène Pesant
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec Canada ; Division of Endocrinology, Department of medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001-12e Avenue Nord, Sherbrooke, Québec J1H 5N4 Canada
| | - Marie-France Hivert
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec Canada ; Division of Endocrinology, Department of medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001-12e Avenue Nord, Sherbrooke, Québec J1H 5N4 Canada
| | - Thomas G Poder
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec Canada ; Department of Economics, Faculty of Administration, Université de Sherbrooke, Sherbrooke, Québec Canada ; UETMIS, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec Canada
| | - Hélène B Lavoie
- Procrea Cliniques, Montréal, Québec Canada ; Department of Medicine, Division of Endocrinology, Université de Montréal, Montréal, Québec Canada
| | - Youssef Ainmelk
- Department of Obstetrics and Gynecology, Université de Sherbrooke, Sherbrooke, Québec Canada
| | | | - Sheila Laredo
- Department of Medicine, Division of Endocrinology, Women's College Hospital, University of Toronto, Toronto, Ontario Canada
| | - Ellen Greenblatt
- Centre for Fertility and Reproductive Health, Mount Sinai Hospital, University of Toronto, Toronto, Ontario Canada
| | - Margaret Sagle
- Department of Obstetrics and Gynaecology, University of Alberta, Edmonton, Ontario Canada
| | - Guy Waddell
- Department of Obstetrics and Gynecology, Université de Sherbrooke, Sherbrooke, Québec Canada
| | - Serge Belisle
- Department of Obstetrics & Gynecology, Université de Montréal, Montréal, Québec Canada
| | | | - Farrah Jean-Denis
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec Canada
| | - Matea Belan
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec Canada ; Division of Endocrinology, Department of medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001-12e Avenue Nord, Sherbrooke, Québec J1H 5N4 Canada
| | - Jean-Patrice Baillargeon
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec Canada ; Division of Endocrinology, Department of medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001-12e Avenue Nord, Sherbrooke, Québec J1H 5N4 Canada
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Kersten FAM, Hermens RPGM, Braat DDM, Tepe E, Sluijmer A, Kuchenbecker WK, Van den Boogaard N, Mol BWJ, Goddijn M, Nelen WLDM. Tailored expectant management in couples with unexplained infertility does not influence their experiences with the quality of fertility care. Hum Reprod 2015; 31:108-16. [PMID: 26573527 DOI: 10.1093/humrep/dev277] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Accepted: 10/13/2015] [Indexed: 11/12/2022] Open
Abstract
STUDY QUESTION Do couples who were eligible for tailored expectant management (TEM) and did not start treatment within 6 months after the fertility work-up, have different experiences with the quality of care than couples that were also eligible for TEM but started treatment right after the fertility work-up? SUMMARY ANSWER Tailored expectant management of at least 6 months in couples with unexplained infertility is not associated with the experiences with quality of care or trust in their physician. WHAT IS KNOWN ALREADY In couples with unexplained infertility and a good prognosis of natural conception within 1 year, expectant management for 6-12 months does not compromise ongoing birth rates and is equally as effective as starting medically assisted reproduction immediately. Therefore, TEM is recommended by various international clinical guidelines. Implementation of TEM is still not optimal because of existing barriers on both patient and professional level. An important barrier is the hesitance of professionals to counsel their patients for TEM because they fear that patients will be dissatisfied with care. However, if and how adherence to TEM actually affects the couples' experience with care is unknown. Experiences with the quality care can be measured by evaluating the patient-centredness of care and the patients' trust in their physician. STUDY DESIGN, SIZE, DURATION This is a retrospective cross-sectional study. A survey with written questionnaires was performed among all couples who participated in the retrospective audit of guideline adherence on TEM in 25 Dutch clinics. PARTICIPANTS/MATERIALS, SETTING, METHODS Couples were eligible to participate if they were diagnosed with unexplained infertility and had a good prognosis (>30%) of natural conception within 1 year based on the Hunault prediction model. We used patient's questionnaires to collect data on the couples' experience with the quality of care and possible confounders for their experiences other than having undergone TEM or not. Multilevel regression analyses were performed to investigate case-mix adjusted association of TEM with the patient-centredness of care (PCQ-Infertility) and the patients' trust in their physician (Wake Forest Trust Scale). MAIN RESULTS AND THE ROLE OF CHANCE Couples who adhered to TEM experienced the quality of care on the same level as couples who were exposed to early treatment, i.e. started fertility treatment within 6 months after fertility work-up. There were no associations between adherence to TEM and the patient-centredness of care or the patients' trust in their physician. LIMITATIONS, REASONS FOR CAUTION Because this study is retrospective, recall bias might occur. Furthermore, we were unable to measure the difference in experience with care over time. Therefore, our results have to be interpreted carefully. WIDER IMPLICATIONS OF THE FINDINGS Prospective research on couples undergoing TEM have to be performed to provide more detailed insight in the patients' experiences with the decision making process and subsequently the expectant period. Tackling the barriers surrounding TEM, i.e. better counselling and more patient information material, could further improve patient experiences with the quality of care for couples who are advised TEM. STUDY FUNDING/COMPETING INTERESTS Supported by Netherlands Organisation for Health Research and Development (ZonMW). ZonMW had no role in designing the study, data collection, analysis and interpretation of data or writing of the report. Competing interests: none. TRIAL REGISTRATION NUMBER www.trialregister.nl NTR3405.
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Affiliation(s)
- F A M Kersten
- Department of Obstetrics and Gynaecology, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - R P G M Hermens
- Scientific institute for Quality of Healthcare, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - D D M Braat
- Department of Obstetrics and Gynaecology, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - E Tepe
- Department of Obstetrics and Gynaecology, Slingeland Ziekenhuis, PO Box 169, 7000 AD, Doetinchem, The Netherlands
| | - A Sluijmer
- Department of Obstetrics and Gynaecology, Wilhelmina Ziekenhuis Assen, PO Box 30001, 9400 RA, Assen, The Netherlands
| | - W K Kuchenbecker
- Department of Obstetrics and Gynaecology, Isala Clinics, PO Box 10400, 8000 GK, Zwolle, The Netherlands
| | - N Van den Boogaard
- Department of Obstetrics and Gynaecology, Academic Medical Centre, University of Amsterdam, PO Box 22660, Amsterdam DD 1100, The Netherlands
| | - B W J Mol
- The Robinson Institute, School of Paediatrics and Reproductive Health, University of Adelaide, 5005 SA Adelaide, Australia
| | - M Goddijn
- Centre for Reproductive Medicine, Academic Medical Centre, PO Box 22660, 1100 DD Amsterdam, The Netherlands
| | - W L D M Nelen
- Department of Obstetrics and Gynaecology, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
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Gameiro S, Boivin J, Dancet E, de Klerk C, Emery M, Lewis-Jones C, Thorn P, Van den Broeck U, Venetis C, Verhaak CM, Wischmann T, Vermeulen N. ESHRE guideline: routine psychosocial care in infertility and medically assisted reproduction-a guide for fertility staff. Hum Reprod 2015; 30:2476-85. [PMID: 26345684 DOI: 10.1093/humrep/dev177] [Citation(s) in RCA: 159] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 06/11/2015] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION Based on the best available evidence in the literature, what is the optimal management of routine psychosocial care at infertility and medically assisted reproduction (MAR) clinics? SUMMARY ANSWER Using the structured methodology of the Manual for the European Society of Human Reproduction and Embryology (ESHRE) Guideline Development, 120 recommendations were formulated that answered the 12 key questions on optimal management of routine psychosocial care by all fertility staff. WHAT IS ALREADY KNOWN The 2002 ESHRE Guidelines for counselling in infertility has been a reference point for best psychosocial care in infertility for years, but this guideline needed updating and did not focus on routine psychosocial care that can be delivered by all fertility staff. STUDY, DESIGN, SIZE, DURATION This guideline was produced by a group of experts in the field according to the 12-step process described in the ESHRE Manual for Guideline Development. After scoping the guideline and listing a set of 12 key questions in PICO (Patient, Intervention, Comparison and Outcome) format, thorough systematic searches of the literature were conducted; evidence from papers published until April 2014 was collected, evaluated for quality and analysed. A summary of evidence was written in a reply to each of the key questions and used as the basis for recommendations, which were defined by consensus within the guideline development group (GDG). Patient and additional clinical input was collected during the scoping and the review phase of the guideline development. PARTICIPANTS/MATERIALS, SETTING, METHODS The guideline group, comprising psychologists, two medical doctors, a midwife, a patient representative and a methodological expert, met three times to discuss evidence and reach consensus on the recommendations. MAIN RESULTS AND THE ROLE OF CHANCE THE GUIDELINE PROVIDES 120 recommendations that aim at guiding fertility clinic staff in providing optimal evidence-based routine psychosocial care to patients dealing with infertility and MAR. The guideline is written in two sections. The first section describes patients' preferences regarding the psychosocial care they would like to receive at clinics and how this care is associated with their well-being. The second section of the guideline provides information about the psychosocial needs patients experience across their treatment pathway (before, during and after treatment) and how fertility clinic staff can detect and address these. Needs refer to conditions assumed necessary for patients to have a healthy experience of the fertility treatment. Needs can be behavioural (lifestyle, exercise, nutrition and compliance), relational (relationship with partner if there is one, family friends and larger network, and work), emotional (well-being, e.g. anxiety, depression and quality of life) and cognitive (treatment concerns and knowledge). LIMITATIONS, REASONS FOR CAUTION We identified many areas in care for which robust evidence was lacking. Gaps in evidence were addressed by formulating good practice points, based on the expert opinion of the GDG, but it is critical for such recommendations to be empirically validated. WIDER IMPLICATIONS OF THE FINDINGS The evidence presented in this guideline shows that providing routine psychosocial care is associated with or has potential to reduce stress and concerns about medical procedures and improve lifestyle outcomes, fertility-related knowledge, patient well-being and compliance with treatment. As only 45 (36.0%) of the 125 recommendations were based on high-quality evidence, the guideline group formulated recommendations to guide future research with the aim of increasing the body of evidence.
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Affiliation(s)
- S Gameiro
- Cardiff Fertility Studies Research Group, School of Psychology, Cardiff University, CF10 3AT Cardiff, UK
| | - J Boivin
- Cardiff Fertility Studies Research Group, School of Psychology, Cardiff University, CF10 3AT Cardiff, UK
| | - E Dancet
- Leuven University Fertility Centre, University Hospitals Leuven, 3000 Leuven, Belgium Center for Reproductive Medicine, Women's and Children's Hospital, Academic Medical Center, University of Amsterdam, Amsterdam 1105 AZ, The Netherlands
| | - C de Klerk
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC University Medical Centre, Rotterdam 3000 CA, The Netherlands
| | - M Emery
- Centre for Medically Assisted Procreation-CPMA, CH-1003 Lausanne, Switzerland
| | | | - P Thorn
- Practice for Couple and Family Therapy, 64546 Moerfelden, Germany
| | - U Van den Broeck
- Leuven University Fertility Centre, University Hospitals Leuven, 3000 Leuven, Belgium
| | - C Venetis
- Women's and Children's Health, St George Hospital, University of New South Wales, NSW 2217 Sydney, Australia
| | - C M Verhaak
- Department of Psychology, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands
| | - T Wischmann
- Institute of Medical Psychology, Centre for Psychosocial Medicine, Heidelberg University Hospital, 69115 Heidelberg, Germany
| | - N Vermeulen
- European Society for Human Reproduction and Embryology, 1852 Grimbergen, Belgium
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179
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Exploratory randomized trial on the effect of a brief psychological intervention on emotions, quality of life, discontinuation, and pregnancy rates in in vitro fertilization patients. Fertil Steril 2015; 104:440-51.e7. [DOI: 10.1016/j.fertnstert.2015.05.009] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 05/08/2015] [Accepted: 05/08/2015] [Indexed: 11/17/2022]
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180
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Boivin J, Gameiro S. Evolution of psychology and counseling in infertility. Fertil Steril 2015; 104:251-9. [PMID: 26092131 DOI: 10.1016/j.fertnstert.2015.05.035] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Revised: 05/20/2015] [Accepted: 05/28/2015] [Indexed: 11/29/2022]
Abstract
Five key paradigm shifts are described to illustrate the evolution of psychology and counseling in infertility. The first paradigm shift was in the 1930s when psychosomatic concepts were introduced in obstetrics and gynecology as causal factors to explain why some couples could not conceive despite the absence of organic pathology. In the second shift, the nurse advocacy movement of the 1970s stimulated the investigation of the psychosocial consequences of infertility and promoted counseling to help couples grieve childlessness when medical treatments often could not help them conceive. The third shift occurred with the advent of IVF, which created a demand for mental health professionals in fertility clinics. Mental health professionals assessed the ability of couples to withstand the demands of this new high technology treatment as well as their suitability as potential parents. The fourth shift, in the 1990s, saw reproductive medicine embrace the principles of evidence-based medicine, which introduced a much more rigorous approach to medical practice (effectiveness and safety) that extended to psychosocial interventions. The most recent paradigm shift, in the new millennium, occurred with the realization that compliance with protracted fertility treatment depended on the adoption of an integrated approach to fertility care. An integrated approach could reduce treatment burden arising from multiple sources (i.e., patient, clinic, and treatment). This review describes these paradigm shifts and reflects on future clinical and research directions for mental health professionals.
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Affiliation(s)
- Jacky Boivin
- Cardiff Fertility Studies Research Group, School of Psychology, Cardiff University, Cardiff, Wales, United Kingdom.
| | - Sofia Gameiro
- Cardiff Fertility Studies Research Group, School of Psychology, Cardiff University, Cardiff, Wales, United Kingdom
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181
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The Development and Effect of Cognitive Behavioral Therapy Program for Psychosocial Adjustment of Infertile Women. ACTA ACUST UNITED AC 2015. [DOI: 10.15703/kjc.16.3.201506.451] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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182
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Steuber KR, High A. Disclosure strategies, social support, and quality of life in infertile women. Hum Reprod 2015; 30:1635-42. [PMID: 25954036 DOI: 10.1093/humrep/dev093] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Accepted: 04/01/2015] [Indexed: 11/12/2022] Open
Abstract
STUDY QUESTION Do the strategies women use to disclose information about their infertility to social network members impact the quality of the support they receive and their quality of life? SUMMARY ANSWER The data showed that women who disclosed infertility-related information in direct ways, rather than in indirect ways (e.g. by incremental disclosures or through third parties), to social network members perceived higher quality support and reported greater quality of life related to their infertility experience. WHAT IS KNOWN ALREADY Social support has been shown to buffer stress associated with various health issues including infertility. The way people disclose information about stressors has been associated with the quality of the support they receive. Disclosing information in a way that most effectively elicits support is beneficial because women with infertility who have lower levels of stress are more likely to seek and remain in treatment. STUDY DESIGN, SIZE, DURATION This cross-sectional study of 301 infertile women was conducted in the USA. PARTICIPANTS/MATERIALS, SETTING, METHODS To determine the variation in length of infertility and treatment decisions, we conducted an online survey of 301 American women coping with infertility. We investigated the strategies women used to disclose infertility-related information with social network members, their perceptions of support from friends and family, and their quality of life both in general (overall quality of life) and related to the experience of infertility (fertility quality of life). MAIN RESULTS AND THE ROLE OF CHANCE Direct disclosure of experiences related to infertility was positively and significantly associated with the perceived quality of social support received (P < 0.01). Strategies of disclosure that use entrapment or indirect media were negatively associated with fertility quality of life (P < 0.001). Directly (P < 0.01) and incremental disclosures (P < 0.01) were positively associated with overall quality of life, while the use of humor was negatively associated with overall quality of life (P < 0.01). Perceived support quality also mediated the influence of direct disclosures on women's fertility quality of life (95% CI: 0.18, 1.05) and overall quality of life (95% CI: 0.10, 0.30). This effect is particularly noteworthy for the model predicting fertility quality of life, which exhibited a non-significant main effect with direct disclosures. The non-significant main effect combined with the significant indirect effect suggests that perceived support quality fully mediates the association between direct disclosures and fertility quality of life. LIMITATIONS, REASONS FOR CAUTION The cross-sectional nature of our convenient sample did not allow us to test cause and effect. It is equally plausible that women who perceive support are more likely to disclose. Longitudinal data are necessary to test the cyclic nature of these variables and confirm directionality. WIDER IMPLICATIONS OF THE FINDINGS When women make the decision to reveal information about their infertility, direct disclosure (i.e. face-to-face, clearly, verbally and with the opportunity for an immediate response) was the only strategy that significantly corresponded with perceived support quality and was one of only two strategies that were positively associated with quality of life. To the extent that social support reduces stress, and lower stress increases the chance that people seek and stay in treatment, infertility clinics and therapists can use this information as a low-cost strategy for supporting infertile women. Scholars and practitioners can also instruct women coping with infertility about how to most effectively engage in seeking effective support. STUDY FUNDING/COMPETING INTERESTS No external funding was either sought or obtained for this study and no competing interests are declared.
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Affiliation(s)
- Keli R Steuber
- Faculty of Communication Studies, The College of New Jersey, Ewing, NJ 08628, USA
| | - Andrew High
- Faculty of Communication, University of Iowa, Iowa City, IA 52241, USA
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183
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La enfermera como apoyo para mejorar la calidad de vida en la reproducción asistida. ENFERMERIA CLINICA 2015; 25:110-6. [DOI: 10.1016/j.enfcli.2015.03.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2014] [Revised: 02/12/2015] [Accepted: 03/14/2015] [Indexed: 11/24/2022]
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Oron G, Allnutt E, Lackman T, Sokal-Arnon T, Holzer H, Takefman J. A prospective study using Hatha Yoga for stress reduction among women waiting for IVF treatment. Reprod Biomed Online 2015; 30:542-8. [PMID: 25779021 DOI: 10.1016/j.rbmo.2015.01.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Revised: 01/17/2015] [Accepted: 01/20/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Galia Oron
- Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec H3A 1A1, Canada.
| | - Erica Allnutt
- Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec H3A 1A1, Canada
| | - Tasha Lackman
- Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec H3A 1A1, Canada
| | - Tamar Sokal-Arnon
- Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec H3A 1A1, Canada
| | - Hananel Holzer
- Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec H3A 1A1, Canada
| | - Janet Takefman
- Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec H3A 1A1, Canada.
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185
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Smith NK, Madeira J, Millard HR. Sexual Function and Fertility Quality of Life in Women Using In Vitro Fertilization. J Sex Med 2015; 12:985-93. [DOI: 10.1111/jsm.12824] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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186
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Asazawa K. Effects of a partnership support program for couples undergoing fertility treatment. Jpn J Nurs Sci 2015; 12:354-66. [PMID: 25780939 DOI: 10.1111/jjns.12074] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Accepted: 11/10/2014] [Indexed: 11/29/2022]
Abstract
AIM The study's purpose was to examine the effects of providing a partnership support program. It was designed to improve Japanese couples' partnership, maintain quality of life, decrease psychological distress, and improve marital relationship satisfaction while they underwent infertility treatment that included the possibility of using assisted reproductive technology. METHODS This quasi-experimental study with a two-group pretest-post-test design used purposive sampling and non-random assignment of 318 consenting Japanese patients from previous phases of assisted reproductive technology fertility treatment who were patients from a fertility clinic in Tokyo, Japan. The intervention group of 152 patients (76 couples) participated in the partnership support program. The comparison group of 166 patients (83 couples) received usual care. Recruitment was age matched. The program provided information and used a participatory-interactive approach to enhance understanding and cooperation in couples undergoing fertility treatment. The main outcome measures were: "partnership", FertiQoL, Quality Marriage Index, and "psychological distress". RESULTS There were 311 participants (intervention group n = 148; comparison group, n = 163). The intervention group showed significant improvement in the couples' partnerships and a significant decrease in women's psychological distress using subgroup analysis. CONCLUSION The partnership support program provided effective improvement in partnership for the couples, and reduced psychological distress for the women; however, it had less impact for the men. The program was not effective in improving couples' overall quality of life (QOL); however, it was effective in improving the "mind-body" aspects of the QOL subscale.
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Affiliation(s)
- Kyoko Asazawa
- Department of Nursing, Tokyo Healthcare University, Tokyo, Japan
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187
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Huppelschoten AG, Nelen WLDM, Westert GP, van Golde RJT, Adang EMM, Kremer JAM. Improving patient-centredness in partnership with female patients: a cluster RCT in fertility care. Hum Reprod 2015; 30:1137-45. [DOI: 10.1093/humrep/dev041] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2014] [Accepted: 02/11/2015] [Indexed: 11/13/2022] Open
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188
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Diamond MP, Legro RS, Coutifaris C, Alvero R, Robinson RD, Casson P, Christman GM, Ager J, Huang H, Hansen KR, Baker V, Usadi R, Seungdamrong A, Bates GW, Rosen RM, Haisonleder D, Krawetz SA, Barnhart K, Trussell JC, Jin Y, Santoro N, Eisenberg E, Zhang H. Assessment of multiple intrauterine gestations from ovarian stimulation (AMIGOS) trial: baseline characteristics. Fertil Steril 2015; 103:962-973.e4. [PMID: 25707331 DOI: 10.1016/j.fertnstert.2014.12.130] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 12/31/2014] [Accepted: 12/31/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To identify baseline characteristics of women with unexplained infertility to determine whether treatment with an aromatase inhibitor will result in a lower rate of multiple gestations than current standard ovulation induction medications. DESIGN Randomized, prospective clinical trial. SETTING Multicenter university-based clinical practices. PATIENT(S) A total of 900 couples with unexplained infertility. INTERVENTION(S) Collection of baseline demographics, blood samples, and ultrasonographic assessments. MAIN OUTCOME MEASURE(S) Demographic, laboratory, imaging, and survey characteristics. RESULT(S) Demographic characteristics of women receiving clomiphene citrate (CC), letrozole, or gonadotropins for ovarian stimulation were very consistent. Their mean age was 32.2 ± 4.4 years and infertility duration was 34.7 ± 25.7 months, with 59% primary infertility. More than one-third of the women were current or past smokers. The mean body mass index (BMI) was 27 and mean antimüllerian hormone level was 2.6; only 11 women (1.3%) had antral follicle counts of <5. Similar observations were identified for hormonal profiles, ultrasound characterization of the ovaries, semen parameters, and quality of life assessments in both male and female partners. CONCLUSION(S) The cause of infertility in the couples recruited to this treatment trial is elusive, as the women were regularly ovulating and had evidence of good ovarian reserve both by basal FSH, antimüllerian hormone levels, and antral follicle counts; the male partners had normal semen parameters. The three treatment groups have common baseline characteristics, thereby providing comparable patient populations for testing the hypothesis that use of letrozole for ovarian stimulation can reduce the rates of multiples from that observed with gonadotropin and CC treatment. CLINICAL TRIAL REGISTRATION NUMBER NCT 01044862.
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Affiliation(s)
- Michael P Diamond
- Department of Obstetrics and Gynecology, Georgia Regents University, Augusta, Georgia; Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan.
| | - Richard S Legro
- Department of Obstetrics and Gynecology, Pennsylvania State University, Hershey, Pennsylvania
| | - Christos Coutifaris
- Department of Obstetrics and Gynecology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
| | - Ruben Alvero
- Department of Obstetrics and Gynecology, University of Colorado, Denver, Colorado
| | - Randal D Robinson
- Department of Obstetrics and Gynecology, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Peter Casson
- Department of Obstetrics and Gynecology, University of Vermont, Burlington, Vermont
| | - Gregory M Christman
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan
| | - Joel Ager
- Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan
| | - Hao Huang
- Department of Biostatistics, Yale University School of Public Health, New Haven, Connecticut
| | - Karl R Hansen
- Department of Obstetrics and Gynecology, University of Oklahoma College of Medicine, Oklahoma City, Oklahoma
| | - Valerie Baker
- Stanford University Medical Center, Stanford, California
| | | | - Aimee Seungdamrong
- New Jersey Medical School - University of Medicine and Dentistry of New Jersey, Rutgers, New Jersey
| | | | - R Mitchell Rosen
- Department of Reproductive Endocrinology and Infertility, University of California, San Francisco, California
| | - Daniel Haisonleder
- Ligand Core Laboratory University of Virginia Center for Research in Reproduction, Charlottesville, Virginia
| | - Stephen A Krawetz
- Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan
| | - Kurt Barnhart
- Department of Obstetrics and Gynecology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
| | | | - Yufeng Jin
- Department of Biostatistics, Yale University School of Public Health, New Haven, Connecticut
| | - Nanette Santoro
- Department of Obstetrics and Gynecology, University of Colorado, Denver, Colorado
| | - Esther Eisenberg
- Fertility and Infertility Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland
| | - Heping Zhang
- Department of Biostatistics, Yale University School of Public Health, New Haven, Connecticut
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Van Dongen A, Huppelschoten AG, Kremer JA, Nelen WL, Verhaak CM. Psychosocial and demographic correlates of the discontinuation ofin vitrofertilization. HUM FERTIL 2015; 18:100-6. [DOI: 10.3109/14647273.2014.995240] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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190
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Erdei M, Cserepes RE, Bugán A. [Knowledge and perception of medical students about infertility]. Orv Hetil 2015; 156:105-12. [PMID: 25577682 DOI: 10.1556/oh.2015.30055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The effectiveness of fertility treatments is influenced by the health care professionals' knowledge regarding infertility as well as their empathy. AIM The aim of the study was to examine infertility-related knowledge and perceptions of emotional and mind/body consequences of infertility among medical students. METHODS A questionnaire design was used. Data were obtained from 112 medical university students (76 women, 36 men) who participated involuntary and compensation-free. RESULTS Medical students' knowledge concerning infertility proved to be incomplete and ambiguous. Subjects underestimated the presence of mind/body and emotional symptoms caused by infertility in men particularly, and overestimated some emotional concerns in women, e.g. sadness. CONCLUSIONS Medical students have gaps in their subject-specific knowledge, so that they need more (even practical) information regarding infertility during their studies. Students' conceptions about emotional and physical consequences of infertility are distorted by stereotypes. The risk of these biases is that it could make it difficult to perceive patients in a non-distorted way, especially infertile male patients.
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Affiliation(s)
- Márta Erdei
- Debreceni Egyetem, Népegészségügyi Kar Magatartástudományi Intézet Debrecen Nagyerdei krt. 98. 4032
| | - Réka Eszter Cserepes
- Debreceni Egyetem, Népegészségügyi Kar Magatartástudományi Intézet Debrecen Nagyerdei krt. 98. 4032
| | - Antal Bugán
- Debreceni Egyetem, Népegészségügyi Kar Magatartástudományi Intézet Debrecen Nagyerdei krt. 98. 4032
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191
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Professional emergence on transnational issues: Linked ecologies on demographic change. JOURNAL OF PROFESSIONS AND ORGANIZATION 2014. [DOI: 10.1093/jpo/jou006] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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192
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Holter H, Sandin-Bojö AK, Gejervall AL, Wikland M, Wilde-Larsson B, Bergh C. Patient-centred quality of care in an IVF programme evaluated by men and women. Hum Reprod 2014; 29:2695-703. [PMID: 25316450 DOI: 10.1093/humrep/deu254] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
STUDY QUESTION Do men and women value the same aspects of quality of care during IVF treatment when measuring rates of importance by the validated instrument, quality from the patient's perspective of in vitro fertilization (QPP-IVF)? SUMMARY ANSWER Women valued most aspects of care as significantly more important than their partner although men and women evaluated the importance of the different care factors in a similar pattern. WHAT IS KNOWN ALREADY A few validated tools measuring patient-centred quality of care during IVF have been developed. Few studies of gender differences concerning experiences of patient-centred quality of care have been reported in the literature to date. STUDY DESIGN, SIZE AND DURATION A two-centre study was conducted between September 2011 and May 2012. Heterosexual couples (n = 497) undergoing IVF were invited to complete a questionnaire before receiving the result of the pregnancy test. PARTICIPANTS/MATERIALS, SETTING, METHODS In all, 363 women and 292 men evaluated quality of care by answering the QPP-IVF questionnaire. The measurements consisted of two kinds of evaluations: the rating of the importance of various aspects of treatment (subjective importance) and the rating of perceived quality of care (perceived reality). Comparisons between men and women on importance ratings and perceived reality ratings were performed both on factor (subscale) and single item levels by intra-couple analyses and corrected for age. A stepwise multiple logistic regression analysis was performed in order to select baseline variables independently predicting evaluation at factor level. MAIN RESULTS AND THE ROLE OF CHANCE The response rate was 67.5%, with 363 women (74.2%) and 292 men (60.6%) completing the study. Both the woman and man responded in 251 couples. Women rated the different care aspects as significantly more important than their partner in all factors except the factor, 'Responsibility/continuity'. Both genders gave the factors, 'Medical care' and 'Information after treatment', the highest scores. At item level women rated the majority of items as significantly more important than men. Perceived reality for the majority of factors and items was similarly rated by men and women in the couples. For women, receiving embryo transfer, short duration of infertility, IVF as a method and number of previous cycles were independently correlated to the highest score of importance of certain factors. LIMITATIONS, REASON FOR CAUTION The lower response rate of men compared with women (60.6 versus 74.2%, respectively) might have influenced the results through selection bias. Only patients who had adequate fluency in the Swedish language participated. WIDER IMPLICATIONS OF THE FINDINGS This study is an important contribution in comparing the needs of men and women undergoing IVF treatments. The QPP-IVF instrument is a suitable instrument for revealing important care aspects identified by both men and women and a useful tool for stimulating patient-centred quality improvements within and between clinics. STUDY FUNDING/COMPETING INTEREST The study was supported by the LUA/ALF agreement at Sahlgrenska University Hospital, Gothenburg, Sweden, and by Hjalmar Svensson's Research Foundation. None of the authors declared any conflict of interests.
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Affiliation(s)
- Herborg Holter
- Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Reproductive Medicine, Sahlgrenska University Hospital, Gothenburg SE-413 45, Sweden
| | - Ann-Kristin Sandin-Bojö
- Department of Health Sciences, Nursing Sciences, Faculty of Health, Science and Technology, Karlstad University, Karlstad SE 651 88, Sweden
| | - Ann-Louise Gejervall
- Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Reproductive Medicine, Sahlgrenska University Hospital, Gothenburg SE-413 45, Sweden
| | - Matts Wikland
- Fertility Centre Scandinavia, Box 5418, Gothenburg SE-40229, Sweden
| | - Bodil Wilde-Larsson
- Department of Health Sciences, Nursing Sciences, Faculty of Health, Science and Technology, Karlstad University, Karlstad SE 651 88, Sweden
| | - Christina Bergh
- Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Reproductive Medicine, Sahlgrenska University Hospital, Gothenburg SE-413 45, Sweden
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Asazawa K, Mori A. Development of a partnership causal model for couples undergoing fertility treatment. Jpn J Nurs Sci 2014; 12:208-21. [PMID: 25302746 DOI: 10.1111/jjns.12061] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Accepted: 07/11/2014] [Indexed: 11/28/2022]
Abstract
AIM The goals of this study were to develop a partnership causal model and verify the model's fitness for couples undergoing fertility treatment. METHODS A purposive sample of 1004 consenting participants (502 couples) undergoing fertility treatment was selected from five fertility clinics across Japan. A mailed self-administered questionnaire was used to collect data. The partnership causal model was examined with structural equation modeling. RESULTS A total of 565 questionnaires were returned (56.3%) and the number of valid responses was 466 (46.4%). The factor "medical professionals' support (nurses and physicians)" influenced the couples' "partnership" (β = 0.16) and had a direct effect on the men's quality of life (QOL) and an indirect effect on the women's QOL (β = 0.20). Couples' partnership had a significant impact on couples' QOL (β = 0.20) and on "satisfaction in their relationship with their partner" (β = 0.48). The multi-population path analysis revealed that married couples influenced each other's perceptions of their partnership (men, β = 0.84; women, β = 0.88). Additionally, the spouse's partnership influenced both individual's QOL (men, β = 0.77; women, β = 0.77) and the satisfaction with the relationship (men, β = 0.46; women, β = 0.59). The participants' "distress" significantly and negatively affected the participants' QOL. CONCLUSION The results revealed that for a couple undergoing fertility treatments, a strong partnership maintains their QOL, and this could decrease the couples' distress (particularly in women). Partnership was also related to the variability of "medical professionals' support".
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Affiliation(s)
| | - Akiko Mori
- St Luke's International University, Tokyo, Japan
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194
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Kim JH, Shin HS. Validation of a Korean Version of Fertility Problem Inventory. Asian Nurs Res (Korean Soc Nurs Sci) 2014. [DOI: 10.1016/j.anr.2014.03.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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195
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Sadri-Ardekani H, Atala A. Testicular tissue cryopreservation and spermatogonial stem cell transplantation to restore fertility: from bench to bedside. Stem Cell Res Ther 2014; 5:68. [PMID: 25157677 PMCID: PMC4056749 DOI: 10.1186/scrt457] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Male infertility management has made significant progress during the past three decades, especially after the introduction of intracytoplasmic sperm injection in 1992. However, many boys and men still suffer from primary testicular failure due to acquired or genetic causes. New and novel treatments are needed to address these issues. Spermatogenesis originates from spermatogonial stem cells (SSCs) that reside in the testis. Many of these men lack SSCs or have lost SSCs over time as a result of specific medical conditions or toxic exposures. Loss of SSCs is critical in prepubertal boys who suffer from cancer and are going through gonadotoxic cancer treatments, as there is no option of sperm cryopresrvation due to sexual immaturity. The development of SSC transplantation in a mouse model to repopulate spermatozoa in depleted testes has opened new avenues of research in other animal models, including non-human primates. Recent advances in cryopreservation and in vitro propagation of human SSCs offer promise for human SSC autotransplantation in the near future. Ongoing research is focusing on safety and technical issues of human SSC autotransplantation. This is the time to counsel parents and boys at risk of infertility on the possibility of cryopreserving and banking a small amount of testis tissue for potential future use in SSC transplantation.
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196
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Verkuijlen J, Verhaak C, Nelen WLDM, Wilkinson J, Farquhar C. Psychological and educational interventions for subfertile men and women. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2014. [DOI: 10.1002/14651858.cd011034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Read SC, Carrier ME, Boucher ME, Whitley R, Bond S, Zelkowitz P. Psychosocial services for couples in infertility treatment: what do couples really want? PATIENT EDUCATION AND COUNSELING 2014; 94:390-5. [PMID: 24290241 DOI: 10.1016/j.pec.2013.10.025] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Revised: 10/04/2013] [Accepted: 10/26/2013] [Indexed: 05/25/2023]
Abstract
OBJECTIVES To describe the psychosocial supports that infertile couples desire to help cope with infertility-related distress, which psychosocial services they sought, and the benefits and drawbacks of these services. METHODS Qualitative interview study with 32 heterosexual infertile couples seeking infertility treatment. Maximum variation sampling was used; data were analyzed using thematic analysis. RESULTS Most couples desired psychosocial support, but only half of the sample sought support. Some couples met with psychologists for help with relationship conflict and coping strategies. Participants suggested peer mentoring to fulfill needs for coping, shared experience, and guidance through the treatment process. Couples also desired written information about practical and emotional aspects of treatment. Negative attitudes toward psychological counseling and a lack of information about support services prevented some couples from seeking support. CONCLUSIONS Infertile couples expressed numerous needs for psychosocial supports, but often felt that supports were not available. A variety of services should be offered in order to fulfill patients' varied needs. PRACTICE IMPLICATIONS Awareness of the reasons why patients desire psychosocial services will help clinicians to refer patients to currently available psychosocial supports, and will aid in the development of appropriate supports, including couples counseling, peer mentoring, and written information in lay language.
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Affiliation(s)
- Suzanne C Read
- Department of Psychiatry, McGill University, Montreal, Canada
| | | | - Marie-Eve Boucher
- Department of Psychiatry, McGill University, Montreal, Canada; Douglas Mental Health University Institute, Montreal, Canada
| | - Robert Whitley
- Department of Psychiatry, McGill University, Montreal, Canada; Douglas Mental Health University Institute, Montreal, Canada
| | - Sharon Bond
- Jewish General Hospital, Montreal, Canada; School of Social Work, McGill University, Montreal, Canada
| | - Phyllis Zelkowitz
- Department of Psychiatry, McGill University, Montreal, Canada; Jewish General Hospital, Montreal, Canada.
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Gameiro S, Canavarro MC, Boivin J. Patient centred care in infertility health care: direct and indirect associations with wellbeing during treatment. PATIENT EDUCATION AND COUNSELING 2013; 93:646-654. [PMID: 24007764 DOI: 10.1016/j.pec.2013.08.015] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2012] [Revised: 07/19/2013] [Accepted: 08/11/2013] [Indexed: 05/27/2023]
Abstract
OBJECTIVE To investigate whether different dimensions of patient centred care (PCC) were directly associated with wellbeing or indirectly, via lower concerns about medical procedures and/or increased tolerability of treatment. METHODS Cross-sectional study with 322 women and 111 men undergoing fertility diagnosis or treatment recruited online and in clinical setting. Participants completed questionnaires that assess PCC (PCQ-Infertility), individual (BSI Anxiety and Depression subscales) and relational wellbeing (FertiQoL Relational Domain), treatment concerns (CART Procedural Concerns scale) and tolerability (FertiQoL Tolerability Domain) and they filled a socio-demographic and fertility data file. RESULTS All dimensions of PCC were positively associated with better wellbeing except for organization of care. Information provision and continuity of care were indirectly associated with better individual wellbeing, the first via lower treatment concerns and the second via higher treatment tolerability. Competence, accessibility, continuity and communication were indirectly associated with better relational wellbeing via higher treatment tolerability. CONCLUSIONS Patient centred care promotes wellbeing during treatment. PCC is directly associated to wellbeing but also indirectly. The mode of action of the different PCC dimensions on wellbeing varies. PRACTICAL IMPLICATIONS To promote patients' wellbeing during treatment clinics should provide treatment related information and allow patients to establish a stable clinical relationship with a trustworthy and competent physician.
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Affiliation(s)
- Sofia Gameiro
- School of Psychology, Cardiff University, Cardiff, UK; Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal.
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Holter H, Sandin-Bojö AK, Gejervall AL, Wikland M, Wilde-Larsson B, Bergh C. Quality of care in an IVF programme from a patient's perspective: development of a validated instrument. Hum Reprod 2013; 29:534-47. [PMID: 24287821 DOI: 10.1093/humrep/det421] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION Is it possible to develop a trustworthy instrument to evaluate the patient's perspective on fertility care and to document fully all methodological steps, including validation? SUMMARY ANSWER A validated instrument has been developed for both women and men undergoing assisted reproduction to monitor the quality of care on a regular basis, similar to live birth rates and other effectiveness data. WHAT IS KNOWN ALREADY?: Within fertility care, several instruments have been developed, but many have significant methodological problems and few have been validated. Most instruments focus exclusively on women and no questionnaires have been directed at women and men separately. STUDY DESIGN, SIZE AND DURATION The questionnaire specific to IVF treatments (QPP-IVF) is based on the theoretical foundation of the validated general instrument, quality of care from patients perspective (QPP), for both women and men. The QPP-IVF was developed and validated by quantitative methods. A two-centre study ran between September 2011 and May 2012. PARTICIPANTS/MATERIALS, SETTING, METHODS In all, 655 women and men participated. The measurements consisted of two kinds of evaluations: the rating of perceived reality of care and the rating of the subjective importance of various aspects of treatment. The questionnaire consisted of 43 items for women and 42 items for men. An exploratory factor analysis was performed for women for all items of subjective importance. Eigenvalue, explained variance and factor loading are given for each factor. Internal consistency of subscales was assessed by Cronbach's alpha, item discriminant validity and percentage scaling success. For external validity, a correlation with fertility quality of life (FertiQoL) was performed and for reliability, a test-retest analysis was carried out. Sensitivity analyses were performed by known-group analyses. All significance tests were two sided and conducted at the 5% significance level. MAIN RESULTS AND THE ROLE OF CHANCE The QPP-IVF instrument, divided into four dimensions, seemed a valid and reliable way of measuring the quality of care from a patient's perspective, for both women and men. The item-scaling test confirmed 10 underlying factors, with scaling success in all subscales and Cronbach's alpha >0.70 for women in almost all subscales. It was somewhat lower for men but still acceptable. The external validity was acceptable, with significant correlation between QPP-IVF and FertiQoL. The test-retest analysis confirmed that QPP-IVF was a stable instrument, with intra-class correlation coefficients from 0.74 to 0.89 for women. Sensitivity analyses indicated a sensitive instrument. LIMITATIONS, REASON FOR CAUTION The response rate to the questionnaire was 67.5%. Although considered acceptable in questionnaire studies, this response level might introduce a certain risk of selection bias. The questionnaire was developed and validated only in Sweden. WIDER IMPLICATIONS OF THE FINDINGS The QPP-IVF may be of use for purposes of quality improvement and national comparisons. Future studies should focus on establishing the QPP-IVF as a valuable instrument for measuring the quality of care outside Sweden. STUDY FUNDING/COMPETING INTEREST The study was supported by the LUA/ALF agreement at Sahlgrenska University Hospital, Gothenburg, Sweden and by Hjalmar Svensson's Research Foundation. None of the authors declared any conflict of interests.
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Affiliation(s)
- Herborg Holter
- Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Reproductive Medicine, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden
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Lopes V, Canavarro M, Verhaak C, Boivin J, Gameiro S. Are patients at risk for psychological maladjustment during fertility treatment less willing to comply with treatment? Results from the Portuguese validation of the SCREENIVF. Hum Reprod 2013; 29:293-302. [DOI: 10.1093/humrep/det418] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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