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Lü L, Liu Y, Yang Y, He J, Luo L, Chen S, Xing H. Bisphenol A Exposure Interferes with Reproductive Hormones and Decreases Sperm Counts: A Systematic Review and Meta-Analysis of Epidemiological Studies. TOXICS 2024; 12:294. [PMID: 38668517 PMCID: PMC11054375 DOI: 10.3390/toxics12040294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 04/04/2024] [Accepted: 04/11/2024] [Indexed: 04/29/2024]
Abstract
Bisphenol A (BPA), an acknowledged endocrine disrupter, is easily exposed to humans via food packaging and container. However, a consensus has not been reached on the extent to which BPA exposure affects the reproductive system. We therefore conducted this systematic review and meta-analysis to elucidate the relationship between BPA exposure and male reproduction-related indicators. Up to October 2023, a comprehensive search was carried out in the PubMed, Embase, Cochrane and Web of Science, and 18 studies were ultimately included. β coefficients from multivariate linear regression analyses were pooled using a random effects model. The results showed that the urinary BPA concentration was negatively correlated with the sperm concentration (β coefficient = -0.03; 95% CI: -0.06 to -0.01; I2 = 0.0%, p = 0.003) and total sperm count (β coefficient = -0.05; 95% CI: -0.08 to -0.02; I2 = 0.0%, p < 0.001). In addition, BPA concentrations were associated with increased sex hormone-binding globulin (SHBG) levels, increased estradiol (E2) levels, and reduced biologically active androgen levels. However, the relationship between an increased risk of below-reference sperm quality and BPA exposure was not robust. This systematic review revealed that BPA exposure disrupts reproductive hormones, reduces sperm counts and may ultimately adversely affect male reproduction.
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Affiliation(s)
- Lei Lü
- School of Food Science and Engineering, Qilu University of Technology, Shandong Academy of Sciences, Jinan 250353, China; (L.L.); (Y.L.); (Y.Y.); (J.H.); (L.L.)
| | - Yuan Liu
- School of Food Science and Engineering, Qilu University of Technology, Shandong Academy of Sciences, Jinan 250353, China; (L.L.); (Y.L.); (Y.Y.); (J.H.); (L.L.)
| | - Yuhong Yang
- School of Food Science and Engineering, Qilu University of Technology, Shandong Academy of Sciences, Jinan 250353, China; (L.L.); (Y.L.); (Y.Y.); (J.H.); (L.L.)
| | - Jinxing He
- School of Food Science and Engineering, Qilu University of Technology, Shandong Academy of Sciences, Jinan 250353, China; (L.L.); (Y.L.); (Y.Y.); (J.H.); (L.L.)
| | - Lulu Luo
- School of Food Science and Engineering, Qilu University of Technology, Shandong Academy of Sciences, Jinan 250353, China; (L.L.); (Y.L.); (Y.Y.); (J.H.); (L.L.)
| | - Shanbin Chen
- Institute of Food & Nutrition Science and Technology, Shandong Academy of Agricultural Sciences, Jinan 250100, China
| | - Hanzhu Xing
- School of Food Science and Engineering, Qilu University of Technology, Shandong Academy of Sciences, Jinan 250353, China; (L.L.); (Y.L.); (Y.Y.); (J.H.); (L.L.)
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Jiang Z, Hou S, Zhang Y, Zong L. The mediating and moderating effects of resilience on the relationship between sleep quality and psychological distress in Chinese women with infertility. BMC Womens Health 2024; 24:192. [PMID: 38515092 PMCID: PMC10956316 DOI: 10.1186/s12905-024-03018-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 03/12/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND Research has widely indicated that the psychological distress experienced by infertile patients during fertility treatments may have a negative effect on the results of assisted reproduction. Although numerous studies have shown that psychological resilience and sleep quality are important influencing factors for psychological distress, the mediating mechanisms of psychological resilience in the relationship between sleep quality and psychological distress for Chinese women in particular remain unclear. Therefore, the current study investigates the association between sleep quality, resilience, and psychological distress in Chinese women with infertility and examines the mediating and moderating roles of resilience on the relationship between sleep quality and psychological distress. METHODS In this cross-sectional study, a total of 595 women with infertility who were undergoing IVF-ET were recruited at the Reproductive Medicine, Shandong University, from April to November 2019. Participants were instructed to complete four questionnaires, including a questionnaire about socio-demographic and clinical-related information, the Pittsburgh Sleep Quality Index (PSQI), the 10-item Connor-Davidson Resilience Scale (CD-RISC-10), and the Kessler-10 (K10). Pearson's correlation analysis was conducted preliminarily to describe the relationships between sleep quality, resilience, and psychological distress. A mediation model and a moderated model were constructed and analyzed using the PROCESS macro for SPSS. The Johnson-Neyman (J-N) technique was then used to identify the regions of significance across the levels of moderator values. RESULTS Patients in the sample had a high prevalence of psychological distress (48.6%, K10 scores > 22), and mediation analysis indicated that resilience played a partially mediating role in the relationship between sleep quality and psychological distress (indict effect = 0.072, P < 0.001). Moderation analysis indicated that resilience also moderated the association between sleep quality and psychological distress. CONCLUSIONS Resilience may play a key role in the relationship between sleep quality and psychological distress. Our findings imply that resilience training may therefore be an effective component of psychological distress intervention in women with infertility.
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Affiliation(s)
- Zhenhua Jiang
- The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jingshi Road, Jinan, 250014, Shandong, China
| | - Sen Hou
- The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jingshi Road, Jinan, 250014, Shandong, China
| | - Yajie Zhang
- Jinan Maternity and Child Care Hospital, Jingsan Road, Jinan, 250000, Shandong, China
| | - Liping Zong
- Jinan Maternity and Child Care Hospital, Jingsan Road, Jinan, 250000, Shandong, China.
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Lvy Y, Zhang F, Cai Z, Zhong D, Xing L. Correlation among irrational parenthood cognitions, fertility stress, and social support in patients with repeated implantation failure and the mediating effect of fertility stress: a cross-sectional survey. J Assist Reprod Genet 2024; 41:205-212. [PMID: 37921970 PMCID: PMC10789702 DOI: 10.1007/s10815-023-02953-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 09/16/2023] [Indexed: 11/05/2023] Open
Abstract
PURPOSE This study investigated the relationships among irrational conceptions of parenthood, fertility stress, and social support, as well as the mediating effect of fertility stress, in patients with repeated implantation failure. METHODS Patients who underwent assisted reproductive technology due to repeated implantation failure at the Reproductive Centre at Women's Hospital between January 2020 and August 2022 were selected using cross-sectional research and convenience sampling. A total of 129 patients with recurrent implantation failure were investigated using the Irrational Parenthood Cognitions Questionnaire (IPCQ), Fertility Problem Inventory (FPI), and Social Support Rating Scale (SSRS). RESULTS The differences in irrational parenthood cognitions, fertility, stress, and social support among patients with repeated implantation failure in the education and yearly household income subgroups were statistically significant (P<0.001). Pearson correlation analysis revealed that irrational parenthood cognitions were favorably correlated with all measures of reproductive stress (r=0.384 to 0.664, all P<0.01) and negatively correlated with social support (r=-0.310, p<0.01). The fertility stress of patients with repeated implantation failure fit the structural equation model of irrational parenthood cognitions and social support well [X2/df=2.04, Comparative Fit Index (CFI)=0.944, Tucker-Lewis (TLI)=0.905, Root Mean Squared Error of Approximation (RMSEA)=0.090]. The bootstrap test results revealed that the mediating effect of the 95% CI ranged between -0.506 and -0.109, and the interval did not contain 0. Fertility stress had a strong mediating effect on the relationship between irrational parenthood cognitions and social support. CONCLUSIONS The mediating effect of reproductive stress on the relationship between irrational parenthood cognitions and social support in patients with repeated implantation failure was significant. It is important for medical and nursing staff to address physical and psychological illnesses and develop effective intervention strategies from the perspectives of fertility stress, social support, and cultural background, with the ultimate goal of improving mental health.
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Affiliation(s)
- Yan Lvy
- Department of Reproductive Endocrinology, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, 310000, Zhejiang, Province, People's Republic of China
| | - Fang Zhang
- Department of Reproductive Endocrinology, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, 310000, Zhejiang, Province, People's Republic of China
| | - Zhongbo Cai
- Department of Reproductive Endocrinology, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, 310000, Zhejiang, Province, People's Republic of China
| | - Danting Zhong
- Department of Reproductive Endocrinology, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, 310000, Zhejiang, Province, People's Republic of China
| | - Lanfeng Xing
- Department of Reproductive Endocrinology, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, 310000, Zhejiang, Province, People's Republic of China.
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Yu J, Fu Y, Zeng L, Xie P, Li L, Zheng Y. Burden of female infertility in China from 1990 to 2019: a temporal trend analysis and forecasting, and comparison with the global level. Sex Health 2023; 20:577-584. [PMID: 37967574 DOI: 10.1071/sh23029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 10/13/2023] [Indexed: 11/17/2023]
Abstract
BACKGROUND Infertility is a common reproductive disease that affects not only individuals and families, but also the growth of the social population. Hence, understanding the burden of female infertility in China and worldwide is of great significance for the development of infertility prevention and treatment strategies. METHODS The Global Burden of Disease Study (GBD 2019) Data Resources were used to collect and collate relevant data on female infertility in China and worldwide from 1990 to 2019. The difference in the number, age-standardised prevalence rate (ASPR), disability-adjusted life years and age-standardised disability-adjusted life years rate (ASDR) of women with infertility in different periods and geographical areas were analysed. The autoregressive integrated moving average method was used to predict the ASPR and ASDR of female infertility in China and worldwide in the next 11years. RESULTS In the past 30years, the number of female infertility cases increased by 7.06million in China and 56.71million worldwide. The corresponding average annual increase of ASPR was 10.10% and 7.28%, respectively, and that of ASDR was 0.08% and 0.79%, respectively. In addition, there are differences in age and time between Chinese and global female infertility. In 1990, the crude prevalence rate of female infertility was the highest in women aged 40-44years and 35-39years in China and worldwide, respectively. In 2019, the crude prevalence rate of female infertility was still the highest in women aged 40-44years in China, whereas that around the world reached the highest in women aged 30-34years, which was significantly earlier. The forecast for the next 11years suggests that the ASPR and ASDR for female infertility in China will first rise and then decline, but the overall magnitude of change is not very significant, whereas the ASPR and ASDR for female infertility globally are still on the rise. The ASPR value of female infertility is expected to be 5025.56 in 100 000 persons in China and 3725.51 in 100 000 persons worldwide by 2030. The ASDR value of female infertility is expected to be 26.16 in 100 000 persons in China and 19.96 in 100 000 persons worldwide by 2030. CONCLUSION The burden of female infertility is still increasing in China and worldwide. Therefore, it is of great significance to pay more attention to infertile women, and advocate a healthy lifestyle to reduce the burden of disease for infertile women.
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Affiliation(s)
- Jingwei Yu
- Gynecology of Traditional Chinese Medicine, Panyu Maternal and Child Care Service Centre (Panyu He Xian Memorial Hospital), Guangzhou City, Guangdong Province 511442, China
| | - Yanhong Fu
- Department of Gynecology, Guangzhou Huadu District Maternal and Child Care Service Centre, Guangzhou City, Guangdong Province 510800, China
| | - Lei Zeng
- Department of Gynecology, First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou City, Guangdong Province 510405, China
| | - Pengpeng Xie
- Department of TCM Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou City, Guangdong Province 510623, China
| | - Limei Li
- Department of Women's Health Care, Guangdong Maternal and Child Health Hospital, Guangzhou City, Guangdong Province 511442, China
| | - Yongxia Zheng
- Gynecology of Traditional Chinese Medicine, Panyu Maternal and Child Care Service Centre (Panyu He Xian Memorial Hospital), Guangzhou City, Guangdong Province 511442, China
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Gao Y, Wang Q, Li G, Zhao X, Qin R, Kong L, Li P. Reliability and validity of the Chinese version of the Copenhagen Multi-Centre Psychosocial Infertility-Fertility Problem Stress Scales. Int J Nurs Pract 2023:e13219. [PMID: 37957031 DOI: 10.1111/ijn.13219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 09/26/2023] [Accepted: 10/22/2023] [Indexed: 11/15/2023]
Abstract
AIMS The aim of this study is to introduce the Copenhagen Multi-Centre Psychosocial Infertility (COMPI)-Fertility Problem Stress Scales (COMPI-FPSS) into China and test its applicability in Chinese infertile population. BACKGROUND Infertility-related stress not only influences patients' psychological well-being but is also strongly associated with reduced pregnancy rates and poorer assisted conception outcomes, thus warranting focussed attention. DESIGN The design used in this study is a cross-sectional survey. METHODS A total of 418 participants were recruited by convenience sampling from March to July 2022. The data were randomly divided into two parts: one for item analysis and exploratory factor analysis and the other for confirmatory factor analysis and reliability test. The critical ratio and homogeneity test were used to verify the differentiation and homogeneity of the COMPI-FPSS; the construct validity was determined by explanatory and confirmatory factor analyses; Cronbach's α coefficient and Spearman-Brown coefficient were used to assess the reliability; and criterion validity was expressed using correlation coefficients for the Perceived Stress Scale and the Negative Affect Scale as the validity criteria. RESULTS The revised Chinese version of COMPI-FPSS has 11 items and 2 dimensions (i.e., personal stress domain and social stress domain). Exploratory factor analysis showed that the cumulative variance contribution rate of the two factors was 68.6%, and confirmatory factor analysis indicated that the model fitted well. The score of the COMPI-FPSS was significantly and positively associated with perceived stress and negative affect. The Cronbach's α coefficient of the total scale was 0.905, and the Spearman-Brown coefficient was 0.836, explaining excellent reliability. CONCLUSION The revised Chinese version of COMPI-FPSS shows good reliability and validity, and it can be used to evaluate the infertility-related stress of infertile patients in China.
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Affiliation(s)
- Yiming Gao
- Department of Health Psychology, School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Qing Wang
- Department of Health Psychology, School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Guopeng Li
- Department of Health Psychology, School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Xiangyu Zhao
- Department of Health Psychology, School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Rui Qin
- Department of Health Psychology, School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Linghua Kong
- Department of Health Psychology, School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Ping Li
- Department of Health Psychology, School of Nursing and Rehabilitation, Shandong University, Jinan, China
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Riddle JN, Hopkins T, Yeaton-Massey A, Hellberg S. No Baby to Bring Home: Perinatal Loss, Infertility, and Mental Illness-Overview and Recommendations for Care. Curr Psychiatry Rep 2023; 25:747-757. [PMID: 37878138 DOI: 10.1007/s11920-023-01469-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/02/2023] [Indexed: 10/26/2023]
Abstract
PURPOSE OF REVIEW Update readers on the state of the research on mental health, perinatal loss, and infertility with a focus on providing a comprehensive overview to empower clinicians in treating this population. RECENT FINDINGS Rates of psychiatric illness are increased in people that experience perinatal loss and infertility. The research remains largely below the clear need for focused screening, prevention, and treatment. Clinicians and researchers need to remain attuned to the impact of perinatal loss and infertility on the mental health of patients and families. Screening, referral, and expanded therapeutic and psychiatric resources are imperative to improving the well-being of these patients and families.
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Affiliation(s)
- Julia N Riddle
- Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, USA.
| | - Tiffany Hopkins
- Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, USA
| | - Amanda Yeaton-Massey
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, USA
| | - Samantha Hellberg
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, NC, USA
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Yang T, Wongpakaran N, Wongpakaran T, Saeng-Anan U, Singhapreecha C, Jenraumjit R, Peisah C. Factors Associated with Depression in Infertile Couples: A Study in Thailand. Healthcare (Basel) 2023; 11:2004. [PMID: 37510445 PMCID: PMC10379005 DOI: 10.3390/healthcare11142004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 06/26/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Infertility can affect a couple's mental health and marital and social relationships. The study aimed to investigate the prevalence of depression among infertile couples and their relationships with other factors. METHODS This study employed a cross-sectional survey. Validated tools were used to assess anxiety and depression, marital satisfaction, personality traits and sufficiency economy. The actor-partner interdependence model (APIM) was used for dyadic analysis. RESULTS The prevalence of depression in infertile couples was 6.7%. Aggression, extraversion and neuroticism were significantly correlated with depression, whereas the expectation of having children, marital satisfaction and sufficiency economy were negatively correlated with depression. The APIM model suggested that neuroticism and marital satisfaction were significant predictors of depression. Partner effect between the expectation of having children and depression was observed (p = 0.039). CONCLUSIONS Like other populations, depression in infertile couples seems to be associated with aggression, extraversion and neuroticism. However, there are specific variables related to infertility that impact the depression levels of these couples. For instance, the expectation of having children can affect the partners of infertile couples, while the role of the sufficiency economy is a new factor that has been examined for depression in this sample and requires further exploration.
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Affiliation(s)
- Tong Yang
- Graduate School, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Nahathai Wongpakaran
- Graduate School, Chiang Mai University, Chiang Mai 50200, Thailand
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Tinakon Wongpakaran
- Graduate School, Chiang Mai University, Chiang Mai 50200, Thailand
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Ubol Saeng-Anan
- Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Charuk Singhapreecha
- Graduate School, Chiang Mai University, Chiang Mai 50200, Thailand
- Faculty of Economics, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Rewadee Jenraumjit
- Graduate School, Chiang Mai University, Chiang Mai 50200, Thailand
- Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Carmelle Peisah
- Graduate School, Chiang Mai University, Chiang Mai 50200, Thailand
- Discipline of Psychiatry and Mental Health, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
- Specialty of Psychiatry, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
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Yang T, Wongpakaran N, Wongpakaran T, Saeng-Anan U, Singhapreecha C, Jenraumjit R, Peisah C. Factors Associated with Anxiety and Depression in Infertile Couples—Study Protocol. Healthcare (Basel) 2022; 10:healthcare10071352. [PMID: 35885878 PMCID: PMC9321015 DOI: 10.3390/healthcare10071352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/14/2022] [Accepted: 07/19/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Infertility refers to the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse. Infertility is an important medical and social problem that causes individual distress, family conflict and emotional impact experienced by about 15% of couples worldwide. Anxiety and depression are the main psychological problems associated with infertility with many potential contributing factors which are yet to be fully elucidated. This study aims to investigate factors related to anxiety and depression among infertile couples. (2) Methods/Design: This study will employ an analytical cross-sectional survey. Sociodemographic information will be collected. Validated tools will be used to assess anxiety and depression (Outcome Inventory-21(OI-21), marital satisfaction (ENRICH Marital Satisfaction Scale, sufficiency economy (Sufficiency Economy Scale (SES) and personality traits (Zuckerman-Kuhlman-Aluja Personality Questionnaire (ZKA-PQ). The Actor-Partner Interdependence Model estimated by multilevel modeling will be used for dyadic analysis. (3) Discussion: This study will provide evidence about factors associated with anxiety and depression in infertile couples. Outcomes will raise awareness about mental health problems among infertile couples and guide future research for interventions.
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Affiliation(s)
- Tong Yang
- Master of Science (Mental Health), Graduate School, Chiang Mai University, Chiang Mai 50200, Thailand; (T.Y.); (T.W.); (C.S.); (R.J.); (C.P.)
| | - Nahathai Wongpakaran
- Master of Science (Mental Health), Graduate School, Chiang Mai University, Chiang Mai 50200, Thailand; (T.Y.); (T.W.); (C.S.); (R.J.); (C.P.)
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Correspondence: ; Tel.: +66-(53)-935422 (ext. 320); Fax: +66-(53)-935426
| | - Tinakon Wongpakaran
- Master of Science (Mental Health), Graduate School, Chiang Mai University, Chiang Mai 50200, Thailand; (T.Y.); (T.W.); (C.S.); (R.J.); (C.P.)
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Ubol Saeng-Anan
- Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand;
| | - Charuk Singhapreecha
- Master of Science (Mental Health), Graduate School, Chiang Mai University, Chiang Mai 50200, Thailand; (T.Y.); (T.W.); (C.S.); (R.J.); (C.P.)
- Faculty of Economics, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Rewadee Jenraumjit
- Master of Science (Mental Health), Graduate School, Chiang Mai University, Chiang Mai 50200, Thailand; (T.Y.); (T.W.); (C.S.); (R.J.); (C.P.)
- Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Carmelle Peisah
- Master of Science (Mental Health), Graduate School, Chiang Mai University, Chiang Mai 50200, Thailand; (T.Y.); (T.W.); (C.S.); (R.J.); (C.P.)
- Discipline of Psychiatry and Mental Health, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
- Specialty of Psychiatry, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
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Li G, Zhao D, Wang Q, Zhou M, Kong L, Fang M, Li P. Infertility-related stress and quality of life among infertile women with polycystic ovary syndrome: Does body mass index matter? J Psychosom Res 2022; 158:110908. [PMID: 35421758 DOI: 10.1016/j.jpsychores.2022.110908] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 03/24/2022] [Accepted: 04/03/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Infertility and obesity are common among women with Polycystic ovary syndrome (PCOS) and related to poor quality of life (QoL). Obesity may confer an elevated adverse effect of infertility-related stress given its relationship with increased susceptibility to stress. This study aimed to investigate the association of infertility-related stress with QoL among infertile women with PCOS, and to evaluate whether body mass index (BMI) modifies this association. METHODS A cross-sectional study was conducted with 306 participants recruited from the infertility outpatient clinic. A self-administered, structured questionnaire including COMPI Fertility Problem Stress Scale (COMPI-FPSS) and the modified PCOS health-related QoL questionnaire (MPCOSQ) was conducted in this study. The moderation model was conducted by the PROCESS macro using SPSS. RESULTS The mean score of QoL was 142.67 (SD = 20.11), ranged from 93 to 183 (theoretical range = 30-210). QoL was negatively associated with infertility-related stress (r = -0.373, P < 0.001). Moderation analysis indicated that the interaction term between infertility-related stress and BMI significantly predicted QoL (β = -0.154, P = 0.005, f2 = 0.03) as well as emotional disturbance (β = -0.170, P = 0.002, f2 = 0.04). Specifically, higher BMI significantly exacerbated the effect of infertility-related stress on QoL and emotional disturbance. CONCLUSION Infertile women with PCOS experienced poor QoL. The moderation role of BMI provides a better understanding of individual difference in relationship between infertility-related stress and QoL. Interventions aiming to improve QoL among infertile women with PCOS should focus on alleviating infertility-related stress, especially among women with high BMI.
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Affiliation(s)
- Guopeng Li
- Department of Health Psychology, School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, 44 Wenhua West Road, Jinan, Shandong 250012, PR China
| | - Di Zhao
- Department of Health Psychology, School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, 44 Wenhua West Road, Jinan, Shandong 250012, PR China
| | - Qing Wang
- Department of Health Psychology, School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, 44 Wenhua West Road, Jinan, Shandong 250012, PR China
| | - Miao Zhou
- Department of Health Psychology, School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, 44 Wenhua West Road, Jinan, Shandong 250012, PR China
| | - Linghua Kong
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Mei Fang
- Center for reproductive medicine, Shandong University, Jingliu Road, Shizhong District, Jinan, Shandong 250000, PR China
| | - Ping Li
- Department of Health Psychology, School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, 44 Wenhua West Road, Jinan, Shandong 250012, PR China.
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The associations between infertility-related stress, family adaptability and family cohesion in infertile couples. Sci Rep 2021; 11:24220. [PMID: 34930989 PMCID: PMC8688530 DOI: 10.1038/s41598-021-03715-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 12/01/2021] [Indexed: 12/15/2022] Open
Abstract
To explore the association between infertility-related stress, family adaptability and family cohesion in infertile couples and the determinants of infertility-related stress in infertile couples. Fertility Problem Inventory (FPI) and Family Adaptability and Cohesion Evaluation Scales (FACESII-CV) were used to measure the infertility-related stress and family adaptability and cohesion of infertile couples. T-test, ANOVA and multiple comparisons (LSD) were conducted to compare the FPI scores of different demographic characteristics subgroups. Stepwise multivariate linear regression was used to explore the determinants of infertility-related stress. Women had greater global stress than men (P < 0.001). Women scored higher on desired family adaptability, cohesion dissatisfaction and adaptive dissatisfaction than men (P = 0.039, P = 0.036, P = 0.008). FPI scores were higher in men and women who lived in rural (P < 0.001, P < 0.001). Family cohesion and education level was negatively correlated with infertility-related stress in men. Family adaptability and education level was negatively correlated with infertility-related stress in women. Healthcare providers should pay more attention and give more support to infertile couples who lived in rural or with low education level, and provide easier medical accessing for them. Moreover, healthcare providers should value more the family function and family support in intervention of reducing infertility-related stress.
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Chamorro PP, Herruzo J, Pino MJ. Study on the Interdependent Relationship between the Marital Satisfaction Variable and the Psychosocial Impact of Infertility and Anxiety Disposition, According to Gender. JOURNAL OF SEX & MARITAL THERAPY 2021; 48:461-474. [PMID: 34873994 DOI: 10.1080/0092623x.2021.2008074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This study assessed the relationship between the marital satisfaction variable and the psychosocial impact of infertility and anxiety disposition, testing for possible gender-based differences. Comparisons performed on 87 couples did reveal differences and analyses disclosed that depression, anxiety and quality of life can influence the assessment each partner makes of their relationship, through an interdependent process. One partner's marital satisfaction can be influenced by those variables in the other partner. These findings indicate that psychosocial care for infertile couples must involve both partners and that they should be made aware of the effect of interdependence on marital satisfaction.
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Affiliation(s)
| | - Javier Herruzo
- Department of Psychology, University of Cordoba, Cordoba, Spain
| | - Maria J Pino
- Department of Psychology, University of Cordoba, Cordoba, Spain
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Yüksekol ÖD, Baltaci N, Yilmaz AN, Ulucan M. Perception of genital self-image, sexual quality of life and marital adjustment in infertile women. SEXUAL AND RELATIONSHIP THERAPY 2021. [DOI: 10.1080/14681994.2021.1998422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Özlem Doğan Yüksekol
- Department of Midwifery, Faculty of Health Sciences, Firat University, Elazig, Turkey
| | - Nazli Baltaci
- Department of Nursing, Faculty of Health Sciences, Ondokuz Mayis University, Samsun, Turkey
| | - Ayşe Nur Yilmaz
- Department of Midwifery, Faculty of Health Sciences, Firat University, Elazig, Turkey
| | - Mihriban Ulucan
- Department of Midwifery, Faculty of Health Sciences, Firat University, Elazig, Turkey
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13
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Vioreanu AM. Psychological Impact of Infertility. Directions for the Development of Interventions. Ment Health (Lond) 2021. [DOI: 10.32437/mhgcj.v4i1.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction: Infertility represents a major health problem that oftentimes is experienced as a crisis situation. Because it interposes with achieving an important life goal, that of having children, its implications on the psycho-emotional level are robust.
Purpose: The present article aimed at exploring the multidimensional effects of infertility on mental health, as well as suitable psychological intervention strategies for patients both at an individual and couple level.
Methodology: An extensive literature review was conducted to select the most relevant information. Articles included were searched in PubMed, Google Scholar and other similar databases within a seven years interval (2014-2021) to assure the up-to-date quality of the paper. The main criteria of inclusion were: studies about the consequences of infertility on mental health, epidemiology, risk and protective factors, psychological models for infertility, psychological evaluation, established instruments, psycho-social and therapeutic interventions, intervention protocols used in public health for infertility patients.
Results and Discussion: Infertility is often experienced as a crisis situation, in which the most common consequences are visible at the level of mood disorders (e.g. anxiety, depression, marked distress) and at the social level (stigma, divorce, social isolation, financial difficulties). Psychological counseling is needed throughout medical treatment and therapeutic interventions (e.g. cognitive-behavioral therapy) have shown favorable results in managing the emotional balance of the individual/couple and reducing the risk of psychopathology.
Conclusions: Research highlights the beneficial effects of psychological interventions on reducing levels of stress related to infertility, anxiety and depressive symptoms and on improving the quality of life and couple dynamics
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Cui C, Wang L, Wang X. Effects of Self-Esteem on the Associations Between Infertility-Related Stress and Psychological Distress Among Infertile Chinese Women: A Cross-Sectional Study. Psychol Res Behav Manag 2021; 14:1245-1255. [PMID: 34408509 PMCID: PMC8364430 DOI: 10.2147/prbm.s326994] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 08/04/2021] [Indexed: 11/23/2022] Open
Abstract
Background Anxiety and depression are the most common psychological causes of distress in infertile women. Our study aimed to evaluate the prevalence of depression and anxiety and investigate the effects of self-esteem on the association of infertility-related stress with depression and anxiety among infertile women. Methods This study was conducted between December 2017 and May 2018. Questionnaires containing Fertility Problem Inventory (FPI), Rosenberg self-esteem scale (RSES) and Hospital Anxiety and Depression Scale (HADS) were distributed among 536 female infertility patients in Shenyang, China. Hierarchical linear regression analyses were used to examine the mediating and moderating role of self-esteem. Baron and Kenny’s technique, asymptotic, and resampling strategies were used to confirm the mediating role of self-esteem on the associations between infertility-related stress with depression and anxiety. Results The prevalence of depression and anxiety was 27.9% and 42.2% among Chinese female infertility patients, respectively. Infertility-related stress was positively associated with depression and anxiety, whereas self-esteem was negatively associated with depression and anxiety. Additionally, the effects of infertility-related stress on depression and anxiety gradually decreased along with an increase in self-esteem. Meanwhile, self-esteem partially mediated the associations between infertility-related stress with depression and anxiety. Conclusion A high prevalence of psychological distress was found among infertile women. Self-esteem mediated and moderated the effects of infertility-related stress on depression and anxiety. Additionally, infertility-related stress and self-esteem were associated with psychological distress, which explained why infertile women had a higher prevalence of depression and anxiety. Therefore, interventions that focus on self-esteem may be effective and should be used as a resource to combat mental health problems.
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Affiliation(s)
- ChunYing Cui
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang North New Area, Shenyang, Liaoning, 110122, People's Republic of China
| | - Lie Wang
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang North New Area, Shenyang, Liaoning, 110122, People's Republic of China
| | - XiaoXi Wang
- Medical Basic Experimental Teaching Center, China Medical University, Shenyang North New Area, Shenyang, Liaoning, 110122, People's Republic of China
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Han Z, Tang X, Li X, Shen Y, Li L, Wang J, Chen X, Hu Z. COVID-19-Related Stressors and Mental Health Among Chinese College Students: A Moderated Mediation Model. Front Public Health 2021; 9:586062. [PMID: 34222162 PMCID: PMC8253361 DOI: 10.3389/fpubh.2021.586062] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 05/24/2021] [Indexed: 12/31/2022] Open
Abstract
This study aims to examine the relation between COVID-19-related stressors and mental health among Chinese college students during the pandemic outbreaks, and the possible mediator or moderator between them. Five hundred and fifty Chinese college students were invited to complete an anonymous survey, and the data were analyzed with SPSS 16.0 software. The results shows that the number of stressors has a negative direct and indirect (through risk perception of being infected with COVID-19 disease) impacts on college students' mental health. Adaptive coping is a protective factor of students' mental health, and could be regarded as a buffer that attenuates the negative effect of the COVID-19-related stressors on risk perception of being infected with COVID-19 disease (or mental health). With regard to demographic variables, females, junior and senior students, or students whose family residence was worst hit by the pandemic tend to report poorer mental health during the pandemic outbreak. These findings enrich our understanding about the impact of the COVID-19 pandemic on college population and have implications for university counseling services during times of acute, large-scale infective disease outbreaks.
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Affiliation(s)
- Zaichao Han
- College of Life Sciences, Jiangxi Normal University, Nanchang, China
| | - Xiujuan Tang
- School of Psychology, Jiangxi Normal University, Nanchang, China
| | - Xiaoshan Li
- School of Psychology, Jiangxi Normal University, Nanchang, China.,Center of Mental Health Education and Research, School of Psychology, Jiangxi Normal University, Nanchang, China
| | - Youtian Shen
- School of Psychology, Jiangxi Normal University, Nanchang, China
| | - Li Li
- School of Psychology, Jiangxi Normal University, Nanchang, China
| | - Jingjing Wang
- School of Psychology, Jiangxi Normal University, Nanchang, China
| | - Xiaowei Chen
- School of Psychology, Jiangxi Normal University, Nanchang, China
| | - Zhijun Hu
- School of Psychology, Jiangxi Normal University, Nanchang, China
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Liu Y, Zhang Y, Ding Y, Chen G, Zhang X, Wang Y, Hua K. Clinical applications of uterus transplantation in China: Issues to take into consideration. J Obstet Gynaecol Res 2020; 46:357-368. [PMID: 31997549 DOI: 10.1111/jog.14199] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 12/31/2019] [Indexed: 01/02/2023]
Affiliation(s)
- Yu Liu
- Department of GynecologyThe Obstetrics and Gynecology Hospital of Fudan University Shanghai China
| | - Ying Zhang
- Department of GynecologyThe Obstetrics and Gynecology Hospital of Fudan University Shanghai China
| | - Yan Ding
- Department of GynecologyThe Obstetrics and Gynecology Hospital of Fudan University Shanghai China
| | - Gaowen Chen
- Department of Obstetrics and GynecologyZhujiang Hospital, Southern Medical University Guangzhou China
| | - Xuyin Zhang
- Department of GynecologyThe Obstetrics and Gynecology Hospital of Fudan University Shanghai China
| | - Yifeng Wang
- Department of Obstetrics and GynecologyZhujiang Hospital, Southern Medical University Guangzhou China
| | - Keqin Hua
- Department of GynecologyThe Obstetrics and Gynecology Hospital of Fudan University Shanghai China
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Pozza A, Dèttore D, Coccia ME. Depression and Anxiety in Pathways of Medically Assisted Reproduction: The Role of Infertility Stress Dimensions. Clin Pract Epidemiol Ment Health 2019; 15:101-109. [PMID: 31819758 PMCID: PMC6882134 DOI: 10.2174/1745017901915010101] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 08/04/2019] [Accepted: 08/05/2019] [Indexed: 11/25/2022]
Abstract
Background: Depressive and anxious symptoms are common psychological reactions to infertility and Medically Assisted Reproduction (MAR). No study compared depressive and anxious symptoms and infertility stress dimensions across homologous and heterologous MAR, nor explored the specific role of the infertility stress dimensions in the two pathways. Homologous MAR may be associated with higher distress as the couple feel that the responsibility to reproduce and carry on the family line falls on them, and they feel inadequate if they are unable to bear children. Objective: We compared depressive/anxious symptoms and infertility stress dimensions between individuals undergoing homologous and heterologous MAR. We also explored the association between the infertility stress dimensions and depressive/anxious symptoms separately in two MAR pathways. Methods: Two-hundred twenty-six individuals participated [mean age = 39.71 years; 54.45% women]: 118 (52.2%) in homologous and 108 (47.8%) in heterologous MAR. The Fertility Problem Inventory, Beck Depression Inventory-II, and State and Trait Anxiety Inventory-Y form were administered. Results: Individuals in homologous MAR had higher depressive/state-trait anxious symptoms, general infertility stress, and infertility-related sexual concerns than those in heterologous MAR. In homologous MAR, social and sexual concerns were associated with depressive/trait anxious symptoms while gender had no effect. In heterologous MAR, male gender was associated with lower state anxious symptoms while infertility stress dimensions had no effect. Conclusion: Individuals in homologous MAR are a more distressed subgroup which requires a tailored supportive psychological intervention specifically on sexual and social concerns.
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Affiliation(s)
- Andrea Pozza
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Davide Dèttore
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Maria Elisabetta Coccia
- Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, Italy
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