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Shen Q, Wang B, He T, Li S, Peng EN, Lei J. Factors associated with discontinuation in fertility treatment: a systematic scoping review. J Assist Reprod Genet 2024; 41:409-421. [PMID: 37987953 PMCID: PMC10894784 DOI: 10.1007/s10815-023-02982-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: 07/26/2023] [Accepted: 10/23/2023] [Indexed: 11/22/2023] Open
Abstract
PURPOSE The discontinuation of fertility treatment could decrease the chances of achieving parenthood for infertile patients and often leads to economic loss and medical resource waste. However, the evidence on the factors associated with discontinuation is unclear and inconsistent in the context of fertility treatment. This scoping review aimed to summarize the evidence on factors associated with discontinuation in fertility treatment, identify the current knowledge gap, and generate recommendations for future research. METHODS We searched PubMed, Embase, The Cochrane Library, Web of Science, CINAHL, American Psychological Association, and http://clinicaltrials.gov from inception to June 2023 without language or time restrictions. We also searched the grey literature in Open Grey and Google Scholar and hand-searched the reference lists of relevant studies to identify potentially eligible studies. Publications that studied factors associated with discontinuation in fertility treatment were included. The identified factors were mapped to the World Health Organization's treatment adherence model. RESULTS Thirty-seven articles involving 41,973 infertile patients from 13 countries were included in this scoping review. All studies identified the factors from the perspective of patients, except for one that described the factors from the healthcare providers' perspective. A total of 42 factors were identified, with most of them belonging to the patient-related dimension, followed by socio-economic-related, treatment-related, condition-related, and healthcare system-related dimensions. Female education level, social support, and insurance coverage decreased the likelihood of treatment discontinuation, whereas multiparous women, male infertility, depression, higher infertility duration, and treatment duration increased the likelihood of treatment discontinuation. Age, education level, and ethnicity are the commonly nonmodifiable factors for treatment discontinuation, while insurance coverage, depression, and anxiety symptoms are among some of the more commonly reported modifiable factors. CONCLUSION This is the first scoping review examining and synthesizing evidence on the factors influencing of discontinuation in fertility treatment. This review could inform researchers, clinicians, and policymakers to address modifiable barriers and facilitators to develop personalized and multicomponent interventions that could improve the discontinuation in fertility treatment.
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Affiliation(s)
- Quan Shen
- Department of Gynecology and Obstetrics of The Third XiangYa Hospital of Central South University, No138, Tongzipo Road, Changsha, 410013, Hunan Province, China
- Department of Reproductive Center of The Third XiangYa Hospital of Central South University, Changsha, Hunan Province, China
- Xiangya Nursing School of Central South University, Changsha, Hunan Province, China
| | - Binglu Wang
- Xiangya Nursing School of Central South University, Changsha, Hunan Province, China
| | - Tan He
- Xiangya Nursing School of Central South University, Changsha, Hunan Province, China
| | - Suya Li
- Tongji Hospital of HuaZhong University of Science and Technology, Wuhan, Hubei Province, China
| | - ENuo Peng
- Department of Reproductive Center of The Third XiangYa Hospital of Central South University, Changsha, Hunan Province, China
| | - Jun Lei
- Department of Gynecology and Obstetrics of The Third XiangYa Hospital of Central South University, No138, Tongzipo Road, Changsha, 410013, Hunan Province, China.
- Department of Reproductive Center of The Third XiangYa Hospital of Central South University, Changsha, Hunan Province, China.
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Ghorbani M, Hoseini FS, Yunesian M, Salehin S, Talebi SS, Keramat A. A supportive randomized clinical trial on Iranian infertile women with the history of infertility treatments dropout following unsuccessful ART cycle/s: A study protocol. Heliyon 2023; 9:e13838. [PMID: 36879964 PMCID: PMC9984792 DOI: 10.1016/j.heliyon.2023.e13838] [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: 07/16/2022] [Revised: 12/27/2022] [Accepted: 01/23/2023] [Indexed: 02/19/2023] Open
Abstract
Introduction Due to high dropout rate of infertility treatments and lack of any intervention for motivating infertile couples to continue treatments, the present study will be conducted with the aim of designing, implementing and determining the effectiveness of the proposed intervention in order to continue infertility treatments. Methods & Analysis: We will conduct this study in two stages; a review of literature and past studies will be done to identify interventions that have been performed for infertile couples, and then an appropriate intervention with the aim of continuing infertility treatments for infertile women will be designed. After that a Delphi study will be designed in accordance with collected information of previous stages and will be approved by experts. In the second stage we will implement designed intervention of a randomized clinical trial on two groups of infertile women (control and intervention) with the history of infertility treatment dropout following unsuccessful cycle. We will use descriptive statistic in first and second stage. In second stage Chi square test and independent samples T test will be used to compare variables between groups and variables in study questionnaires before and after the intervention between two groups of study. Discussion The present study will be the first study to be performed as a clinical trial on infertile women who have discontinued the treatments, with the aim of continuing treatments. Thereupon, it seems that the results of this study will be the basis for studies around the world to prevent premature cessation of infertility treatments.
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Affiliation(s)
- Maryam Ghorbani
- Student Research Committee, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Fatemeh Sadat Hoseini
- Faculty Member of School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
| | - Masud Yunesian
- School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahrbanoo Salehin
- Sexual Health and Fertility Research center. Shahroud University of Medical sciences. Shahroud. Iran
| | - Seyedeh Solmaz Talebi
- Department of Epidemiology, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Afsaneh Keramat
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
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3
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Sousa E, Nery SF, Casalechi M, Thimóteo LC, Paiva SP, Silva-Filho AL, Reis FM. Characteristics, prevalence and sources of stress in individuals who discontinue assisted reproductive technology treatments: a systematic review. Reprod Biomed Online 2023; 46:819-825. [PMID: 36907754 DOI: 10.1016/j.rbmo.2023.01.020] [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: 12/29/2022] [Accepted: 01/24/2023] [Indexed: 02/04/2023]
Abstract
By considering the reasons behind discontinuing assisted reproductive technology (ART) treatment, several studies have indicated that 'stress' is an important issue, but the prevalence of stressors and stress responses, either acute or chronic, remains unclear. In this systematic review, we evaluated the characteristics, prevalence and causes of what was perceived and reported as 'stress' by couples who discontinued ART treatment. Electronic databases were systematically searched, and studies were considered eligible if they evaluated stress as a possible reason for ART discontinuation. Twelve studies were included, with 15,264 participants from eight countries. In all studies, 'stress' was assessed through generic questionnaires or medical records, not by validated stress questionnaires or biomarkers. The prevalence of 'stress' ranged from 11-53%. When the results were pooled, 'stress' was cited as a reason for ART discontinuation by 775 out of 2507 participants (30.9%). Clinical factors associated with worse prognosis, physical discomfort due to treatment procedures, family demands, time pressure and economic burden were identified as sources of 'stress' that contributed to ART discontinuation. Precisely knowing the characteristics of the stress associated with infertility is essential to devise preventive or supportive interventions to help patients to cope and endure the treatments. Further studies are necessary to investigate whether the mitigation of stress factors can reduce ART discontinuation rates.
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Affiliation(s)
- Elaine Sousa
- Division of Human Reproduction, Department of Obstetrics and Gynaecology; Hospital das Clínicas, UFMG, Av. Alfredo Balena, 110, 9˚ Andar, 30130-100 Belo Horizonte, MG, Brazil
| | - Simone F Nery
- Division of Human Reproduction, Department of Obstetrics and Gynaecology; Hospital das Clínicas, UFMG, Av. Alfredo Balena, 110, 9˚ Andar, 30130-100 Belo Horizonte, MG, Brazil
| | - Maíra Casalechi
- Division of Human Reproduction, Department of Obstetrics and Gynaecology; Hospital das Clínicas, UFMG, Av. Alfredo Balena, 110, 9˚ Andar, 30130-100 Belo Horizonte, MG, Brazil
| | - Luiz C Thimóteo
- Division of Human Reproduction, Department of Obstetrics and Gynaecology; Hospital das Clínicas, UFMG, Av. Alfredo Balena, 110, 9˚ Andar, 30130-100 Belo Horizonte, MG, Brazil
| | - Sara Pc Paiva
- Division of Human Reproduction, Department of Obstetrics and Gynaecology; Hospital das Clínicas, UFMG, Av. Alfredo Balena, 110, 9˚ Andar, 30130-100 Belo Horizonte, MG, Brazil
| | - Agnaldo L Silva-Filho
- Division of Human Reproduction, Department of Obstetrics and Gynaecology; Hospital das Clínicas, UFMG, Av. Alfredo Balena, 110, 9˚ Andar, 30130-100 Belo Horizonte, MG, Brazil
| | - Fernando M Reis
- Division of Human Reproduction, Department of Obstetrics and Gynaecology; Hospital das Clínicas, UFMG, Av. Alfredo Balena, 110, 9˚ Andar, 30130-100 Belo Horizonte, MG, Brazil.
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Ghorbani M, Hoseini FS, Yunesian M, Salehin S, Keramat A, Nasiri S. A systematic review and meta-analysis on dropout of infertility treatments and related reasons/factors. J OBSTET GYNAECOL 2022; 42:1642-1652. [DOI: 10.1080/01443615.2022.2071604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Maryam Ghorbani
- Student Research Committee, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Fatemeh Sadat Hoseini
- Faculty Member of School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
| | - Masud Yunesian
- School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahrbanoo Salehin
- Sexual Health and Fertility Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Afsaneh Keramat
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Saeideh Nasiri
- Department of Midwifery, School of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran
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Ghorbani M, Hosseini FS, Yunesian M, Keramat A. Dropout of infertility treatments and related factors among infertile couples. Reprod Health 2020; 17:192. [PMID: 33267894 PMCID: PMC7709385 DOI: 10.1186/s12978-020-01048-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 11/22/2020] [Indexed: 11/23/2022] Open
Abstract
Background Dropout of infertility treatments is a global issue and many factors play role in this phenomenon. It is one of the most challenges in life of infertile couples. The purpose of this study was to determine dropout rate and related factors/reasons in the world and in Iran. Methods We will conduct a mixed method study with sequential exploratory design (systematic review, qualitative and quantitative phase). In the first stage a systematic review on dropout rate of infertility treatments and related factors will be done. In second stage (quantitative–qualitative study), a retrospective cohort study will be conducted on infertile couples to determine dropout rate of infertility treatments. The follow-up period to assess the discontinuation of treatment in patients, who have discontinued the treatment, will be considered 6 months after the treatment cessation. Data would be analyzed by descriptive statistics. We want to determine proportion and percentage of discontinuation rate among different groups with different causes of infertility. Then, we also will use Chi-square test to compare discontinuation rates among these groups. In qualitative section of second stage, semi-structured interviews would be performed with infertile female who had the history of infertility treatments failure. In this stage, participants will be selected using purposeful sampling method with maximum variation in terms of age, education, occupation, type of infertility, type of treatments, number of unsuccessful treatment and infertility duration. Data would be analyzed using conventional content analysis. Discussion Determining dropout rate and its related factors/reasons would be helpful for future studies to plan suitable interventions for supporting infertile couples. It also helps politicians to have a better understanding of infertility and its consequences on infertile couple’s life. Plain English Summary In today’s world, infertility is a common phenomenon due to postponement of childbearing following the older age of marriage, tendency to reach higher educational level, economical problems and etc. Infertility brings many challenges and stresses to the individuals by itself and it is very hard to cope with. The problem gets worse, when it is associated with failure in treatments. Many of infertile couples cannot tolerate this failure and may decide to discontinue treatments before achieving pregnancy for ending many stressors which are associated with treatments. As we know, childbearing and having at least one child has important position in some societies such as Iranian culture; so ending the treatment before achieving optimal result may have some adverse consequences in the families such as divorce, remarriage, family conflicts, et. Absolutely many factors play role in dropout of infertility treatments, and many studies around the world have suggested many factors/reasons in dropout of infertility treatments, but there are still many gaps about this subject, especially among Iranian society. This study would be conducted in three consecutive stages, in the first stage; we will do a complete review of existing studies of the world to find out related factors/reasons of dropout in detail. In second stage, dropout rate of infertile couples (380 couples) after at least one unsuccessful cycle of treatment would be achieved by assessing medical records and telephone interview. Data of the first and second stage will help us to have better vision about the issue of dropout and would be used to construct a semi structured interview for the last stage. And finally in the third stage, reasons of dropout would be asked by an in depth interview from infertile couples. We hope the information from this study will help politicians better understand and plan for dropout of treatment.
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Affiliation(s)
- Maryam Ghorbani
- Student Research Committee, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | | | - Masud Yunesian
- School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Afsaneh Keramat
- Reproductive Studies and Women's Health Research Center, Shahroud University of Medical Sciences, Shahroud, Iran.
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6
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Saadati N, Nikbakht R, Sattari A, Amininezhad FS. Spontaneous pregnancies and determinant factors in infertility: A cross-sectional study. Int J Reprod Biomed 2020; 18:905-910. [PMID: 33134803 PMCID: PMC7569715 DOI: 10.18502/ijrm.v13i10.7775] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 09/14/2019] [Accepted: 05/17/2020] [Indexed: 11/24/2022] Open
Abstract
Background The phenomenon of infertility may be derived from different factors - either in males or females or both genders, including few unexplained factors. It is generally managed by medical and surgical treatments. Objective To find a relation of occurrence of spontaneous pregnancy (SP) with effective factors in infertility. Materials and Methods This cross-sectional study was conducted at two referral infertility centers (university and privacy center) in the southwest of Iran from March 2015 and March 2016 on 655 infertile couples, who were divided in two groups of with (n = 31) and without (n = 624) SP. The variables included female and male age, male smoking, male job, the place of living, the causes of infertility, the type and duration of infertility, and the subgroups of infertility causes. Results Infertility may be caused due to both male- and female- related factors (47.5%). While female-related infertility was found in 31.5%, male-related infertility in 14.5%, and infertility due to unexplained factors in 6.6% of our patients. The rate of SP was 4.7%, which had a significant relation with the duration of infertility (p = 0.01), with women's age (p = 0.048), unexplained infertility (p = 0.001), and husband's job (p = 0.004). Conclusion The occurrence of SP in infertile couples was related to age of the female partner, the duration of unexplained infertility, and the male partner's job.
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Affiliation(s)
- Nasrin Saadati
- Department of Community Medicine, School of Medicine, Fertility Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Roshan Nikbakht
- Department of Obstetrics and Gynecology, Fertility Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Alireza Sattari
- Fertility Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Fatemeh Sadat Amininezhad
- Fertility Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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ElMokhallalati Y, van Eekelen R, Bhattacharya S, McLernon DJ. Treatment-independent live birth after in-vitro fertilisation: a retrospective cohort study of 2,133 women. Hum Reprod 2020; 34:1470-1478. [PMID: 31306480 DOI: 10.1093/humrep/dez099] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 04/29/2019] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION What is the chance of a treatment-independent live birth following IVF (including ICSI) treatment? SUMMARY ANSWER Over 5 years of follow-up, the treatment-independent live birth rate was 17% in unsuccessfully treated women and 15% in those who had a live birth after IVF. WHAT IS KNOWN ALREADY A limited number of studies have investigated the chance of treatment-independent conception following completion of IVF, but most of them have been based on surveys with poor response rates and limited sample sizes. STUDY DESIGN, SIZE, DURATION This is a population-based, retrospective cohort study of 2133 women who received IVF treatment between 1998 and 2011 at a single regional IVF Unit and were followed for a minimum of 1 year and maximum of 15 years after their last IVF or ICSI treatment cycle. PARTICIPANTS/MATERIALS, SETTING, METHODS This study included all women, residing in the north-east of the UK, who attended the Aberdeen Fertility Clinic and received IVF treatment between 1998 and 2011. Clinical and diagnostic information of all women was linked with treatment and pregnancy outcome data. A total of 2133 women were divided into two groups: (i) those who achieved a live birth following successful IVF or ICSI treatment (n = 1060) and (ii) those in whom treatment was unsuccessful i.e. resulted in either no pregnancy or pregnancy loss (n = 1073). The two groups were followed from the date of the last embryo transfer until the first treatment-independent live birth or 31 December 2012, whichever came first. The primary outcome was the treatment-independent live birth rate at 1, 2.5, 5 and 10 years of follow-up. Cox regression was used to determine factors associated with treatment-independent live birth in each group. MAIN RESULTS AND THE ROLE OF CHANCE Within 5 years of follow-up, the treatment-independent live birth rate was 17% (95% CI, 15-19%) among women whose IVF or ICSI treatment was unsuccessful and 15% (95% CI, 12-17%) among women whose treatment resulted in live birth. In both groups, shorter duration of infertility, younger female age and IVF as compared to ICSI were associated with a higher chance of achieving treatment-independent live birth. Among unsuccessfully treated women, the chance of post-IVF live birth was reduced in those with tubal factor infertility. Three or more previous IVF or ICSI embryo transfers were associated with a lower chance of treatment-independent live birth among successfully treated women. LIMITATIONS, REASONS FOR CAUTION The study was conducted in a single fertility centre, which could compromise the generalizability of the findings. Moreover, data were unavailable on the women's use of contraception or active attempts to get pregnant, both of which could influence treatment-independent live birth rates. WIDER IMPLICATIONS OF THE FINDINGS This study provides a better understanding of the long-term prognosis for treatment-independent live birth after completion of IVF or ICSI treatment. The results will inform women of their chances of a treatment-independent live birth following failed or successful treatment and the factors that are associated with it. STUDY FUNDING/COMPETING INTEREST(S) This work was funded by a Chief Scientist Office Postdoctoral Training Fellowship in Health Services Research and Health of the Public Research (Ref PDF/12/06). The views expressed here are those of the authors and not necessarily those of the Chief Scientist Office. The authors have no competing interests. TRIAL REGISTRATION NUMBER Not applicable.
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Affiliation(s)
- Yousuf ElMokhallalati
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Polwarth Building, Aberdeen, UK
| | - Rik van Eekelen
- Centre for Reproductive Medicine, Academic Medical Centre, Meibergdreef 9, Amsterdam, The Netherlands
| | - Siladitya Bhattacharya
- Institute of Applied Health Sciences, University of Aberdeen, Polwarth Building, Aberdeen, UK
| | - David J McLernon
- Medical Statistics Team, Institute of Applied Health Sciences, University of Aberdeen, Polwarth Building, Aberdeen, UK
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Morshed-Behbahani B, Lamyian M, Joulaei H, Montazeri A. Analysis and exploration of infertility policies in Iran: a study protocol. Health Res Policy Syst 2020; 18:5. [PMID: 31941503 PMCID: PMC6961321 DOI: 10.1186/s12961-019-0505-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Accepted: 11/07/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Infertility is a complex and neglected reproductive health issue of global proportions, with varying effects on couples and their relationships. Therefore, international organisations and several countries have been compelled to consider infertility policies. In recent years, a shift in population policy trends toward increasing birth rates in Iran have set infertility policies in the health sector's agenda. Since infertility and its associated problems are multifactorial, all health systems, including that of Iran, need to have a comprehensive policy package that covers all of its dimensions. Policy analysis is necessary to formulate such policies. This project will therefore analyse the infertility policies in Iran's health sector and clarify the multilateral effects of their different components. METHODS This multidisciplinary study outlines the conceptual framework of infertility policies and consists of three stages. Stage I will involve the review of infertility policies in selected countries and Iran for the operational model of infertility programmes, rules and policies. Stage II will consist of a documentary infertility policy analysis of Iran. At this stage, Iran's infertility policies will be analysed using the Walt and Gilson framework in four areas, namely content, context, process and actors. Stage III will involve the analysis of infertility policies in Iran. At this stage, a qualitative study will be conducted to understand and provide in-depth explanations of the existing policies. Finally, the concepts and outcomes obtained from the first stage will be combined with the content of the qualitative analysis of the second and third stages for exploration of Iran's infertility policies, and a package including a framework for infertility policies will be proposed. DISCUSSION The findings of this study can be used by the Ministry of Health and public health policy-makers to determine which policies, in view of socio-cultural and economic contexts and actors' roles in each country, can be used to reach the goals defined by international organisations, on the prevention of infertility and reproductive health.
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Affiliation(s)
- Bahar Morshed-Behbahani
- Department of Reproductive Health and Midwifery, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Minoor Lamyian
- Department of Reproductive Health and Midwifery, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Hassan Joulaei
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Montazeri
- Population Health Research Group, Health Metrics Research Center, Institute for Health Sciences Research, ACECR, Tehran, Iran
- Faculty of Humanity Sciences, University of Sciences & Culture, ACECR, Tehran, Iran
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9
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Ebrahimzadeh Zagami S, Latifnejad Roudsari R, Janghorban R, Mousavi Bazaz SM, Amirian M, Allan HT. Infertile Couples' Needs after Unsuccessful Fertility Treatment: a Qualitative Study. J Caring Sci 2019; 8:95-104. [PMID: 31249819 PMCID: PMC6589480 DOI: 10.15171/jcs.2019.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Accepted: 07/25/2018] [Indexed: 11/18/2022] Open
Abstract
Introduction: Infertility is a major medical issue. Investigations and treatment of infertility are the beginning of a complex, time-consuming and stressful process for couples that may fail well. The present study explored the needs of infertile couples following treatment failure with Assisted Reproductive Technologies (ARTs). Methods: A descriptive qualitative study was conducted in an Iranian infertility center, in the Northeast of the country between April 2016 and June 2017. The researchers recruited 29 individuals including 9 couples, 9 women and two men with primary infertility through purposive sampling. The data were collected using semi-structured interviews and analyzed iteratively, using conventional content analysis with MAXQDA software. Results: The main concepts obtained from the data were classified into one theme titled: ""The need for support"" and four main categories along with their subcategories, and included the need for psychological support, the need for more useful information, the need for social support and the need to access to supplementary services. Conclusion: The findings show that following treatment failure, the infertile patients’ expressed needs and preferences were not met. Identifying and meeting their needs may help the infertile couples to deal with ARTs failure and to reach a decision about future treatment.
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Affiliation(s)
| | - Robab Latifnejad Roudsari
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Research Center for Patient Safety, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Roksana Janghorban
- Community Based Psychiatric Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Mojtaba Mousavi Bazaz
- Department of Community Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maliheh Amirian
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Helen T Allan
- Department of Adult Child and Midwifery, School of Health and Education, Middlesex University, London, UK
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10
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Dodge LE, Sakkas D, Hacker MR, Feuerstein R, Domar AD. The impact of younger age on treatment discontinuation in insured IVF patients. J Assist Reprod Genet 2016; 34:209-215. [PMID: 27889867 DOI: 10.1007/s10815-016-0839-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 11/02/2016] [Indexed: 11/28/2022] Open
Abstract
PURPOSE This retrospective cohort study aimed to determine whether age influences treatment discontinuation among insured patients undergoing in vitro fertilization (IVF). We hypothesized that the youngest patients would be the least likely to discontinue treatment. METHODS All women age 18-42 who underwent their first fresh, non-donor IVF cycle from 2002 to 2013 were followed until a live birth was achieved, until they discontinued treatment at our center (not presenting for treatment for a one-year period), or until they completed six fresh or frozen embryo transfer cycles, whichever occurred first. RESULTS Of 11,361 women included, 4336 (38.2 %) discontinued treatment at our center before achieving a live birth or undergoing six IVF cycles. Discontinuation differed by age for cycles 2-4 (all P ≤ 0.004), with the proportion among women age 40-42 averaging 6-7 % higher than the other groups; discontinuation per cycle was similar among women <30 compared to women age 30-<35 and 35-<40. This continued in cycles 5 and 6, and in the sixth, 35.2, 32.0, 32.3, and 40.2 % of women among the four age groups discontinued treatment, respectively (P = 0.17). In cycles 2-5, women in the oldest two age groups with secondary infertility consistently discontinued treatment more frequently than those with primary infertility. CONCLUSIONS We found that women in the oldest age group were more likely to discontinue IVF treatment than younger women. Surprisingly, we found that the youngest women discontinued treatment in a similar fashion to women age 30-<40.
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Affiliation(s)
- Laura E Dodge
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, 330 Brookline Ave. KS 3, Boston, MA, 02215, USA.,Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, MA, USA
| | - Denny Sakkas
- Boston IVF, 130 2nd Ave., Waltham, MA, 02451, USA
| | - Michele R Hacker
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, 330 Brookline Ave. KS 3, Boston, MA, 02215, USA.,Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, MA, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave., Boston, MA, 02115, USA
| | | | - Alice D Domar
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, 330 Brookline Ave. KS 3, Boston, MA, 02215, USA. .,Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, MA, USA. .,Boston IVF, 130 2nd Ave., Waltham, MA, 02451, USA.
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Seven out of 10 couples treated by IVF achieve parenthood following either treatment, natural conception or adoption. Reprod Biomed Online 2016; 33:560-567. [DOI: 10.1016/j.rbmo.2016.08.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 08/03/2016] [Accepted: 08/03/2016] [Indexed: 11/22/2022]
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Dag H, Yigitoglu S, Aksakal BI, Kavlak O. The association between coping method and distress in infertile woman: A cross-sectional study from Turkey. Pak J Med Sci 2016; 31:1457-62. [PMID: 26870115 PMCID: PMC4744300 DOI: 10.12669/pjms.316.8605] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objectives: To assess the distress level in infertile women and their coping skills. Methods: One hundred and twenty-seven infertile women who had been referred to the Family Planning and Infertility Research and Practice Center (IRPC) of a university hospital to receive therapy between June 2012-2013 were enrolled in this study. Several surveys, including the “Infertile Woman Identification Form”, the “Infertility Distress Scale (IDS)” and the “Ways of Coping Inventory (WCI),” were used as data collection tools. Results: The mean age of the women who participated in the study was 32.34 ± 5.44. They had been on therapy for 3.95 ± 3.21 years and had been referred for therapy 2.73 ± 1.76 times. The mean score of the IDS was determined to be 37.0 ± 9.7 (23–66), and the mean score of the WCI subscale was 1.86 ± 0.55 (0.5-3.0). In the IDS and WCI subscales, statistically significant negative relationships were detected between “Optimism” (r=-0.327), “Seeking Social Support” (r=-0.255), and “Self-Confidence” (r=-0.305), whereas there were statistically significant positive relationships between “Helplessness” (r=0.376) and “Submissiveness” (r=0.278) (p<0.01). Conclusion: The women who developed negative coping strategies had higher infertility distress scores than other women.
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Affiliation(s)
- Hande Dag
- Dr. Hande Dag, PhD. Research Assistant, Adnan Menderes University, School of Health, Women's Health and Diseases Nursing Department, Aydin, Turkey
| | - Sayime Yigitoglu
- Sayime Yigitoglu, Msc. the Family Planning and Infertility Application & Research Center, Ege University Hospital, Izmir, Turkey
| | - Belgin Iyik Aksakal
- Belgin Iyik Aksakal, RN. the Family Planning and Infertility Application & Research Center, Ege University Hospital, Izmir, Turkey
| | - Oya Kavlak
- Oya Kavlak, Associate Professor, Women's Health and Diseases Nursing Department, Ege University Faculty of Nursing, Izmir, Turkey
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Arousell J, Carlbom A. Culture and religious beliefs in relation to reproductive health. Best Pract Res Clin Obstet Gynaecol 2015; 32:77-87. [PMID: 26542927 DOI: 10.1016/j.bpobgyn.2015.08.011] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 08/10/2015] [Accepted: 08/11/2015] [Indexed: 11/19/2022]
Abstract
An increasing number of contemporary research publications acknowledge the influence of religion and culture on sexual and reproductive behavior and health-care utilization. It is currently hypothesized that religious influences can partly explain disparities in sexual and reproductive health outcomes. In this paper, we will pay particular attention to Muslims in sexual and reproductive health care. This review reveals that knowledge about devout Muslims' own experience of sexual and reproductive health-care matters is limited, thus providing weak evidence for modeling of efficient practical guidelines for sexual and reproductive health care directed at Muslim patients. Successful outcomes in sexual and reproductive health of Muslims require both researchers and practitioners to acknowledge religious heterogeneity and variability, and individuals' possibilities to negotiate Islamic edicts. Failure to do so could lead to inadequate health-care provision and, in the worst case, to suboptimal encounters between migrants with Muslim background and the health-care providers in the receiving country.
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Affiliation(s)
- Jonna Arousell
- Department of Women's and Children's Health (IMCH), Uppsala University, Sweden.
| | - Aje Carlbom
- Faculty of Health and Society, Malmö University, Sweden
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Heredia M, Tenías JM, Rocio R, Amparo F, Calleja MA, Valenzuela JC. Quality of life and predictive factors in patients undergoing assisted reproduction techniques. Eur J Obstet Gynecol Reprod Biol 2013; 167:176-80. [PMID: 23347604 DOI: 10.1016/j.ejogrb.2012.12.011] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2012] [Revised: 08/28/2012] [Accepted: 12/13/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVES To evaluate the quality of life (QOL) of a cohort of women undergoing assisted reproduction techniques (ART), to compare two QOL questionnaires [Short Form 36 (SF36) and FertiQoL], and to identify the predictive factors related to QOL. STUDY DESIGN Women who received infertility medication from a hospital pharmacist during a one-year period were included in this study. Two standardized validated questionnaires - FertiQoL and SF36 - were used. Multivariate analyses were used to assess predictive factors for QOL. RESULTS Sixty-one women participated in this study. Median QOL scores ranged from 58 to 100. Comparisons between the two questionnaires revealed lower QOL scores when using FertiQoL. Most correlations between the questionnaires were positive, and significant for the majority of SF36 mental dimensions. The major predictors of QOL were: accompanied to the pharmacist's visit by partner, nationality, ART (in vitro fertilization or artificial insemination), employment status (employed or unemployed), tobacco consumption, age, number of cycles, infertility factor and treatment results (pregnancy, no pregnancy or treatment cancellation). CONCLUSIONS FertiQoL examines dimensions such as partner and social relationships. As such, it is recommended that FertiQoL should be used together with a short version of SF36 to investigate QOL among patients undergoing ART.
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Affiliation(s)
- M Heredia
- Hospital Pharmacy Service, La Mancha-Centro Hospital, Ciudad Real, Spain.
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