Evidence-Based Care for Couples With Infertility

Patient satisfaction with nursing care in infertility patients: A questionnaire survey

Infertility remains a persistent global reproductive health challenge, with causative factors encompassing abnormalities in both the male and female reproductive systems. Typically, female partners seek initial consultations for infertility concerns, often within the context of routine annual well-woman check-ups. Nurses providing preventive care play a crucial role, conducting initial diagnostic assessments, and addressing certain causes of infertility. Patient satisfaction serves as a vital indicator of care quality. Identifying factors contributing to patient satisfaction with nursing services is crucial, yet research in this area has been limited. This study aimed to compare infertility patients' assessments of nurse quality and satisfaction with hospital services. The findings could offer valuable insights for healthcare providers, hospitals, and policymakers, guiding improvements in nursing care delivery and enhancing patient satisfaction in China's infertility treatment sector. By understanding patients' perspectives and experiences, healthcare providers can make necessary adjustments to improve care quality and patient outcomes. The sample included 1200 patients, and data collection utilized a self-assessment questionnaire, with percentages employed for analysis. Nurses are integral to caring for infertility patients during visits and conducting research to advance fertility care practices.

Factors that affect career success of nurses who practice in assisted reproductive technology

to examine the relationship between career success and work environment of nurses who practice in assisted reproductive technology and to identify factors that affect career success. a cross-sectional study conducted in 53 fertility centres in 26 provinces in mainland China. Data were collected using a demographic data questionnaire, a specialised nursing competence questionnaire, the Career-Success Scale, and the Nursing Work Environment Scale. Descriptive and inferential statistics were applied. 597 assisted reproductive technology nurses participated in our survey, and 555 valid questionnaires were collected. Theoverall mean scores for career success and work environment were 3.75 [standard deviation (SD) = 1.01] and 3.42 (SD = 0.77) respectively. There was a strong positive correlation between career success and work environment (r = 0.742, p < 0.01). Multiple regression showed that attending academic conferences, psychological care, professional development, support and care, salary, and welfare were significant factors that influence career success. attending academic conferences, psychological care, and work environment are positively related to career success. Administrators should consider ways to address these factors.

Factors that affect career success of nurses who practice in assisted reproductive technology

to examine the relationship between career success and work environment of nurses who practice in assisted reproductive technology and to identify factors that affect career success. a cross-sectional study conducted in 53 fertility centres in 26 provinces in mainland China. Data were collected using a demographic data questionnaire, a specialised nursing competence questionnaire, the Career-Success Scale, and the Nursing Work Environment Scale. Descriptive and inferential statistics were applied. 597 assisted reproductive technology nurses participated in our survey, and 555 valid questionnaires were collected. Theoverall mean scores for career success and work environment were 3.75 [standard deviation (SD) = 1.01] and 3.42 (SD = 0.77) respectively. There was a strong positive correlation between career success and work environment (r = 0.742, p < 0.01). Multiple regression showed that attending academic conferences, psychological care, professional development, support and care, salary, and welfare were significant factors that influence career success. attending academic conferences, psychological care, and work environment are positively related to career success. Administrators should consider ways to address these factors.

Understanding the Effects of Disordered Eating on Fertility and Fertility Outcomes

Disordered eating and subthreshold eating disorders can affect fertility. A negative cumulative energy balance that occurs through inadequate nutrition and excessive exercise is often found in individuals engaging in disordered eating behaviors; these disruptions can affect the normal functioning of the hypothalamic-pituitary-gonadal axis and, thus, fertility. Appropriate screening; assessment; and medical, nutritional, and psychosocial interventions are needed to successfully treat these individuals. Educating nurses about the impact of disordered eating on fertility status will enable those who work with clients of reproductive age to better recognize signs and symptoms of disordered eating and to ultimately provide better care. This article addresses how to appropriately recognize and treat individuals presenting with infertility and disordered eating symptomatology.

Paramedical counselling in infertility treatment: its effects on anxio-depressive symptom severity, perceived stress and self-esteem

Aims

The importance of contributing psychological factors and stress-control in female infertility is well documented, but research on their role in male infertility is scarce. The present study aimed to evaluate the effects of a novel paramedical counselling on anxio-depressive symptom severity, perceived stress and self-esteem in infertile men participating in an infertility treatment programme.

Methods

Patients were recruited from clinics of University of Szeged, Hungary between 2019 May and 2020 December, and were sorted into control (n = 51) and experimental (n = 57) groups, where patients in the experimental group received a 5-session paramedical counselling in extension to their medical treatment. The levels of anxio-depressive symptom severity, perceived stress and self-esteem were measured prior to and after receiving paramedical counselling. The control group scored lower in regards of the severity of depressive symptom, and showed an increase of self-esteem, while the experimental group resulted in a significant decrease of anxio-depressive scores with the elevation of the level of self-esteem.

Results

Our results indicate that joining an infertility treatment programme alone had a positive role in reducing depressive symptoms and in the increase of self-esteem among infertile men, but receiving additional paramedical counselling throughout the treatment programme resulted in the decrease of anxio-depressive symptoms, besides the elevation of the level of self-esteem, with a significantly higher decrease in the state anxiety compared to not receiving this additional paramedical counselling.

Conclusions

Thus, it would be advisable for infertility treatment programmes to incorporate screening for psychological vulnerability and implement additional paramedical counselling to alleviate these confounding symptoms detrimental to conceiving.

Comparison of Hysterosalpingography With Laparoscopy in the Diagnosis of Tubal Factor of Female Infertility

Background: Laparoscopy is considered to be the gold standard in the evaluation of causes leading to infertility. Hysterosalpingography (HSG) permits indirect visualization of the cervical canal, uterine cavity, and tube patency, which is helpful for evaluating the causes of infertility.

Objective: This study aimed to detect tubal abnormalities in infertile women by HSG or laparoscopy and determine the value of HSG in diagnosing fallopian tube status.

Methods: The study group consisted of 1,276 patients. HSG was performed as a preliminary test for the evaluation of fallopian tube status. Women were subjected to laparoscopic examination on evidence of HSG abnormalities.

Results: The negative predictive value of HSG for detecting patency or occlusion for the right/left tube was 92.08 and 95.44%, respectively. The kappa values for the consistent diagnosis in the right/left tube were 0.470 and 0.574, respectively. In cases of low patency of the right/left tube, there was a greater than a 40% chance for the tube to be patent, and the remaining high probability was pelvic adhesion. The positive predictive value of HSG for detecting patency or occlusion for both tubes was 87.2%. The kappa value was 0.898 [95% CI (0.838, 0.937), p < 0.001], which meant that the diagnostic accuracy of HSG for both tube patency/occlusion was explicit. The kappa value for the diagnosis of hydrosalpinx (especially for bilateral tube hydrosalpinx) was 0.838 [95% CI (0.754, 0.922), p < 0.001], and the diagnostic accuracy for HSG was 79.8, 67.9, and 72.4%, respectively.

Conclusion: The current study concluded that HSG is a good diagnostic modality to detect tube abnormalities in infertile patients. HSG and laparoscopy are complementary to each other and whenever the patient is undertaken for diagnosis of infertility. Cost-effective HSG had good predictive value in identifying tubal factor infertility.

One couple's experience with infertility: Nursing theory-based practice case study

Infertility can be devastating for some couples. The purpose of this paper is to demonstrate a translation of knowledge and nursing theory-based practice regarding nursing care of couples experiencing infertility through a case study approach. It is important to consider the translation of knowledge to probable scenarios so that we may have opportunities to be better prepared when addressing such situations in actual nursing practice. Data sources include current literature, theoretical perspectives on power as knowing participation in change and nursing classifications. Data synthesis is illustrated within the context of a simulated case study of a couple experiencing unexplained secondary infertility through the application of a theory-based practice methodology, health patterning. The authors conclude that the theoretical perspectives of unitary science and the theory of power as knowing participation in change can be applied in practice. Theory-based practice methodologies such as health patterning offer an opportunity to provide holistic care to couples experiencing infertility. Using these theoretical perspectives, nurses can engage with couples expressing a readiness for enhanced power for a desired change. Nursing implications include the value of theory-based practice and the essential view of couples as unique human beings. In addition, it demonstrates the ongoing usefulness of case study approaches for nursing education as vehicles to enhance awareness of unitary experiences, updates to clinical care, and demonstration of the application of theory to practice.

Mesenchymal Stem Cells in Preclinical Infertility Cytotherapy: A Retrospective Review

Infertility is a global reproductive disorder which is caused by a variety of complex diseases. Infertility affects the individual, family, and community through physical, psychological, social and economic consequences. The results from recent preclinical studies regarding stem cell-based therapies are promising. Stem cell-based therapies cast a new hope for infertility treatment as a replacement or regeneration strategy. The main features and application prospects of mesenchymal stem cells in the future of infertility should be understood by clinicians. Mesenchymal stem cells (MSCs) are multipotent stem cells with abundant source, active proliferation, and multidirectional differentiation potential. MSCs play a role through cell homing, secretion of active factors, and participation in immune regulation. Another advantage is that, compared with embryonic stem cells, there are fewer ethical factors involved in the application of MSCs. However, a number of questions remain to be answered prior to safe and effective clinical application. In this review, we summarized the recent status of MSCs in the application of the diseases related to or may cause to infertility and suggest a possible direction for future cytotherapy to infertility.

Social representation of reproductive biotechnologies among nurses working in sexual and reproductive health

OBJECTIVES

to compare the social representations of reproductive biotechnologies among sexual and reproductive health nurses, and their links with professional practice.

METHODS

an analytical, comparative, qualitative research, supported by the Theory of Social Representation, carried out in May/2014-February/2015, with 32 nurses from the city of Rio de Janeiro. Semi-structured interview, analyzed by ALCESTE® software.

RESULTS

nurses not active in assisted human reproduction represent reproductive biotechnologies as unnatural methods of human reproduction, assessing the practice in this field as generalist and bureaucratic. Those who work represent as auxiliary and supporting nature for heterosexual couples, considering the innovative and specialized practice.

FINAL CONSIDERATIONS

each group presented specific contents and dimensions about reproductive biotechnologies. The representations are centered on moral, normative and ideological personal values, anchored in the traditional conceptions of human and family reproduction, but also collective, acquired in the professional routine, showing group identity and its distinct practices considering reproductive biotechnologies.

Mini review: The FDA-approved prescription drugs that induce ovulation in women with ovulatory problems

Infertility is defined as not being able to become pregnant after 12 months or more of unprotected sexual intercourse. Female infertility as a serious health issue can result from ovulation disorders, menstrual cycle problems, structural problems, and environmental factors. Ovulation occurs once a month between the time of menarche and menopause. The release of a mature egg from the ovary is controlled with the hypothalamic-pituitary-ovarian axis. Several hormones such as gonadotropin-releasing hormone (GnRH), FSH (follicle-stimulating hormone), LH (luteinizing hormone), estrogen, and progesterone play fundamental roles in the ovulation process. Both FSH and LH are the main treatment for women with ovulation disorders. Depending on the reasons for infertility, several different types of treatment are available for infertile women. Fertility drugs as an important part of treatment work like the natural hormones to treat infertility. Several fertility drugs can regulate ovulation and the release of an egg from the ovary in women with polycystic ovary syndrome (PCOS) or undergoing in vitro fertilization (IVF) treatment. This mini-review is about the FDA-approved prescription drugs that induce ovulation in women with ovulatory problems.

Multicentric, prospective observational data show sperm capacitation predicts male fertility, and cohort comparison reveals a high prevalence of impaired capacitation in men questioning their fertility

RESEARCH QUESTIONS

Can a previously defined relationship between sperm capacitation and the probability of a man generating pregnancy within three cycles, prospectively predict male fertility in diverse clinical settings? A second study asked, what is the prevalence of impaired sperm fertilizing ability in men questioning their fertility (MQF), and does this relate to traditional semen analysis metrics?

DESIGN

In the multicentric, prospective observational study, data (n = 128; six clinics) were analysed to test a published relationship between the percentage of fertilization-competent, capacitated spermatozoa (Cap-Score) and probability of generating pregnancy (PGP) within three cycles of intrauterine insemination. Logistic regression of total pregnancy outcomes (n = 252) assessed fit. In the cohort comparison, Cap-Scores of MQF (n = 2155; 22 clinics) were compared with those of 76 fertile men.

RESULTS

New outcomes (n = 128) were rank-ordered by Cap-Score and divided into quintiles (25-26 per group); chi-squared testing revealed no difference between predicted and observed pregnancies (P = 0.809). Total outcomes (n = 252; 128 new + 124 previous) were pooled and the model recalculated, yielding an improved fit (P < 0.001). Applying the Akaike information criterion found that the optimal model used Cap-Score alone. Cap-Scores were performed on 2155 men (with semen analysis data available for 1948). To compare fertilizing ability, men were binned by PGP (≤19%, 20-29%, 30-39%, 40-49%, 50-59%, ≥60%). Distributions of PGP and the corresponding Cap-Scores were significantly lower in MQF versus fertile men (P < 0.001). Notably, 64% of MQF with normal volume, concentration and motility (757/1183) had PGP of 39% or less (Cap-Scores ≤31), versus 25% of fertile men.

CONCLUSIONS

Sperm capacitation prospectively predicted male fertility. Impaired capacitation affects many MQF with normal semen analysis results, informing diagnosis versus idiopathic infertility.

Adaptive coping strategies in male infertility, paramedical counselling as a way of support

Aims: In the last decades, the number of infertile males increased worldwide which gained more focus. The extent to which a person or a couple is able to cope adaptively with the problem of infertility depends on the combined effect of several variables. Our aim was to apply counselling among males suffering from infertility problems. During the therapy - besides providing information - we aim to elaborate the effects of the treatment and experiences, to process information, to develop adaptive coping strategies against stress and to indirectly or directly change health behaviours influencing reproduction.Methods: Only patients with male factor infertility were involved. They were divided into an observed group (n = 57) and a control (n = 51) group after a thorough physical examination and assessment of their reactions to, and awareness of, the disease.Results: The group that received the interventions had an intense awareness of the diagnosis and aims and nature of the indicated treatment. They employed purposeful problem-solving coping strategies, reported being satisfied with the infertility treatment.Conclusions: The counselling of clients with infertility problems a more favourable mental well-being can be established by the active participation of professional helpers. Patients might receive effective, targeted and problem-specific help.Abbreviations: ART: Assisted Reproductive Technology.

Effect of education and counselling on reducing pain and anxiety in women undergoing hysterosalpingography: A randomised controlled trial

AIMS AND OBJECTIVES

To investigate the effects of education and counselling on anxiety and pain in women undergoing hysterosalpingography (HSG) as part of infertility treatment.

BACKGROUND

The hysterosalpingography has an important diagnostic role in finding the cause of infertility and making a decision on management of treatment. In addition, it is considered a feared procedure in the infertility process and the one about which very little is known. Women often experience anxiety and pain during the HSG procedure.

DESIGN

A randomised controlled trial.

METHODS

The CONSORT guidelines have been used to describe the methods. Women who were diagnosed with infertility between February-October 2016 were included in the study. The participants were randomised and divided into intervention (52) and control (53) groups. The sociodemographic and obstetric data collection form, the State-Trait Anxiety Inventory and a visual analogue scale were used before the procedure. After the questionnaires were applied to the intervention group, individual learning and counselling sessions were given about the hysterosalpingography process. Brochures were also distributed to the patients for their reference after the learning session. The control group received standard care.

RESULTS

When the intervention and control groups were compared, it was found that the education and counselling given before the HSG procedure significantly decreased the level of pain and anxiety felt by women. In addition, a significant positive correlation was found between pain and anxiety after the training in the intervention group.

CONCLUSIONS

This study indicates that the education and counselling given to women before the HSG procedure are effective interventions for reducing pain and anxiety in women undergoing HSG.

RELEVANCE TO CLINICAL PRACTICE

With the application of HSG education and counselling, and the distribution of brochures to each patient, pain and anxiety can be reduced during the HSG procedure.

Are There Differences in Marital-Role Quality between Women and Their Male Partners Who Conceived Via IVF and Those Who Did Not?

OBJECTIVES

Marital-role quality (MRQ) is a predictor of mental well-being, sexual intimacy, and maternal attachment. Data on differences in MRQ during pregnancy between women and their male partners who conceived spontaneously or via IVF are inconclusive. This study compared MRQ across pregnancy in these two groups.

METHODS

The sample's two groups: (a) 26 women and 26 male partners who conceived via IVF; and (b) 25 women and 20 male partners who conceived spontaneously. All 97 participants completed a MRQ scale during each trimester of pregnancy. Trajectory analyses were conducted to test for between-group differences in the changes in subscales across pregnancy within dyads.

RESULTS

Scores did not reveal any significant differences in subscales in those who conceived via IVF compared to non-IVF groups across the three trimesters in each dyad. The observed effect sizes were small, with exception that males in the non-IVF comparison group had greater concerns during the first trimester than did males in the IVF group (Cohen d= 0.51, moderate effect size).

CONCLUSIONS

Though the IVF population perceives pregnancy differently and experiences more anxiety than those who conceive spontaneously, their marital-role quality during pregnancy does not seem to be affected. Their perceptions before conception and in early parenting are worthy of investigation.

Oocyte Cryopreservation for Fertility Preservation in Healthy Women

Advancements in methods of fertility preservation have resulted in more options available to women seeking to postpone reproduction. Preservation of unfertilized oocytes provides women with the possibility for reproduction even after age-related declines in fertility might make conceiving a child difficult to impossible. As oocyte cryopreservation rises in popularity among women, it is crucial for nurses and other clinicians to understand the background, process, ethical issues, and risks involved to help women make informed medical decisions.