Gender Differences in Quality of Life, Intensity of Dysfunctional Attitudes, Unconditional Self-acceptance, Emotional Distress and Dyadic Adjustment of Infertile Couples

A pathway study of factors influencing quality of fertility life

BACKGROUD

To investigate the factors influencing fertility quality of life in infertile men, constructing a structural equation model of the factors influencing fertility quality of life in infertile men, and to provide suggested measures for improving fertility quality of life in infertile men.

METHODS

It is a Observational study. Infertile men (n = 250) attending a fertility centre in a hospital in Xinjiang, matched 1:2 men with no obvious male factor in the control group (n = 500).The Quality of Fertility Life Scale, the Social Support Scale, the Fertility Stress Scale and the Positive Attention Awareness Scale were used to conduct the survey. The model was constructed by applying the maximum likelihood estimation method in Mplus 8.3 software, to explore the factors influencing the quality of reproductive life of infertile men through path analyses. Differences between the case and control groups were statistically significant (P < 0.05) in terms of total fertility quality of life scores, core entry dimensions, affective responses, physical and mental relationships, selective treatment dimensions, and treatment tolerance.

RESULTS

Past medical history, history of exposure to hazardous environments, health insurance reimbursement, social support, fertility stress, and mindfulness are important factors affecting the quality of fertility life of infertile men.

CONCLUSION

The quality of fertility life of infertile men is not optimistic. By improving the level of mindfulness, fertility stress, and social support, we propose appropriate measures to improve the quality of fertility life of infertile men. These measures can improve their confidence in clinical diagnosis and infertility treatment, enabling them to cope positively with these challenges.

Dual mediating effects of social support and fertility stress on mindfulness and fertility quality of life in infertile men: A case-control study

Background

Infertility is one of the three major public health problems in the world, bringing immense physical and psychological damage to men and affecting the quality of men’s fertility life. Thus, the purpose of this study was to analyze the status of social support, fertility stress, mindfulness, and fertility quality of life in infertile men, and to explore the dual mediating effects of social support and fertility stress on mindfulness and fertility quality.

Methods

A case–control group study was conducted, with 246 men in the case group and 149 in the control group. The Social Support Scale, Fertility Stress Scale, Mindfulness Scale, and Fertility Quality of Life Scale were used to establish a structural equation model using Mplus 8.3 to explore social support and fertility stress. Pathway relationships were drawn between mindfulness and fertility quality of life in infertile men.

Results

There were significant differences between infertile and healthy men in each dimension of the core module of fertility quality of life, in the total score of the treatment module, in the total score of social support, in subjective and objective support, and in the total score of fertility stress, social pressure, sexual pressure, marital relationship, and childless pressure (p &lt; 0.05 in each case). Further, the fertility quality of life in infertile men was positively correlated with mindfulness and social support, and negatively correlated with fertility stress (p &lt; 0.05); mindfulness could directly affect the core and treatment modules of fertility life quality, and indirectly affect the core of fertility life quality through social support (mediation effect accounted for 19.0%), while the treatment module (mediation effect accounted for 13.7%), and the core module indirectly affected fertility life quality through fertility stress (mediation effect accounted for 16.8%).

Conclusion

The fertility quality of life of infertile men is not optimistic. Mindfulness-related interventions and programs can improve their fertility quality of life.

Quality of life and related constructs in a group of infertile Hungarian women: a validation study of the FertiQoL

Quality-of-life measurement is a basic prerequisite for psychologically sensitive fertility care and the FertiQoL is a psychometrically sound outcome measure in this field. The aim of the present research was to investigate the reliability and validity of the Hungarian Core FertiQoL. Two independent samples of infertile women were merged (n = 320). While the model fit of the four-factor Confirmatory Factor Analysis was under the level of acceptability (χ²(246) = 626.36, p < 0.001, RMSEA = 0.070 [CI₉₀ = 0.063-0.076], CFI = 0.878, SRMR = 0.071), the four-factor Exploratory Structural Equation Model showed much improved model fit (χ²(186) = 395.63, p < 0.001, RMSEA = 0.059 [CI₉₀ = 0.051-0.067], CFI = 0.933, SRMR = 0.035). Good internal consistency (Cronbach's Alphas 0.77-0.92) and construct reliability (0.75-0.95) were found for both factor structures. Depression correlated negatively with fertility-specific quality of life. Almost a quarter of the sample suffered from moderate-to-severe depression. Multivariate analysis of variance indicated that Beck Depression Inventory categories (mild, moderate etc.) co-occurred with significantly distinct FertiQoL score ranges, leading to a possible, clinically meaningful threshold on the Core FertiQoL. Pearson coefficients showed secondary infertility, rural residency and pre-treatment status to be associated with better fertility quality of life.

A qualitative investigation of the experience of participation in Mindfulness-based Intervention for IVF-ET (MBII) with Chinese women undergoing first IVF-ET

AIM

To explore what the women experience during their first IVF-ET treatment while participating a mindfulness-based intervention for IVF-ET (MBII), and how they use it to enhance their infertility-related quality of life (QoL).

DESIGN

Qualitative exploratory design.

METHODS

As part of a larger multimethod study, this study shares the description from 38 IVF-ET women. We conducted semi-structured interviews and collected daily practice diary. Each interview was conducted one-on-one within one week after MBII programme. Data were analysed using inductive thematic analysis.

RESULTS

Four primary themes described participants' perceptions of how the programme benefitted IVF-ET treatment and daily lives: improved infertility-related QoL, enhanced awareness, increased acceptance and regained control over life. Additionally, enhanced awareness, regained control over life and increased acceptance may be implicated in the effectiveness of MBII on the infertility-related QoL. Clinicians and nurses working with women undergoing first IVF-ET have another tool to recommend to the patients.

Mindfulness and fertility quality of life in Chinese women with infertility: assessing the mediating roles of acceptance, autonomy and self-regulation

Objectives: To examine whether high dispositional mindfulness was associated with heightened specific aspects of fertility quality of life (FertiQoL) in infertile women, and whether acceptance, autonomy and self-regulation, mediated any association. Background: Quality of life is one of the most important issues to be addressed in infertility counselling. A large body of evidence reveals that populations with higher dispositional mindfulness fare better than their less mindful counterparts on psychological well-being. However, no research has examined the influence of mindfulness on infertile women's FertiQoL and potential mechanisms underlying these associations. Methods: This was a cross-sectional study of infertile women attending to Southwest Hospital, China. Standardized measures of FertiQoL and proposed mediators (self-regulation, acceptance and autonomy) were administered at the conclusion of the patient's medical appointment from December 2015 to March 2016. Structural equation modelling was used to test the hypothesised mediation model. Results: Mindfulness was positively related to Core and Treatment FertiQoL. Higher mindfulness was related to higher autonomous and self-regulatory abilities, as well as lower experiential avoidance, which in turn resulted in better Treatment FertiQoL. Meanwhile, mindfulness exerted its indirect effect on Core FertiQoL through self-regulation. However, acceptance and autonomy could not mediate the link between mindfulness and Core FertiQoL. Conclusion: Mindfulness appears to be a protective individual characteristic of infertile women, and self-regulation, autonomy and acceptance may be implicated in the effects of mindfulness on specific aspects of FertiQoL. The findings can provide useful suggestions to design mindfulness-based interventions aiming at improving FertiQoL in infertile women, by adding or emphasising intentional self-regulation, autonomy and acceptance components.

Effects of a mindfulness-based intervention on fertility quality of life and pregnancy rates among women subjected to first in vitro fertilization treatment

Generally, undergoing an in vitro fertilization (IVF) treatment is an emotional and physical burden for the infertile woman, which may negatively influence the treatment outcome. We conducted a study to investigate the effectiveness of a mindfulness-based intervention (MBI) among women subjected to first IVF treatment at a fertility medical center in China. Among infertile women registered for their first IVF treatment, 58 completed the intervention, and 50 were assigned to a control group using a non-randomized controlled study. Standardized measures of mindfulness, self-compassion, emotion regulation difficulties, infertility-related coping strategies and fertility quality of life (FertiQoL) were endorsed pre- and post-MBI, and measure of pregnancy rates at the sixth months after the intervention. Both groups were shown to be equivalent at baseline. By the end of the intervention, women who attended the intervention revealed a significant increase in mindfulness, self-compassion, meaning-based coping strategies and all FertiQoL domains. Inversely, they presented a significant decrease in emotion regulation difficulties, active- and passive-avoidance coping strategies. Women in the control group did not present significant changes in any of the psychological measures. Moreover, there were statistically significant differences between participants in the pregnancy rates, the experiment group higher than the control group. Being fully aware of the present moment without the lens of judgment, seems to help women relate to their infertility and IVF treatment in new ways. This is beneficial for promoting their self-compassion, adaptive emotion regulation and infertility-related coping strategies, which, in turn, may influence the FertiQoL and pregnancy rates. The brief and nonpharmaceutical nature of this intervention makes it a promising candidate for women' use during first IVF treatment.