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Torkel S, Wang R, Norman RJ, Zhao L, Liu K, Boden D, Xu W, Moran L, Cowan S. Barriers and enablers to a healthy lifestyle in people with infertility: a mixed-methods systematic review. Hum Reprod Update 2024:dmae011. [PMID: 38743500 DOI: 10.1093/humupd/dmae011] [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: 10/24/2023] [Revised: 02/20/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND While there is a recognized role of optimizing lifestyle (diet and physical activity) behaviours in the management of infertility, the best practice remains unknown and factors influencing the lifestyle of people with infertility are not well understood. OBJECTIVE AND RATIONALE This systematic review evaluated barriers and enablers to a healthy lifestyle in people with infertility, from the perspectives of people with infertility and health professionals, in order to inform optimal behavioural change strategies. SEARCH METHODS Ovid MEDLINE(R), PsycINFO, EMBASE, EBM Reviews, and CINAHL were searched from inception to 28 August 2023. Eligible studies were qualitative and quantitative primary studies that explored barriers and/or enablers to lifestyle for infertility management. Quality assessment was performed using the Centre for Evidence-Based Management Critical Appraisal of a Survey Tool and the Critical Appraisal Skills Programme Qualitative Checklist. Data were analysed by thematic analysis with themes mapped to the Capability, Opportunity, Motivation and Behaviour (COM-B) model and Theoretical Domains Framework (TDF). OUTCOMES After screening 12 326 abstracts and 99 full-texts, 27 studies were included (12 quantitative, 6 qualitative and 9 mixed-methods) with 22 studies of women with infertility (n = 2524), 11 studies of men with infertility (n = 1407), and 6 studies of health professionals (n = 372). We identified barriers and enablers relating to capability (e.g. strategies for behaviour change), opportunity (e.g. limited time, resources, and money), and motivation (e.g. interplay between lifestyle and emotional state). Based on the identified themes, suggested intervention components to integrate into lifestyle management of infertility include facilitating development of self-management skills to support lifestyle change (e.g. self-monitoring, action planning, and goal setting) and incorporating mental health strategies (e.g. providing information about the benefits of healthy lifestyle behaviours for mental health and encouraging patients to reframe healthy lifestyle behaviours as self-care strategies). WIDER IMPLICATIONS The findings have identified important factors that influence lifestyle management in people with infertility and have suggested relevant intervention components to consider when designing interventions. Given the paucity of qualitative studies identified, more research is needed to further understand the complex and interacting factors that shape lifestyle during the fertility journey.
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Affiliation(s)
- Sophia Torkel
- Monash Centre for Health Research and Implementation, Monash University, Clayton, VIC, Australia
| | - Rui Wang
- Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, Australia
| | - Robert J Norman
- Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
| | - Lijun Zhao
- Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
| | - Kai Liu
- Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
| | - Dana Boden
- Monash Centre for Health Research and Implementation, Monash University, Clayton, VIC, Australia
| | - Wentong Xu
- Monash Centre for Health Research and Implementation, Monash University, Clayton, VIC, Australia
| | - Lisa Moran
- Monash Centre for Health Research and Implementation, Monash University, Clayton, VIC, Australia
| | - Stephanie Cowan
- Monash Centre for Health Research and Implementation, Monash University, Clayton, VIC, Australia
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Hecht LM, Joseph-Mofford G, Iacobelli R, Ahmed M, Haley E, Loree AM, Miller-Matero LR. Anxiety, depression, and infertility-specific distress among women with female factor infertility. J Health Psychol 2024:13591053241235092. [PMID: 38413845 DOI: 10.1177/13591053241235092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024] Open
Abstract
This study aimed to evaluate whether anxiety, depression, and infertility-specific distress differ among women with female infertility who are trying to conceive and/or seeking infertility treatment. Women with diagnosed female factor infertility in the past 2 years (N = 188) completed demographic questions, and measures of infertility-specific distress, anxiety, and depression. The majority of the sample were actively trying to conceive (78.7%, n = 148) and approximately one third (33.5%, n = 63) were undergoing fertility treatment. Anxiety and depression scores did not differ based on trying to conceive or treatment-seeking, although these subgroups reported higher levels of need for parenthood and rejection of a childfree lifestyle. High levels of mood and anxiety are experienced by women with female infertility. Although infertility-specific distress is experienced more so by women with anxiety and depression, a substantial proportion of those without mental health conditions had high levels of distress, underscoring the need for screening and treatment.
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Arhin SM, Mensah KB, Agbeno EK, Yirdong F, Opoku-Agyeman K, Ansah C. Psychological distress of Ghanaian couples after unsuccessful treatment for infertility. Ghana Med J 2023; 57:275-283. [PMID: 38957853 PMCID: PMC11215225 DOI: 10.4314/gmj.v57i4.4] [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] [Indexed: 07/04/2024] Open
Abstract
Objective The main objective of the study was to assess psychological distress and to identify any gender specific differences in the psychological distress among infertile couples after one year of unsuccessful pharmacotherapy. Design A descriptive cross-sectional study. Setting The study was conducted in four fertility clinics in the Cape Coast Metropolis. Participants One hundred and twenty respondents (71 women and 49 men) were recruited by simple random sampling. Statistical analysis Statistical analysis was done using SPSS (v. 25). Psychological distress scores were presented as Mean±SD and were analysed using One-way ANOVA, followed by Bonferroni's post hoc test. Associations between exposures and outcomes were measured using relative risk. Outcome measure The main outcome measure was the level of depression, anxiety, and stress among infertile couples after unsuccessful pharmacotherapy. Results Anxiety was the predominant psychological distress experienced by respondents (60.8%), followed by depression (43.3%) and stress (37.5%). Generally, psychological distress scores increased with age among female respondents but decreased with age for male respondents. The duration of infertility only significantly affected anxiety (p=0.01) but not depression (p=0.51) and stress (p=0.06) levels. Approximately 31.7% of respondents reported experiencing extremely severe anxiety. Male respondents reported higher degree of depressive symptoms than females (46.9 vs. 40.8%). Conclusion Unsuccessful pharmacotherapy of infertility is associated with varied degrees of psychological distress among Ghanaian infertile couples, which can be affected by age, duration of infertility and gender. Funding None declared.
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Affiliation(s)
- Stephen M Arhin
- Department of Pharmacology, Kwame Nkrumah University of Science and Technology (KNUST), Ghana
- Department of Pharmacology, School of Medical Sciences, University of Cape Coast, Ghana
| | - Kwesi B Mensah
- Department of Pharmacology, Kwame Nkrumah University of Science and Technology (KNUST), Ghana
| | - Evans K Agbeno
- Department of Obstetrics and Gynaecology, School of Medical Sciences, University of Cape Coast, Ghana
| | - Felix Yirdong
- Department of Psychological Medicine and Mental Health, University of Cape Coast, Ghana
- Department of Psychology, The New School, New York, U.S.A
| | - Kwame Opoku-Agyeman
- Department of Pharmacology, Kwame Nkrumah University of Science and Technology (KNUST), Ghana
| | - Charles Ansah
- Department of Pharmacology, Kwame Nkrumah University of Science and Technology (KNUST), Ghana
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Swift A, Reis P, Swanson M. Comparing infertility-related stress, coping, and quality of life among assisted reproductive technology and non-assisted reproductive technology treatments. HUM FERTIL 2023; 26:1248-1255. [PMID: 36597775 DOI: 10.1080/14647273.2022.2163465] [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: 01/19/2022] [Accepted: 11/11/2022] [Indexed: 01/05/2023]
Abstract
Women who undergo assisted reproductive technology (ART) treatments experience infertility-related stress and have low quality of life (QOL). However, there is limited understanding of infertility-related stress, coping, or QOL among women who undergo non-ART treatments. The purpose of this study was to examine infertility-related stress, coping, and QOL among women who undergo ART and non-ART infertility treatments. Using a descriptive correlational cross-sectional design, we recruited 200 women who underwent infertility treatments. Participants completed the Copenhagen Multi-centre Psychosocial Infertility (COMPI) Fertility Problem Stress Scale, COMPI Coping Styles Scale, Fertility Quality of Life tool, and a demographic infertility survey. Data analysis included descriptive statistics, independent t-test, chi-square, and hierarchical multiple regression. Women who underwent non-ART had more personal stress, used more active-avoidance coping, and had lower emotional, social, and treatment environment QOL compared to those in ART treatment. Women who underwent ART treatments used more meaning-based coping but had lower treatment tolerability QOL. Stress and coping contribute to core QOL differently among infertility treatment groups. Both treatment groups report low satisfaction with emotional services. Regardless of the treatment type, women who undergo infertility treatments may need care to address their psychological health.
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Affiliation(s)
- Alison Swift
- Department of Advanced Nursing Practice and Education, East Carolina University College of Nursing, Greenville, NC, USA
| | - Pamela Reis
- Department of Nursing Science, East Carolina University College of Nursing, Greenville, NC, USA
| | - Melvin Swanson
- Department of Nursing Science, East Carolina University College of Nursing, Greenville, NC, USA
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Renzi A, Mariani R, Fedele F, Maniaci VG, Petrovska E, D’Amelio R, Mazzoni G, Di Trani M. Women's Narratives on Infertility as a Traumatic Event: An Exploration of Emotional Processing through the Referential Activity Linguistic Program. Healthcare (Basel) 2023; 11:2919. [PMID: 37998411 PMCID: PMC10671616 DOI: 10.3390/healthcare11222919] [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: 09/18/2023] [Revised: 10/25/2023] [Accepted: 11/06/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND the diagnosis of infertility and its related treatment can be traumatic, leading to profound psychological distress and a variety of psychopathological symptoms. The primary objective of this study is to contrast the linguistic features of narratives from women undergoing Assisted Reproductive Treatment with those of women not undergoing any fertility treatment. This study examines the speech of both groups of individuals as an indicator of their capacity to cope with current and past distressing experiences. METHOD 44 women (mean age 36.05; SD = 4.66) enrolled in a fertility medical center in Rome, and 43 control women (mean age 36.07; SD = 3.47) completed a socio-demographic questionnaire and a semi-structured interview designed to collect their memories of a neutral, a positive, and a negative event. This interview also aimed to investigate: (a) (for women with fertility difficulties) how they realized they and their partner had fertility problems and a description of an event when they talked about these difficulties with their partner; and (b) (for control group participants) the most difficult moment of their pregnancy and an event when they talked about it with their partner. The interviews were audio recorded and transcribed, and the text was analyzed using the referential process (RP) linguistic measures software. RESULTS Mann-Whitney non-parametric U tests for the independent samples showed several significant differences regarding the linguistic measures applied to the narratives of neutral, positive, negative, and difficult experiences in the form of a linguistic style, with more intellectualization and defenses in all the narratives associated with the women with fertility problems compared to the women in the control group. CONCLUSIONS the traumatic and painful experience of infertility and ART seems to characterize the whole mode of narrating life experiences. Present findings sustain the importance of helping women to elaborate on their experience and to understand and recognize the difficult feelings that are activated in relation to the difficulties of having a child.
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Affiliation(s)
- Alessia Renzi
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, Via degli Apuli 1, 00185 Rome, Italy; (R.M.); (V.G.M.); (G.M.); (M.D.T.)
| | - Rachele Mariani
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, Via degli Apuli 1, 00185 Rome, Italy; (R.M.); (V.G.M.); (G.M.); (M.D.T.)
| | - Fabiola Fedele
- ART Italian National Register, National Centre for Diseases Prevention and Health Promotion, Italian National Health Institute, Viale Regina Elena 299, 00161 Rome, Italy;
| | - Vito Giuseppe Maniaci
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, Via degli Apuli 1, 00185 Rome, Italy; (R.M.); (V.G.M.); (G.M.); (M.D.T.)
| | - Elena Petrovska
- Derner School of Psychology, Adelphi University, Garden City, NY 11530-0701, USA;
| | - Renzo D’Amelio
- Department of Gynecologic-Obstetrical and Urologic Sciences, Umberto I Hospital, Sapienza University of Rome, 00185 Rome, Italy;
| | - Giuliana Mazzoni
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, Via degli Apuli 1, 00185 Rome, Italy; (R.M.); (V.G.M.); (G.M.); (M.D.T.)
| | - Michela Di Trani
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, Via degli Apuli 1, 00185 Rome, Italy; (R.M.); (V.G.M.); (G.M.); (M.D.T.)
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Köksal S, Goisis A. Loneliness during the Pregnancy-Seeking Process: Exploring the Role of Medically Assisted Reproduction. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2023; 64:209-227. [PMID: 37144327 DOI: 10.1177/00221465231167847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
This study explores whether undergoing medically assisted reproduction (MAR) is associated with experiencing loneliness and whether this association varies by gender and having a live birth. Using two waves of the Generations and Gender Survey (n = 2,725) from countries in Central and Eastern Europe, we estimate the changes in levels of emotional and social loneliness among pregnancy seekers in heterosexual relationships and test if they vary by the mode of conception while controlling for individual sociodemographic characteristics. Individuals who underwent MAR experienced increased levels of social loneliness compared to individuals who were trying to conceive spontaneously. This association is entirely driven by respondents who did not have a live birth between the two observation periods, while the results did not differ by gender. No differences emerged in emotional loneliness. Our findings suggest that increased social loneliness during the MAR process might be attributable to infertility-related stress and stigma.
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Allsop DB, Péloquin K, Saxey MT, Rossi MA, Rosen NO. Perceived financial burden is indirectly linked to sexual well-being via quality of life among couples seeking medically assisted reproduction. Front Psychol 2023; 14:1063268. [PMID: 37082570 PMCID: PMC10110993 DOI: 10.3389/fpsyg.2023.1063268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 03/01/2023] [Indexed: 04/07/2023] Open
Abstract
IntroductionMedically assisted reproduction is a difficult treatment process for couples both financially and sexually. Yet, these two domains have not been examined together among couples seeking treatment, leaving couples and practitioners without guidance on how to address these domains together.MethodsIn line with Couples and Finance Theory, we tested the hypothesis that perceived financial burden and couple income would predict quality of life during medically assisted reproduction, which would then predict four domains of sexual well-being (i.e., sexual satisfaction, desire, distress, and frequency). We also examined if the results differed by treatment status—that is, between partners who were receiving treatment and those who were not. Cross-sectional data from 120 couples who had undergone medically assisted reproduction in the past six months were analyzed via structural equation modeling through an actor-partner interdependence mediation model.ResultsAn individual’s greater perceived financial burden predicted their own lower quality of life during medically assisted reproduction, which in turn predicted their lower sexual satisfaction, desire and distress, as well as their partner’s lower sexual satisfaction. Household income did not indirectly predict any sexual well-being domains, and results regarding treatment status were inconclusive.DiscussionClinicians can discuss with couples how perceived financial strain of medically assisted reproduction affects their quality of life and what ramifications that may have for their sexual well-being.
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Affiliation(s)
- David B. Allsop
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Katherine Péloquin
- Département de Psychologie, Université de Montréal, Montreal, QC, Canada
| | - Matthew T. Saxey
- School of Family Life, Brigham Young University, Provo, UT, United States
| | - Meghan A. Rossi
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Natalie O. Rosen
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
- Department of Obstetrics and Gynaecology, Dalhousie University, Halifax, NS, Canada
- *Correspondence: Natalie O. Rosen,
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Renzi A, Fedele F, Di Trani M. Assisted Reproductive Treatments, Quality of Life, and Alexithymia in Couples. Healthcare (Basel) 2023; 11:healthcare11071026. [PMID: 37046953 PMCID: PMC10093954 DOI: 10.3390/healthcare11071026] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 03/19/2023] [Accepted: 03/27/2023] [Indexed: 04/14/2023] Open
Abstract
Infertility and related treatments can negatively affect a couple's wellbeing. The aim of this study was to evaluate couples starting assisted reproductive treatment, differences in alexithymia and quality of life levels between partners, and the association of these psychological dimensions within the couple's members. Data was collected in two fertility centres in Rome; 47 couples completed the Fertility Quality of Life (FertiQoL), the 20-item Toronto Alexithymia Scale (TAS-20), and a socio-demographic questionnaire. Data analysis showed a worsened quality of life in women compared with their partners, as well as higher externally oriented thinking in men compared with their spouses. Associations between alexithymia and quality of life levels between women and men emerged. According to the regression analysis, a better quality of life in women was predicted by a greater partner's capabilities in identifying and describing emotion as well as by a better partner's quality of life, whereas for men, a better quality of life was predicted by their spouse's higher levels of quality of life. This study highlights the protective role that couples can play in the perception of the negative impact that infertility can have on their partner's quality of life. Further investigations are needed for the development of specific therapeutic interventions for the promotion of the couples' wellbeing.
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Affiliation(s)
- Alessia Renzi
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, Via Degli Apuli 1, 00185 Rome, Italy
| | - Fabiola Fedele
- ART Italian National Register, National Centre for Diseases Prevention and Health Promotion, Italian National Health Institute, Viale Regina Elena 299, 00161 Rome, Italy
| | - Michela Di Trani
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, Via Degli Apuli 1, 00185 Rome, Italy
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9
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Hamzehgardeshi Z, Khalilian A, Peyvandi S, Elyasi F, Kalantari F, Gelehkolaee KS. Complex factors related to marital and sexual satisfaction among couples undergoing infertility treatment: A cross-sectional study. Heliyon 2023; 9:e15049. [PMID: 37101648 PMCID: PMC10123143 DOI: 10.1016/j.heliyon.2023.e15049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 03/18/2023] [Accepted: 03/24/2023] [Indexed: 03/31/2023] Open
Abstract
Objectives This study assesses complex factors related to marital and sexual satisfaction among couples undergoing infertility treatment. Methods This cross-sectional study was conducted with 140 couples who visited fertility centers in Iran, between September 2015 and July 2016. Data collection was done by Marital and Sexual Satisfaction Questionnaires and were analyzed by the IBM SPSS 26 software. Results There was a significant difference between wives and husbands in the MSQ total scores (p = 0.027). However, there was no significant difference between wives and husbands in the SSQ total scores (p = 0.398). Sexual satisfaction and decision-maker in life among wives and husbands were significant predictors of MSQ. The kind of treatment, cause of infertility and BMI among wives and kinds of treatment, cause of infertility, and decision-maker among husbands were also significant predictors of SSQ. Conclusion The findings of this study showed that there is a difference between the understanding of marital and sexual satisfaction in wives and their husbands. Healthcare providers need to pay more attention to these differences.
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Affiliation(s)
- Zeinab Hamzehgardeshi
- Sexual and Reproductive Health Research Center, Department of Reproductive Health and Midwifery, Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Alireza Khalilian
- Department of Biostatistics, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Sepideh Peyvandi
- Department of Obstetrics and Gynecology, IVF Ward, Sexual and Reproductive Health Research Center, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Forouzan Elyasi
- Psychiatry and Behavioral Sciences Research Center, Sexual and Reproductive Health Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Imam Khomeini Educational and Treatment Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Fereshteh Kalantari
- Imam Khomeini Educational and Treatment Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Keshvar Samadaee Gelehkolaee
- Sexual and Reproductive Health Research Center, Department of Reproductive Health and Midwifery, Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
- Corresponding author.
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10
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Dura-Ferrandis E, Bonilla-Campos A, Alhambra-Borras T. Psychometric properties of the Spanish version of the FertiQoL measure in couples undergoing infertility treatment. J Reprod Infant Psychol 2023:1-15. [PMID: 36814063 DOI: 10.1080/02646838.2023.2180623] [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: 07/31/2022] [Accepted: 02/10/2023] [Indexed: 02/24/2023]
Abstract
BACKGROUND Both the diagnosis and the process of undergoing fertility treatment have a considerable negative effect on a person's quality of life (QoL). The evaluation of this effect is essential to offer comprehensive and high-quality care. The FertiQoL questionnaire is the most widely used instrument to evaluate QoL in people with fertility issues. OBJECTIVE This study is aimed at examining the dimensionality, validity and reliability of the Spanish version of the FertiQoL questionnaire in a sample of Spanish heterosexual couples undergoing fertility treatment. METHODS FertiQoL was administered to 500 people (50.2% women; 49.8% men; average age 36.1 years) recruited from a public Assisted Reproduction Unit in Spain. In this cross-sectional study, Confirmatory Factor Analysis (CFA) was used to analyse the dimensionality, validity and reliability of FertiQoL. Discriminant and convergent validity were assessed using the Average Variance Extracted (AVE), and model reliability was shown by Composite Reliability (CR) and Cronbach's alpha. RESULTS CFA's results support the 6-factor solution of the original FertiQoL (RMSEA and SRMR <0.09; CFI and TLI >0.9). However, several items had to be eliminated due to their low factorial weights - in particular, items Q4, Q5, Q6, Q11, Q14, Q15 and Q21. Moreover, FertiQoL showed good reliability (CR >0.7) and validity (AVE >0.5). CONCLUSION The Spanish version of FertiQoL is a reliable and valid instrument in measuring QoL in heterosexual couples undergoing fertility treatment. The CFA confirms the original 6-factors model but indicates that by eliminating some items the psychometric properties could improve. However, further research is recommended to address some of the measurement issues.
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Affiliation(s)
| | - Amparo Bonilla-Campos
- Department of Personality, Assessment, and Psychological Treatments, University of Valencia, Valencia, Spain
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11
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Taebi M, Kariman N, Montazeri A, Alavi Majd H, jahangirifar M. Development and psychometric properties of Female Infertility Stigma Instrument (ISI-F): A sequential mixed method study. BMC Womens Health 2022; 22:557. [PMID: 36581923 PMCID: PMC9801592 DOI: 10.1186/s12905-022-02139-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 12/20/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Infertility stigma is a hidden burden that overshadows the dimensions of reproductive and sexual health in infertile women. The aim of this study was to develop and evaluate the psychometric properties of the Female Infertility Stigma Instrument (ISI-F). METHODS This mixed method study with sequential exploratory design was conducted in qualitative and quantitative phases. In the first phase, the initial item pool of the Female Infertility Stigma Instrument (ISI-F) was generated using in-depth interviews. In the quantitative phase, psychometric properties of the ISI-f including content, face and construct validity, as well as reliability (internal consistency and stability) were assessed. Exploratory factor analysis was performed on the collected data from 300 infertile women for evaluation of construct validity. Data was analyzed using SPSS version 20. This study has followed the Mixed Methods Article Reporting Standards checklist. RESULTS The final version of ISI-F had 20 items. Total CVI and CVR were 0.94 and 0.87, respectively. Explanatory factor analysis identified 3 main factors that explained 54.013% of the variance. These factors consisted of stigma profile (7 items), self-stigma (6 items) and escaping from stigma (7 items). Internal consistency and stability of the ISI-F has been approved by Cronbach's alpha, McDonald's Omega (0.909, 0.916) and Intraclass Correlation Coefficient (ICC = 0.878). CONCLUSION The Female Infertility Stigma Instrument (ISI-F) is a valid and reliable tool for evaluation of the perceived female infertility stigma, that was developed in this study.
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Affiliation(s)
- Mahboube Taebi
- grid.411036.10000 0001 1498 685XReproductive Sciences and Sexual Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nourossadat Kariman
- grid.411600.2Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, Shahid Beheshti University of Medical Sciences, P.O. Box 1996835119, Tehran, Iran
| | - Ali Montazeri
- grid.417689.5Health Metrics Research Centre, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
| | - Hamid Alavi Majd
- grid.411600.2Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam jahangirifar
- grid.1002.30000 0004 1936 7857Faculty of Medicine, Nursing and Health Sciences, School of Nursing and Midwifery, Monash University, Melbourne, Australia
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Yamanaka-Altenstein M, Rauch-Anderegg V, Heinrichs N. The link between infertility-related distress and psychological distress in couples awaiting fertility treatment: a dyadic approach. HUM FERTIL 2022; 25:924-938. [PMID: 34232107 DOI: 10.1080/14647273.2021.1948112] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
While there is broad evidence to suggest that individual stress increases, and that high couple relationship quality reduces the risk for psychological distress, our understanding of these associations in couples dealing with infertility remains limited. In this cross-sectional study, we used dyadic data-analysis (Actor-Partner Interdependence Model; APIM) to examine the effects of infertility-related distress (experienced as an individual risk factor) and couple relationship quality (experienced as a couple-based resource), on psychological distress in a sample of 116 infertile couples. 59% of women and 23% of men reported clinical levels of psychological distress, 71% of women and 45% of men reported infertility-related distress, and 3% of participants reported low couple relationship quality. Infertility-related distress predicted psychological distress at the individual level ('actor effects') while men's infertility-related distress predicted women's psychological distress (partner effect'). Women without medically assisted reproduction (MAR) treatment exposure reported significantly higher couple relationship quality than women with MAR exposure, and men without treatment exposure reported significantly lower infertility-related distress than men with exposure. The level of psychological distress depended on whether both or neither of the partners, or only one partner reported infertility-related distress. Couple relationship quality was not associated with distress, which may imply that dyadic dimensions other than overall satisfaction could be relevant in supporting couples facing infertility.
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Affiliation(s)
| | | | - Nina Heinrichs
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Bremen, Bremen, Germany
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Yamanaka-Altenstein M. Bedarfsorientierte kognitiv-behaviorale Intervention für
Paare mit Infertilität (FERTIFIT): Eine Pilotstudie zur Entwicklung,
Durchführbarkeit und Akzeptanz. Psychother Psychosom Med Psychol 2022; 73:197-205. [PMID: 36323334 DOI: 10.1055/a-1939-7285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Zusammenfassung
Einleitung Weltweit schwankt die Prävalenz für
Infertilität zwischen 4–17% und in westlichen
Ländern ist rund eins von sieben Paaren mit Kinderwunsch betroffen. Das
Erleben einer Infertilität ist mit einer erhöhten
Wahrscheinlichkeit für psychische und partnerschaftliche Belastungen
assoziiert, wobei sich Partner einer Paarbeziehung in ihrem Befinden gegenseitig
beeinflussen. Dennoch ist die Versorgungslücke für betroffene
Paare groß. In dieser Pilotstudie wird eine praktikabel umsetzbare,
bedarfsorientierte und kognitiv-verhaltenstherapeutische Intervention
für Paare mit Infertilität vorgestellt, die die
partnerschaftliche Bewältigung typischer Problembereiche fördern
und einer zunehmenden Belastung entgegenwirken soll.
Material und Methoden Insgesamt nahmen 21 heterosexuelle Paare an dieser
Studie mit Eigen-Warte-Kontrollgruppendesign teil. Die Intervention beinhaltete
bedarfsabhängig 5–10 paartherapeutische Sitzungen. Die
psychische und infertilitätsbedingte Belastung, die
Partnerschaftsqualität, sowie die Anwendung von individuellen und
partnerschaftlichen Ressourcen wurden zu vier Messzeitpunkten (M1=vor
Wartekontrollphase, M2=vor Intervention, M3=nach Intervention,
M4=nach Katamnese) mittels Fragebögen erhoben.
Ergebnisse Bei Frauen besserten sich die psychische und
infertilitätsbedingte Belastung, und sie griffen auf mehr Ressourcen
zurück, die zum Wohlbefinden und zur aktiven Problembewältigung
und Emotionsregulation beitragen. Während des Interventionszeitraumes
kam es bei Männern zu einem zunehmenden Erleben hilfreicher
Unterstützung, und sowohl bei Männern als auch bei Frauen zu
einem häufigeren Einsatz partnerschaftlicher Copingstrategien. Die
Evaluation zeigte, dass die Teilnehmenden sehr zufrieden waren mit der
Intervention insgesamt und mit der erhaltenen Unterstützung.
Diskussion Die Befunde deuten auf eine gute Durchführbarkeit und
Akzeptanz dieser Intervention in der psychotherapeutischen Praxis hin und
liefern erste Hinweise auf mögliche erwünschte Effekte, die
allerdings aufgrund des Studiendesigns und der vorliegenden Limitationen nicht
eindeutig auf die Intervention zurückgeführt werden
können.
Schlussfolgerung Die Stärke der vorliegenden Studie liegt in der
Vorstellung eines in der psychotherapeutischen Praxis gut anwendbaren
paartherapeutischen Konzepts, das bedarfsgerecht angeboten werden kann.
Für die Überprüfung der gefundenen Effekte ist eine
anschließende größer angelegte klinische Studie mit
randomisiert-kontrolliertem Design notwendig.
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Affiliation(s)
- Misa Yamanaka-Altenstein
- Gynäkopsychologie und Infertilität,
Klaus-Grawe-Institut für Psychologische Therapie Zürich,
Zürich, Switzerland
- Institut für Psychologie, Technische Universität
Braunschweig, Braunschweig, Germany
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Patra S, Unisa S. An exploration of treatment seeking behavior of women experienced infertility and need for services in rural India. FRONTIERS IN REPRODUCTIVE HEALTH 2022; 4:978085. [PMID: 36303623 PMCID: PMC9580773 DOI: 10.3389/frph.2022.978085] [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: 06/25/2022] [Accepted: 08/08/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundTo make informed decisions on fertility treatment, couples need to understand the treatment options available to them. A wide range of treatment options is available from the traditional and biomedical service providers in India. There is a dearth of research to find out factors that influence the treatment-seeking behavior of couples, particularly in rural areas.ObjectivesThe study aimed to document the treatment-seeking behavior of women for their infertility problems. Further, the research focused on the socio-economic determinants affecting allopathic treatment-seeking of women and the services needed for couples experiencing infertility in rural India.MethodsThe study is cross-sectional. Primary data were collected from the two high infertility prevalence districts. Complete mapping and listing were carried out to identify the eligible respondents. A total of 159 ever-married women (20–49 years) out of 172 identified women were interviewed. Bivariate and multivariate analyses were performed.ResultsAmong 159 interviewed women, only three did not seek any kind of treatment. Of the 156 women, 63, 65, and 28 women (mutually exclusive) received first, second and third-order treatment, respectively. The number of women decreased in the succeeding phases of infertility. Women aged above 35 years, were significantly less (OR = 0.310, p < 0.05) compared to women aged below 30 years to receive allopathic treatment. The use of allopathic treatment was significantly three times higher among women who were educated (OR = 3.712, p < 0.01) and two times higher among those who were exposed (OR = 2.217, p < 0.5) to media. Further, for those who had felt the treatment was necessary, about 30, 44, 10, and 19% mentioned that due to unaffordability, inaccessibility, or inconveniences they couldn't consult allopathic treatment.ConclusionsTimely diagnosis and appropriate treatment play important role in infertility management. Women who are more educated and are exposed to media tend to consult allopathic treatment. Similarly, time and money spent on care vary significantly and independently by type of treatment and socioeconomic factors. There is a need for mandatory insurance coverage for infertility treatment enacted by the state government. In addition to the public services, the private sector and the traditional healers are both important alternative sources of first help.
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Affiliation(s)
- Shraboni Patra
- Department of Population and Development, International Institute for Population Sciences (IIPS), Mumbai, India
- *Correspondence: Shraboni Patra
| | - Sayeed Unisa
- Department of Biostatistics and Epidemiology, International Institute for Population Sciences (IIPS), Mumbai, India
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Tokgoz VY, Kaya Y, Tekin AB. The level of anxiety in infertile women whose ART cycles are postponed due to the COVID-19 outbreak. J Psychosom Obstet Gynaecol 2022; 43:114-121. [PMID: 32812477 DOI: 10.1080/0167482x.2020.1806819] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
AIM This study evaluated the level of fear and anxiety related to the COVID-19 outbreak, in infertile women whose ART cycles were delayed due to the pandemic. MATERIALS AND METHODS An online survey was sent to women whose ART cycles were postponed due to the COVID-19 outbreak between April and May 2020. The study population were 101 participants. The main outcome measure is to determine the levels of fear and anxiety in infertile women by using the Spielberger State-Trait Anxiety Inventory (STAI-T and STAI-S) and Fear of COVID-19 scale (FCV-19S). The relationship of the COVID-19 outbreak with the willingness to go ahead with the desire for pregnancy was also assessed. RESULTS The state-anxiety levels were significantly higher in women above 35 years (45.0 ± 5.2 vs. 42.2 ± 4.5, p = 0.006). Women with diminished ovarian reserve had a higher state-anxiety compared to other causes, but were not found to be significant (44.7 ± 5.2 vs. 42.5 ± 5.0, p = 0.173). Women who thought that the possibility of not being able to get pregnant was more important than being infected with the COVID-19 had higher anxiety levels than women who thought just the opposite. The diminished ovarian reserve and high duration of infertility were found to be significantly associated with higher anxiety levels (OR = 2.5, p < 0.05). The diminished ovarian reserve and previous ART failure significantly predicted the presence of clinical state-anxiety. CONCLUSION The state-anxiety was found to be higher in women whose cycles were postponed due to the outbreak and the presence of diminished ovarian reserve also significantly affected anxiety levels. Further research is needed to assess whether COVID-19 will have any impact on ART treatments in the next few years.
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Affiliation(s)
- Vehbi Yavuz Tokgoz
- Department of Obstetrics and Gynecology, Eskisehir Osmangazi University, Faculty of Medicine, Eskisehir, Turkey
| | - Yeliz Kaya
- Department Obstetric And Women's Disease Nursing, Eskisehir Osmangazi University, Faculty of Health Sciences, Eskisehir, Turkey
| | - Ahmet Basar Tekin
- Department of Obstetrics and Gynecology, Eskisehir Osmangazi University, Faculty of Medicine, Eskisehir, Turkey
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Swift A, Reis P, Swanson M. Infertility-related stress and quality of life in women experiencing concurrent reproductive trauma. J Psychosom Obstet Gynaecol 2022; 43:171-176. [PMID: 34907847 DOI: 10.1080/0167482x.2021.2008901] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
PURPOSE To compare differences in infertility-related stress and quality of life (QOL) among women with infertility and concurrent reproductive trauma, defined as pregnancy loss during the infertility experience. MATERIALS AND METHODS We used a descriptive, cross-sectional study design to recruit 205 women who underwent infertility treatments from infertility-related Facebook support groups and pages. Participants completed the Copenhagen Multi-center Psychosocial Infertility Fertility Problem Stress Scale, the Fertility Quality of Life tool, and a supplemental infertility demographic form. Statistical analyses included descriptive statistics, Pearson correlations, multivariate analysis of variance (MANOVA), univariate ANOVA, and eta squared. Statistical significance was evaluated using a Bonferroni adjusted alpha = .05/7 = .007. RESULTS Participants with concurrent reproductive trauma had significantly higher social stress (p < .001), and significantly lower emotional QOL (p = .003) than women with infertility alone. Although not statistically significant, participants with concurrent reproductive trauma reported higher personal and marital stress scores and lower mind/body, relational, and social QOL scores than women with infertility alone. CONCLUSIONS Women with concurrent reproductive trauma may need psychological support to combat the emotional distress of pregnancy loss during infertility treatment.
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Affiliation(s)
- Alison Swift
- Department of Advanced Nursing Practice and Education, East Carolina University College of Nursing, Greenville, NC, USA
| | - Pamela Reis
- Department of Nursing Science, East Carolina University College of Nursing, Greenville, NC, USA
| | - Melvin Swanson
- Department of Nursing Science, East Carolina University College of Nursing, Greenville, NC, USA
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Teklemicheal AG, Kassa EM, Weldetensaye EK. Prevalence and correlates of infertility related psychological stress in women with infertility: a cross-sectional hospital based survey. BMC Psychol 2022; 10:91. [PMID: 35392978 PMCID: PMC8988399 DOI: 10.1186/s40359-022-00804-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 03/31/2022] [Indexed: 11/23/2022] Open
Abstract
Background Psychological stress is commonly found among infertile women. Untreated stress can affect negatively the success of infertility treatment. Most of the available knowledge is generated from developed countries and is largely based on women undergoing In vitro fertilization (IVF) treatment. However, very little is known on infertile women from Ethiopia including other countries in East Africa. The aim of this study was to determine the prevalence of psychological stress and possible demographic-clinical correlates in Ethiopian women suffering from infertility. Method This cross sectional descriptive correlation study was conducted from May to August, 2021 involving 96 women undergoing a non-IVF treatment for infertility at Gandhi Memorial and Tikur Anbessa hospitals. The sampling was continuous and based on inclusion criteria that include infertility duration of a minimum one year, female sex and Ethiopian nationality. Data on Infertility related stress was collected using the Copenhagen Multi‐Centre Psychosocial Infertility-Fertility Problem Stress questionner administered by an interviewer. The socio demographic and clinical factors were collected using Amharic version of structured interviewer administered questionnaire and chart review. The analysis of relationship between infertility related stress and background variables was done with an independent sample t-test or one-way ANOVA statistics supplemented with effect size assessment. Results The prevalence of infertility related stress was overall 92.71% (95% CI, 87–98%). The personal, marital, and social subdomain mean scores (SD) were 2.74 (.80), 1.54 (.81) and 1.90 (.80), respectively. Infertility related stress was higher for those women who were: aged above 35, living in a cohabitation marital type, has no living children, and with 4–6 years duration of infertility (all P < 0.05). Whereas, there was insufficient evidence to suggest that infertility related stress varies by education, income, knowledge of cause of infertility or history of past treatment (all P > 0.05). Conclusions The prevalence of psychological stress among Ethiopia women having infertility was very high. The results provide preliminary evidence that infertility related stress is associated with age, marital status, motherhood status and duration of infertility. Responsible bodies need to avail psychological screening and services prioritizing women at higher risk of developing stress.
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Affiliation(s)
- Ashebir Getachew Teklemicheal
- Gandhi Memorial Hospital, Addis Ababa, Ethiopia. .,Department of Obstetrics and Gynecology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Eyasu Mesfin Kassa
- Department of Obstetrics and Gynecology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
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Flykt MS, Prince M, Vänskä M, Lindblom J, Minkkinen J, Tiitinen A, Poikkeus P, Biringen Z, Punamäki RL. Adolescent attachment to parents and peers in singletons and twins born with assisted and natural conception. Hum Reprod Open 2022; 2022:hoac012. [PMID: 35419495 PMCID: PMC8994490 DOI: 10.1093/hropen/hoac012] [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: 08/20/2021] [Revised: 03/01/2022] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION Does adolescent attachment to parents and peers differ between singletons and twins born with ART or natural conception (NC)? SUMMARY ANSWER Adolescent attachment anxiety with the father was higher among NC singletons than among ART and NC twins, whereas attachment avoidance with the father was higher in ART singletons than in NC singletons and NC twins. No differences were found in attachment to the mother, best friend or romantic partner. WHAT IS KNOWN ALREADY Most studies have not found differences between ART and NC singletons in parent–adolescent relationships, but twin relationships may be more at risk. No previous study has examined all four groups in the same study, or specifically looked at attachment relationships. STUDY DESIGN, SIZE, DURATION This was an 18-year, prospective and controlled longitudinal study with families of 496 ART singletons, 101 ART twin pairs, 476 NC singletons and 22 NC twin pairs. Families were recruited during the second trimester of pregnancy; the ART group was recruited from five infertility clinics in Finland and the control group was recruited from a hospital outpatient clinic during a routine visit. PARTICIPANTS/MATERIALS, SETTING, METHODS Mothers and fathers gave background information for this study during pregnancy, and during the child’s first year and early school age (7–8 years). For the ART group, infertility characteristics and prenatal medical information was also obtained from the patient registry of the infertility clinics. Children (originally 50% girls) filled in electronic questionnaires related to their attachment to mother, father, best friend and romantic partner (Experiences in Close Relationships—Relationship Structures) at 17–19 years of age. MAIN RESULTS AND THE ROLE OF CHANCE Adolescent attachment anxiety to father was higher in NC singletons than in ART twins, P = 0.004 and marginally higher than in NC twins, P = 0.06. Adolescent attachment avoidance to father was higher in ART singletons than in NC singletons, P = 0.006 and marginally higher than in NC twins, P = 0.055. LIMITATIONS, REASONS FOR CAUTION The sample size was small especially in the NC twin group and there was drop-out over the 18-year time period, especially among boys and families with lower parental education level. The study only included native Finnish-speaking families. The results could differ in a more diverse population. ART singletons were younger and had fewer siblings than ART twins and NC children, and ART and NC twins had more newborn health risks than ART and NC singletons. WIDER IMPLICATIONS OF THE FINDINGS The study adds to a growing body of evidence that neither ART treatments nor being a twin places mother–child relationships or peer relationships at long-term risk. However, in our study, which was the first to examine both ART and twinhood simultaneously, we found that there may be more problems in father–adolescent relationships, but only in ART singletons and only related to attachment avoidance. Our findings suggest that men, as well as women, should receive enough support in pre- and peri-natal health care during and after infertility treatments. STUDY FUNDING/COMPETING INTEREST(S) This study was funded by Academy of Finland (grant number 2501308988), the Juho Vainio Foundation and the Finnish Cultural Foundation. The authors report no conflict of interest. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- M S Flykt
- University of Helsinki, Faculty of Medicine, Department of Psychology and Logopedics, 00014 University of Helsinki, Helsinki, Finland
- Tampere University, Faculty of Social Sciences, Department of Psychology, 33014 Tampere University, Tampere, Finland
| | - M Prince
- Colorado State University, Department of Psychology, Fort Collins, Colorado, 80523, USA
| | - M Vänskä
- Tampere University, Faculty of Social Sciences, Department of Psychology, 33014 Tampere University, Tampere, Finland
| | - J Lindblom
- Tampere University, Faculty of Social Sciences, Department of Psychology, 33014 Tampere University, Tampere, Finland
- University of Turku, Department of Clinical Medicine, 20014 University of Turku, Turku, Finland
| | - J Minkkinen
- Tampere University, Faculty of Social Sciences, Department of Psychology, 33014 Tampere University, Tampere, Finland
| | - A Tiitinen
- University of Helsinki, Faculty of Medicine, Department of Obstetrics and Gynecology, 00014 University of Helsinki, Helsinki, Finland
- Helsinki University Hospital, 00029 Helsinki University Hospital, Helsinki, Finland
| | - P Poikkeus
- University of Helsinki, Faculty of Medicine, Department of Obstetrics and Gynecology, 00014 University of Helsinki, Helsinki, Finland
- Helsinki University Hospital, 00029 Helsinki University Hospital, Helsinki, Finland
| | - Z Biringen
- Colorado State University, Department of Human Development and Family Studies, Fort Collins, Colorado, 80523, USA
| | - R-L Punamäki
- Tampere University, Faculty of Social Sciences, Department of Psychology, 33014 Tampere University, Tampere, Finland
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McQuillan J, Passet-Wittig J, Greil AL, Bujard M. Is perceived inability to procreate associated with life satisfaction? Evidence from a German panel study. REPRODUCTIVE BIOMEDICINE & SOCIETY ONLINE 2022; 14:87-100. [PMID: 34877417 PMCID: PMC8627902 DOI: 10.1016/j.rbms.2021.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 08/13/2021] [Accepted: 09/24/2021] [Indexed: 05/19/2023]
Abstract
Most studies of the psychosocial consequences of infertility have focused on those who seek medical treatment, leaving a research gap regarding the psychosocial consequences of perceived inability to procreate in the general population. Moreover, most studies are cross-sectional and the results are thus likely affected by omitted variable bias. Inspired by aspects of the Theory of Conjunctural Action, this study analysed 10 waves of data from the German Family Panel (pairfam) for women and men using fixed effects panel regression and including time-varying control variables suggested by theory and research. This study found that both women and men experienced lower life satisfaction in years when they perceived an inability to procreate. This association was not affected by the inclusion of relevant time-varying control variables. Furthermore, the association between perceived barriers to procreation and life satisfaction was found to differ depending on life circumstances and gender. Women with partners and men without partners had lower life satisfaction when they perceived an inability to procreate compared with when they did not. Women and men who intended to have a(nother) child had lower life satisfaction when they perceived an inability to procreate compared with when they did not. The association, however, was only significant for men. Somewhat surprisingly, women who perceived an inability to procreate also had lower life satisfaction when they were not intending to have a(nother) child. This study makes an important contribution to research on the psychosocial consequences of perceived infertility, and provides insights into why some people may pursue assisted reproductive technology for family creation.
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Affiliation(s)
- Julia McQuillan
- Department of Sociology, University of Nebraska-Lincoln, Lincoln, NE, USA
| | | | - Arthur L. Greil
- Liberal Arts and Sciences, Alfred University, Alfred, NY, USA
| | - Martin Bujard
- Federal Institute for Population Research, Wiesbaden, Germany
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Laboring to Conceive: Reducing Barriers to Fertility Care for Same-Sex Mothers Pursuing Parenthood. WOMEN 2022. [DOI: 10.3390/women2010005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Infertility clinics and providers in the United States have made efforts to become LGBTQ-inclusive, yet patients in same-sex partnerships continue to face disproportionate barriers to accessing fertility services when pursuing parenthood. This narrative case study of a same-sex couple’s “labor to conceive” illustrates some of the structural barriers to family building that lesbian mothers face when seeking fertility care, including insurance coverage of fertility treatments, federal regulations for sperm donation, and legal definitions of parenthood. Exclusionary medical and legal systems are discussed, as are the informal strategies that this same-sex couple utilized to negotiate and circumvent these barriers. A patient-centered model of advocacy that facilitates access to and protection of same-sex partners seeking (in)fertility services is presented. Intervention points at the (1) Logistical and (2) Societal levels are considered with respect to three domains of same-sex reproduction: (A) insurance; (B) sperm donation; (C) legal adoption.
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21
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Hecht LM, Hadwiger A, Patel S, Hecht BR, Loree A, Ahmedani BK, Miller-Matero LR. Disordered eating and eating disorders among women seeking fertility treatment: A systematic review. Arch Womens Ment Health 2022; 25:21-32. [PMID: 34175997 DOI: 10.1007/s00737-021-01156-x] [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: 03/21/2021] [Accepted: 06/14/2021] [Indexed: 10/21/2022]
Abstract
The purpose of this systematic review is to evaluate the prevalence of disordered eating and eating disorders among women seeking fertility treatment.Observational studies were searched in Ovid MEDLINE, Web of Science, Embase, and PsycInfo. Studies published prior to September 2020 when the search was conducted were considered. Inclusion criteria included (1) original and empirical research, (2) published in a peer-reviewed journal, and (3) reported on disordered eating among women seeking fertility treatment in the sample or reported on prevalence of eating disorders among women seeking fertility treatment in the sample. Independent screening of abstracts was conducted by two authors (LH and AH). Ten studies met the inclusion criteria. Sample size, study location, measures, and results for each study in this review were reported.Among women pursuing fertility treatment, rates of current eating disorders ranged from 0.5 to 16.7%, while past eating disorder prevalence rates ranged from 1.4 to 27.5%. Current anorexia nervosa or bulimia nervosa was reported by up to 2% and 10.3% of women, respectively, while history of anorexia nervosa or bulimia nervosa was reported by up to 8.5% and 3.3% of women, respectively. Binge eating disorder or other eating disorders were reported by up to 18.5% and 9.1% of women, respectively. Disordered eating pathology was endorsed by 1.6 to 48% of women seeking fertility treatment. Endorsement of pathological eating attitudes was generally higher among women seeking fertility treatment with current or past eating disorders as compared to community samples, with the exception of dietary restraint. Rates of current and past eating disorders are higher among women seeking fertility treatment than in the general population. Providers treating women with infertility should be cognizant of these prevalence rates and consider screening for eating pathology in their patients as this may contribute to their likelihood of successful conception and/or subsequent pregnancy outcomes.
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Affiliation(s)
- Leah M Hecht
- Henry Ford Health System, Center for Health Policy and Health Services Research, 1 Ford Place Suite 3A, Detroit, MI, 48202, USA.
| | - Ashley Hadwiger
- Henry Ford Health System, Behavioral Health, 1 Ford Place Suite 1C, Detroit, MI, 48202, USA
| | - Shivali Patel
- Henry Ford Health System, Behavioral Health, 1 Ford Place Suite 1C, Detroit, MI, 48202, USA
| | - Bryan R Hecht
- MetroHealth Medical Center, Division of Reproductive Endocrinology, 2500 Metrohealth Dr, Cleveland, OH, 44109, USA
| | - Amy Loree
- Henry Ford Health System, Center for Health Policy and Health Services Research, 1 Ford Place Suite 3A, Detroit, MI, 48202, USA
| | - Brian K Ahmedani
- Henry Ford Health System, Center for Health Policy and Health Services Research, 1 Ford Place Suite 3A, Detroit, MI, 48202, USA.,Henry Ford Health System, Behavioral Health, 1 Ford Place Suite 1C, Detroit, MI, 48202, USA
| | - Lisa R Miller-Matero
- Henry Ford Health System, Center for Health Policy and Health Services Research, 1 Ford Place Suite 3A, Detroit, MI, 48202, USA.,Henry Ford Health System, Behavioral Health, 1 Ford Place Suite 1C, Detroit, MI, 48202, USA
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22
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Woods BM, Patrician PA, Fazeli PL, Ladores S. Infertility-related stress: A concept analysis. Nurs Forum 2021; 57:437-445. [PMID: 34873709 DOI: 10.1111/nuf.12683] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 11/08/2021] [Accepted: 11/29/2021] [Indexed: 11/30/2022]
Abstract
AIM To develop a clear definition of infertility-related stress using Rodgers' method of concept analysis. BACKGROUND Infertility affects approximately 13% of women in the United States. Though poorly defined in the literature, previous studies suggest infertility-related stressors contribute to psychological distress. DESIGN Rodgers' method of concept analysis guided the review, including sample and setting, literature search, and data analysis. DATA SOURCE PubMed, CINAHL, and PsycINFO were searched for relevant literature. REVIEW METHODS Following abstract, title, and text screenings, 21 articles were included and reported using the PRISMA-S checklist. Texts were analyzed and results informed the proposed definition of infertility-related stress. RESULTS Antecedents included infertility, desire for children, and fear of the unknown. Attributes were identity crisis, social isolation and stigma, sexual stress, and financial strain. Consequences included treatment dropout and marital strain. Anxiety, depression, and decreased quality of life were identified as both attributes and consequences. CONCLUSIONS Synthesized results informed a proposed definition of infertility-related stress. Improved understanding of infertility-related stress allows for measurement development and facilitates recognition of patients in need of additional support, while potentially reducing the impact on the health and well-being of infertile women.
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Affiliation(s)
- Brittany M Woods
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Patricia A Patrician
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Pariya L Fazeli
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Sigrid Ladores
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Fledderjohann J. Self-reported fertility impairments and help-seeking strategies among young women in Malawi. Glob Public Health 2021; 17:2139-2155. [PMID: 34376104 PMCID: PMC8831643 DOI: 10.1080/17441692.2021.1965179] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This paper analyses wave 4 the Tsogolo la Thanzi survey of n = 1349 Malawian women aged 16–26 to explore the prevalence and predictors of self-reported fertility impairments (difficulties conceiving and/or difficulties carrying a pregnancy to term) and help-seeking strategies. Using descriptive statistics, logistic regression models, and graphic displays, the correlates of self-reporting an impairment and patterns of help-seeking strategies are examined. Nearly 13% (n = 117) of those who had ever tried to conceive reported experiencing a fertility impairment. Age was positively associated with reporting an impairment, while there was a negative association with education and with parity. Of women who reported an impairment, 85.5% sought help. Visiting a hospital or clinic was the most common response, followed closely by going to a traditional healer. Around one-quarter employed multiple help-seeking strategies, highlighting the need for various help-seeking behaviours to be viewed in tandem rather than in isolation.
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Grunberg PH, Da Costa D, Dennis CL, O'Connell S, Lahuec A, Zelkowitz P. 'How did you cope with such concerns?': insights from a monitored online infertility peer support forum. HUM FERTIL 2021:1-15. [PMID: 34347545 DOI: 10.1080/14647273.2021.1959952] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The Research Question posed was 'What coping strategies do fertility patients and trained peer supporters discuss in an online infertility peer support forum?' A thematic analysis was used to examine 244 online posts from a sample of 39 users (37 women and two men) for themes in coping with fertility-related stressors. Data were collected from Connect, a monitored online discussion forum with trained peer supporters. Connect users ranged from 27 to 44 years of age (mean = 34.38) and 33 (84.6%) were nulliparous at the time of the study. A variety of cognitive-reappraisal and practical management coping strategies was discussed across four themes: (i) balancing interpersonal relationships; (ii) partner support; (iii) uncertainty and lack of control; and (iv) positivity and negativity. Experiences of uncertainty and lack of control related to time and schedule, outcomes and waiting for physical symptoms, and the clinic. Connect users commonly discussed the helpfulness of coping strategies. Connect users actively requested experiential information about ways of coping from other patients and peer supporters, highlighting the importance of lived experience to those currently in treatment. Findings support conceptualizations of infertility coping as a process that is unique to the infertility treatment context and that may change throughout a patient's treatment. Trained peer supporters may benefit fertility patients by normalizing, reappraising, and providing practical strategies to ameliorate difficult infertility-related challenges.
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Affiliation(s)
- Paul H Grunberg
- Department of Psychology, McGill University, Montreal, Canada.,Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada
| | - Deborah Da Costa
- Department of Medicine, Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, McGill University, Montreal, Canada
| | - Cindy-Lee Dennis
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Siobhan O'Connell
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada
| | - Alix Lahuec
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada
| | - Phyllis Zelkowitz
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada.,Department of Psychiatry, McGill University, Montreal, Canada
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Shreffler KM, Gibbs L, Tiemeyer S, McQuillan J, Greil AL. Is Reproductive Orientation Associated with Sexual Satisfaction Among Partnered U.S. Women? ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:2459-2469. [PMID: 34346003 PMCID: PMC8515561 DOI: 10.1007/s10508-021-01984-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 03/02/2021] [Accepted: 03/10/2021] [Indexed: 06/13/2023]
Abstract
Little is known about how "reproductive orientation" (i.e., trying to get pregnant, ambivalent about pregnancy, trying to avoid pregnancy, or having had a sterilization surgery) is associated with sexual satisfaction among women of childbearing age. Using data from the National Survey of Fertility Barriers (N = 2811), we examined the association of reproductive orientation with sexual satisfaction, adjusting for relationship characteristics including union type (cohabitation versus marriage), quality, and length; infertility history; and demographic characteristics including age, parity, and race/ethnicity. Results indicated that women who were ambivalent or trying to get pregnant reported significantly higher levels of sexual satisfaction than women who were sterile in the unadjusted model, but not in the models that included relationship quality. The association of reproductive orientation and sexual satisfaction depended upon relationship quality; among women with lower relationship quality, "trying" was associated with higher, and among those with higher relationship quality, with lower sexual satisfaction.
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Affiliation(s)
- Karina M Shreffler
- College of Nursing, University of Oklahoma Health Sciences Center, 1100 N. Stonewall Ave., Oklahoma City, OK, 73117, USA.
| | - Larry Gibbs
- Department of Sociology and Anthropology, Southern Oregon University, Ashland, OR, USA
| | - Stacy Tiemeyer
- Center for Integrative Research on Childhood Adversity, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Julia McQuillan
- Department of Sociology, The University of Nebraska at Lincoln, Lincoln, NE, USA
| | - Arthur L Greil
- Department of Sociology, Alfred University, Alfred, NY, USA
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Öztürk R, Herbell K, Morton J, Bloom T. "The worst time of my life": Treatment-related stress and unmet needs of women living with infertility. JOURNAL OF COMMUNITY PSYCHOLOGY 2021; 49:1121-1133. [PMID: 33616236 PMCID: PMC8324009 DOI: 10.1002/jcop.22527] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/27/2021] [Accepted: 02/02/2021] [Indexed: 05/11/2023]
Abstract
Approximately 12% of women in the United States have difficulty getting pregnant or carrying a pregnancy to term (i.e., infertility). Infertility permeates women's lives and is psychologically, socially and financially burdensome. This study aimed to describe women's experiences regarding infertility and explore factors that women find helpful to alleviate their fertility-related stressors. Using purposive sample, we conducted in-depth qualitative interviews with infertile women. Participants reported multiple infertility treatment-related stressors including (a) difficulty accessing infertility treatment due to financial issues, geographic disparities, and healthcare provider factors; (b) challenges during infertility treatment related to painful, embarrassing, confusing treatments, side effects, and healthcare providers' failures to fully address women's needs. The stories and findings add to a body of literature that elucidate significant stressors that women encounter in their fertility journey including a desire for empathetic, understandable, and effective treatment and support, and the crucial role of healthcare providers.
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Affiliation(s)
- Ruşen Öztürk
- Women Health and Diseases Nursing Department, Ege University Nursing Faculty, izmir, Turkey
| | - Kayla Herbell
- Ohio State University College of Nursing, Ohio State University, 1585 Neil Ave, Columbus, Ohio, USA
| | - Jamie Morton
- Sinclair School of Nursing, University of Missouri, Columbia, Missouri, USA
| | - Tina Bloom
- Sinclair School of Nursing, University of Missouri, Columbia, Missouri, USA
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Deepti MK, Reka K, Chinta P, Karthikeyan M, Kunjummen AT, Kamath MS. Perinatal Outcomes Using Ejaculate versus Surgical Sperm Retrieval in Patients Undergoing Intracytoplasmic Sperm Injection for Male Infertility - A Retrospective Analysis of 628 Cycles. J Hum Reprod Sci 2021; 14:49-55. [PMID: 34083992 PMCID: PMC8057148 DOI: 10.4103/jhrs.jhrs_197_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 12/17/2020] [Accepted: 01/27/2021] [Indexed: 12/02/2022] Open
Abstract
Background: Men with azoospermia undergoing a surgical sperm retrieval are anxious about the well-being of the baby. It is therefore important to study the perinatal outcomes in this group compared to the ejaculate sample group. Aim: The aim of the study was to compare the perinatal outcomes between ejaculate and surgical sperm retrieval (SSR) groups in couples undergoing intracytoplasmic sperm injection for male factor. Study Setting and Design: This was a retrospective cohort study conducted in a university-level infertility unit. Materials and Methods: It is a retrospective cohort study analysis of 628 assisted reproductive technique (ART) cycles with male factor and combined (male and female) factor infertility over a period of 5 years (January 2011–December 2015). All women who underwent a fresh embryo ART cycle were followed up. The study population included the ejaculate and SSR groups. The perinatal outcomes of these two groups were compared. The congenital anomaly risks among the two groups were also analyzed. Statistical Analysis: Chi-square test, Fisher's exact test and Logistic regression Results: A total of 628 ART cycles were included in the current study, of which 478 cycles used ejaculate sperm, while SSR was done in 150 cycles. The analysis was restricted to singletons, and the risk of preterm birth was 22.9% in the ejaculate group, 5.9% in the epididymal group, and 12% in the testicular group (epididymal vs. ejaculate odds ratio [OR], 0.21; 95% confidence interval [CI]: 0.02–1.66) (testicular vs. ejaculate OR, 0.46; 95% CI: 0.12–1.65). The risk of low birth weight was 23.7% in the ejaculate group, 11.8% in the epididymal group, and 20.0% in the testicular group (epididymal vs. ejaculate OR, 0.42; 95% CI: 0.09–1.9) (testicular vs. ejaculate OR, 0.80; 95% CI: 0.27–2.3). The incidence of congenital anomalies was 7.3% in the ejaculate group, 0 in the epididymal group, and 3.5% in the testicular group (epididymal vs. ejaculate OR, 0.28; 95% CI: 0.01–5.2) (testicular vs. ejaculate OR, 0.63; 95% CI: 0.10–3.7) which was not significantly different. Conclusion: The current study showed no significant differences in the risk of adverse perinatal outcomes in the ejaculate group versus the surgically retrieved sperm groups.
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Affiliation(s)
- Mogili Krishna Deepti
- Department of Obstetrics and Gynaecology, NRI Medical College and General Hospital, Chinakakani, Andhra Pradesh, India
| | - Karuppusami Reka
- Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Parimala Chinta
- Department of Reproductive Medicine, Christian Medical College, Vellore, Tamil Nadu, India
| | - Muthukumar Karthikeyan
- Department of Reproductive Medicine, Christian Medical College, Vellore, Tamil Nadu, India
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Infertility Stress, Cortisol, Coping, and Quality of Life in U.S. Women Who Undergo Infertility Treatments. J Obstet Gynecol Neonatal Nurs 2021; 50:275-288. [DOI: 10.1016/j.jogn.2020.12.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/01/2021] [Indexed: 12/21/2022] Open
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Chauhan D, Jackson E, Harper JC. Childless by circumstance - Using an online survey to explore the experiences of childless women who had wanted children. REPRODUCTIVE BIOMEDICINE & SOCIETY ONLINE 2021; 12:44-55. [PMID: 33336089 PMCID: PMC7732864 DOI: 10.1016/j.rbms.2020.09.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 08/08/2020] [Accepted: 09/29/2020] [Indexed: 05/23/2023]
Abstract
Childlessness is increasing globally. This study aimed to explore the experiences of childless women who had wanted children. An online survey study was promoted through social media to recruit women aged ≥46 years who were childless by circumstance. The survey remained open for 15 days. In total, 303 survey responses were collected, 176 of which were complete surveys. In total, 15.3% (27/176) of women who had wanted children reported that they had not tried to have children, most commonly due to the lack of a partner (40.7%, 11/27). Of the 139 women who had tried to have children, 70.5% (98/139) had used calendar-based menstrual cycle tracking methods to identify their fertile window, and many had undergone fertility checks including hormone tests (75.5%, 105/139) and ultrasound scans (71.2%, 99/139). A significant proportion of women had experienced a miscarriage (40.2%, 56/139). Many women had decided not to have any fertility treatment (43.2%, 60/139). For those who did, the majority had tried in-vitro fertilization (74.6%, 59/79). The most common reason that women gave for stopping fertility treatment was due to emotional reasons (74.7%, 59/79). When asked how women felt now about their childlessness, the most common issues identified were unhappiness (85/158, 54%), acceptance (43/158, 27%) and happiness (30/158, 19%). There should be more support for unsuccessful fertility patients and other childless women, and more emphasis should be placed upon fertility education in order to ensure that women are better informed about fertility issues.
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Affiliation(s)
- Dilan Chauhan
- Institute for Women’s Health, University College London, London, UK
| | - Emily Jackson
- Department of Law, London School of Economics, London, UK
| | - Joyce C Harper
- Institute for Women’s Health, University College London, London, UK
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30
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Lemoine ME, O'Connell SBL, Grunberg PH, Gagné K, Ells C, Zelkowitz P. Information needs of people seeking fertility services in Canada: a mixed methods analysis. Health Psychol Behav Med 2021; 9:104-127. [PMID: 34104552 PMCID: PMC8158234 DOI: 10.1080/21642850.2021.1879650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Background Infertility is a challenging experience associated with high levels of psychological distress. Many people seeking fertility services use the internet to obtain information about their conditions and treatments. Objectives This mixed-methods study aimed to describe the information-seeking experience of people seeking fertility services with respect to the fulfillment of their individually defined information needs and explore relationships between the fulfillment of information needs and psychological outcomes. Methods One hundred and four participants completed a survey with close-ended and open-ended questions about their experience using an informational web-based application (app) called ‘Infotility’ and about their mental well-being before and after using the app. The questionnaires administered were the The Mobile Application Rating Scale (uMARS), the Fertility Quality of Life questionnaire (FertiQol), the Patient Empowerment Questionnaire (PEQ) and the General Anxiety Disorder 7-item Scale (GAD-7). Eleven participants completed in-depth qualitative interviews about their experience using the app. A thematic analysis was used to interpret qualitative results and quantitization was used to dichotomize participants into those with met information needs versus those with unmet information needs. Google Analytics was used to compare participants’ reported experience with their actual use of the app. Results The results of this study show that there is variability in the amount of information that people seeking fertility services wish to receive. Participants whose information needs were met reported improved psychological outcomes after using the app, while those with unmet needs showed no change in their psychological outcomes. Conclusions Our results suggest that fulfilling information needs was associated with improved psychological outcomes in people seeking fertility services. Our results also suggest that individual differences in information needs should be considered when developing health educational materials.
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Affiliation(s)
- Marie-Eve Lemoine
- Lady Davis Institute for Medical Research, Montreal, Canada.,University of Montreal, School of Public Health, Montreal, Canada
| | | | | | - Karolanne Gagné
- Jewish General Hospital Psychiatry Research Division, Montreal, Canada
| | - Carolyn Ells
- McGill University, Biomedical Ethics Unit, Montreal, Canada
| | - Phyllis Zelkowitz
- Jewish General Hospital Institute of Community and Family Psychiatry, Psychiatry, Montreal, Canada.,McGill University, Montreal, Canada
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31
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McQuillan J, Greil AL, Rybińska A, Tiemeyer S, Shreffler KM, Colaner CW. Is a dyadic stressor experienced as equally distressing by both partners? The case of perceived fertility problems. JOURNAL OF SOCIAL AND PERSONAL RELATIONSHIPS 2021; 38:342-362. [PMID: 38486941 PMCID: PMC10939084 DOI: 10.1177/0265407520953903] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/17/2024]
Abstract
Using data from a population survey, this article explores whether perceptions of having a fertility problem among 926 U.S. couples in heterosexual relationships (women aged 25-45 and male partners) are associated with distress. Most couples did not perceive a fertility problem (58%). In almost a third (30%) of the couples, only women perceived a fertility problem; in 4%, only the men; and in nearly a fifth (19%), both perceived a problem. Adjusted for characteristics associated with fertility problems and depressive symptoms, those who perceived a problem exhibited significantly more depressive symptoms than those who did not. Fertility problems are sometimes experienced as individual because in some couples only one partner perceives a problem or has higher distress in response to their own rather than to their partners' perceived problems. For women, fertility problems are experienced as a couple phenomenon because women were more distressed when both partners perceive a problem. The perception of fertility problems is gendered in that women were more likely to perceive a problem than men. Furthermore, men are most distressed when they perceive a problem and their partner does not.
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Affiliation(s)
| | | | - Anna Rybińska
- Duke University Sanford School of Public Policy, USA
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32
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Renzi A, Di Trani M, Solano L, Minutolo E, Tambelli R. Alexithymia, infertility-related stress and quality of life in women undergoing an assisted reproductive treatment. Stress Health 2020; 36:654-662. [PMID: 32472734 DOI: 10.1002/smi.2967] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 05/06/2020] [Accepted: 05/08/2020] [Indexed: 01/20/2023]
Abstract
The investigation of the association between alexithymia and quality of life in infertility is a relatively neglected area of research. The aim of this study was to evaluate the association between alexithymia and infertility-related quality of life in women during Assisted Reproductive Treatment. Data were collected in a clinic in Rome, 93 infertile women completed the 20-item Toronto Alexithymia Scale (TAS-20), the Fertility Quality of Life (FertiQoL) questionnaire and a socio-demographic questionnaire. TAS-20 total and two factors-Difficulty in Identifying Feelings (DIF) and Difficulty in Describing Feelings (DDF)-showed significant negative correlations with the overall questionnaire and with both Core and Treatment modules of FertiQoL. The regression model explained the 43% variance in FertiQol overall scores (R2 = 0.43; adjusted R2 = .38); a significant effect was reported for the number of previous attempts (beta = 0.20; p < .04), TAS-20 DIF (beta = -0.47; p < .001) and TAS-20 Externally Orientated Thinking (EOT) (beta = 0.20; p < .04); after applying Benjamini-Hochberg correction procedure only TAS-20 DIF maintained its significance. Alexithymia is associated with a worsened quality of life in infertile women; specifically, low difficulties in identifying feelings were associated to higher quality of life. Further investigations are needed also to develop specific therapeutic interventions aimed to promote emotional abilities in infertile people.
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Affiliation(s)
- Alessia Renzi
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
| | - Michela Di Trani
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
| | - Luigi Solano
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
| | - Elisa Minutolo
- Department of Reproductive Medicine, Altamedica-Artemisia SpA, Rome, Italy
| | - Renata Tambelli
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
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33
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Szigeti F J, Grevenstein D, Wischmann T, Lakatos E, Balog P, Sexty R. Quality of life and related constructs in a group of infertile Hungarian women: a validation study of the FertiQoL. HUM FERTIL 2020; 25:456-469. [PMID: 32985277 DOI: 10.1080/14647273.2020.1824079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
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.
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Affiliation(s)
- Judit Szigeti F
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | | | - Tewes Wischmann
- Institute of Medical Psychology, University Hospital Heidelberg, Heidelberg, Germany
| | - Enikő Lakatos
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | - Piroska Balog
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | - Réka Sexty
- Department of Neonatology, Children's Hospital, University Hospital Bonn, Bonn, Germany
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Chawłowska E, Lipiak A, Krzysztoszek J, Krupa B, Staszewski R. Reproductive Health Literacy and Fertility Awareness Among Polish Female Students. Front Public Health 2020; 8:499. [PMID: 33014982 PMCID: PMC7516014 DOI: 10.3389/fpubh.2020.00499] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 08/04/2020] [Indexed: 11/26/2022] Open
Abstract
The falling fertility indicators and high prevalence of infertility in Poland make it important for people of reproductive age to have good knowledge of their own fertility in order to be able to take care of their reproductive health. This paper examines reproductive health literacy and fertility awareness among Polish female students. It can help identify gaps in reproductive health education in Poland. The study group included 456 women aged 18–29, who were students of 6 public universities located in Poznan, Poland. The method used was a survey using a self-developed questionnaire assessing the students' knowledge of female and male fertility-related physiology and fertility patterns. The respondents' knowledge was assessed on the basis of the percentage of correct answers. Regression analysis and univariate analysis of variance were used to explore relationships between the students' knowledge and their age, year of study, university and source(s) of information. The average score of correct answers was 55.8%. Older students and medical university students were the most knowledgeable. 93.4% of the respondents correctly identified the optimum age for a woman to have the first child from the point of view of achieving pregnancy fast. Over 90% of the respondents knew such fertility-compromising risks as smoking, diseases and psychological distress. There was much poorer awareness of the adverse effect of unbalanced diet, irregular sleep, and long-lasting physical effort. 47.1% of the students reported gaining information from a number of sources, but as many as 28.3% said their only source was primary or middle school classes. Reproductive health knowledge among the young female students is incomplete, especially as regards lifestyle-related risks. They should be encouraged to supplement it by consulting reliable sources such as health professionals. It is advisable to ensure that the curricula of medical university students provide thorough knowledge in this area, and to arrange suitable electives for students from other universities. As primary and secondary school classes remain an important source of information, quality teaching at these levels should be offered with a focus on making the knowledge as practical and operational as possible. Relevant graduate, postgraduate and in-service courses should be available to professionals responsible for spreading reproductive health knowledge.
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Affiliation(s)
- Ewelina Chawłowska
- Laboratory of International Health, Department of Preventive Medicine, Poznan University of Medical Sciences, Poznań, Poland
| | - Agnieszka Lipiak
- Laboratory of International Health, Department of Preventive Medicine, Poznan University of Medical Sciences, Poznań, Poland
| | - Jana Krzysztoszek
- Department of Physical Activity Teaching, Poznan University of Physical Education, Poznań, Poland
| | | | - Rafał Staszewski
- Department of Hypertensiology, Angiology and Internal Diseases, Poznan University of Medical Sciences, Poznań, Poland
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Stellenwert psychotherapeutischer Betreuung im Rahmen der Subfertilitätsbehandlung. GYNAKOLOGISCHE ENDOKRINOLOGIE 2020. [DOI: 10.1007/s10304-020-00323-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Lasheras G, Mestre-Bach G, Clua E, Rodríguez I, Farré-Sender B. Cross-Border Reproductive Care: Psychological Distress in A Sample of Women Undergoing In Vitro Fertilization Treatment with and without Oocyte Donation. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2020; 14:129-135. [PMID: 32681625 PMCID: PMC7382677 DOI: 10.22074/ijfs.2020.5997] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 10/13/2019] [Indexed: 12/05/2022]
Abstract
Background Cross-border reproductive care (CBRC) refers to the movement of patients to foreign countries
for fertility treatment. Limited evidence indicates that this phenomenon is associated with a risk of psychologi-
cal distress, but few studies on the psychological impact of CBRC are currently available. The aim of this study
was to compare the anxiety and depression levels of a group of cross-border patients with a local Spanish patient
group, both of which underwent in vitro fertilization (IVF) treatment. We also sought to explore the clinical,
sociodemographic and personality profiles of the CBRC group and local women. Materials and Methods This present cross-sectional study was conducted on 161 infertile females (71 CBRC
patients and 90 local women) who were undergoing IVF treatment. The following questionnaires were used to
collect data: Spielberger State Anxiety Inventory (STAI-S), the Beck Depression Inventory-II (BDI-II) and the
Zuckerman-Kuhlman Personality Questionnaire (ZKPQ). Sociodemographic, clinical, reproductive and CBRC
variables were also recorded. Results CBRC patients, specifically CBRC oocyte recipients, showed higher levels of anxiety compared to lo-
cal women. However, no significant differences in depression scores were found between both groups. Finally,
when analysing personality, the Activity scale scores of the ZKPQ were found to be higher in CBRC oocyte
recipients, which indicated a greater tendency for general activity and higher energy levels. Conclusion CBRC oocyte recipient women may have greater vulnerability to anxiety than local women prior
to infertility treatment. Screening and psychological support protocols for anxiety in this population should be
considered.
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Affiliation(s)
- Gracia Lasheras
- Department of Psychiatry, Psychology and Psychosomatics, Dexeus University Hospital, Barcelona, Spain. Electronic Address:
| | - Gemma Mestre-Bach
- Department of Psychiatry, Psychology and Psychosomatics, Dexeus University Hospital, Barcelona, Spain.,Facultad de Ciencias de la Salud. Universidad Internacional de La Rioja, La Rioja, Spain
| | - Elisabet Clua
- Department of Obstetrics, Gynaecology and Reproduction, Dexeus University Hospital, Barcelona, Spain
| | - Ignacio Rodríguez
- Department of Obstetrics, Gynaecology and Reproduction, Dexeus University Hospital, Barcelona, Spain
| | - Borja Farré-Sender
- Department of Psychiatry, Psychology and Psychosomatics, Dexeus University Hospital, Barcelona, Spain
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Taebi M, Kariman N, Montazeri A, Majd HA. Development and psychometric evaluation of the female infertility stigma instrument (ISI-F): protocol for a mixed method study. Reprod Health 2020; 17:70. [PMID: 32448294 PMCID: PMC7245766 DOI: 10.1186/s12978-020-0904-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Accepted: 04/01/2020] [Indexed: 11/10/2022] Open
Abstract
Background Infertility stigma is one of the greatest challenges in most societies for reproduction and sexual health of infertile women. Since no specific tool exists for assessing the infertility stigma in women, this study would be conducted to develop and evaluate the psychometric properties of Female Infertility Stigma Instrument (ISI-F). Methods This is a mixed method study with sequential exploratory design (qualitative and quantitative phase). In the first qualitative phase, semi-structured interviews would be performed with infertile female who had experienced infertility whithout any psychological disorder. Women who are eligible for participating in the study will be selected using purposeful sampling method with maximum variation in terms of age, education, occupation and infertility duration. Data would be analyzed using conventional content analysis and in this phase the primary item pool will be developed for the Female Infertility Stigma Instrument (ISI-F). In the quantitative phase, the psychometric properties of the Instrument would be evaluated, including the content, face and construct validity as well as reliability via the internal consistency and stability. The psychometric properties described in the COSMIN checklist will be utilized for designing the instrument. Discussion Developing a valid and reliable scale for Female Infertility Stigma Instrument (ISI-F) would be helpful for future studies to assess the status of this situation. It also helps planning interventional studies for improvement of the reproductive health of infertile women.
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Affiliation(s)
- Mahboubeh Taebi
- Student Research Committee, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nourossadat Kariman
- Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Ali Montazeri
- Health Metrics Research Centre, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
| | - Hamid Alavi Majd
- Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Fieldsend M, Smith JA. 'Either stay grieving, or deal with it': the psychological impact of involuntary childlessness for women living in midlife. Hum Reprod 2020; 35:876-885. [PMID: 32268357 DOI: 10.1093/humrep/deaa033] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 01/29/2020] [Accepted: 02/10/2020] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION What is it like for women to be involuntarily childless in midlife? SUMMARY ANSWER Involuntarily childless women may be suffering from prolonged grief due to its ambiguous and intangible nature; however, they are also striving to find ways of dealing with their internal pain in order to live with their loss. WHAT IS KNOWN ALREADY Many studies examining issues around human reproduction have tended to place childlessness in the realm of medicalised infertility and report generalised mental issues, such as depression and psychological distress, existing amongst women undergoing fertility treatments. Few studies, however, have focused on the individual with regard to the experiential significance of involuntary childlessness and living beyond the phase of trying for a baby. STUDY DESIGN, SIZE, DURATION A phenomenologically oriented person-centred qualitative design was used. In-depth semi-structured interviews were conducted with 12 White British women, who identified themselves as involuntarily childless, recruited via three leading childless support networks in the UK. PARTICIPANTS/MATERIALS, SETTING, METHODS In order to retain an idiographic commitment to the detailed account of a person's experience, a homogeneous and purposive sampling was used applying the following criteria: women aged between 45 and 55; in long-term heterosexual relationships with no adopted children, stepchildren or children of a partner from a previous marriage or relationship; and no longer trying to have a child. Considering the homogeneity of ethnic background and wishing to respect cultural differences, this study focused on White British women living in the UK. Of the 12, one woman was found to not meet the criteria, and therefore, the experiential data of 11 interviews were used for the study and analysed using interpretative phenomenological analysis (IPA). MAIN RESULTS AND THE ROLE OF CHANCE Two higher-order levels of themes that illustrate intrapersonal features were identified: the intrapersonal consequences of loss and confronting internal pain. The former explicated the depth of internal pain while the latter revealed ways in which the participants deal with it in their everyday lives. The important finding here is that both themes are co-existing internal features and dynamically experienced by the participants as they live with the absence of much-hoped-for children. LIMITATIONS, REASONS FOR CAUTION Given the homogeneous sampling and the small number of participants, which is consistent with IPA, we want to be cautious in generalising our study findings. WIDER IMPLICATIONS OF THE FINDINGS This study offers the view that there might be potential mental health issues surrounding involuntary childlessness that are currently overlooked. Particularly because the loss of hope cannot be pathologised, and the grief is ambiguous and intangible, it might make people's grieving process more complicated. An ongoing sense of uncertainty also may persist in that involuntarily childless people may develop symptoms similar to those diagnosed with prolonged grief disorder (PGD). The overall findings elucidate the need for clinicians, counsellors and health professionals to be aware of the possible association with PGD and promote long-term support and care in helping to maintain psychological well-being for people dealing with involuntary childlessness. Furthermore, this research points to an educational application for younger people by offering information beyond an explanation of infertility and fertility treatment, helping to understand the lived experience of involuntary childlessness. STUDY FUNDING/COMPETING INTEREST(S) No funding was obtained for this study. The authors have no conflicts of interest to declare. TRIAL REGISTRATION NUMBER Not applicable.
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Affiliation(s)
- Megumi Fieldsend
- Department of Psychological Sciences, Birkbeck, University of London, Malet Street, London WC1E 7HX, UK
| | - Jonathan A Smith
- Department of Psychological Sciences, Birkbeck, University of London, Malet Street, London WC1E 7HX, UK
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Shreffler KM, Greil AL, Tiemeyer SM, McQuillan J. Is infertility resolution associated with a change in women's well-being? Hum Reprod 2020; 35:605-616. [PMID: 32112095 PMCID: PMC7105324 DOI: 10.1093/humrep/dez297] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 12/11/2019] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION Is giving birth associated with improved subjective well-being among involuntarily childless women? SUMMARY ANSWER Resolution of infertility is associated with increased life satisfaction and self-esteem, but not with a decrease in depressive symptoms. WHAT IS KNOWN ALREADY Cross-sectional data and studies of treatment-seekers show that infertility is associated with lower subjective well-being. Childless women with infertility tend to report lower subjective well-being than women who experience secondary infertility, but a prospective study using a random sample of involuntarily childless women over time has not previously been conducted. STUDY DESIGN, SIZE, DURATION The sample for the current study includes all women without children who met medical criteria for infertility or perceived a fertility problem (N = 283) at baseline and who were interviewed in both waves (3 years apart) of the National Survey of Fertility Barriers (NSFB), in a random-digit dialing telephone survey. It is therefore possible to explore here whether there are differences in the association of infertility resolution and subjective well-being among women who do and do not perceive themselves as having a fertility problem. PARTICIPANTS/MATERIALS, SETTING, METHODS Depressive symptoms (as measured by the Center for Epidemiologic Studies-Depression Scale), self-esteem (as measured by a modified version of the Rosenberg Self-esteem Scale) and life satisfaction (as measured by a modified version of the Satisfaction with Life Scale) were assessed for all 283 participants at both waves. For all three variables, change scores of 47 involuntarily childless women who resolved their infertility through a live birth were compared to the scores for the 236 women who remained childless. A number of variables shown to be associated with subjective well-being among infertile women were included as controls. MAIN RESULTS AND THE ROLE OF CHANCE No relationship between infertility resolution and change in depressive symptoms was observed (b = -0.04; P > 0.05). Involuntarily childless women who resolved their infertility improved in self-esteem (b = 0.74; P < 0.01) and life satisfaction (b = 1.06; P < 0.01). LIMITATIONS, REASONS FOR CAUTION Women were measured at only two time points. Only 47 women had a live birth between waves. While it is common practice to make causal interpretations based on panel data, such interpretations should be made with caution. In addition, the NSFB was conducted in the USA where medical expenditures are high and most fertility treatment expenses are not covered by insurance. Thus it may not be possible to generalize the findings to other modern industrialized societies. WIDER IMPLICATIONS OF THE FINDINGS Knowing that resolution of infertility is associated with improved subjective well-being is important for infertile couples and infertility professionals alike. STUDY FUNDING/COMPETING INTEREST(S) This research was supported in part by NICHD grant R01-HD044144 and NIGMS grant P20-GM109097 from the National Institutes of Health. The authors have no competing interests.
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Affiliation(s)
- Karina M Shreffler
- Human Development and Family Science, Oklahoma State University, Tulsa, OK, USA
| | - Arthur L Greil
- Emeritus of Sociology, Alfred University, Alfred, NY, USA
| | - Stacy M Tiemeyer
- Human Development and Family Science, Oklahoma State University, Tulsa, OK, USA
| | - Julia McQuillan
- Sociology, The University of Nebraska at Lincoln, Lincoln, NE, USA
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Grunberg P, Miner S, Zelkowitz P. Infertility and perceived stress: the role of identity concern in treatment-seeking men and women. HUM FERTIL 2020; 25:117-127. [DOI: 10.1080/14647273.2019.1709667] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Paul Grunberg
- Department of Psychology, McGill University, Montreal, Canada
| | - Skye Miner
- Department of Sociology, McGill University, Montreal, Canada
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada
| | - Phyllis Zelkowitz
- Department of Psychology, McGill University, Montreal, Canada
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada
- Department of Psychiatry, McGill University, Montreal, Canada
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Volpini L, Mazza C, Mallia L, Guglielmino N, Rossi Berluti F, Fernandes M, Violani C. Psychometric properties of the FertiQoL questionnaire in Italian infertile women in different stages of treatment. J Reprod Infant Psychol 2019; 38:324-339. [PMID: 31820662 DOI: 10.1080/02646838.2019.1698017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Reliable Fertility-specific QoL measures can be obtained through the FertiQoL, a questionnaire with six-subscales that consider different core aspects of the person's wellbeing and way of behaving during treatment. OBJECTIVE Examine the psychometric properties of all six-subscales of the Italian FertiQoL in a sample of infertile women and explore the effects of the ART treatment phases. METHOD 323 women, in three different treatment stages (Diagnostic, Stimulation, Transfer), completed the FertiQoL. Raw data were subject to Confirmatory Factor Analysis (CFA), and a structural equation modelling (SEM) was used to validate the hypothesised model. RESULTS CFA shows a good fit of the data to the FertiQoL hierarchical model (chi-square/df = 1.989, CFI = 0.88, RMSEA = 0.055). After the deletion of 2 items, all FertiQoL scales have good internal consistency. SEM showed that the ART treatment phase was positively associated with fertility-related QoL scores both in the Relational (β = 0.14, p < 0.05) and in the Tolerability (β = 0.17, p < 0.05) subscales. CONCLUSION All scales of the Italian FertiQoL version maintain good psychometric characteristics; Tolerability and Relational subscales are sensitive to the treatment stage and thus providing relevant information for the medical staff.
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Affiliation(s)
- Laura Volpini
- Department of Psychology, "Sapienza" University of Rome , Rome, Italy
| | - Cristina Mazza
- Department of Psychology, "Sapienza" University of Rome , Rome, Italy
| | - Luca Mallia
- Department of Movement, Human and Health Sciences, "Foro Italico" University of Rome , Rome, Italy
| | - Nino Guglielmino
- U.M.R. Centre - Hera, Reproductive Medicine Unity , Catania, Italy
| | | | - Mariana Fernandes
- Department of Psychology, "Sapienza" University of Rome , Rome, Italy
| | - Cristiano Violani
- Department of Psychology, "Sapienza" University of Rome , Rome, Italy
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St-Laurent A, Lardon É, Babineau V, Ruchat SM. Reproductive history, maternal anxiety and past physical activity practice predict physical activity levels throughout pregnancy. Prev Med Rep 2019; 16:100992. [PMID: 31788414 PMCID: PMC6879977 DOI: 10.1016/j.pmedr.2019.100992] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 08/15/2019] [Accepted: 09/15/2019] [Indexed: 12/02/2022] Open
Abstract
We compared physical activity (PA) levels between pregnant women who conceived naturally (NC) or after fertility treatments (FT) and determined factors predicting prenatal moderate-to-vigorous intensity physical activity (MVPA). The study was conducted in Trois-Rivières (Canada) between October 2015 and July 2018. MVPA and anxiety levels were assessed at each trimester of pregnancy (TR1, TR2 and TR3) using an accelerometer and the State-Trait Anxiety Inventory, respectively. Sociodemographic and reproductive history data were self-reported or collected from medical files. Repeated measures analysis of variance and regression analyses were conducted. Ninety-six women were included in the analyses (58 NC and 38 FT). MVPA levels and daily step counts decreased significantly throughout pregnancy (time effect: F = 28.68, p < 0.0001 and F = 39.18, p < 0.0001, respectively), but NC and FT women presented similar MVPA and daily step counts (no group effect). The decline in PA practice throughout pregnancy was similar in both groups (no interaction effect). At TR1, State (β = −0.272, p = 0.012) and Trait (β = −0.349, p = 0.001) anxiety and past PA (β = 0.483, p < 0.0001) were correlated with MVPA. Past MVPA was also correlated with MVPA at TR2 (β = 0.595, p < 0.0001) and TR3 (β = 0.654, p < 0.0001). Past PA was the strongest predictors of MVPA levels at TR1, TR2, and TR3, predicting 17% (p = 0.0002), 34% (p < 0.0001) and 42% (p < 0.0001), respectively. Overall, our findings suggest that MVPA practice throughout pregnancy is built on past PA practice. Therefore, to be effective at promoting PA throughout pregnancy, obstetric health care providers and fitness professionals should reinforce the importance of being active as early as possible during pregnancy.
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Affiliation(s)
- Audrey St-Laurent
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | - Émeline Lardon
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, Canada.,Institut Franco-Européen de Chiropraxie, Paris, France
| | - Véronique Babineau
- Department of Obstetrics and Gynaecology, Centre intégré universitaire de santé et de services sociaux de la Mauricie et- du-Centre-du-Québec, affiliated to the University of Montreal, Trois-Rivières, Quebec, Canada
| | - Stephanie-May Ruchat
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
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Greil AL, McQuillan J, Burch AR, Lowry MH, Tiemeyer SM, Slauson-Blevins KS. Change in Motherhood Status and Fertility Problem Identification: Implications for Changes in Life Satisfaction. JOURNAL OF MARRIAGE AND THE FAMILY 2019; 81:1162-1173. [PMID: 32981967 PMCID: PMC7518405 DOI: 10.1111/jomf.12595] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 06/05/2019] [Indexed: 05/22/2023]
Abstract
OBJECTIVE To determine whether the association between changes in life satisfaction and becoming a mother (or not) depends on fertility problem identification status. BACKGROUND Evidence and symbolic interactionist theory suggest that, for women who initially perceive a fertility barrier, gaining the valued identity "mother" should be associated with increases, and continuing to face a blocked goal (i.e. not becoming a mother) should be associated with decreases in life satisfaction. METHOD This study used the nationally representative two-wave National Survey of Fertility Barriers to conduct a change-score analysis with chained multiple imputation (MICE). The focal dependent variable was change in life satisfaction. Focal independent variables were Wave 1 life satisfaction, fertility problem identification status, and birth between waves, controlling for stability and change in relationship status, talking to a doctor about how to get pregnant, religiosity, social support, importance of parenthood, importance of leisure, importance of work success, and economic hardship. RESULTS Among women who perceived a fertility problem at both waves, becoming a mother was associated with increased life satisfaction and not becoming a mother was associated with decreased life satisfaction. Women who gained or lost a fertility problem perception between waves but did not have a live birth experienced a gain in life satisfaction between waves, suggesting the relevance of the duration of fertility problem perception for change in life satisfaction.
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Affiliation(s)
- Arthur L Greil
- Division of Social Sciences, Alfred University, 1 Saxon Drive, Alfred, NY 14802
| | - Julia McQuillan
- Department of Sociology, University of Nebraska, 709 Oldfather Hall. Lincoln, NE 68588-0324
| | - Andrea R Burch
- Division of Counseling and School Psychology, Alfred University, Alfred University, 1 Saxon Drive, Alfred, NY 14802
| | - Michele H Lowry
- Division of Social Sciences, Alfred University, 1 Saxon Drive, Alfred, NY 14802
| | - Stacy M Tiemeyer
- Department of Human Development and Family Science, Oklahoma State University, 2121 Main Hall, Tulsa, OK
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Nagórska M, Bartosiewicz A, Obrzut B, Darmochwał-Kolarz D. Gender Differences in the Experience of Infertility Concerning Polish Couples: Preliminary Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16132337. [PMID: 31269703 PMCID: PMC6651646 DOI: 10.3390/ijerph16132337] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 06/30/2019] [Accepted: 06/30/2019] [Indexed: 11/16/2022]
Abstract
The World Health Organization (WHO) determines infertility as a disease of the reproductive system defined clinically by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse. Estimates indicate that the problem of infertility in the world is continuing to grow. The aim of the study was to compare approaches to disease in partners of both sexes diagnosed with infertility. The study was conducted among 61 couples treated for infertility using an original questionnaire developed by the authors. The Chi square independence test was used for statistical analysis. Both men and women responded to the diagnosis of infertility with negative emotions. Regardless of sex, sadness and anxiety were the dominant feelings associated with the diagnosis of infertility. Women believed in the success of the treatment to a greater extent than men. Mainly women attempted to talk openly about the problem of infertility, while men were more restrained in this respect. Women accepted the assisted reproductive technologies (ART) to a greater extent than men, but men would accept childlessness more often than women.
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Affiliation(s)
- Małgorzata Nagórska
- Institute of Experimental and Clinical Medicine, Medical Faculty, University of Rzeszow, 35-959 Rzeszow, Poland.
| | - Anna Bartosiewicz
- Institute of Nursing and Health Sciences, Medical Faculty, University of Rzeszow, 35-959 Rzeszow, Poland
| | - Bogdan Obrzut
- Institute of Experimental and Clinical Medicine, Medical Faculty, University of Rzeszow, 35-959 Rzeszow, Poland
- Department of Obstetrics and Gynecology, Clinical Provincial Hospital No.2, Rzeszow, 35-301 Rzeszow, Poland
| | - Dorota Darmochwał-Kolarz
- Institute of Experimental and Clinical Medicine, Medical Faculty, University of Rzeszow, 35-959 Rzeszow, Poland
- Department of Obstetrics and Gynecology, Clinical Provincial Hospital No.2, Rzeszow, 35-301 Rzeszow, Poland
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Roomaney R, Kagee A, Heylen S. Biopsychosocial predictors of symptoms of depression in a sample of South African women diagnosed with endometriosis. Health Care Women Int 2019; 41:308-329. [PMID: 31242076 DOI: 10.1080/07399332.2019.1624758] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
We examined biopsychosocial predictors of symptoms of depression in women with endometriosis. The sample consisted of 202 women with endometriosis who completed a battery of measures including a demographic questionnaire, Beck Depression Inventory, Stellenbosch Endometriosis Quality of life Menstrual characteristics subscale, Short form health survey Physical functioning subscale, and three modular components of the Endometriosis Health Profile 30, namely the Sexual Relationships, Feelings about the Medical Profession, and Feelings about Infertility modules. About 43.1% of the sample reported moderate to severe symptoms of depression. Physical functioning, feelings about the medical profession and sexual relationships were significant predictors of symptoms of depression. The identification of these predictors may enable researchers and practitioners to identify patients to be screened for depression, e.g., patients who report sub-optimal physical functioning, negative feelings about the medical profession and difficult sexual relationships.
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Affiliation(s)
- Rizwana Roomaney
- Department of Psychology, Stellenbosch University, Matieland, South Africa
| | - Ashraf Kagee
- Department of Psychology, Stellenbosch University, Matieland, South Africa
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Huang MZ, Sun YC, Gau ML, Puthussery S, Kao CH. First-time mothers' experiences of pregnancy and birth following assisted reproductive technology treatment in Taiwan. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2019; 38:10. [PMID: 30925940 PMCID: PMC6441228 DOI: 10.1186/s41043-019-0167-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 03/18/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Assisted reproductive technology (ART) treatment tends to involve significant physical and emotional commitments that can impact maternal, infant, and family health and well-being. An in-depth understanding of experiences is necessary to provide adequate support for women and their families during pregnancy and transition to parenthood following ART treatment. The aim of this study was to explore first-time mothers' experiences of pregnancy and transition to parenthood following successful ART treatment in Taiwan. METHOD Twelve first-time mothers who conceived and gave live birth using ART treatment were purposively selected from a fertility centre in Taipei, Taiwan. Women's experiences in pregnancy and in their transition to motherhood were explored using semi-structured in-depth interviews. All interviews were recorded, transcribed, and analysed using the Colaizzi strategy. RESULTS The mothers' accounts reflected three main themes: 'being different from mothers who became pregnant naturally', 'ensuring health and safety of the foetus', and 'welcoming new lives with excitement'. The difference mothers felt about themselves was evident in four subthemes: becoming pregnant after a long wait, feeling vulnerable during pregnancy, relying on family's assistance and support, and worrying about the impact of ART on health. The theme on 'ensuring health and safety of the foetus' encompassed three subthemes: activities to protect the unborn baby, monitoring foetal movement constantly to maintain peace of mind, and receiving foetal reduction for the sake of the pregnancy. Narratives around 'welcoming new lives with excitement' reflected four subthemes: overcoming hardship for worthwhile results, realising one's life and dreams, proving to be fertile enough to give birth, and return to normal life track. CONCLUSION Findings indicate the need for educational and psychosocial interventions to support women and their families physically and psychologically during ART treatment. The stigma related to infertility and the psychosocial support from family are aspects to consider while planning intervention programmes.
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Affiliation(s)
- Mei-Zen Huang
- Department of Nursing, National Tainan Junior College of Nursing, 78, Sec.2 Minzu Rd, Tainan City, Taiwan
| | - Yi-Chin Sun
- Department of Nursing, National Taipei University of Nursing and Health Sciences, 365, Ming-Te Road, Peitou, Taipei, Taiwan
| | - Meei-Ling Gau
- Department of Midwifery and Women Health Care, National Taipei University of Nursing and Health Sciences, 365, Ming-Te Road, Peitou, Taipei, Taiwan
| | - Shuby Puthussery
- Maternal and Child Health Research Centre, Institute for Health Research & School of Health Care Practice, University of Bedfordshire, Putteridge Bury, Luton, Bedfordshire, LU2 8LE UK
| | - Chien-Huei Kao
- Department of Midwifery and Women Health Care, National Taipei University of Nursing and Health Sciences, 365, Ming-Te Road, Peitou, Taipei, Taiwan
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Greil AL, Slauson-Blevins KS, Lowry MH, McQuillan J. Concerns about treatment for infertility in a probability-based sample of US women. J Reprod Infant Psychol 2019; 38:16-24. [PMID: 30892066 DOI: 10.1080/02646838.2019.1587395] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: Many women experience infertility as distressing, but only about half of US women seek medical services. It is unknown whether concerns about fertility treatment are related to receiving fertility treatment or to distress levels.Methods: Using the nationally representative National Survey of Fertility Barriers, we constructed a nine-item scale measuring fertility treatment concerns. The analytical sample for this study included 1218 women who said that they were trying to become pregnant and who were asked questions regarding treatment concerns. We conducted multiple regression analysis to discover factors associated with treatment concerns and whether treatment concerns were associated with depressive symptoms and fertility-specific distress. We used logistic regression to determine whether treatment concerns were associated with receiving fertility tests.Results: Desiring a(nother) child, infertility stigma, higher family income, higher economic hardship and claiming a Hispanic identity were associated with higher levels of treatment concerns than those in the comparison groups. Having friends and family with children and having private health insurance were associated with lower levels of concern. Treatment concerns were not associated with receiving fertility tests. Higher levels of treatment concern were associated with higher levels of fertility-specific distress and depressive symptoms. Higher infertility stigma was related both directly and indirectly to higher levels of fertility-specific distress and depressive symptoms.Conclusion: For US women, fertility treatment concerns are not associated with whether women pursue fertility testing, but they are associated with higher levels of fertility-specific and general distress.
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Affiliation(s)
- Arthur L Greil
- Division of Social Sciences, Alfred University, Alfred, NY, USA
| | | | - Michele H Lowry
- Division of Social Sciences, Alfred University, Alfred, NY, USA
| | - Julia McQuillan
- Division of Social Sciences, University of Nebraska-Lincoln, Alfred, NY, USA
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Farquhar CM, Bhattacharya S, Repping S, Mastenbroek S, Kamath MS, Marjoribanks J, Boivin J. Female subfertility. Nat Rev Dis Primers 2019; 5:7. [PMID: 30679436 DOI: 10.1038/s41572-018-0058-8] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Subfertility is common and affects one in six couples, half of whom lack an explanation for their delay in conceiving. Developments in the diagnosis and treatment of subfertility over the past 50 years have been truly remarkable. Indeed, current generations of couples with subfertility are more fortunate than previous generations, as they have many more opportunities to become parents. The timely access to effective treatment for subfertility is important as many couples have a narrow window of opportunity before the age-related effects of subfertility limit the likelihood of success. Assisted reproduction can overcome the barriers to fertility caused by tubal disease and low sperm count, but little progress has been made in reducing the effect of increasing age on ovarian function. The next 5-10 years will likely see further increases in birth rates in women with subfertility, a greater awareness of lifestyle factors and a possible refinement of current assisted reproduction techniques and the development of new ones. Such progress will bring challenging questions regarding the potential benefits and harms of treatments involving germ cell manipulation, artificial gametes, genetic screening of embryos and gene editing of embryos. We hope to see a major increase in fertility awareness, access to safe and cost-effective fertility care in low-income countries and a reduction in the current disparity of access to fertility care.
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Affiliation(s)
- Cynthia M Farquhar
- Department of Obstetrics and Gynaecology, University of Auckland, Auckland, New Zealand.
| | - Siladitya Bhattacharya
- College of Biomedical and Life Sciences, Cardiff University School of Medicine, Cardiff, UK
| | - Sjoerd Repping
- Amsterdam UMC, University of Amsterdam, Center for Reproductive Medicine, Amsterdam Reproduction & Development research institute, Amsterdam, Netherlands
| | - Sebastiaan Mastenbroek
- Amsterdam UMC, University of Amsterdam, Center for Reproductive Medicine, Amsterdam Reproduction & Development research institute, Amsterdam, Netherlands
| | - Mohan S Kamath
- Department of Reproductive Medicine, Christian Medical College, Vellore, India
| | - Jane Marjoribanks
- Department of Obstetrics and Gynaecology, University of Auckland, Auckland, New Zealand
| | - Jacky Boivin
- School of Psychology, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
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Patel A, Sharma PSVN, Kumar P. "In Cycles of Dreams, Despair, and Desperation:" Research Perspectives on Infertility Specific Distress in Patients Undergoing Fertility Treatments. J Hum Reprod Sci 2018; 11:320-328. [PMID: 30787515 PMCID: PMC6333040 DOI: 10.4103/jhrs.jhrs_42_18] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
"Emotional distress in infertility" is a broad expression that loosely denotes anxiety, depression, grief, crisis, depleting psychological well-being, and all forms of affective and interpersonal disturbances faced by individuals with infertility. The distress is usually associated with involuntary childlessness as it is an unwelcoming event. The developmental crisis associated with childlessness poses a threat to one's sense of self at all levels (individual, family and social). Distress may begin before or during treatments as a person experiences the loss of control over attaining parenthood, anxiety or dejection after the diagnosis, treatments, its complications particularly its limited success rates. This paper reviews the basic concepts, theoretical models related to infertility specific distress (ISD). It elaborates on the effects of individual and treatment-specific variables on ISD with special highlights gathered from the national and international research.
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Affiliation(s)
- Ansha Patel
- Department of Psychiatry, Kasturba Medical College, Manipal, Karnataka, India
| | - P. S. V. N. Sharma
- Department of Psychiatry, Kasturba Medical College, Manipal, Karnataka, India
| | - Pratap Kumar
- Department of Obstetrics and Gynaecology, Kasturba Medical College, Manipal, Karnataka, India
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Skvirsky V, Taubman-Ben-Ari O, Ben Shlomo S, Azuri J, Horowitz E. Contributors to Women's Perceived Stress at the Start of Assisted Reproductive Technology. THE JOURNAL OF PSYCHOLOGY 2018; 153:23-36. [PMID: 30211664 DOI: 10.1080/00223980.2018.1471037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
Clinicians are often called upon to treat the stress that accompanies Assisted Reproductive Technology (ART). In this study, we sought to examine the contribution of the internal resources of meaning in life and attachment style and the interpersonal resource of self-disclosure to her mother to a woman's level of perceived stress upon commencement of ART. In addition, we examined the association between age and perceived stress. The sample consisted of 180 Israeli women (106 aged 20-34; 74 aged 35-44) who completed a series of self-report questionnaires after their initial meeting with a fertility specialist. Regression analysis indicated that older age, lower attachment anxiety, higher perception of meaning in life, and greater self-disclosure to the mother were related to lower levels of perceived stress. Self-disclosure was also found to mediate the association between avoidant attachment and stress. The study highlights the importance of a woman's personal and interpersonal resources for reducing the experience of stress in the early stages of ART. The results have practical implications for the development of professional interventions seeking to enhance these resources among women embarking on fertility treatment.
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