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Akbari R, Panahi Z, Ghaemi M, Hantoushzadeh S. The knowledge domain and emerging trends in the infertility field: A 67-year retrospective study. Health Care Women Int 2024:1-31. [PMID: 38231619 DOI: 10.1080/07399332.2024.2304110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 01/08/2024] [Indexed: 01/19/2024]
Abstract
Infertility is a significant problem influencing many couples. Our purpose was to assess the field of infertility in Obstetrics and Gynecology from 1955 to 2022 reviewing 3575 documents found in the Web of Science database. Most articles were in the areas of Reproductive Biology, Fertility, Endometriosis & Hysterectomy, and Chromosome Disorders. We found publication has increased dramatically since 1989. Agarwal, Thomas, and Sharma; United States, England, and Canada; Fertility and Sterility, Human Reproduction, and AJOG were the most-cited authors, countries, and journals, respectively. We discovered five substantive clusters: male infertility factors, female infertility factors, causes and treatment of infertility, the consequence of infertility, and assisted reproductive techniques. Using bibliometric review (Co-citation analysis) six research areas were found: semen analysis and sperm morphology, regional differences in the psychological effects of infertility, unexplained infertility, endometriosis, diagnosis and treatment of infertility, and polycystic ovary syndrome. Despite advances in understanding infertility, further research is needed.
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Affiliation(s)
- Razieh Akbari
- Department of Gynecology and Obstetrics, School of Medicine, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Zahra Panahi
- Department of Gynecology and Obstetrics, School of Medicine, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Marjan Ghaemi
- Department of Gynecology and Obstetrics, School of Medicine, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Sedigheh Hantoushzadeh
- Vali-e-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
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2
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Koparal B, Gürlek B, Hocaoğlu Ç, Polat S. Levels of anxiety sensitivity, somatosensory amplification and alexithymia in patients with unexplained infertility. Int J Clin Pract 2021; 75:e14761. [PMID: 34455676 DOI: 10.1111/ijcp.14761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 08/25/2021] [Accepted: 08/27/2021] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE In this study, we aimed to focus on the psychological aspect of unexplained infertility by comparing their psychological features to those of infertile patients with a known causes and fertile patients. PATIENTS AND METHODS Sixty unexplained infertility patients, 50 infertile patients with a known cause and 56 fertile patients were included in the study. Patients were evaluated using socio-demographic data form, Toronto Alexithymia Scale (TAS-20), Somatosensory Amplification Scale (SAS) and Anxiety Sensitivity Index (ASI-3). RESULTS No significant differences in the levels of alexithymia, somatosensory amplification and anxiety sensitivity were detected between the groups (P > .05). When the correlation of clinical scale scores with each other was analysed in the whole group of infertile patients regardless of the cause, a weak positive correlation was found between anxiety sensitivity and difficulty in identifying feelings. CONCLUSION In our study, it has been found out that; regardless of the knowledge of the aetiology of infertility, the levels of alexithymia, somatosensory amplification and anxiety sensitivity of infertile cases did not differ from those of fertile women. However, it has been shown that as the difficulty in identifying emotions increases in infertile cases, anxiety sensitivity, which may cause psychological infertility, also increases.
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Affiliation(s)
- Buket Koparal
- Department of Psychiatry, Recep Tayyip Erdogan University Training and Research Hospital, Rize, Turkey
| | - Beril Gürlek
- Department of Obstetrics and Gynecology, Recep Tayyip Erdogan University Training and Research Hospital, Rize, Turkey
| | - Çiçek Hocaoğlu
- Department of Psychiatry, Recep Tayyip Erdogan University Training and Research Hospital, Rize, Turkey
| | - Selim Polat
- Department of Psychiatry, Recep Tayyip Erdogan University Training and Research Hospital, Rize, Turkey
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3
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A surprising link with unexplained infertility: a possible Covid-19 paradox? J Assist Reprod Genet 2020; 37:2661-2662. [PMID: 32845433 PMCID: PMC7447604 DOI: 10.1007/s10815-020-01911-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 08/03/2020] [Indexed: 11/16/2022] Open
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Young K, Fisher J, Kirkman M. Partners instead of patients: Women negotiating power and knowledge within medical encounters for endometriosis. FEMINISM & PSYCHOLOGY 2019. [DOI: 10.1177/0959353519826170] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Endometriosis is currently poorly understood by the medical sciences; contemporary healthcare has been evidenced as failing to meet the diverse needs of the women who live with the condition. This study examined women’s experiences of navigating knowledge and power within medical encounters for endometriosis. In-depth interviews were conducted with 26 women who have been diagnosed with endometriosis about their experiences of the condition and associated healthcare. Women valued both their own knowledge and their doctor’s clinical expertise; as to which they privileged was situational, but it was essential the woman dictated which it would be. Women were wary of the social status and power of doctors to reduce their wellbeing through medical labels they did not identify with or by inhibiting their access to care. They identified the need for doctors to listen to and believe them as being essential to the provision of healthcare that meets women’s needs and addresses the complexities of endometriosis. Our findings suggest that medical education needs to equip doctors with the skills to acknowledge and incorporate women’s knowledge of their bodies within the medical encounter, and to understand how their practice affects women’s social and economic participation.
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Palomba S, Daolio J, Romeo S, Battaglia FA, Marci R, La Sala GB. Lifestyle and fertility: the influence of stress and quality of life on female fertility. Reprod Biol Endocrinol 2018; 16:113. [PMID: 30501641 PMCID: PMC6275085 DOI: 10.1186/s12958-018-0434-y] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 10/24/2018] [Indexed: 12/13/2022] Open
Abstract
There is growing evidence that lifestyle choices account for the overall quality of health and life (QoL) reflecting many potential lifestyle risks widely associated with alterations of the reproductive function up to the infertility. This review aims to summarize in a critical fashion the current knowledge about the potential effects of stress and QoL on female reproductive function. A specific literature search up to August 2017 was performed in IBSS, SocINDEX, Institute for Scientific Information, PubMed, Web of Science and Google Scholar. Current review highlights a close relationship in women between stress, QoL and reproductive function, that this association is more likely reported in infertile rather than fertile women, and that a vicious circle makes them to have supported each other. However, a precise cause-effect relationship is still difficult to demonstrate due to conflicting results and the lack of objective measures/instruments of evaluation.
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Affiliation(s)
- Stefano Palomba
- Unit of Obstetrics and Gynecology, Grande Ospedale Metropolitano “Bianco – Melacrino - Morelli”, Reggio Calabria, Italy
| | - Jessica Daolio
- Center of Reproductive Medicine “P. Bertocchi” Department of Obstetrics and Gynecology, Azienda Unità Sanitaria Locale – IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Sara Romeo
- Unit of Obstetrics and Gynecology, Grande Ospedale Metropolitano “Bianco – Melacrino - Morelli”, Reggio Calabria, Italy
| | - Francesco Antonino Battaglia
- Unit of Obstetrics and Gynecology, Grande Ospedale Metropolitano “Bianco – Melacrino - Morelli”, Reggio Calabria, Italy
| | - Roberto Marci
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of Obstetrics and Gynecology, University Hospital of Geneva, Geneva, Switzerland
| | - Giovanni Battista La Sala
- Center of Reproductive Medicine and Surgery, Arcispedale Santa Maria Nuova (ASMN) - Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Reggio Emilia, Italy
- University of Modena and Reggio Emilia, Modena, Italy
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Biringer E, Kessler U, Howard LM, Pasupathy D, Mykletun A. Anxiety, depression and probability of live birth in a cohort of women with self-reported infertility in the HUNT 2 Study and Medical Birth Registry of Norway. J Psychosom Res 2018; 113:1-7. [PMID: 30190040 DOI: 10.1016/j.jpsychores.2018.07.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 07/05/2018] [Accepted: 07/05/2018] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The 'psychogenic' hypothesis has a long history in the field of infertility. The present study investigated whether anxiety or depressive symptoms are associated with probability of subsequent live birth in a cohort of infertile women from the general population. METHODS Using linked data from 12,987 women in the North-Trøndelag Health Study 1995-97 (HUNT 2) and the Medical Birth Registry of Norway (MBRN) a cohort of 467 women with self-reported infertility was followed prospectively in the MBRN for 11 years with regard to live birth. Anxiety and depressive symptoms were measured at baseline in HUNT 2 by the Hospital Anxiety and Depression Scale (HADS), i.e. the Anxiety (HADS-A) and Depression (HADS-D) sub-scales. The relationship between anxiety or depressive symptoms and live birth in the MBRN was analysed using Cox proportional hazards regression analysis. RESULTS Anxiety and depressive symptoms were not associated with live birth rates. For anxiety symptoms, the crude hazard ratios (HR) for live birth was 1.004 (95% confidence interval (CI) = 0.96; 1.05); adjusted HR = 0.99 (95% CI = 0.94; 1.04), for depressive symptoms crude HR was 0.98 (95% CI = 0.92; 1.04); adjusted HR = 1.01 (95% CI = 0.94; 1.08). Among the 104 women with HADS-A ≥ 8 and/or HADS-D ≥ 8, 34 (32.7%) were registered with live birth in MBRN during the period of observation. However, 100 (27.6%) of the 363 women with both HADS-A ≤ 7 and HADS-D ≤ 7 were registered with live birth. CONCLUSION Anxiety and depressive symptoms are not associated with probability of live birth in women with self-reported infertility in the general population.
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Affiliation(s)
- Eva Biringer
- Section of Research and Innovation, Helse Fonna Local Health Authority, 5504 Haugesund, Norway.
| | - Ute Kessler
- Division of Psychiatry, Haukeland University Hospital, 5021 Bergen, Norway; Department of Clinical Medicine, University of Bergen, 5021 Bergen, Norway
| | - Louise M Howard
- Health Service and Population Research Department, Institute of Psychiatry, King's College London, SE5 8AF London, UK
| | - Dharmintra Pasupathy
- Division of Women's Health, King's College London, SE1 7EH London, UK; NIHR Biomedical Research Centre, SE1 9RT London, UK
| | - Arnstein Mykletun
- Division of Mental Health, Norwegian Institute of Public Health, 0403 Oslo, Norway; University of New South Wales, NSW 2052, Sydney, Australia
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Nicoloro-SantaBarbara J, Busso C, Moyer A, Lobel M. Just relax and you'll get pregnant? Meta-analysis examining women's emotional distress and the outcome of assisted reproductive technology. Soc Sci Med 2018; 213:54-62. [PMID: 30056327 DOI: 10.1016/j.socscimed.2018.06.033] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 06/14/2018] [Accepted: 06/24/2018] [Indexed: 12/14/2022]
Abstract
RATIONALE Couples worldwide are seeking treatment for infertility in growing numbers. Both infertility and its treatment are stressful experiences that generate considerable emotional distress. There is speculation that women's distress is associated with poorer likelihood of pregnancy via assisted reproductive technology (ART) and plausible psychobiological mechanisms bolster this association, although prior reviews of existing evidence find little support. A rigorous, comprehensive, and up to date analysis of research on the association of women's distress with ART outcomes is imperative. OBJECTIVE We systematically searched for and analyzed evidence regarding the association of women's distress before and during treatment with the likelihood of treatment success via ART. METHOD Meta-analysis using a random-effects model was conducted on prospective studies (k = 20) that compared levels of anxiety, depressive symptoms, or perceived stress before or during ART treatment in women who achieved successful pregnancy outcomes versus those who did not (total N = 4308). RESULTS Anxiety, depressive symptoms, or perceived stress pre-treatment, and anxiety or depressive symptoms during treatment, were not associated with less favorable ART outcomes. Prior treatment experience, age, and duration of infertility were not significant moderators of these associations. No eligible studies examined perceived stress during treatment. CONCLUSION Results cast doubt on the belief that distress impedes the success of infertility treatment, offering hope and optimism to the many women who feel emotionally responsible for the outcome of ART and informing the evidence-based practices of their health-care providers. We also identify specific areas and research methods needed to corroborate and extend study conclusions, including study of factors that elevate or attenuate distress in women undergoing infertility treatment.
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Affiliation(s)
| | - Cheyanne Busso
- Department of Psychology, Stony Brook University, 100 Nicolls Road, Stony Brook, NY, 11794-2500, USA.
| | - Anne Moyer
- Department of Psychology, Stony Brook University, 100 Nicolls Road, Stony Brook, NY, 11794-2500, USA.
| | - Marci Lobel
- Department of Psychology, Stony Brook University, 100 Nicolls Road, Stony Brook, NY, 11794-2500, USA.
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9
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Sominsky L, Hodgson DM, McLaughlin EA, Smith R, Wall HM, Spencer SJ. Linking Stress and Infertility: A Novel Role for Ghrelin. Endocr Rev 2017; 38:432-467. [PMID: 28938425 DOI: 10.1210/er.2016-1133] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 07/24/2017] [Indexed: 12/23/2022]
Abstract
Infertility affects a remarkable one in four couples in developing countries. Psychological stress is a ubiquitous facet of life, and although stress affects us all at some point, prolonged or unmanageable stress may become harmful for some individuals, negatively impacting on their health, including fertility. For instance, women who struggle to conceive are twice as likely to suffer from emotional distress than fertile women. Assisted reproductive technology treatments place an additional physical, emotional, and financial burden of stress, particularly on women, who are often exposed to invasive techniques associated with treatment. Stress-reduction interventions can reduce negative affect and in some cases to improve in vitro fertilization outcomes. Although it has been well-established that stress negatively affects fertility in animal models, human research remains inconsistent due to individual differences and methodological flaws. Attempts to isolate single causal links between stress and infertility have not yet been successful due to their multifaceted etiologies. In this review, we will discuss the current literature in the field of stress-induced reproductive dysfunction based on animal and human models, and introduce a recently unexplored link between stress and infertility, the gut-derived hormone, ghrelin. We also present evidence from recent seminal studies demonstrating that ghrelin has a principal role in the stress response and reward processing, as well as in regulating reproductive function, and that these roles are tightly interlinked. Collectively, these data support the hypothesis that stress may negatively impact upon fertility at least in part by stimulating a dysregulation in ghrelin signaling.
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Affiliation(s)
- Luba Sominsky
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria 3083, Australia
| | - Deborah M Hodgson
- School of Psychology, Faculty of Science and IT, The University of Newcastle, New South Wales 2308, Australia
| | - Eileen A McLaughlin
- School of Biological Sciences, Faculty of Science, The University of Auckland, Auckland 1010, New Zealand.,School of Environmental & Life Sciences, Faculty of Science and IT, The University of Newcastle, New South Wales 2308, Australia
| | - Roger Smith
- Mothers and Babies Research Centre, Hunter Medical Research Institute, Lookout Road, New Lambton Heights, New South Wales 2305, Australia.,Priority Research Centre in Reproductive Science, The University of Newcastle, New South Wales 2308, Australia
| | - Hannah M Wall
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria 3083, Australia
| | - Sarah J Spencer
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria 3083, Australia
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10
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Maleki-Saghooni N, Amirian M, Sadeghi R, Latifnejad Roudsari R. Effectiveness of infertility counseling on pregnancy rate in infertile patients undergoing assisted reproductive technologies: A systematic review and meta-analysis. Int J Reprod Biomed 2017. [DOI: 10.29252/ijrm.15.7.391] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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11
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Maleki-Saghooni N, Amirian M, Sadeghi R, Latifnejad Roudsari R. Effectiveness of infertility counseling on pregnancy rate in infertile patients undergoing assisted reproductive technologies: A systematic review and meta-analysis. Int J Reprod Biomed 2017; 15:391-402. [PMID: 29177241 PMCID: PMC5601930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Psychological interventions such as counseling for infertile patients seem to increase pregnancy rate. OBJECTIVE The aim of this systematic review and meta-analysis was to examine if counseling improves pregnancy rate among infertile patients. Thus, randomized controlled trials investigating the effect of counseling on pregnancy rate in infertile patients undergoing ART were pooled in a meta-analysis. MATERIALS AND METHODS The databases of PubMed, Scopus, Cochrane, Google Scholar, and Persian databases including SID, Iran Medex, and Magiran were searched from 1997 to July 2016 to identify relevant articles. Included studies were trials on infertile patients (women or couples) receiving counseling independent of actual medical treatment. The outcome measure was pregnancy rate. Out of 620 relevant published trials, a total of nine RCTs were ultimately reviewed systematically and included in a meta-analysis to measure the efficacy of counseling on pregnancy rate. Odds ratio and Risk difference were calculated for pregnancy rate. All statistical analyses were done by Comprehensive Meta-analysis Version 2. RESULTS Nine RCTs involving 1079 infertile women/couples were included in the study. The findings from RCTs indicated significant effect of counseling on pregnancy rate so that there was a positive impact of counseling on pregnancy rate (OR= 3.852; 95% CI: 2.492-5.956; p=0.00) and (RD= 0.282; 95%; CI: 0.208-0.355; p=0.00). CONCLUSION Counseling was found to improve patients' chances of becoming pregnant. So counseling represents an attractive treatment option, in particular, for infertile patients who are not receiving medical treatments.
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Affiliation(s)
- Nahid Maleki-Saghooni
- Student Research Committee, Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Malihe Amirian
- Department of Obstetrics and Gynecology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Ramin Sadeghi
- Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Robab Latifnejad Roudsari
- Evidence-Based Care Research Center, Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
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Omani Samani R, Vesali S, Navid B, Vakiliniya B, Mohammadi M. Evaluation on Hope and Psychological Symptoms in Infertile Couples Undergoing Assisted Reproduction Treatment. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2017; 11:123-129. [PMID: 28670431 PMCID: PMC5347450 DOI: 10.22074/ijfs.2017.4838] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 09/22/2016] [Indexed: 01/22/2023]
Abstract
BACKGROUND This study evaluated hope, depression, anxiety, and stress among three groups of infertile couples. MATERIALS AND METHODS This cross-sectional study consisted of three groups of infertile couples-candidates for oocyte donation (n=60), embryo donation (n=60), and normal infertile (n=60). Participants included couples seen at Royan Institute, Tehran, Iran between 2013-2014 who were at least 18 years of age and could read and write in Persian. Participants provided demographic and general characteristics and completed the Persian version of the Adult Trait Hope Scale (hope, agency and pathway) and Depression, Anxiety, and Stress Scale (DASS). Data was analyzed by the paired t test, ANOVA, ANCOVA and Pearson correlation tests using SPSS statistical software. RESULTS Overall, 180 infertile couples participated in the three groups. There was a significant higher mean score for hope in husbands compared to wives in the normal infertile group (P=0.046). Husbands in the normal infertile group also had a significantly higher mean score for pathway (P=0.032). The frequency of anxiety significantly differed in female subjects (P=0.028). In the normal infertile group, the anxiety distribution significantly differed between wives and husbands (P=0.006). There was a significantly different stress frequency in male subjects (P=0.048). In the embryo donation group, stress significantly differed between wives and husbands (P=0.002). In the normal infertile group, stress also significantly differed between wives and husbands (P=0.05). CONCLUSION The results have suggested that hope might be important in reducing psychological symptoms and psychological adjustment in those exposed to infertility problems who follow medical recommendations, which accelerates recovery. It is recommended to hold psychological counseling sessions (hope therapy) during reproduction cycles.
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Affiliation(s)
- Reza Omani Samani
- Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Samira Vesali
- Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Behnaz Navid
- Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Bahareh Vakiliniya
- Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Maryam Mohammadi
- Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
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Donarelli Z, Lo Coco G, Gullo S, Marino A, Volpes A, Salerno L, Allegra A. Infertility-related stress, anxiety and ovarian stimulation: can couples be reassured about the effects of psychological factors on biological responses to assisted reproductive technology? REPRODUCTIVE BIOMEDICINE & SOCIETY ONLINE 2016; 3:16-23. [PMID: 29774246 PMCID: PMC5952838 DOI: 10.1016/j.rbms.2016.10.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 08/04/2016] [Accepted: 10/24/2016] [Indexed: 06/08/2023]
Abstract
The aim of this prospective, longitudinal study was to examine the association between couples' pre-treatment psychological characteristics (state anxiety and infertility-related stress levels of both partners) and ovarian response during assisted reproductive technology treatment in a well-controlled sample. A total of 217 heterosexual couples (434 patients), suffering from primary infertility and undergoing their first assisted reproductive technology treatment at the Reproductive Medicine Unit of ANDROS Day Surgery Clinic in Palermo (Italy), were recruited. Psychological variables were assessed using the State Scale of State-Trait Anxiety Inventory (STAI-S) and the Fertility Problem Inventory (FPI). The number of follicles ≥ 16 mm in diameter, evaluated by transvaginal ultrasound scan on the eleventh day of the workup, was chosen as the outcome measure. No association between women's level of anxiety and infertility-related stress, and the number of follicles ≥ 16 mm in diameter was found. Moreover, the male partner's infertility stress and anxiety did not influence the relationship between the woman's infertility-related stress, anxiety level and ovarian response. Fertility staff should reassure couples that the woman's biological response to ovarian stimulation is not influenced by either partner's level of psychological distress.
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Affiliation(s)
| | - Gianluca Lo Coco
- Department of Psychological and Educational Sciences, University of Palermo, Palermo, Italy
| | - Salvatore Gullo
- ANDROS Day Surgery Clinic, Medical Statistics Unit, Palermo, Italy
| | - Angelo Marino
- ANDROS Day Surgery Clinic, Reproductive Medicine Unit, Palermo, Italy
| | - Aldo Volpes
- ANDROS Day Surgery Clinic, Reproductive Medicine Unit, Palermo, Italy
| | - Laura Salerno
- ANDROS Day Surgery Clinic, Psychology Unit, Palermo, Italy
| | - Adolfo Allegra
- ANDROS Day Surgery Clinic, Reproductive Medicine Unit, Palermo, Italy
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14
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Santos C, Sobral MP, Martins MV. Effects of life events on infertility diagnosis: comparison with presumably fertile men and women. J Reprod Infant Psychol 2016. [PMID: 29517288 DOI: 10.1080/02646838.2016.1249834] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To compare the occurrence and degree of stress attributed to life events during childhood/adolescence and adulthood between individuals diagnosed with infertility and presumably fertile individuals, and to examine the effect of life events occurrence and stress levels on an infertility diagnosis. BACKGROUND Although stress has been explored as a consequence of the experience of infertility, its role as a predictor of this disease still lacks research, particularly regarding the use of adequate control groups composed of non-parents. METHODS The final sample had 151 infertile subjects (74 males and 77 females) and 225 presumably fertile participants (95 males and 130 females), who completed a questionnaire indicating occurrence (y/n) and degree of stress of life events (1-5) during childhood/adolescence and adulthood. RESULTS Significant differences regarding occurrence were found in seven stressful life events in men and in nine events in women, with infertile groups presenting higher occurrence than presumably fertile groups. Eleven stressful life events were rated differently by men and women regarding the degree of stress, with group significant differences observed in both directions. While most events were rated as more stressful by infertile men, infertile women reported less stress resulting from these events than presumably fertile women. After controlling for age, the degree of stress induced by life events in childhood/adolescence and adulthood were not significant predictors of infertility diagnosis, for both men and women. CONCLUSION The amount of stress associated with earlier or concurrent life events does not seem to be related with infertility. Further prospective research is needed to validate these findings.
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Affiliation(s)
- Carina Santos
- a Faculty of Psychology and Educational and Education Sciences , University of Porto , Porto , Portugal
| | - Maria Pedro Sobral
- a Faculty of Psychology and Educational and Education Sciences , University of Porto , Porto , Portugal.,b Faculty of Psychology and Education Sciences , Center for Psychology at University of Porto , Porto , Portugal
| | - Mariana V Martins
- a Faculty of Psychology and Educational and Education Sciences , University of Porto , Porto , Portugal.,b Faculty of Psychology and Education Sciences , Center for Psychology at University of Porto , Porto , Portugal
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Wang B, Katsube T, Begum N, Nenoi M. Revisiting the health effects of psychological stress-its influence on susceptibility to ionizing radiation: a mini-review. JOURNAL OF RADIATION RESEARCH 2016; 57:325-35. [PMID: 27242342 PMCID: PMC4973650 DOI: 10.1093/jrr/rrw035] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 02/02/2016] [Accepted: 02/25/2016] [Indexed: 05/03/2023]
Abstract
Both psychological stress (PS) and ionizing radiation (IR) cause varied detrimental effects on humans. There has been no direct evidence so far showing PS alone could cause cancer; however, long-lasting PS may affect our overall health and ability to cope with cancer. Due to their living conditions and occupations, some people may encounter concurrent exposure to both PS and IR to a high extent. In addition to possible health effects resulting directly from exposure to IR on these people, fear of IR exposure is also a cause of PS. The question of whether PS would influence susceptibility to IR, radiocarcinogenesis in particular, is of great concern by both the academic world and the public. Recently, investigations using animal PS models demonstrated that PS could modulate susceptibility to IR, causing increased susceptibility to radiocarcinogenesis in Trp53-heterozygous mice, hematological toxicity in peripheral blood and elevated chromosome aberration (dicentrics) frequency in splenocytes of Trp53-wild-type mice. To actively reduce health risk from exposure to IR, further studies are needed to cumulate more evidence and provide insights into the mechanisms underlying the alterations in susceptibility due to PS modulation. This mini-review gives a general overview of the significance of PS effects on humans and experimental animals, with a special focus on summarizing the latest weight-of-evidence approaches to radiobiological studies on PS-induced alterations in susceptibility in experimental animal models. The susceptibility being investigated is mainly in the context of the impact of the modulatory effect of PS on radiocarcinogenesis; we seek to improve understanding of the combined effects of exposure to both PS and IR in order to facilitate, via active intervention, strategies for radiation risk reduction.
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Affiliation(s)
- Bing Wang
- Radiation Risk Reduction Research Program, Research Center for Radiation Protection, National Institute of Radiological Sciences, Chiba 263-8555, Japan
| | - Takanori Katsube
- Radiation Risk Reduction Research Program, Research Center for Radiation Protection, National Institute of Radiological Sciences, Chiba 263-8555, Japan
| | - Nasrin Begum
- Center for Nuclear Medicine and Ultrasound, Rajshahi Medical College Hospital Campus, G.P.O. Box No. 35, Rajshahi, Bangladesh
| | - Mitsuru Nenoi
- Radiation Risk Reduction Research Program, Research Center for Radiation Protection, National Institute of Radiological Sciences, Chiba 263-8555, Japan
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Martins MV, Basto-Pereira M, Pedro J, Peterson B, Almeida V, Schmidt L, Costa ME. Male psychological adaptation to unsuccessful medically assisted reproduction treatments: a systematic review. Hum Reprod Update 2016; 22:466-78. [PMID: 27008894 DOI: 10.1093/humupd/dmw009] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 02/25/2016] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Similarly to women, men suffer from engaging in fertility treatments, both physically and psychologically. Although there is a vast body of evidence on the emotional adjustment of women to infertility, there are no systematic reviews focusing on men's psychological adaptation to infertility and related treatments. OBJECTIVE AND RATIONALE The main research questions addressed in this review were 'Does male psychological adaptation to unsuccessful medically assisted reproduction (MAR) treatment vary over time?' and 'Which psychosocial variables act as protective or risk factors for psychological maladaptation?' SEARCH METHODS A literature search was conducted from inception to September 2015 on five databases using combinations of MeSH terms and keywords. Eligible studies had to present quantitative prospective designs and samples including men who did not achieve pregnancy or parenthood at follow-up. A narrative synthesis approach was used to conduct the review. OUTCOMES Twelve studies from three continents were eligible from 2534 records identified in the search. The results revealed that psychological symptoms of maladjustment significantly increased in men 1 year after the first fertility evaluation. No significant differences were found two or more years after the initial consultation. Evidence was found for anxiety, depression, active-avoidance coping, catastrophizing, difficulties in partner communication and the use of avoidance or religious coping from the wife as risk factors for psychological maladjustment. Protective factors were related to the use of coping strategies that involve seeking information and attribution of a positive meaning to infertility, having the support of others and of one's spouse, and engaging in open communication about the infertility problem. WIDER IMPLICATIONS Our findings recommend an active involvement of men during the treatment process by health care professionals, and the inclusion of coping skills training and couple communication enhancement interventions in counselling. Further prospective large studies with high-quality design and power are warranted.
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Affiliation(s)
- Mariana Veloso Martins
- Faculty of Psychology and Education Sciences, University of Porto, 4200-135 Porto, Portugal Center for Psychology at University of Porto, 4200-135 Porto, Portugal
| | | | - Juliana Pedro
- Faculty of Psychology and Education Sciences, University of Porto, 4200-135 Porto, Portugal Center for Psychology at University of Porto, 4200-135 Porto, Portugal
| | - Brennan Peterson
- School of Psychology, University of Minho, 4710-057 Braga, Portugal Crean College of Health and Behavioral Sciences, Chapman University, Orange, CA 92866, USA
| | - Vasco Almeida
- Crean College of Health and Behavioral Sciences, Chapman University, Orange, CA 92866, USA Faculty of Sciences, University of Porto, 4169-007 Porto, Portugal
| | - Lone Schmidt
- Section of Social Medicine, University of Copenhagen, 1014 Copenhagen K, Denmark
| | - Maria Emília Costa
- Faculty of Psychology and Education Sciences, University of Porto, 4200-135 Porto, Portugal Center for Psychology at University of Porto, 4200-135 Porto, Portugal
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Abstract
Infertility and perinatal loss are common, and associated with lower quality of life, marital discord, complicated grief, major depressive disorder, anxiety disorders, and post-traumatic stress disorder. Young women, who lack social supports, have experienced recurrent pregnancy loss or a history of trauma and / or preexisting psychiatric illness are at a higher risk of experiencing psychiatric illnesses or symptoms after a perinatal loss or during infertility. It is especially important to detect, assess, and treat depression, anxiety, or other psychiatric symptoms because infertility or perinatal loss may be caused or perpetuated by such symptoms. Screening, psychoeducation, provision of resources and referrals, and an opportunity to discuss their loss and plan for future pregnancies can facilitate addressing mental health concerns that arise. Women at risk of or who are currently experiencing psychiatric symptoms should receive a comprehensive treatment plan that includes the following: (1) proactive clinical monitoring, (2) evidence-based approaches to psychotherapy, and (3) discussion of risks, benefits, and alternatives of medication treatment during preconception and pregnancy.
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Affiliation(s)
- Amritha Bhat
- Department of Psychiatry, University of Washington, Box 35650, Seattle, WA, 98195, USA.
| | - Nancy Byatt
- Departments of Psychiatry and Obstetrics and Gynecology, UMass Medical School, Worcester, MA, USA
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Saravelos SH, Wong AWY, Kong GWS, Huang J, Klitzman R, Li TC. Pain during embryo transfer is independently associated with clinical pregnancy in fresh/frozen assisted reproductive technology cycles. J Obstet Gynaecol Res 2016; 42:684-93. [DOI: 10.1111/jog.12962] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 12/14/2015] [Accepted: 01/07/2016] [Indexed: 01/25/2023]
Affiliation(s)
- Sotirios H. Saravelos
- Assisted Reproductive Technology Unit; Prince of Wales Hospital, Chinese University of Hong Kong; Shatin New Territories Hong Kong
| | - Alice WY. Wong
- Assisted Reproductive Technology Unit; Prince of Wales Hospital, Chinese University of Hong Kong; Shatin New Territories Hong Kong
| | - Grace WS. Kong
- Assisted Reproductive Technology Unit; Prince of Wales Hospital, Chinese University of Hong Kong; Shatin New Territories Hong Kong
| | - Jin Huang
- Assisted Reproductive Technology Unit; Prince of Wales Hospital, Chinese University of Hong Kong; Shatin New Territories Hong Kong
| | - Robert Klitzman
- Mailman School of Public Health; Columbia University Medical Centre; New York USA
| | - Tin-Chiu Li
- Assisted Reproductive Technology Unit; Prince of Wales Hospital, Chinese University of Hong Kong; Shatin New Territories Hong Kong
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Soleimani AA, Najafi M, Ahmadi K, Javidi N, Hoseini Kamkar E, Mahboubi M. The Effectiveness of Emotionally Focused Couples Therapy on Sexual Satisfaction and Marital Adjustment of Infertile Couples with Marital Conflicts. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2015. [PMID: 26644864 DOI: 10.22074/ijfs.2015.4556.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND The purpose of this investigation is to determine the efficacy of emotionally focused couples therapy (EFT-C) on enhancement of marital adjustment in infertile couples. MATERIALS AND METHODS This was a semi-experimental study with a pre- and post-test design. We selected 30 infertile couples (60 subjects) by purposive sampling. Couples were randomly assigned to two groups, sample and control. Each group consisted of 15 couples who had marital maladjustment and low sexual satisfaction. Couples answered the marital adjustment and sexual satisfaction questionnaires at baseline after which the sample group received 10 sessions of EFT-C. RESULTS Results of pre-test and post-test showed that EFT-C significantly impacted marital adjustment and sexual satisfaction. CONCLUSION EFT-C had a significant effect on enhancement of satisfaction, cohesion and affectional expression. This approach impacted physical and emotional sexual satisfaction of infertile couples.
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Affiliation(s)
| | - Maryam Najafi
- Department of Psychology, University of Science and Culture, Tehran, Iran
| | - Khodabakhsh Ahmadi
- Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Nasirudin Javidi
- Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | | | - Mohamad Mahboubi
- Abadan College of Medical Sciences and Health Services, Abadan, Iran
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Soleimani AA, Najafi M, Ahmadi K, Javidi N, Hoseini Kamkar E, Mahboubi M. The Effectiveness of Emotionally Focused Couples Therapy on Sexual Satisfaction and Marital Adjustment of Infertile Couples with Marital Conflicts. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2015; 9:393-402. [PMID: 26644864 PMCID: PMC4671378 DOI: 10.22074/ijfs.2015.4556] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Accepted: 05/20/2014] [Indexed: 11/25/2022]
Abstract
Background The purpose of this investigation is to determine the efficacy of emotionally
focused couples therapy (EFT-C) on enhancement of marital adjustment in infertile couples. Materials and Methods This was a semi-experimental study with a pre- and post-test
design. We selected 30 infertile couples (60 subjects) by purposive sampling. Couples
were randomly assigned to two groups, sample and control. Each group consisted of 15
couples who had marital maladjustment and low sexual satisfaction. Couples answered
the marital adjustment and sexual satisfaction questionnaires at baseline after which the
sample group received 10 sessions of EFT-C. Results Results of pre-test and post-test showed that EFT-C significantly impacted marital adjustment and sexual satisfaction. Conclusion EFT-C had a significant effect on enhancement of satisfaction, cohesion and
affectional expression. This approach impacted physical and emotional sexual satisfaction
of infertile couples.
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Affiliation(s)
| | - Maryam Najafi
- Department of Psychology, University of Science and Culture, Tehran, Iran
| | - Khodabakhsh Ahmadi
- Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Nasirudin Javidi
- Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | | | - Mohamad Mahboubi
- Abadan College of Medical Sciences and Health Services, Abadan, Iran
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Alosaimi FD, Altuwirqi MH, Bukhari M, Abotalib Z, BinSaleh S. Psychiatric disorders among infertile men and women attending three infertility clinics in Riyadh, Saudi Arabia. Ann Saudi Med 2015; 35:359-67. [PMID: 26506969 PMCID: PMC6074374 DOI: 10.5144/0256-4947.2015.359] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND AND OBJECTIVES No study has assessed psychiatric disorders among infertile men and women seeking fertility treatment in Saudi Arabia. Therefore, we sought to measure the rate of psychiatric disorders in this population. DESIGN AND SETTING This was a cross-sectional observational study among patients attending infertility clinics at three referral hospitals in Riyadh, Saudi Arabia, between January 2013 and September 2014. PATIENTS AND METHODS 406 patients (206 women and 200 men) participated in the study. The approved Arabic version of the MINI tool was used to assess 18 common psychiatric illnesses. RESULTS The response rate was 81%. Of the men surveyed, only 4.5% self-reported having a psychiatric disorder. Of the women surveyed, only 10.2% reported having a psychiatric disorder. However, using the MINI scale, psychiatric illness was documented in 30% of males and 36.9% of females. The most common diagnoses for both genders were depression (21.7%) and anxiety (21.2%). Significantly more females than males exhibited suicidality and depression. In contrast, significantly more males than females had bipolar disorders and substance-related disorders. A low monthly income among male and female participants and polygamy among female participants were significantly associated with psychiatric disorders. CONCLUSIONS This study shows that a higher prevalence of psychiatric disorders, particularly depression and anxiety, among infertile men and women in Saudi Arabia is associated with lower income and polygamy. This study highlights the importance of integrated care for alleviating the psychological burden of this unfortunate population and improving outcomes and quality of life. This study also encourages follow-up studies that aim to further understand the complex relationship between fertility and psychological well-being.
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Affiliation(s)
- Fahad Dakheel Alosaimi
- Dr. Fahad Dakheel Alosaimi, Department of Psychiatry,, King Saud University Hospital,, PO Box 7805, Riyadh 11472,, Saudi Arabia ., +966503441370,
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Boivin J, Gameiro S. Evolution of psychology and counseling in infertility. Fertil Steril 2015; 104:251-9. [PMID: 26092131 DOI: 10.1016/j.fertnstert.2015.05.035] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Revised: 05/20/2015] [Accepted: 05/28/2015] [Indexed: 11/29/2022]
Abstract
Five key paradigm shifts are described to illustrate the evolution of psychology and counseling in infertility. The first paradigm shift was in the 1930s when psychosomatic concepts were introduced in obstetrics and gynecology as causal factors to explain why some couples could not conceive despite the absence of organic pathology. In the second shift, the nurse advocacy movement of the 1970s stimulated the investigation of the psychosocial consequences of infertility and promoted counseling to help couples grieve childlessness when medical treatments often could not help them conceive. The third shift occurred with the advent of IVF, which created a demand for mental health professionals in fertility clinics. Mental health professionals assessed the ability of couples to withstand the demands of this new high technology treatment as well as their suitability as potential parents. The fourth shift, in the 1990s, saw reproductive medicine embrace the principles of evidence-based medicine, which introduced a much more rigorous approach to medical practice (effectiveness and safety) that extended to psychosocial interventions. The most recent paradigm shift, in the new millennium, occurred with the realization that compliance with protracted fertility treatment depended on the adoption of an integrated approach to fertility care. An integrated approach could reduce treatment burden arising from multiple sources (i.e., patient, clinic, and treatment). This review describes these paradigm shifts and reflects on future clinical and research directions for mental health professionals.
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Affiliation(s)
- Jacky Boivin
- Cardiff Fertility Studies Research Group, School of Psychology, Cardiff University, Cardiff, Wales, United Kingdom.
| | - Sofia Gameiro
- Cardiff Fertility Studies Research Group, School of Psychology, Cardiff University, Cardiff, Wales, United Kingdom
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23
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The Development and Effect of Cognitive Behavioral Therapy Program for Psychosocial Adjustment of Infertile Women. ACTA ACUST UNITED AC 2015. [DOI: 10.15703/kjc.16.3.201506.451] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Lundin U, Elmerstig E. “Desire? Who needs desire? Let's just do it!”– a qualitative study concerning sexuality and infertility at an internet support group. SEXUAL AND RELATIONSHIP THERAPY 2015. [DOI: 10.1080/14681994.2015.1031100] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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25
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Piva I, Lo Monte G, Graziano A, Marci R. A literature review on the relationship between infertility and sexual dysfunction: Does fun end with baby making? EUR J CONTRACEP REPR 2014; 19:231-7. [DOI: 10.3109/13625187.2014.919379] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Jamali S, Zarei H, Rasekh Jahromi A. The relationship between body mass index and sexual function in infertile women: A cross-sectional survey. IRANIAN JOURNAL OF REPRODUCTIVE MEDICINE 2014; 12:189-198. [PMID: 24799879 PMCID: PMC4009573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Revised: 08/28/2013] [Accepted: 10/17/2013] [Indexed: 06/03/2023]
Abstract
BACKGROUND Infertility as the bitterest life experience can affect sexual function. Many studies have shown agitation, depression, marital dissatisfaction, and sexual dysfunction as the psychological outcomes resulting from infertility. Many factors, including body mass index, influence the female sexual function. OBJECTIVE This study aimed to assess the prevalence of female sexual dysfunction and the relationship between sexual function and body mass index in the Iranian infertile women who had attended the infertility clinic. MATERIALS AND METHODS This cross-sectional study was conducted on 502 infertile women who had attended Honoree clinic, Jahrom in Iran between April 2012 and December 2012. The infertile cases were classified into three groups according to the body mass index: 20-24.9 (Group I), 25-29.9 (Group II), and >29.9 and above (Group III). In addition, Female sexual function index (FSFI) questionnaire was used in order to assess the sexual problems. Finally, the data were analyzed by descriptive statistics, ANOVA and Student's t-test. RESULTS The mean age of women was 30.95±6.80 years. The results showed that 430 subjects (87.1%) had sexual dysfunction. Furthermore, the rate of sexual dysfunction among the infertile women was reported as 23.30%, 31.47%, and 45.23% in groups I, II, and III, respectively. Considering body mass index, FSFI score was 21.65±1.70 in the women with normal weight, 18.08±1.52 in overweight women, and 12.21±3.62 in obese women and the difference was statistically significant (p<0.001). CONCLUSION The prevalence of sexual dysfunction was quite high in infertile women, which might be due to the lack of knowledge about marital issues and lack of training in the society. If body mass index is too high, it can have a great effect on fertility. In this study, being overweight and obese based on body mass index had a negative effect on the infertile woman's sexual function.
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Affiliation(s)
- Safieh Jamali
- Department of Midwifery, Faculty of Nursing and Midwifery, Jahrom University of Medical Sciences, Jahrom, Iran.
| | - Hossein Zarei
- Department of Physical Education, Islamic Azad University, Jahrom, Iran.
| | - Athar Rasekh Jahromi
- Department of Obstetrics and Gynecology, Jahrom University of Medical Sciences, Jahrom, Iran.
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Increasing and decreasing factors of hope in infertile women with failure in infertility treatment: A phenomenology study. IRANIAN JOURNAL OF REPRODUCTIVE MEDICINE 2014; 12:117-24. [PMID: 24799869 PMCID: PMC4009559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Revised: 10/05/2013] [Accepted: 10/13/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Assisted reproductive technology (ART) provide the hope of pregnancy for infertile women, but do not always turn this hope into reality. OBJECTIVE The purpose of this study was to explore the lived experience of infertile women from increasing and decreasing factors of hope in infertile women with failure in infertility treatment. MATERIALS AND METHODS Using a qualitative research design (Phenomenology study), 23 subjects were selected who had experienced infertility failure visited by gynecologist (Rasekh Infertility center) in 2012. The data were collected through semi structured interviews and analyzed using interpretive research strategies of phenomenology by Collizi's seven-stage method. RESULTS Totally 96 codes were identified. The data arranged in two categories. The factors decreasing and increasing hope in infertility treatments. Totally 5 themes and 20 sub themes were extracted. The increasing factors which emerged from the data contain "spiritual source", "family interaction and support" and "information through the media", and decreasing factors contain "nature of treatments" and "negatively oriented mind".
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29
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Minucci D. Psychological and ethical implications related to infertility. Int J Gynaecol Obstet 2013; 123 Suppl 2:S36-8. [DOI: 10.1016/j.ijgo.2013.09.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Aisenberg Romano G, Ravid H, Zaig I, Schreiber S, Azem F, Shachar I, Bloch M. The psychological profile and affective response of women diagnosed with unexplained infertility undergoing in vitro fertilization. Arch Womens Ment Health 2012; 15:403-11. [PMID: 22847827 DOI: 10.1007/s00737-012-0299-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2012] [Accepted: 07/18/2012] [Indexed: 11/24/2022]
Abstract
It has been hypothesized that unexplained infertility may be related to specific personality and coping styles. We studied two groups of women with explained infertility (EIF, n = 63) and unexplained infertility (UIF, n = 42) undergoing an in vitro fertilization (IVF) cycle. Women completed personality and coping style questionnaires prior to the onset of the cycle, and state depression and anxiety scales before and at two additional time points during the cycle. Almost no in-between group differences were found at any of the measured time points in regards to the Minnesota Multiphasic Personality Inventory-2 validity and clinical scales, Illness Cognitions and Life Orientation Test, or for the situational measures. The few differences found suggest a more adaptive, better coping, and functioning defensive system in women with EIF. In conclusion, we did not find any clinically significant personality differences or differences in depression or anxiety levels between women with EIF and UIF during an IVF cycle. Minor differences found are probably a reaction to the ambiguous medical situation with its uncertain prognosis, amplifying certain traits which are not specific to one psychological structure but rather to the common experience shared by the group. The results of this study do not support the possibility that personality traits are involved in the pathophysiology of unexplained infertility.
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Marci R, Graziano A, Piva I, Lo Monte G, Soave I, Giugliano E, Mazzoni S, Capucci R, Carbonara M, Caracciolo S, Patella A. Procreative sex in infertile couples: the decay of pleasure? Health Qual Life Outcomes 2012; 10:140. [PMID: 23176107 PMCID: PMC3543253 DOI: 10.1186/1477-7525-10-140] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2012] [Accepted: 11/16/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Infertility represents a major challenge to the emotional balance and sexual life of couples, with long-lasting and gender-specific effects. The objective of this study is to explore personality features of infertile patients and detect possible sexual disorders in couples undergoing infertility treatment. MATERIALS AND METHODS In this prospective study 60 infertile couples and 52 fertile control couples were asked to complete standardized and validated questionnaires: the Adjective Check List (ACL) to enquire about personality features and the Female Sexual Function Index (FSFI) or the International Index of Erectile Function (IIEF) to assess sexual functioning of female and male partners. The study population was divided into 3 groups: Group A (N = 30, recently diagnosed infertile couples) Group B (N = 30, infertile couples already undergoing Intrauterine Insemination) and Group C (N = 52, fertile control group). RESULTS Infertile patients did not display any distinguishing personality features. Regarding sexual function, men of all the three groups scored higher in both questionnaires (sexual satisfaction, desire and orgasm) than their female partners. Comparing results between groups, Group A male partners obtained lower scores in all the subscales. Women belonging to Group A and Group B showed an impairment of sexual arousal, satisfaction, lubrification and orgasm when compared to fertile controls. CONCLUSIONS Even if at the very first stages of infertility treatment no personality disturbances can be detected, the couples' sexual life is already impaired with different sexual disorders according to gender.
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Affiliation(s)
- Roberto Marci
- Department of Biomedical Sciences and Advanced Therapies, Section of Obstetrics and Gynecology, University of Ferrara, Italy.
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Zaig I, Azem F, Schreiber S, Gottlieb-Litvin Y, Meiboom H, Bloch M. Women's psychological profile and psychiatric diagnoses and the outcome of in vitro fertilization: is there an association? Arch Womens Ment Health 2012; 15:353-9. [PMID: 22767032 DOI: 10.1007/s00737-012-0293-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Accepted: 06/23/2012] [Indexed: 11/29/2022]
Abstract
The influence of psychological processes and psychiatric syndromes on the outcome of fertility treatments is not well understood. In this prospective study, we investigated the effect of baseline psychiatric diagnosis and situational psychiatric symptoms on several biological outcome factors of in vitro fertilization treatments (IVF). Women undergoing their first IVF treatment (n = 108) were interviewed before treatment for the presence of a lifetime DSM-IV-TR disorder. Questionnaires measuring state depression (Center for Epidemiologic Studies Depression scale), anxiety (State Trait Anxiety Inventory), and psychiatric symptomatology (Brief Symptom Inventory) were administered at ovulation induction. Outcome variables were number of retrieved and fertilized oocytes, chemical pregnancy, and a take home baby. Situational anxiety, depression, or other psychiatric symptoms had no effect on any of the outcome measures. Women diagnosed with mood or anxiety disorder prior to the onset of the IVF treatment showed a higher, though not statistically significant, pregnancy success rate compared to women without a diagnosis (57 % compared to 38 %). We speculate that in women with such psychopathology, chronic stress results in biological effects that impede successful implantation, thus impairing fertility. Fertility treatment using the IVF paradigm may bypass this negative effect, resulting in high success rates. This hypothesis should be further explored.
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Affiliation(s)
- Inbar Zaig
- Department of Psychiatry, Tel Aviv Souraski Medical Center, Tel Aviv, Israel
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Mosalanejad L, Khodabakshi Koolaee A, Jamali S. Effect of cognitive behavioral therapy in mental health and hardiness of infertile women receiving assisted reproductive therapy (ART). IRANIAN JOURNAL OF REPRODUCTIVE MEDICINE 2012; 10:483-8. [PMID: 25246916 PMCID: PMC4169688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2011] [Revised: 06/19/2011] [Accepted: 10/02/2011] [Indexed: 11/20/2022]
Abstract
BACKGROUND Infertility is a stressful event that can give rise to psychological difficulties. Now, a wide range of psychosocial interventions for infertile couples has been developed. OBJECTIVE Purpose of this study was to determine the effect of group cognitive behavioral therapy (CBT) to reduce stress, anxiety and depression of women undergoing assisted reproductive therapy (ART). MATERIALS AND METHODS This study was an experimental study (before and after study with control group) on infertile women who were referring to Gynecological clinics of Jahrom University of Medical Sciences to receive ART. 31 women who had criteria to enter the study were randomly divided into experimental group (n=15) and control group (n=16). The participants in the experimental group received 1 hour and 30 minute weekly session's group therapy in 15 week as intervention. For gathering data, depression, anxiety and stress scale (DASS) normalized Persian version and Ahvaz Hardiness Test (AHT) were used to assess psychological distress and psychological hardiness in pre-posttest. RESULTS There were significant differences in mean score of infertile psychological distress, anxiety, depression, and stress in experimental group pretest with posttest. Furthermore, the results indicated that there were significant differences between hardiness in two groups. The experimental group had higher scores in hardiness than control group (p=0.001). CONCLUSION It seems to be, that group therapy interventions, specially, cognitive behavioral therapy (CBT) can be useful and applicable to women who receiving ART.
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Affiliation(s)
- Leili Mosalanejad
- Department of Psychiatry, Jahrom University of Medical Sciences, Jahrom, Iran.
| | | | - Safie Jamali
- Department of Obstetrics and Gynecology, Jahrom University of Medical Sciences, Jahrom, Iran.
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Wischmann T, Korge K, Scherg H, Strowitzki T, Verres R. A 10-year follow-up study of psychosocial factors affecting couples after infertility treatment. Hum Reprod 2012; 27:3226-32. [DOI: 10.1093/humrep/des293] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Peterson B, Boivin J, Norré J, Smith C, Thorn P, Wischmann T. An introduction to infertility counseling: a guide for mental health and medical professionals. J Assist Reprod Genet 2012; 29:243-8. [PMID: 22290604 DOI: 10.1007/s10815-011-9701-y] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2011] [Accepted: 12/22/2011] [Indexed: 11/26/2022] Open
Abstract
The practice of infertility counseling delivered by mental health and medical professionals has become more sophisticated and widespread over the past decade. This paper summarizes information presented at the second campus workshop of the Special Interest Group of Psychology and Counseling of the European Society of Human Reproduction and Embryology (ESHRE). This group is dedicated to improving infertility services by creating meaningful connections between mental health and medical professionals. The paper identifies key issues that infertility counselors must consider in their work with couples experiencing infertility. The use of supportive psychosocial interventions and treatments are highlighted. The paper also details the process for choosing the most appropriate type of infertility counseling, and the use of assessment tools that assist in understanding infertility related symptoms. Infertility counselors should also consider gender differences, the impact of infertility on a couple's sexual relationship,and the unique challenges couples face regarding third-party conception. Finally, the paper addresses specific recommendations for infertility counselors in mental health and medical settings.
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Affiliation(s)
- Brennan Peterson
- Faculty of Psychology, Crean School of Health and Life Sciences, Chapman University, One University Drive, Orange, CA 92866, USA.
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Schilling K, Toth B, Rösner S, Strowitzki T, Wischmann T. Prevalence of behaviour-related fertility disorders in a clinical sample: results of a pilot study. Arch Gynecol Obstet 2012; 286:1307-14. [PMID: 22752595 DOI: 10.1007/s00404-012-2436-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2012] [Accepted: 06/14/2012] [Indexed: 10/28/2022]
Abstract
INTRODUCTION There is no doubt that lifestyle factors can be detrimental to fertility. The aim of the present pilot study was to identify initial prevalence rates for behaviour-related fertility disorders in a clinical sample of couples wanting a child. METHODS Between February 2010 and August 2010, all patients coming for the first time to Heidelberg University's Women's Hospital for consultation on involuntary childlessness were asked to fill out a questionnaire designed by the authors of this article. The questionnaire was based on a review of the relevant literature, with special reference to the latest research findings on behaviour detrimental to fertility. Of the 156 couples addressed, 110 women and 100 men took part in the study. RESULTS For behaviour-related infertility, 9 % of the women and 3 % of the men in our sample were classified on the basis of BMI <18.5, sexual disorders, or abuse of anabolic steroids. If we include smokers, these figures increase: 11 % female smokers and 18 % male smokers. A further 19 % of the women practised sport to an excessive degree; and 26 % of the women and 53 % of the men had a BMI ≥25. DISCUSSION The prevalence of behaviour-related fertility disorders should not be underestimated. For the prevention of behaviour-related fertility disorders, it is important to inform the population about lifestyle-mediated fertility risks.
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Affiliation(s)
- Kathrin Schilling
- Centre for Psychosocial Medicine, Institute of Medical Psychology, University of Heidelberg, Bergheimer Strasse 20, 69115 Heidelberg, Germany
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Mosalanejad L, Khodabakshi Koolaee A, Shoyokh F. Does spiritual group psychotherapy impact on the rate of pregnancy? A case report. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2012; 6:78-81. [PMID: 24644475 PMCID: PMC3939952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/14/2011] [Revised: 12/29/2011] [Accepted: 02/29/2012] [Indexed: 11/20/2022]
Abstract
Distressing character of infertility has led to the development of several psychosocial interventions. We describe two women who suffered from infertility with unknown cause for a long-time period. They participated in weekly, one and half hour group psychotherapy for 10 sessions regularly and became pregnant after these sessions. Group psychotherapy can be used for infertile women who suffer from infertility with unknown cause.
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Affiliation(s)
- Leili Mosalanejad
- Department of Mental Health Education, Jahrom University of Medical Sciences, Jahrom, Iran.,Corresponding author: LeiliMosalanejad, PhD. Department of Mental Health Education, Jahrom University of Medical Sciences, Jahrom, Iran. Tel::+0989177920813 Fax: 98 0791-3336087 E-mail:
| | | | - Fahime Shoyokh
- Department of Mental Health Education, Jahrom University of Medical Sciences, Jahrom, Iran
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Herrmann D, Scherg H, Verres R, von Hagens C, Strowitzki T, Wischmann T. Resilience in infertile couples acts as a protective factor against infertility-specific distress and impaired quality of life. J Assist Reprod Genet 2011; 28:1111-7. [PMID: 21901362 DOI: 10.1007/s10815-011-9637-2] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2011] [Accepted: 08/31/2011] [Indexed: 10/17/2022] Open
Abstract
OBJECTIVE Our hypothesis was that resilience (=psychosocial stress-resistance) reduces infertility-specific distress and maintains quality of life of infertile couples. METHODS Questionnaire data of WHO Quality of Life assessment (WHOQOL; domains: 'physical', 'psychological', 'social relationships' and 'environment'), Fertility Problem Inventory (FPI; scales: 'social concern', 'sexual concern', 'relationship concern', 'rejection of childfree lifestyle' and 'need for parenthood'), Resilience Scale (RS), as well as sociographic and medical data were available for 199 infertile couples. RESULTS Age, medical diagnosis and 'intensity of desire for a child' had no influence on quality of life. High scores on 'suffering from childlessness' went along with less satisfaction on 'physical' and 'psychological' domains for the women only. For both partners, high scores on 'suffering from childlessness' went along with higher scores on all FPI scales. High resilience was associated with high scores on all WHOQOL domains for both partners, also with low scores on all FPI scales except for 'need for parenthood' for the women and with a low score only on 'relationship concern' for the men. CONCLUSIONS For infertile couples, resilience can be considered as an unspecific protective factor against infertility-specific distress and impaired quality of life. When offering counselling to involuntarily childless couples, awareness should be raised for resilience as a couple's resource and a "generic" factor of coping.
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Affiliation(s)
- Darja Herrmann
- Institute of Medical Psychology, Centre for Psychosocial Medicine, University of Heidelberg, Bergheimer Straße 20, 69115, Heidelberg, Germany
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Norré J, Wischmann T. The position of the fertility counsellor in a fertility team: a critical appraisal. HUM FERTIL 2011; 14:154-9. [PMID: 21732890 DOI: 10.3109/14647273.2011.580824] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The ongoing evolution of reproductive medicine has revealed the complexity of emotional reactions of couples seeking to fulfil their desire for a child. The position of counselling is evaluated from three perspectives: the couple, medical staff and the individual counsellor. This leads to three proposed levels of counselling, as an integrated component of Assisted Reproductive Technology (ART).
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Affiliation(s)
- Jan Norré
- Leuven Institute for Fertility & Embryology, Leuven, Belgium
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Park YC, Park SC, Park MI. The preconception stress and mental health of couples. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2011. [DOI: 10.5124/jkma.2011.54.8.832] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Yong Chon Park
- Department of Neuropsychiatry, Hanyang University College of Medicine, Seoul, Korea
| | - Seon-Cheol Park
- Department of Neuropsychiatry, Hanyang University College of Medicine, Seoul, Korea
| | - Moon-Il Park
- Department of Obstetrics and Gynecology, Hanyang University College of Medicine, Seoul, Korea
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Van den Broeck U, Emery M, Wischmann T, Thorn P. Counselling in infertility: individual, couple and group interventions. PATIENT EDUCATION AND COUNSELING 2010; 81:422-428. [PMID: 21075589 DOI: 10.1016/j.pec.2010.10.009] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2010] [Revised: 10/01/2010] [Accepted: 10/06/2010] [Indexed: 05/30/2023]
Abstract
OBJECTIVE Infertility is considered a biopsychosocial crisis and infertility counselling is recommended as an integral part of a multidisciplinary approach. This article will outline the theoretical background and describe common interventions used in infertility counselling for individuals, couples and in a group setting. METHODS This article summarizes the proceedings of the first campus workshop of the Special interest group of Psychology and Counselling of the European Society for Human Reproduction and Embryology (ESHRE). RESULTS Infertility counselling offers the opportunity to explore, discover and clarify ways of living more satisfyingly and resourcefully when fertility impairments have been diagnosed. The Heidelberg Fertility Consultation Service is presented as a framework for individual and couples counselling and highlights important issues in counselling patients. For group work a number of steps to set up a group within an infertility framework are discussed. CONCLUSION In recent years, infertility counselling has become a specialist form of counselling requiring professional expertise and qualification. Key issues and common interventions are presented to raise awareness for the specific counselling needs of individuals and couples experiencing infertility and undergoing medical treatment. PRACTICE IMPLICATIONS Mental health professionals new to the field of reproductive technologies as well as those in other areas of mental health counselling clients with fertility disorders can benefit from the topics addressed.
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Affiliation(s)
- Uschi Van den Broeck
- University Hospital Gasthuisberg, Leuven University Fertility Centre (LUFC), Herestraat 49, B-3000 Leuven, Belgium.
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Gorman JR, Roesch SC, Parker BA, Madlensky L, Saquib N, Newman VA, Pierce JP. Physical and mental health correlates of pregnancy following breast cancer. Psychooncology 2010; 19:517-24. [PMID: 20425779 DOI: 10.1002/pon.1614] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
INTRODUCTION The safety of pregnancy after breast cancer is an important issue for many younger breast cancer survivors and their health care providers. Current research does not indicate that pregnancy negatively affects survival, but the 'healthy mother bias,' suggesting that survivors who go on to become pregnant are a self-selected healthier group based on their prognosis, has led to cautious interpretation of these findings. No studies have systematically evaluated the potential for this bias. METHODS This nested case-control study includes 81 younger participants from the Women's Healthy Eating and Living (WHEL) study (N=3088). Our sample includes 27 cases who had children after breast cancer and 54 controls, matched on age and stage at diagnosis. We used hierarchical linear modeling to accommodate longitudinal data with individuals nested within matched sets (cases and controls). The primary aim was to evaluate the association between summary scores of health and childbearing after breast cancer. Covariates were added for adjustment and to improve model precision. RESULTS Controlling for other variables in the model, physical health scores were not different between cases and controls (B=0.14, p=0.96). Mental health scores were marginally higher among cases (B=6.40, p=0.08), as compared with controls, a difference considered clinically significant. CONCLUSION This preliminary study did not find evidence of a healthy mother bias based on physical health. However, mental health was 6 points higher (p=0.08) among those who had children, indicating that the role of mental health needs evaluation in future research. Larger studies are needed to verify these findings.
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Affiliation(s)
- Jessica R Gorman
- Cancer Prevention and Control Program, Moores UCSD Cancer Center, University of California, La Jolla, San Diego, CA 92093-0901, USA
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Wischmann TH. ORIGINAL RESEARCH—COUPLES' SEXUAL DYSFUNCTIONS: Sexual Disorders in Infertile Couples. J Sex Med 2010; 7:1868-76. [DOI: 10.1111/j.1743-6109.2010.01717.x] [Citation(s) in RCA: 93] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Clancy KBH. Reproductive ecology and the endometrium: physiology, variation, and new directions. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2010; 140 Suppl 49:137-54. [PMID: 19890864 DOI: 10.1002/ajpa.21188] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Endometrial function is often overlooked in the study of fertility in reproductive ecology, but it is crucial to implantation and the support of a successful pregnancy. Human female reproductive physiology can handle substantial energy demands that include the production of fecund cycles, ovulation, fertilization, placentation, a 9-month gestation, and often several years of lactation. The particular morphology of the human endometrium as well as our relative copiousness of menstruation and large neonatal size suggests that endometrial function has more resources allocated to it than many other primates. The human endometrium has a particularly invasive kind of hemochorial placentation and trophoblast that maximizes surface area and maternal-fetal contact, yet these processes are actually less efficient than the placentation of some of our primate relatives. The human endometrium and its associated processes appear to prioritize maximizing the transmission of oxygen and glucose to the fetus over efficiency and protection of maternal resources. Ovarian function controls many aspects of endometrial function and thus variation in the endometrium is often a reflection of ecological factors that impact the ovaries. However, preliminary evidence and literature from populations of different reproductive states, ages and pathologies also suggests that ecological stress plays a role in endometrial variation, different from or even independent of ovarian function. Immune stress and psychosocial stress appear to play some role in the endometrium's ability to carry a fetus through the mechanism of inflammation. Thus, within reproductive ecology we should move towards a model of women's fecundity and fertility that includes many components of ecological stress and their effects not only on the ovaries, but on processes related to endometrial function. Greater attention on the endometrium may aid in unraveling several issues in hominoid and specifically human evolutionary biology: a low implantation rate, high rates of early pregnancy loss, prenatal investment in singletons but postnatal support of several dependent offspring at once, and higher rate of reproductive and pregnancy-related pathology compared to other primates, ranging from endometriosis to preeclampsia. The study of the endometrium may also complicate some of these issues, as it raises the question of why humans have a maximally invasive placentation method and yet slow fetal growth rates. In this review, I will describe endometrial physiology, methods of measurement, variation, and some of the ecological variables that likely produce variation and pregnancy losses to demonstrate the necessity of further study. I propose several basic avenues of study that leave room for testable hypotheses in the field of reproductive ecology. And finally, I describe the potential of this work not just in reproductive ecology, but in the resolution of broader women's health issues.
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Affiliation(s)
- Kathryn B H Clancy
- Department of Anthropology, University of Illinois, Urbana-Champaign, Urbana, IL 61801, USA.
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Greil AL, Slauson-Blevins K, McQuillan J. The experience of infertility: a review of recent literature. SOCIOLOGY OF HEALTH & ILLNESS 2010; 32:140-62. [PMID: 20003036 PMCID: PMC3383794 DOI: 10.1111/j.1467-9566.2009.01213.x] [Citation(s) in RCA: 388] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
About 10 years ago Greil published a review and critique of the literature on the socio-psychological impact of infertility. He found at the time that most scholars treated infertility as a medical condition with psychological consequences rather than as a socially constructed reality. This article examines research published since the last review. More studies now place infertility within larger social contexts and social scientific frameworks although clinical emphases persist. Methodological problems remain but important improvements are also evident. We identify two vigorous research traditions in the social scientific study of infertility. One tradition uses primarily quantitative techniques to study clinic patients in order to improve service delivery and to assess the need for psychological counselling. The other tradition uses primarily qualitative research to capture the experiences of infertile people in a sociocultural context. We conclude that more attention is now being paid to the ways in which the experience of infertility is shaped by social context. We call for continued progress in the development of a distinctly sociological approach to infertility and for the continued integration of the two research traditions identified here.
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Affiliation(s)
- Arthur L Greil
- Division of Social Sciences, Alfred University, Alfred, New York 14802, USA.
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Hämmerli K, Znoj H, Barth J. The efficacy of psychological interventions for infertile patients: a meta-analysis examining mental health and pregnancy rate. Hum Reprod Update 2009; 15:279-95. [PMID: 19196795 DOI: 10.1093/humupd/dmp002] [Citation(s) in RCA: 108] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Psychological interventions for infertile patients seek to improve mental health and increase pregnancy rates. The aim of the present meta-analysis was to examine if psychological interventions improve mental health and pregnancy rate among infertile patients. Thus, controlled studies were pooled investigating psychological interventions following the introduction of assisted reproductive treatments (ART). METHODS The databases of Medline, PsycINFO, PSYNDEX, Web of Science and the Cochrane Library were searched to identify relevant articles published between 1978 and 2007 (384 articles). Included were prospective intervention studies on infertile patients (women and men) receiving psychological interventions independent of actual medical treatment. The outcome measures were mental health and pregnancy rate. A total of 21 controlled studies were ultimately included in a meta-analysis comparing the efficacy of psychological interventions. Effect sizes (ES) were calculated for psychological measures and risk ratios (RR) for pregnancy rate. RESULTS The findings from controlled studies indicated no significant effect for psychological interventions regarding mental health (depression: ES 0.02, 99% CI: -0.19, 0.24; anxiety: ES 0.16, 99% CI: -0.10, 0.42; mental distress: ES 0.08, 99% CI: -0.10, 0.51). Nevertheless, there was evidence for the positive impact of psychological interventions on pregnancy rates (RR 1.42, 99% CI: 1.02, 1.96). Concerning pregnancy rates, significant effects for psychological interventions were only found for couples not receiving ART. CONCLUSIONS Despite the absence of clinical effects on mental health measures, psychological interventions were found to improve some patients' chances of becoming pregnant. Psychological interventions represent an attractive treatment option, in particular, for infertile patients who are not receiving medical treatment.
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Affiliation(s)
- Katja Hämmerli
- Institute of Psychology, Department of Clinical Psychology and Psychotherapy, University of Bern, Switzerland.
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Haemmerli K, Znoj H, Burri S, Graf P, Wunder D, Perrig-Chiello P. Psychological interventions for infertile patients: a review of existing research and A new comprehensive approach. COUNSELLING & PSYCHOTHERAPY RESEARCH 2008. [DOI: 10.1080/14733140802292895] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Wischmann T. Implications of psychosocial support in infertility--a critical appraisal. J Psychosom Obstet Gynaecol 2008; 29:83-90. [PMID: 18484439 DOI: 10.1080/01674820701817870] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE Various psychosocial interventions have been recommended for infertile persons, but it remains unclear what their implications are, and if some of them might even be harmful under certain circumstances. METHODS A survey is given of papers concerning the usefulness of psychosocial support in infertility. RESULTS Providing procedural information concerning the technical aspects of infertility investigation probably facilitates coping with infertility and with assisted reproductive techniques. This information can be given in the form of booklets or educational films. Using the Internet is a fast and easy way to obtain information on infertility and its treatment, but with the risk of getting wrong or misleading information. Telephone counseling can be helpful in providing specific information about the infertility workup but it cannot replace face-to-face counseling on distressing psychosocial issues. Attendance at support groups can be recommended to strengthen coping abilities. Psychosocial counseling and psychotherapy are definitely effective in reducing negative affect, mostly within a short period of time (less than 10 sessions). Pregnancy rates are unlikely to be affected by psychosocial interventions. CONCLUSION Infertility counseling and support groups seem to be the most efficient psychosocial interventions in infertility. Therefore, infertility counseling should be available at all stages of medical therapy, and it should be free of charge for the persons attending it. Course, content and goals of the infertility counseling should be made transparent. The efficacy of support groups has to be evaluated more systematically. Several methodological questions have to be solved yet, and the generalizability of these results is still restricted.
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Affiliation(s)
- Tewes Wischmann
- Heidelberg University Hospital, Center for Psychosocial Medicine, Institute of Medical Psychology, Heidelberg, Germany.
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Barone-Chapman M. The hunger to fill an empty space: an investigation of primordial affects and meaning-making in the drive to conceive through repeated use of ART. THE JOURNAL OF ANALYTICAL PSYCHOLOGY 2007; 52:479-501. [PMID: 17718759 DOI: 10.1111/j.1468-5922.2007.00678.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This research aims to investigate the drive to conceive through repeated use of Assisted Reproductive Technology (ART) in relation to the affective and meaning-making processes related to this drive, through the use of the participants' memories of mother and being mothered, the choices they made regarding sex, intimacy and non-uterine activity in early adulthood and their fantasies of how a child would change their lives. Though prepared for an MSc dissertation it is a pilot empirical study using interpretative phenomenological analysis and applications of Jungian analytic and psychoanalytical theory. The collected data consists of three semi-structured interviews analysed through recurrent themes and amplification. Developmental and archetypal thinking has been suggested as a means of understanding. The results are strongly suggestive of two main themes across the interviews and further research is underway. The first theme is the importance of the relationship to mother and the quality of the mothering received in contributing to a woman's availability to become a mother at a time in her life when she is most fertile. The second theme of the pilot suggested that the crisis of infertility is a mask for another crisis of identity that also had links to the personal mother. At the core of these issues with mother there is an absence of father and an intra-psychic couple. Repeated infertility treatment becomes a transformative process necessitating repetition until something new can be created.
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Schanz S, Baeckert-Sifeddine IT, Braeunlich C, Collins SE, Batra A, Gebert S, Hautzinger M, Fierlbeck G. A new quality-of-life measure for men experiencing involuntary childlessness. Hum Reprod 2005; 20:2858-65. [PMID: 15980002 DOI: 10.1093/humrep/dei127] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Infertility may considerably reduce quality-of-life. Many of the existing generic quality-of-life measures, which often focus on physical impairments, do not represent the specific complaints of infertile patients. In this article, we report on the development and validation of the TLMK (Tübinger Lebensqualitätsfragebogen für Männer mit Kinderwunsch), an instrument for measuring quality-of-life in male patients with involuntary childlessness. METHODS The first version of the questionnaire, which consisted of 91 items, was administered to 275 men who attended andrology and gynaecology clinics for fertility evaluations. After the questionnaires were scored, item analysis and reduction, principal component analysis and internal consistency analyses were conducted. RESULTS The final version of the TLMK consists of 35 items in four scales and provides an internally consistent quality-of-life profile for men experiencing involuntary childlessness. Convergent and discriminant validity was supported through the correlation of the TLMK scales with established questionnaires on life satisfaction (FLZ) and partnership (PFB). CONCLUSION The TLMK provides information about the quality-of-life in men experiencing involuntary childlessness and was found to be easy to administer and acceptable to patients. It may be used to assess patients' baseline and ongoing quality-of-life during fertility treatment and as an outcome variable in the evaluation of integrated psychological counselling.
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Affiliation(s)
- S Schanz
- Department of Dermatology, Eberhard-Karls-University, Tübingen, Germany.
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