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Clark CJ, Al-Hamdan Z, Bawadi H, Alsalem H, Hamadneh J, Abu Al-Haija A, Hadd AR, Spencer RA, Bergenfeld I, Hall-Clifford R. Preventing violence and enhancing mental health among clients of an invitro fertilization clinic in Jordan: results of a pre/post pilot test of the use of cognitive behavioral therapy. Reprod Health 2024; 21:117. [PMID: 39129010 PMCID: PMC11316984 DOI: 10.1186/s12978-024-01860-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 08/05/2024] [Indexed: 08/13/2024] Open
Abstract
INTRODUCTION Infertility increases women's risk of intimate partner violence (IPV). Cognitive behavioral therapy (CBT) is commonly used to treat mental health problems among fertility treatment seeking patients. CBT has not been tested for its potential to reduce IPV in this population. We pilot test the use of CBT to prevent IPV and improve patients' mental health in a fertility clinic in Jordan. METHODS Of 38 eligible fertility-treatment seeking couples, 16 consented and underwent up to 11 CBT sessions (average = 9) over 3 months. Interviews at baseline and 16 weeks post intervention (endline) assessed IPV, quality of life, social support, coping, and fear of spouse. Wilcoxon signed-rank and McNemar's tests were used to assess change in outcomes. RESULTS At baseline, women's rates of IPV, depression, and anxiety were 75%, 87.5%, and 75% respectively, whereas men's rates of depression and anxiety were each 80%. Average baseline post-traumatic stress disorder (PTSD) symptoms for men and women were 3.3 and 2.7 respectively out of 5. IPV decreased 25% after treatment, and women reported less spousal fear. For both men and women, depression, anxiety, and PTSD symptoms decreased and social support and fertility quality of life improved. CONCLUSION Psychosocial support should be standard of care for the treatment of infertility given the burden of mental health problems and IPV and the utility of CBT in this patient population. Co-design with couples is needed to identify strategies to bolster participation along with population-based interventions to combat the stigma of infertility and mental health service use and enhance women's status.
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Affiliation(s)
- Cari Jo Clark
- Rollins School of Public Health, Emory University, Atlanta, GA, USA.
| | - Zaid Al-Hamdan
- Faculty of Nursing/WHO Collaborating Center, Jordan University of Science and Technology, Irbid, Jordan
| | - Hala Bawadi
- Maternal and Child Health Nursing Department, the University of Jordan, Amman, Jordan
| | - Hussein Alsalem
- Psychosocial Department, Institute for Family Health, King Hussein Foundation, Amman, Jordan
| | - Jehan Hamadneh
- Consultant of Reproductive Endocrinology and IVFHead of Obstetrics and Gynecology DepartmentDirector of IVF Center/ KAUH, Jordan University of Science and Technology (JUST), King Abdullah University Hospital (KAUH), Irbid, Jordan
| | | | | | | | - Irina Bergenfeld
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Rachel Hall-Clifford
- Center for the Study of Human Health and Department of Sociology, Emory University, Atlanta, GA, USA
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Simbar M, Ghasemi V, Taherian R, Kalhor M, Mohammadian F, Kiani Z. Prevalence of anxiety symptoms in infertile men: a systematic review and meta-analysis. BMC Public Health 2024; 24:1805. [PMID: 38971742 PMCID: PMC11227185 DOI: 10.1186/s12889-024-19299-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 06/28/2024] [Indexed: 07/08/2024] Open
Abstract
BACKGROUND Infertility in men causes problems in various aspects of their lives, including personal, family and social life. One of the most important of these problems is anxiety. Anxiety in infertile men can affect their health, quality of life, and response to treatment, highlighting the significance of anxiety in these men. Thus, this systematic review and meta-analysis was conducted to investigate the prevalence of anxiety symptoms in infertile men. METHODS To conduct this review study, two researchers independently searched international databases such as PubMed, Cochrane Library, Web of sciences, Scopus, PsyINFO, and the Google scholar search engine in English without considering any time limit until January 2, 2024. Keywords such as "anxiety," "infertility," "prevalence," and "epidemiology" were used, taking into account the specific search method of each database. Using the Newcastle-Ottawa Scale (NOS), the quality of the articles was evaluated by two researchers independently. RESULTS In the systematic part of the study, 27 studies were included, and given the variety of measurement tools (8 different tools) used to investigate anxiety symptoms in infertile men, 24 studies were analyzed in five subgroups of tools. The pooled prevalence of anxiety symptoms in infertile men was 21.37% (95% CI: 15.73-27.02). The lowest and highest prevalence of anxiety in infertile men were related to the Beck anxiety inventory (BAI) and Depression Anxiety Stress Scales (DASS), accounting for 7.08% (95% CI: 3.27-10.90) and 34.90% (95%CI: 28.90-40.90) values respectively. This prevalence was 19.80% (95%CI: 9.01-30.59) for the Hospital Anxiety and Depression Scale (HADS), 30.06% (95%CI: 18.59-41.52) for the Spielberger Trait Anxiety Inventory (STAI-T), and 18.52% (95%CI: 7.76-29.29) for the Self-Rating Anxiety Scale (SAS). CONCLUSION The results of this systematic review and meta-analysis indicated that the prevalence of anxiety symptoms in infertile men requires special attention to healthcare planning. The healthcare system of different countries should evaluate the symptoms of anxiety in infertile men and take appropriate measures to reduce them according to the culture of the countries. It is recommended that all infertile couples be assessed for anxiety symptoms using a standardized tool during their initial evaluation.
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Affiliation(s)
- Masoumeh Simbar
- Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Vida Ghasemi
- Department of Public Health, Asadabad School of Medical Sciences, Asadabad, Iran
| | - Reza Taherian
- Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehri Kalhor
- Department of Midwifery and Reproductive Health, Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fateme Mohammadian
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Kiani
- Midwifery and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Tiwari P, Yadav A, Kaushik M, Dada R. Cancer risk and male Infertility: Unravelling predictive biomarkers and prognostic indicators. Clin Chim Acta 2024; 558:119670. [PMID: 38614420 DOI: 10.1016/j.cca.2024.119670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 04/08/2024] [Accepted: 04/10/2024] [Indexed: 04/15/2024]
Abstract
In recent years, there has been a global increase in cases of male infertility. There are about 30 million cases of male infertility worldwide and male reproductive health is showing rapid decline in last few decades. It is now recognized as a potential risk factor for developing certain types of cancer, particularly genitourinary malignancies like testicular and prostate cancer. Male infertility is considered a potential indicator of overall health and an early biomarker for cancer. Cases of unexplained male factor infertility have high levels of oxidative stress and oxidative DNA damage and this induces both denovo germ line mutations and epimutations due to build up of 8-hydroxy 2 deoxygunaosine abase which is highly mutagenic and also induces hypomethylation and genomic instability. Consequently, there is growing evidence to explore the various factors contributing to an increased cancer risk. Currently, the available prognostic and predictive biomarkers associated with semen characteristics and cancer risk are limited but gaining significant attention in clinical research for the diagnosis and treatment of elevated cancer risk in the individual and in offspring. The male germ cell being transcriptionally and translationally inert has a highly truncated repair mechanism and has minimal antioxidants and thus most vulnerable to oxidative injury due to environmental factors and unhealthy lifestyle and social habits. Therefore, advancing our understanding requires a thorough evaluation of the pathophysiologic mechanisms at the DNA, RNA, protein, and metabolite levels to identify key biomarkers that may underlie the pathogenesis of male infertility and associated cancer. Advanced methodologies such as genomics, epigenetics, proteomics, transcriptomics, and metabolomics stand at the forefront of cutting-edge approaches for discovering novel biomarkers, spanning from infertility to associated cancer types. Henceforth, in this review, we aim to assess the role and potential of recently identified predictive and prognostic biomarkers, offering insights into the success of assisted reproductive technologies, causes of azoospermia and idiopathic infertility, the impact of integrated holistic approach and lifestyle modifications, and the monitoring of cancer susceptibility, initiation and progression. Comprehending these biomarkers is crucial for providing comprehensive counselling to infertile men and cancer patients, along with their families.
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Affiliation(s)
- Prabhakar Tiwari
- Lab for Molecular Reproduction and Genetics, Department of Anatomy, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India.
| | - Anjali Yadav
- Lab for Molecular Reproduction and Genetics, Department of Anatomy, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India
| | - Meenakshi Kaushik
- Lab for Molecular Reproduction and Genetics, Department of Anatomy, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India
| | - Rima Dada
- Lab for Molecular Reproduction and Genetics, Department of Anatomy, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India.
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Rathi I, Mavi A, Shannawaz M, Saeed S, Yadav A, Hasan S. Effectiveness of Ayurveda Intervention in the Management of Infertility: A Systematic Review. Cureus 2024; 16:e57730. [PMID: 38711705 PMCID: PMC11073818 DOI: 10.7759/cureus.57730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2024] [Indexed: 05/08/2024] Open
Abstract
Infertility is encountered as a stressful condition by couples worldwide, impacting not just their physical and mental well-being but also placing financial strain on them. Ayurvedic management provides a promising, cost-effective avenue for addressing infertility disorders and enhances the success rates of in vitro fertilization (IVF), especially after previous unsuccessful attempts. This study aims to enhance clinical evidence and expand the scope of Ayurvedic approaches for managing infertility. A systematic literature search was conducted in PubMed and Scopus search engines for studies evaluating Ayurveda treatment modalities in infertility. Articles were searched using a combination of Medical Subject Heading (MeSH) terms, and the risk of bias was assessed using Robvis and the Joanna Briggs Institute (JBI) Critical Appraisal Tool. The review followed Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A total of 14 studies were considered in this systematic review, involving 248 patients. Among them, 84 were males and 164 were females. Of the 14 included studies, six were original studies, whereas eight were case reports. Our research contributes to addressing a notable research gap by conducting a comprehensive analysis of Ayurvedic treatments for infertility or medical conditions that lead to infertility. However, the limited sample size and lack of standardized protocols highlight the need for rigorous experimental research to establish the efficacy and safety of Ayurvedic treatments for infertility.
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Affiliation(s)
- Isha Rathi
- Epidemiology and Public Health, Amity Institute of Public Health & Hospital Administration, Amity University, Noida, IND
| | - Aarushi Mavi
- Epidemiology and Public Health, Amity Institute of Public Health & Hospital Administration, Amity University, Noida, IND
| | - Mohd Shannawaz
- Epidemiology and Public Health, Amity Institute of Public Health & Hospital Administration, Amity University, Noida, IND
| | - Shazina Saeed
- Epidemiology and Public Health, Amity Institute of Public Health & Hospital Administration, Amity University, Noida, IND
| | - Ankur Yadav
- Communication, National Institute of Health and Family Welfare, New Delhi, IND
| | - Shamimul Hasan
- Oral Medicine and Radiology, Jamia Millia Islamia, New Delhi, IND
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Hudnall MT, Ambulkar SS, Lai JD, Pham MN, Fantus RJ, Keeter MK, Wren J, Bennett NE, Brannigan RE, Halpern JA. Characteristics of men who use direct-to-consumer men's health telemedicine services. Int J Impot Res 2023; 35:753-757. [PMID: 36310185 PMCID: PMC9618023 DOI: 10.1038/s41443-022-00635-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 10/04/2022] [Accepted: 10/11/2022] [Indexed: 11/08/2022]
Abstract
The characteristics of men who use direct-to-consumer (DTC) men's health services are not well understood. We conducted an online survey of adult men via ResearchMatch, assessing sociodemographic data, health behaviors, and concern for low testosterone and infertility. Logistic regression estimated the association between participant characteristics and familiarity with and reported use of DTC services such as Hims® and Roman®. Among 1276 men surveyed, 62.2% were concerned about low testosterone. While almost half (48.5%) were familiar with men's DTC health services, only 37 (2.9%) reported using these services. On multivariable analysis, men who used DTC men's health services were more likely to be younger (age 18-39: odds ratio [OR] 2.94, 95% confidence interval [CI] 1.03-8.38, p = 0.04; age 40-59: OR 3.26, CI 1.17-9.10, p = 0.02; referent age ≥60), have annual income between $75k and $100k (OR 5.25, CI 1.39-19.87.45, p = 0.02), and be concerned about low testosterone (OR 3.81, CI 1.46-9.96, p = 0.01). In conclusion, younger men and those with mid-range incomes were more likely to use online DTC men's health services compared to older or wealthier men. Likewise, men with concerns about low testosterone were more likely to use DTC services, but other health-conscious behaviors and frequency of doctor visits did not predict use.
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Affiliation(s)
- Matthew T Hudnall
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Siddhant S Ambulkar
- Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Jeremy D Lai
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Minh N Pham
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | | | - Mary Kate Keeter
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - James Wren
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Nelson E Bennett
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Robert E Brannigan
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Joshua A Halpern
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA.
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Thanscheidt CL, Wischmann T. Systematic Review: Risk Factors of Anxiety, Depressiveness, and (Lack of) Social Support in Women and Men Prior to Assisted Reproduction. Geburtshilfe Frauenheilkd 2023; 83:1350-1360. [PMID: 37928411 PMCID: PMC10624543 DOI: 10.1055/a-2166-4374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 08/19/2023] [Indexed: 11/07/2023] Open
Abstract
This review provides a systematic overview of the state of knowledge to date of psychosocial risk factors with a focus on anxiety, depressiveness, and (lack of) social support among involuntarily childless women and men prior to assisted reproduction. The databases PubMed, PubPsych, PsycINFO-Ebsco, and Web of Science were searched for relevant publications in English or German, and finally a total of 20 publications were included in the systematic review. Of these, 18 studies focused on depressiveness, 15 studies focused on anxiety, and 9 studies focused on social support. Half of the studies included both men and women, while the other half included only women. Due to the large heterogeneity of the study results as well as limitations, no clear conclusions can be drawn regarding a difference between the risk profiles of men and women with an unfulfilled desire to have children. However, it has been shown that infertile couples or women experience higher levels of stress in the form of depressiveness and anxiety compared to fertile participants. Furthermore, it was found that social support, regardless of gender difference, within the couple and from family and friends may be associated with a lower risk for depressiveness and anxiety.
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Affiliation(s)
| | - Tewes Wischmann
- Institut für Medizinische Psychologie, Universitätsklinikum Heidelberg, Heidelberg, Germany
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Obst KL, Oxlad M, Turnbull D, McPherson NO. "No One Asked Me If I'm Alright": A Mixed-Methods Study Exploring Information/Support Needs and Challenges Engaging Men Diagnosed With Male-Factor Infertility. Am J Mens Health 2023; 17:15579883231209210. [PMID: 38069523 PMCID: PMC10710112 DOI: 10.1177/15579883231209210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 09/12/2023] [Accepted: 10/04/2023] [Indexed: 12/18/2023] Open
Abstract
There is limited research exploring men's experiences of infertility, and fewer previous studies have examined what information and support men desire after being diagnosed specifically with male-factor infertility. We conducted a mixed-methods study utilizing a combined sequential, concurrent design (online survey/semi-structured interviews). Survey outcomes (N =12) were analyzed using quantitative data analysis, while qualitative survey data (N = 5) was analyzed by reflexive thematic analysis. Heterosexual men (>18 years), fluent in English, diagnosed solely with male-factor infertility/sub-fertility, who required assisted reproductive treatment within Australia in the past 5 years were recruited online and through fertility clinics Australia-wide. Most men reported that their information and support needs were only somewhat, slightly or not at all met. Preferred information sources on male infertility were a dedicated online resource, app, or fertility doctor/specialist, while support was preferred from fertility specialists and partners. Three themes were identified from the qualitative analysis about men's experiences and support needs when diagnosed with male infertility (a) Ultimate threat to masculinity; (b) Holistic care, and (c) the power of words. The information-rich data collected provided valuable insights into men's experiences of male-factor infertility and important considerations to improve recruitment for future research. A diagnosis of male-factor infertility has the potential to be deeply impactful and difficult to navigate for men. Adequate and holistic information, recognition of emotional impacts, proactive offers of support and sensitive language are needed to improve men's experiences when undergoing assisted reproductive technology.
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Affiliation(s)
- Kate L. Obst
- School of Psychology, Adelaide Health and Medical School, The University of Adelaide, Adelaide, South Australia, Australia
- Discipline of Reproduction and Development, School of Biomedicine, Adelaide Health and Medical School, The University of Adelaide, Adelaide, South Australia, Australia
- Freemasons Centre for Male Health and Wellbeing, The University of Adelaide, Adelaide, South Australia, Australia
| | - Melissa Oxlad
- School of Psychology, Adelaide Health and Medical School, The University of Adelaide, Adelaide, South Australia, Australia
- Freemasons Centre for Male Health and Wellbeing, The University of Adelaide, Adelaide, South Australia, Australia
| | - Deborah Turnbull
- School of Psychology, Adelaide Health and Medical School, The University of Adelaide, Adelaide, South Australia, Australia
- Freemasons Centre for Male Health and Wellbeing, The University of Adelaide, Adelaide, South Australia, Australia
| | - Nicole O. McPherson
- Discipline of Reproduction and Development, School of Biomedicine, Adelaide Health and Medical School, The University of Adelaide, Adelaide, South Australia, Australia
- Freemasons Centre for Male Health and Wellbeing, The University of Adelaide, Adelaide, South Australia, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia
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Panner Selvam MK, Kapoor A, Baskaran S, Moharana AK, Sikka SC. A Scientometric Evaluation of COVID-19 and Male Reproductive Research. Clin Pract 2023; 13:1319-1330. [PMID: 37987419 PMCID: PMC10660474 DOI: 10.3390/clinpract13060118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/13/2023] [Accepted: 10/20/2023] [Indexed: 11/22/2023] Open
Abstract
The COVID-19 pandemic due to the SARS-CoV-2 coronavirus showed acute and prolonged effects on human health. In addition, over the past four years, there has been a tremendous surge in COVID-19-related scientific publications, as shown by bibliometric and scientometric studies. However, such analysis of the scientific literature is lacking in the area of male reproduction. The current scientometric study analyzes publication characteristics of articles related to male reproduction and COVID-19 infection. We used the Scopus database to analyze scientometric data (the number of publications, journals, countries, type of documents, and subject area) related to COVID-19 and male reproductive research. Our literature search identified 345 articles related to COVID-19 and male reproductive research. Most of the articles were published in the USA (n = 72), Italy (n = 55), and China (n = 51). Such research was mainly focused around medicine (57.1%), followed by biochemistry, genetics, and molecular biology (25.7%). Also, in the area of male reproduction, only 37.1% (n = 128) of the articles contributed towards original research, whereas 52.8% (n = 182) were review articles and editorials focusing more on sexual dysfunction than infertility. Such a small number of studies published on COVID-19-related effects on male reproduction warrants a significant increase in research, which is required to decipher the mechanism(s) underlying SARS-CoV-2 infection-associated impairment of male reproductive function.
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Affiliation(s)
- Manesh Kumar Panner Selvam
- Department of Urology, School of Medicine, Tulane University, New Orleans, LA 70112, USA; (S.B.); (A.K.M.)
| | | | - Saradha Baskaran
- Department of Urology, School of Medicine, Tulane University, New Orleans, LA 70112, USA; (S.B.); (A.K.M.)
| | - Ajaya Kumar Moharana
- Department of Urology, School of Medicine, Tulane University, New Orleans, LA 70112, USA; (S.B.); (A.K.M.)
- Redox Biology & Proteomics Laboratory, Department of Zoology, School of Life Sciences, Ravenshaw University, Cuttack 753003, Odisha, India
| | - Suresh C. Sikka
- Department of Urology, School of Medicine, Tulane University, New Orleans, LA 70112, USA; (S.B.); (A.K.M.)
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Kiani Z, Fakari FR, Hakimzadeh A, Hajian S, Fakari FR, Nasiri M. Prevalence of depression in infertile men: a systematic review and meta-analysis. BMC Public Health 2023; 23:1972. [PMID: 37821902 PMCID: PMC10568846 DOI: 10.1186/s12889-023-16865-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 09/29/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Generally, infertile men hide their depression, which can threaten their health and lower their quality of life. Given the role of depression and its impact on people's health, this systematic review and meta-analysis aimed to investigate the prevalence of depression in infertile men. METHODS This research is a systematic review and meta-analysis based on preferred reporting items for systematic reviews and meta-analyses (PRISMA). Using the keywords of "Depression", "Emotional Depression", "Infertility", "Prevalence", and "Epidemiology", all English language articles were searched in international databases (PubMed, Cochran library, Web of sciences, Scopus, Embase, PsyINFO, and Google scholar) by two reviewers independently and without considering the time limit until September 2022. Title, abstract, full text and quality of each study were evaluated by two reviewers independently using the Newcastle-Ottawa Scale checklist. The results were analyzed using programming language and R software, and I2 test and Egger's Test were used to check heterogeneity and publication bias, respectively. RESULTS Twenty-two studies were included in the systematic part of this study; and 8 different measurement tools were used to identify depression. Then, based on the possibility of meta-analysis, 18 studies were included in 4 subgroups. Given the heterogeneity of the articles, random effect model was used. The overall prevalence of depression in infertile men was 18.30%. The lowest and highest overall prevalence of depression in men was reported to be 14.04% and 23.63% in the Zung Self-Rating Depression Scale (ZDS) and the Depression Anxiety Stress Scales (DASS) tools, respectively. The overall prevalence of depression among infertile men was reported to be 18.55% and 16.75% using the Beck Depression Inventory (BDI) and the Hospital Anxiety and Depression Scale (HADS) tools, respectively. CONCLUSION Based on the findings of this study, the significant prevalence of depression in infertile men requires a specific attention and planning. The study revealed varying degrees of depression among infertile men, emphasizing the importance of assessing their mental health, specifically in terms of depression, during infertility treatments as a hidden variable. It is strongly recommended to develop training programs for health service providers to effectively utilize diagnostic tools in this particular field.
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Affiliation(s)
- Zahra Kiani
- Midwifery and Reproductive Health Research Center, ShahidBeheshti University of Medical Sciences, Tehran, Iran
| | - Fahimeh Rashidi Fakari
- Department of Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Atena Hakimzadeh
- Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sepideh Hajian
- Department of Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzaneh Rashidi Fakari
- Department of Midwifery, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Malihe Nasiri
- Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Hassan S, Bhatti MI, Habib S, Fatima S, Bhader S, Khan NH, Jiang E. How fear of intimacy affects infertile men's neuropsychological functioning through mental toughness. Front Psychiatry 2023; 14:1049008. [PMID: 37555007 PMCID: PMC10406444 DOI: 10.3389/fpsyt.2023.1049008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 05/03/2023] [Indexed: 08/10/2023] Open
Abstract
OBJECTIVE There is a significant need in Pakistan to investigate the psychological effects of infertility on the mental health of infertile men. The current study examined how fear of intimacy affects neuropsychological impairment and evaluated its relationship to other variables including quality of life and mental toughness. METHOD An analytical cross-sectional study was carried out on infertile male patients in various healthcare settings in Punjab, Pakistan. The participants were recruited using a non-probability (purposive) sampling strategy. The sample size was 120 infertile. SPSS 26 was used to analyze the data. RESULTS Fear of intimacy was found significant impact on neuropsychological impairment (r = 0.40; ***p < 0.001), as well as fear of intimacy, significantly associated with emotional problems (r = 0.48; **p < 0.01), learning problems (r = 0.33; **p < 0.01), sensory and motor problem (r = 0.55; **p < 0.01), concentration problem (r = 0.21; **p < 0.01), mental & physical in coordination (r = 0.37; **p < 0.01) and depression (r = 0.22; **p < 0.01). Fear of intimacy has negative impact on QoL (r = -0.25; *p > 0.05). Similarly, neuropsychological impairment was found to be negatively associated with QoL (r = -0.52; **p > 0.01). The relationship between fear of intimacy and neuropsychological impairment was found to be significantly mediated by QoL. Furthermore, the findings revealed that mental toughness significantly moderated the relationship between fear of intimacy and neuropsychological impairment. CONCLUSION Overall, infertile men in Pakistan had relatively high levels of fear of intimacy, which largely caused neuropsychological impairment. This study can help neuropsychological researchers, mental health professionals, as well as policymakers in improving clinical mental health practices for infertile patients.
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Affiliation(s)
- Sajid Hassan
- Institute of Nursing and Health, Henan University, Kaifeng, China
| | - Mazhar Iqbal Bhatti
- Department of Psychology, International Islamic University, Islamabad, Pakistan
| | - Shazia Habib
- Department of Applied Psychology, Government College University Faisalabad, Faisalabad, Pakistan
| | - Sidra Fatima
- University Gillani Law College, Bahauddin Zakariya University, Multan, Pakistan
| | - Sher Bhader
- Department of Psychology, International Islamic University, Islamabad, Pakistan
| | - Nazeer Hussain Khan
- Institute of Nursing and Health, Henan University, Kaifeng, China
- Department of Animal Sciences, Quaid I Azam University, Islamabad, Pakistan
| | - Enshe Jiang
- Institute of Nursing and Health, Henan University, Kaifeng, China
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Marthi S, Shandley LM, Ismaeel N, Anderson-Bialis J, Anderson-Bialis D, Kawwass JF, Hipp HS, Mehta A. Factors associated with a positive experience at US fertility clinics: the male partner perspective. J Assist Reprod Genet 2023; 40:1317-1328. [PMID: 37310665 PMCID: PMC10310652 DOI: 10.1007/s10815-023-02848-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 05/31/2023] [Indexed: 06/14/2023] Open
Abstract
OBJECTIVE To determine factors associated with a positive male patient experience (PMPE) at fertility clinics among male patients. DESIGN Cross-sectional study Setting: Not applicable Patients: Male respondents to the FertilityIQ questionnaire ( www.fertilityiq.com ) reviewing the first or only US clinic visited between June 2015 and August 2020. INTERVENTIONS None Main outcome measures: PMPE was defined as a score of 9 or 10 out of 10 to the question, "Would you recommend this fertility clinic to a best friend?". Examined predictors included demographics, payment details, infertility diagnoses, treatment, and outcomes, physician traits, and clinic operations and resources. Multiple imputation was used for missing variables and logistic regression was used to calculate adjusted odds ratios (aORs) for factors associated with PMPE. RESULTS Of the 657 men included, 60.9% reported a PMPE. Men who felt their doctor was trustworthy (aOR 5.01, 95% CI 0.97-25.93), set realistic expectations (aOR 2.73, 95% CI 1.10-6.80), and was responsive to setbacks (aOR 2.43, 95% CI 1.14-5.18) were more likely to report PMPE. Those who achieved pregnancy after treatment were more likely to report PMPE; however, this was no longer significant on multivariate analysis (aOR 1.30, 95% CI 0.68-2.47). Clinic-related factors, including ease of scheduling appointments (aOR 4.03, 95% CI 1.63-9.97) and availability of same-day appointments (aOR 4.93, 95% CI 1.75-13.86), were associated with PMPE on both univariate and multivariate analysis. LGBTQ respondents were more likely to report PMPE, whereas men with a college degree or higher were less likely to report PMPE; however, sexual orientation (aOR 3.09, 95% CI 0.86-11.06) and higher educational level (aOR 0.54, 95% CI 0.30-1.10) were not associated with PMPE on multivariate analysis. CONCLUSION Physician characteristics and clinic characteristics indicative of well-run administration were the most highly predictive of PMPE. By identifying factors that are associated with a PMPE, clinics may be able to optimize the patient experience and improve the quality of infertility care that they provide for both men and women.
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Affiliation(s)
- Siddharth Marthi
- Department of Urology, Emory University School of Medicine, Clifton Rd NE STE B1400, Atlanta, GA, 1365, USA.
| | - Lisa M Shandley
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Emory University School of Medicine, Atlanta, GA, USA
| | - Nourhan Ismaeel
- Department of Urology, Emory University School of Medicine, Clifton Rd NE STE B1400, Atlanta, GA, 1365, USA
| | | | | | - Jennifer F Kawwass
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Emory University School of Medicine, Atlanta, GA, USA
| | - Heather S Hipp
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Emory University School of Medicine, Atlanta, GA, USA
| | - Akanksha Mehta
- Department of Urology, Emory University School of Medicine, Clifton Rd NE STE B1400, Atlanta, GA, 1365, USA
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12
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Mburu G, Kamuyango A, Kidula N, Kabra R, Thatte N, Kiarie J, Allotey P. Fulfilment of fertility desires for the attainment of Global Sustainable Development Goals. BMJ Glob Health 2023; 8:e012322. [PMID: 37015732 PMCID: PMC10083769 DOI: 10.1136/bmjgh-2023-012322] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 03/20/2023] [Indexed: 04/06/2023] Open
Affiliation(s)
- Gitau Mburu
- UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Asantesana Kamuyango
- UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Nancy Kidula
- UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Rita Kabra
- UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Nandita Thatte
- UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - James Kiarie
- UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Pascale Allotey
- UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
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13
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Santona A, Vismara L, Gorla L, Tognasso G, Ambrosini C, Luli A, Rollè L. The Relationship between Attachment, Dyadic Adjustment, and Sexuality: A Comparison between Infertile Men and Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3020. [PMID: 36833722 PMCID: PMC9962621 DOI: 10.3390/ijerph20043020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/23/2023] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Abstract
Infertility impacts several life dimensions. Among them, sexuality is particularly affected; yet studies have mainly focused on infertile women. We aimed to explore infertile men's and women's experiences in sexual satisfaction, internal control, and anxiety, and the relationship between attachment, dyadic adjustment, and sexuality. The sample consisted of 129 infertile people (47.3% females, 52.7% males, Mage = 39 years) who fulfilled an ad hoc questionnaire, the Multidimensional Sexuality Questionnaire (MSQ), the Experiences in Close Relationship-Revised (ECR-R), and the Dyadic Adjustment Scale (DAS). We found a significant effect of type of infertility and infertility factors on sexual anxiety only in infertile men. As regards infertile women, dyadic adjustment predicted sexual satisfaction, anxious attachment decreased sexual internal control, and avoidant attachment reduced sexual anxiety. As regards infertile men, high dyadic adjustment increased sexual satisfaction and a high avoidant attachment predicted high levels of sexual internal control. There was no relationship between attachment, dyadic adjustment, and sexual anxiety for infertile men. From the results, it emerges how important is to consider both dyadic adjustment and attachment in studying how infertility impacts women's and men's lives.
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Affiliation(s)
- Alessandra Santona
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy
| | - Laura Vismara
- Department of Pedagogy, Psychology, Philosophy, University of Cagliari, 09123 Cagliari, Italy
| | - Laura Gorla
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy
| | - Giacomo Tognasso
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy
| | - Carolina Ambrosini
- Department of Developmental Psychology and Socialisation, University of Padua, 35131 Padova, Italy
| | - Anisa Luli
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy
| | - Luca Rollè
- Department of Psychology, University of Torino, 10124 Torino, Italy
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14
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Karami NA, Latifi M, Berahmand N, Eini F, Al-Suqri MN. The Impact of Individual Factors on Health Information-Seeking Behavior of Infertile Couples Undergoing Assisted Reproductive Technologies: Longo Model. Adv Biomed Res 2023; 12:68. [PMID: 37200740 PMCID: PMC10186049 DOI: 10.4103/abr.abr_181_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 10/10/2022] [Accepted: 10/12/2022] [Indexed: 05/20/2023] Open
Abstract
Background This study investigated the impact of individual factors on the Health information-seeking behavior (HISB) of infertile couples undergoing Assisted Reproductive Technologies (ART). Materials and Methods This applied study was done using the descriptive-analytical method. The population of the study remains to be infertile couples undergoing ART referred to a public Infertility Center and a private one in Bandar Abbas (capital of Hormozgan province, Southern Iran) in the summer of 2020. Using simple random sampling, 168 people were selected. The data collection tool was a questionnaire extracted from Longo HISB Model, used after validation and reliability. Data were analyzed by SPSS software using descriptive and inferential tests. Results The results showed that individual factors (gender, education, income, age, and cause of infertility) affect the HISB of infertile couples. Based on the analysis of variance, there was a significant difference between infertile couples concerning Passive Information Receipt (F = 2.688 and P = 0.048) so the couples with a male cause used Passive Information Receipt more. Conclusions Considering the results, it is necessary for the country's health system to take appropriate measures to provide an appropriate situation for better decision-making for infertile couples and improve the chances of fertility by reducing the existing inequalities to Active Information Receipt and quality health information.
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Affiliation(s)
- Nader Alishan Karami
- Department of Health Information Technology, School of Allied Medical Sciences, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Masoomeh Latifi
- PhD in Information Sciences and Knowledge Studies, Fertility and Infertility Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
- Address for correspondence: Dr. Masoomeh Latifi, PhD in Information Sciences and Knowledge Studies, Fertility and Infertility Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran. E-mail:
| | - Nilofar Berahmand
- PhD in Information Sciences and Knowledge Studies, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Eini
- Research Assistant Professor of Reproductive Biology Fertility and Infertility Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mohammed N. Al-Suqri
- Associate Professor of Information Studies, Sultan Qaboos University, Muscat, Oman
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15
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Le Goff J, Reignier A, Mirallie S, Dubourdieu S, Barrière P, Fréour T, Lefebvre T. Sexual function in heterosexual couples undergoing assisted reproductive technology (ART) cycles with donor sperm. Arch Gynecol Obstet 2023; 307:625-632. [PMID: 36480033 PMCID: PMC9734951 DOI: 10.1007/s00404-022-06877-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 11/29/2022] [Indexed: 12/13/2022]
Abstract
PURPOSE Sexuality and the desire for children are closely linked, and infertility can increase the risk of sexual dysfunction (SD). Among heterosexual infertile couples undergoing assisted reproductive technology (ART) cycles, those referred for donor sperm cycles constitute a specific subgroup, potentially different than those undergoing ART with partner's sperm, as giving up on biological parenthood can be difficult to overcome. However, the impact of donor sperm ART on infertile couples' sexuality has been hardly explored in the literature. This study aimed to describe the sexual function in couples undergoing ART with donor sperm. METHODS This monocentric prospective observational study was conducted in heterosexual couples undergoing ART cycle with sperm donor, using the FSFI and the IIEF15 questionnaires. Seventy-nine couples were solicited to participate in the study. RESULTS In our sample, 39.3% (n = 24) of women had sexual dysfunction (SD). Among men, 26.5% (n = 13) had erectile dysfunction (ED). No statistically significant difference was found between both groups (with or without SD) in men and women in univariate analysis. Therefore, multivariate analysis was not performed and no specific predictor of SD could be identified. CONCLUSION Although this should be confirmed in a larger number of participants, our study demonstrates that a significant proportion of infertile patients undergoing ART with donor semen suffer from SD. No significant predictor could, however, be identified. Further research should focus on the evaluation of psychological interventions to treat or improve these disorders.
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Affiliation(s)
- Juliette Le Goff
- Service de Médecine et Biologie de la Reproduction, Hôpital Mère et Enfant, CHU de Nantes, 38 Boulevard Jean Monnet, Nantes, France
| | - Arnaud Reignier
- Service de Médecine et Biologie de la Reproduction, Hôpital Mère et Enfant, CHU de Nantes, 38 Boulevard Jean Monnet, Nantes, France ,Center for Research in Transplantation and Translational Immunology, UMR 1064, Nantes Université, CHU Nantes, INSERM, 44000 Nantes, France
| | - Sophie Mirallie
- Service de Médecine et Biologie de la Reproduction, Hôpital Mère et Enfant, CHU de Nantes, 38 Boulevard Jean Monnet, Nantes, France
| | - Sophie Dubourdieu
- Service de Médecine et Biologie de la Reproduction, Hôpital Mère et Enfant, CHU de Nantes, 38 Boulevard Jean Monnet, Nantes, France
| | - Paul Barrière
- Service de Médecine et Biologie de la Reproduction, Hôpital Mère et Enfant, CHU de Nantes, 38 Boulevard Jean Monnet, Nantes, France ,Center for Research in Transplantation and Translational Immunology, UMR 1064, Nantes Université, CHU Nantes, INSERM, 44000 Nantes, France
| | - Thomas Fréour
- Service de Médecine et Biologie de la Reproduction, Hôpital Mère et Enfant, CHU de Nantes, 38 Boulevard Jean Monnet, Nantes, France. .,Center for Research in Transplantation and Translational Immunology, UMR 1064, Nantes Université, CHU Nantes, INSERM, 44000, Nantes, France. .,Department of Obstetrics, Gynecology and Reproductive Medicine, Dexeus University Hospital, Barcelona, Spain.
| | - Tiphaine Lefebvre
- Service de Médecine et Biologie de la Reproduction, Hôpital Mère et Enfant, CHU de Nantes, 38 Boulevard Jean Monnet, Nantes, France
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16
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De Jonge CJ, Gellatly SA, Vazquez-Levin MH, Barratt CL, Rautakallio-Hokkanen S. Male Attitudes towards Infertility: Results from a Global Questionnaire. World J Mens Health 2023; 41:204-214. [PMID: 36047077 PMCID: PMC9826912 DOI: 10.5534/wjmh.220099] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/20/2022] [Accepted: 07/11/2022] [Indexed: 01/21/2023] Open
Abstract
PURPOSE In general, men are less likely to seek health care than women. Infertility is a global disease that afflicts approximately 15% of reproductive age couples and the male contributes to 40% of the diagnosable cause. Remarkably, no large or multi-national population data exist regarding men's perceptions about their infertility. The purpose of this study was to advance our knowledge about the infertile male's social experience regarding: (1) how they feel about their infertility, (2) what motivated them to seek health care, (3) how likely are they to talk with others about their infertility, (4) their awareness of male infertility support groups, and (5) what their primary source for information is regarding male infertility? Based on the results from this study, these simple questions now have clearer definition. MATERIALS AND METHODS An Institutional Review Board-approved, male-directed, anonymous questionnaire translated into 20 languages was made globally available through the Fertility Europe website (https://fertilityeurope.eu). Males (n=1,171) age 20-49 years were invited to complete the online survey after informed consent. RESULTS Most respondents were European (86%). Of European men, <15.8% were self-motivated to seek medical help. Further, their physician was not the primary source of information regarding their infertility. While most men (59%) viewed their infertility positively, a large majority were not very likely (73%) to talk about it. Most respondents indicated a lack of awareness or absence of male infertility support groups. CONCLUSIONS These are the first multi-national population data revealing men's feelings about their infertility, what motivates them to seek help and their awareness of resources for peer support and information. These findings also serve to highlight significant gaps that exist in the provision of male reproductive health care and in supportive resources for men suffering from infertility. We offer recommendations on how to address the problem(s).
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Affiliation(s)
| | | | - Mónica H. Vazquez-Levin
- Instituto de Biología y Medicina Experimental (IBYME), CONICET-FIBYME; CDRossi, Buenos Aires, Argentina
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17
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Burke ND, Nixon B, Roman SD, Schjenken JE, Walters JLH, Aitken RJ, Bromfield EG. Male infertility and somatic health - insights into lipid damage as a mechanistic link. Nat Rev Urol 2022; 19:727-750. [PMID: 36100661 DOI: 10.1038/s41585-022-00640-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2022] [Indexed: 11/08/2022]
Abstract
Over the past decade, mounting evidence has shown an alarming association between male subfertility and poor somatic health, with substantial evidence supporting the increased incidence of oncological disease, cardiovascular disease, metabolic disorders and autoimmune diseases in men who have previously received a subfertility diagnosis. This paradigm is concerning, but might also provide a novel window for a crucial health reform in which the infertile phenotype could serve as an indication of potential pathological conditions. One of the major limiting factors in this association is the poor understanding of the molecular features that link infertility with comorbidities across the life course. Enzymes involved in the lipid oxidation process might provide novel clues to reconcile the mechanistic basis of infertility with incident pathological conditions. Building research capacity in this area is essential to enhance the early detection of disease states and provide crucial information about the disease risk of offspring conceived through assisted reproduction.
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Affiliation(s)
- Nathan D Burke
- Priority Research Centre for Reproductive Science, School of Environmental and Life Sciences, Discipline of Biological Sciences, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, Infertility and Reproduction Research Program, New Lambton Heights, New South Wales, Australia
| | - Brett Nixon
- Priority Research Centre for Reproductive Science, School of Environmental and Life Sciences, Discipline of Biological Sciences, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, Infertility and Reproduction Research Program, New Lambton Heights, New South Wales, Australia
| | - Shaun D Roman
- Priority Research Centre for Reproductive Science, School of Environmental and Life Sciences, Discipline of Biological Sciences, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, Infertility and Reproduction Research Program, New Lambton Heights, New South Wales, Australia
- Priority Research Centre for Drug Development, School of Environmental and Life Sciences, Discipline of Biological Sciences, University of Newcastle, Callaghan, New South Wales, Australia
| | - John E Schjenken
- Priority Research Centre for Reproductive Science, School of Environmental and Life Sciences, Discipline of Biological Sciences, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, Infertility and Reproduction Research Program, New Lambton Heights, New South Wales, Australia
| | - Jessica L H Walters
- Priority Research Centre for Reproductive Science, School of Environmental and Life Sciences, Discipline of Biological Sciences, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, Infertility and Reproduction Research Program, New Lambton Heights, New South Wales, Australia
| | - R John Aitken
- Priority Research Centre for Reproductive Science, School of Environmental and Life Sciences, Discipline of Biological Sciences, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, Infertility and Reproduction Research Program, New Lambton Heights, New South Wales, Australia
| | - Elizabeth G Bromfield
- Priority Research Centre for Reproductive Science, School of Environmental and Life Sciences, Discipline of Biological Sciences, University of Newcastle, Callaghan, New South Wales, Australia.
- Hunter Medical Research Institute, Infertility and Reproduction Research Program, New Lambton Heights, New South Wales, Australia.
- Department of Biomolecular Health Sciences, Utrecht University, Utrecht, Netherlands.
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18
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Latifi M, Allahbakhshian L, Eini F, Karami NA, Al-Suqri MN. Health Information Needs of Couples Undergoing Assisted Reproductive Techniques. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2022; 27:522-530. [PMID: 36712307 PMCID: PMC9881548 DOI: 10.4103/ijnmr.ijnmr_328_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 11/29/2021] [Accepted: 05/17/2022] [Indexed: 01/31/2023]
Abstract
Background Couples undergoing Assisted Reproductive Techniques (ART) come across various information needs. This study aimed to identify the health information needs of couples undergoing ART. Materials and Methods The methodology of the present applied study was qualitative and the research method was conventional qualitative content analysis performed with the participation of 25 infertile couples under ART. The study took nine months (July 2020 to March 2021). The samples were objectively screened based on the criteria from the couples referred to the infertility center affiliated to Hormozgan University of Medical Sciences (Public) and Ome-Leila Specialized infertility clinic (Private) in Bandar Abbas (Iran). Data collection was performed by semi-structured interviews. The typical content analysis method was used in this research. Data analysis was carried out based on coding by the use of MAXQDA a software for qualitative and mixed methods data analysis. Results Information needs of couples under ART were categorized into three main categories and ten subcategories: 1) main cause of infertility [feminine or masculine cause, and etiology (nature and origin)], 2) treatment of infertility [identifying ART, treatment success rate, complications and risks (outcomes) of the treatment method, and treatment duration], and 3) healthcare [advice on medication, healthy nutrition (diet), sexual relations, and daily routine]. Conclusions The results of this study emphasize that the country's health officials, especially those in charge of the healthcare of infertile couples under ART, must necessarily pay more attention to meeting the needs of this group of people in society.
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Affiliation(s)
- Masoomeh Latifi
- Fertility and Infertility Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Leili Allahbakhshian
- Information Sciences and Knowledge Studies, Vice-Chancellery for Research and Technology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Eini
- Fertility and Infertility Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Nader Alishan Karami
- Department of Health Information Technology, School of Allied Medical Sciences, Hormozgan University of Medical Sciences, Bandar Abbas, Iran,Address for correspondence: Dr. Nader Alishan Karami, Assistant Professor of Library and Information Sciences, Department of Health Information Technology, School of Allied Medical Sciences, Hormozgan University of Medical Sciences, Bandar Abbas, Iran. E-mail:
| | - Mohammed Nasser Al-Suqri
- Associate Professor and the Dean of Postgraduate Studies, Sultan Qaboos University, Muscat, Oman
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19
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Yamanaka-Altenstein M. Bedarfsorientierte kognitiv-behaviorale Intervention für
Paare mit Infertilität (FERTIFIT): Eine Pilotstudie zur Entwicklung,
Durchführbarkeit und Akzeptanz. Psychother Psychosom Med Psychol 2022; 73:197-205. [PMID: 36323334 DOI: 10.1055/a-1939-7285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Zusammenfassung
Einleitung Weltweit schwankt die Prävalenz für
Infertilität zwischen 4–17% und in westlichen
Ländern ist rund eins von sieben Paaren mit Kinderwunsch betroffen. Das
Erleben einer Infertilität ist mit einer erhöhten
Wahrscheinlichkeit für psychische und partnerschaftliche Belastungen
assoziiert, wobei sich Partner einer Paarbeziehung in ihrem Befinden gegenseitig
beeinflussen. Dennoch ist die Versorgungslücke für betroffene
Paare groß. In dieser Pilotstudie wird eine praktikabel umsetzbare,
bedarfsorientierte und kognitiv-verhaltenstherapeutische Intervention
für Paare mit Infertilität vorgestellt, die die
partnerschaftliche Bewältigung typischer Problembereiche fördern
und einer zunehmenden Belastung entgegenwirken soll.
Material und Methoden Insgesamt nahmen 21 heterosexuelle Paare an dieser
Studie mit Eigen-Warte-Kontrollgruppendesign teil. Die Intervention beinhaltete
bedarfsabhängig 5–10 paartherapeutische Sitzungen. Die
psychische und infertilitätsbedingte Belastung, die
Partnerschaftsqualität, sowie die Anwendung von individuellen und
partnerschaftlichen Ressourcen wurden zu vier Messzeitpunkten (M1=vor
Wartekontrollphase, M2=vor Intervention, M3=nach Intervention,
M4=nach Katamnese) mittels Fragebögen erhoben.
Ergebnisse Bei Frauen besserten sich die psychische und
infertilitätsbedingte Belastung, und sie griffen auf mehr Ressourcen
zurück, die zum Wohlbefinden und zur aktiven Problembewältigung
und Emotionsregulation beitragen. Während des Interventionszeitraumes
kam es bei Männern zu einem zunehmenden Erleben hilfreicher
Unterstützung, und sowohl bei Männern als auch bei Frauen zu
einem häufigeren Einsatz partnerschaftlicher Copingstrategien. Die
Evaluation zeigte, dass die Teilnehmenden sehr zufrieden waren mit der
Intervention insgesamt und mit der erhaltenen Unterstützung.
Diskussion Die Befunde deuten auf eine gute Durchführbarkeit und
Akzeptanz dieser Intervention in der psychotherapeutischen Praxis hin und
liefern erste Hinweise auf mögliche erwünschte Effekte, die
allerdings aufgrund des Studiendesigns und der vorliegenden Limitationen nicht
eindeutig auf die Intervention zurückgeführt werden
können.
Schlussfolgerung Die Stärke der vorliegenden Studie liegt in der
Vorstellung eines in der psychotherapeutischen Praxis gut anwendbaren
paartherapeutischen Konzepts, das bedarfsgerecht angeboten werden kann.
Für die Überprüfung der gefundenen Effekte ist eine
anschließende größer angelegte klinische Studie mit
randomisiert-kontrolliertem Design notwendig.
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Affiliation(s)
- Misa Yamanaka-Altenstein
- Gynäkopsychologie und Infertilität,
Klaus-Grawe-Institut für Psychologische Therapie Zürich,
Zürich, Switzerland
- Institut für Psychologie, Technische Universität
Braunschweig, Braunschweig, Germany
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20
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Borowczak M, Rotoli S. Possible Gender Differences in the Level of Perceived Social Support in Couples Who Are Experiencing Issues With Infertility. Cureus 2022; 14:e29343. [DOI: 10.7759/cureus.29343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2022] [Indexed: 11/05/2022] Open
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21
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Olisa NP, Campo-Engelstein L, Martins da Silva S. Male infertility: what on earth is going on? Pilot international questionnaire study regarding clinical evaluation and fertility treatment for men. REPRODUCTION AND FERTILITY 2022; 3:RAF-22-0033. [PMID: 36065802 PMCID: PMC9578063 DOI: 10.1530/raf-22-0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 09/05/2022] [Indexed: 11/08/2022] Open
Abstract
Infertility is a time-consuming and exhaustive process, which disproportionally affects women. Although concerns have been raised about deficiencies in clinical evaluation of infertile men, there is currently little published data documenting this. A SurveyMonkey questionnaire was therefore created to capture current clinical practice of fertility specialists working in IVF clinics. Responses were collected May - July 2021. 112 clinicians completed the pilot survey with respondents from Europe (n=49; 43.8%), Africa (n=39, 34.8%), North America (n=6; 5.4%), Asia (n=16; 14.3%), South America (n=1; 0.9%) and Australasia (n=1;0.9%). 41% fertility specialists (45/110) reported taking only a brief medical history and 24% reported that they never routinely examined infertile male patients. 54% fertility specialists also reported issues getting men to undertake diagnostic semen analysis. Treatment for male infertility spanned Assisted Reproductive Technology (ART), with themes of individualised medicine influencing treatment recommendations. 48.2% clinicians reported using empirical medical therapy (EMT) for unexplained male infertility. Notably, 3.6% respondents recommended testosterone treatment, despite likely negative impact on spermatogenesis. However, high levels of opportunistic general health advice were reported, including discussion of life exposures thought to be important for male reproductive health. This study adds novel evidence and highlights current deficiencies in clinical practice relating to male infertility. Evaluation of the infertile male using simple medical tools (detailed history taking and clinical examination) has the potential to identify treatable or reversible conditions and should be an immediate focus for education and improvement in Reproductive Medicine. Investment in research and development is much needed in the field of andrology, to develop effective non-ART treatment options for male infertility.
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Affiliation(s)
- Nkoyenum Pamela Olisa
- Reproductive Medicine Research Group, School of Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK
| | - Lisa Campo-Engelstein
- Institute for the Medical Humanities, Preventative Medicine and Population Health, University of Texas Medical Branch, Galveston, Texas, USA
| | - Sarah Martins da Silva
- Reproductive Medicine Research Group, School of Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK
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Shabto JM, Patil D, Poulose K, Bennett MP, Xiao AX, Hipp HS, Kawwass JF, Mehta A. Access to Care for Infertile Men: Referral Patterns of Fertility Clinics in the United States. Urology 2022; 166:152-158. [PMID: 35217029 DOI: 10.1016/j.urology.2022.01.047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/28/2021] [Accepted: 01/05/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To evaluate fertility clinic management of male factor infertility, including website educational content as well as factors associated with referral for urologic evaluation and care. MATERIALS AND METHODS Using 2015-2018 Centers for Disease Control and Prevention Fertility Clinic Success Rates Reports, 480 operative fertility clinics in the United States were identified. Clinic websites were systematically reviewed for content regarding male infertility. Structured telephone interviews of clinic representatives were performed to determine clinic-specific practices for management of male factor infertility. Multivariable logistic regression models were used to predict how clinic characteristics (geographic region, practice size, practice setting, proximity to urologist, in-state andrology fellowship, state-mandated fertility coverage, annual in vitro fertilization cycles, and percentage of in vitro fertilization cycles for male factor infertility) were associated with patient referral to a urologist for male infertility care. RESULTS We interviewed 477 fertility clinics and analyzed available websites (n = 474). The majority of websites (77%) discussed male infertility evaluation while 46% discussed treatment. Fifty clinics (11%) had an on-site urologist. Clinics with on-site urologists were more likely to be larger practices, academically affiliated, and discuss male infertility treatment on their website (all P ≤ .05). For clinics without an on-site urologist, practice size and presence of an in-state andrology fellowship program were the strongest predictors of urologic referral (P <.02). CONCLUSION Variability in patient-facing education and infertility practice setting and size influence access to urologic care for couples with male factor infertility.
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Affiliation(s)
- Julie M Shabto
- Department of Urology, Emory University School of Medicine, Atlanta, GA
| | - Dattatraya Patil
- Department of Urology, Emory University School of Medicine, Atlanta, GA
| | - Katherine Poulose
- Department of Urology, Emory University School of Medicine, Atlanta, GA
| | | | - Angel X Xiao
- Department of Urology, Emory University School of Medicine, Atlanta, GA
| | - Heather S Hipp
- Division of Reproductive Endocrinology and Infertility, Emory University School of Medicine, Atlanta, GA
| | - Jennifer F Kawwass
- Division of Reproductive Endocrinology and Infertility, Emory University School of Medicine, Atlanta, GA
| | - Akanksha Mehta
- Department of Urology, Emory University School of Medicine, Atlanta, GA.
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Szatmári A, Helembai K, Zádori J, Kovács I. Paramedical counselling in infertility treatment: its effects on anxio-depressive symptom severity, perceived stress and self-esteem. Heliyon 2022; 8:e09827. [PMID: 35800247 PMCID: PMC9254525 DOI: 10.1016/j.heliyon.2022.e09827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 04/05/2022] [Accepted: 06/24/2022] [Indexed: 11/24/2022] Open
Abstract
Aims The importance of contributing psychological factors and stress-control in female infertility is well documented, but research on their role in male infertility is scarce. The present study aimed to evaluate the effects of a novel paramedical counselling on anxio-depressive symptom severity, perceived stress and self-esteem in infertile men participating in an infertility treatment programme. Methods Patients were recruited from clinics of University of Szeged, Hungary between 2019 May and 2020 December, and were sorted into control (n = 51) and experimental (n = 57) groups, where patients in the experimental group received a 5-session paramedical counselling in extension to their medical treatment. The levels of anxio-depressive symptom severity, perceived stress and self-esteem were measured prior to and after receiving paramedical counselling. The control group scored lower in regards of the severity of depressive symptom, and showed an increase of self-esteem, while the experimental group resulted in a significant decrease of anxio-depressive scores with the elevation of the level of self-esteem. Results Our results indicate that joining an infertility treatment programme alone had a positive role in reducing depressive symptoms and in the increase of self-esteem among infertile men, but receiving additional paramedical counselling throughout the treatment programme resulted in the decrease of anxio-depressive symptoms, besides the elevation of the level of self-esteem, with a significantly higher decrease in the state anxiety compared to not receiving this additional paramedical counselling. Conclusions Thus, it would be advisable for infertility treatment programmes to incorporate screening for psychological vulnerability and implement additional paramedical counselling to alleviate these confounding symptoms detrimental to conceiving.
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Nasution R, Husein A, Laksmi LI, Silalahi BN. Challenges in diagnosis and management of perineal hypospadias with a testicular seminoma mimicking paratesticular tumor in a solitary testis: A case report. Urol Case Rep 2022; 43:102050. [PMID: 35342714 PMCID: PMC8943400 DOI: 10.1016/j.eucr.2022.102050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/21/2022] [Accepted: 03/04/2022] [Indexed: 11/06/2022] Open
Abstract
Diagnosing and managing perineal hypospadias in patient with a suspected paratesticular seminoma in a solitary testis may be challenging. We describe a case of 26-year-old male presented with painless left scrotal swelling with hypospadias and chordee. The patient underwent two-staged surgery: chordectomy and open inguinal testicular biopsy followed by urethroplasty and radical orchidectomy.
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Affiliation(s)
- Ramlan Nasution
- Division of Urology, Department of Surgery, Faculty of Medicine, Haji Adam Malik Hospital, Universitas Sumatera Utara, Indonesia
| | - Ali Husein
- Division of Urology, Department of Surgery, Faculty of Medicine, Haji Adam Malik Hospital, Universitas Sumatera Utara, Indonesia
| | - Lidya Imelda Laksmi
- Department of Anatomical Pathology, Faculty of Medicine, Universitas Sumatera Utara, Indonesia
| | - Belman Novenry Silalahi
- Department of Anatomical Pathology, Faculty of Medicine, Universitas Sumatera Utara, Indonesia
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Danis R, Sriprasert I, Petok W, Stone J, Paulson R, Samplaski M. Does male fertility-related quality of life differ when undergoing evaluation by reproductive urologist versus reproductive endocrinologist? HUM FERTIL 2022:1-8. [PMID: 35762174 DOI: 10.1080/14647273.2022.2081095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The female infertility experience is well-described, but the male experience is less explored. We sought to understand if fertility motivations and quality of life differ for males undergoing fertility evaluation by a reproductive urologist (RU) versus a reproductive endocrinologist (RE). A cross-sectional study of 201 males undergoing fertility evaluation at an academic centre, by either a RU or RE, over a 2-year period, was performed. A survey was administered, with demographic, medical, and fertility motivations questions, and the validated Fertility Quality of Life (FertiQoL) questionnaire. Responses were compared by provider type using descriptive statistics, chi-square, and t-test. Most men (91.1%) pursued evaluation because of a mutual desire for children. RE evaluated males were older, earned higher incomes, and were more likely to pursue IVF versus those RU evaluated (p < 0.05). Men evaluated by RUs had lower FertiQoL scores, (p < 0.05), which correlated with having known male factor infertility (p < 0.05). Nearly all (96.2%) men evaluated by RUs indicated this was helpful for understanding their infertility. Our findings provide new insight into the male fertility evaluation experience. Despite the lower QoL seen by men seeing a RU, nearly all men reported that a RU evaluation was helpful for understanding their infertility experience.
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Affiliation(s)
- Rachel Danis
- Division of Reproductive Endocrinology & Infertility; Department of Obstetrics & Gynecology; Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Intira Sriprasert
- Department of Obstetrics & Gynecology; Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - William Petok
- Department of Obstetrics & Gynecology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, USA
| | - Jesse Stone
- USC Fertility, University of Southern California, Los Angeles, California, USA
| | - Richard Paulson
- Division of Reproductive Endocrinology & Infertility; Department of Obstetrics & Gynecology; Keck School of Medicine, University of Southern California, Los Angeles, California, USA.,USC Fertility, University of Southern California, Los Angeles, California, USA
| | - Mary Samplaski
- Institute of Urology, University of Southern California, Los Angeles, California, USA
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Haimbaugh A, Akemann C, Meyer D, Gurdziel K, Baker TR. Insight into 2,3,7,8-tetrachlorodibenzo-p-dioxin-induced disruption of zebrafish spermatogenesis via single cell RNA-seq. PNAS NEXUS 2022; 1:pgac060. [PMID: 35799832 PMCID: PMC9252172 DOI: 10.1093/pnasnexus/pgac060] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 06/17/2022] [Indexed: 02/05/2023]
Abstract
2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) is a potent and environmentally persistent endocrine disrupting chemical. Our previous work demonstrated the latent reproductive maladies of early-life TCDD exposure in zebrafish. Zebrafish acutely exposed to low, environmentally relevant levels of TCDD (50 pg/mL) during two windows of sexual differentiation in development (1 hour of exposure at 3 and 7 weeks postfertilization) were later infertile, showed a reduction in sperm, and exhibited gene expression consistent with an altered microenvironment, even months after exposure. Due to the highly heterogeneous cell- type and -stage landscape of the testes, we hypothesized various cell types contribute markedly different profiles toward the pathology of TCDD exposure. To investigate the contributions of the diverse cell types in the adult zebrafish testes to TCDD-induced pathology, we utilized single-cell RNA-seq and the 10x Genomics platform. The method successfully captured every stage of testicular germ cell development. Testes of adult fish exposed during sexual differentiation to TCDD contained sharply decreased populations of late spermatocytes, spermatids, and spermatozoa. Spermatogonia and early spermatocyte populations were, in contrast, enriched following exposure. Pathway analysis of differentially expressed genes supported previous findings that TCDD exposure resulted in male infertility, and suggested this outcome is due to apoptosis of spermatids and spermatozoa, even years after exposure cessation. Increased germ cell apoptosis was confirmed histologically. These results provide support for an environmental exposure explanation of idiopathic male infertility.
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Affiliation(s)
- Alex Haimbaugh
- Department of Pharmacology, School of Medicine, Wayne State University, Detroit, MI 48207, USA
| | - Camille Akemann
- Department of Pharmacology, School of Medicine, Wayne State University, Detroit, MI 48207, USA
| | - Danielle Meyer
- Department of Pharmacology, School of Medicine, Wayne State University, Detroit, MI 48207, USA
| | - Katherine Gurdziel
- Applied Genome Technology Center, School of Medicine, Wayne State University, Detroit, MI 48207, USA
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27
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Flykt MS, Prince M, Vänskä M, Lindblom J, Minkkinen J, Tiitinen A, Poikkeus P, Biringen Z, Punamäki RL. Adolescent attachment to parents and peers in singletons and twins born with assisted and natural conception. Hum Reprod Open 2022; 2022:hoac012. [PMID: 35419495 PMCID: PMC8994490 DOI: 10.1093/hropen/hoac012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 03/01/2022] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION Does adolescent attachment to parents and peers differ between singletons and twins born with ART or natural conception (NC)? SUMMARY ANSWER Adolescent attachment anxiety with the father was higher among NC singletons than among ART and NC twins, whereas attachment avoidance with the father was higher in ART singletons than in NC singletons and NC twins. No differences were found in attachment to the mother, best friend or romantic partner. WHAT IS KNOWN ALREADY Most studies have not found differences between ART and NC singletons in parent–adolescent relationships, but twin relationships may be more at risk. No previous study has examined all four groups in the same study, or specifically looked at attachment relationships. STUDY DESIGN, SIZE, DURATION This was an 18-year, prospective and controlled longitudinal study with families of 496 ART singletons, 101 ART twin pairs, 476 NC singletons and 22 NC twin pairs. Families were recruited during the second trimester of pregnancy; the ART group was recruited from five infertility clinics in Finland and the control group was recruited from a hospital outpatient clinic during a routine visit. PARTICIPANTS/MATERIALS, SETTING, METHODS Mothers and fathers gave background information for this study during pregnancy, and during the child’s first year and early school age (7–8 years). For the ART group, infertility characteristics and prenatal medical information was also obtained from the patient registry of the infertility clinics. Children (originally 50% girls) filled in electronic questionnaires related to their attachment to mother, father, best friend and romantic partner (Experiences in Close Relationships—Relationship Structures) at 17–19 years of age. MAIN RESULTS AND THE ROLE OF CHANCE Adolescent attachment anxiety to father was higher in NC singletons than in ART twins, P = 0.004 and marginally higher than in NC twins, P = 0.06. Adolescent attachment avoidance to father was higher in ART singletons than in NC singletons, P = 0.006 and marginally higher than in NC twins, P = 0.055. LIMITATIONS, REASONS FOR CAUTION The sample size was small especially in the NC twin group and there was drop-out over the 18-year time period, especially among boys and families with lower parental education level. The study only included native Finnish-speaking families. The results could differ in a more diverse population. ART singletons were younger and had fewer siblings than ART twins and NC children, and ART and NC twins had more newborn health risks than ART and NC singletons. WIDER IMPLICATIONS OF THE FINDINGS The study adds to a growing body of evidence that neither ART treatments nor being a twin places mother–child relationships or peer relationships at long-term risk. However, in our study, which was the first to examine both ART and twinhood simultaneously, we found that there may be more problems in father–adolescent relationships, but only in ART singletons and only related to attachment avoidance. Our findings suggest that men, as well as women, should receive enough support in pre- and peri-natal health care during and after infertility treatments. STUDY FUNDING/COMPETING INTEREST(S) This study was funded by Academy of Finland (grant number 2501308988), the Juho Vainio Foundation and the Finnish Cultural Foundation. The authors report no conflict of interest. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- M S Flykt
- University of Helsinki, Faculty of Medicine, Department of Psychology and Logopedics, 00014 University of Helsinki, Helsinki, Finland
- Tampere University, Faculty of Social Sciences, Department of Psychology, 33014 Tampere University, Tampere, Finland
| | - M Prince
- Colorado State University, Department of Psychology, Fort Collins, Colorado, 80523, USA
| | - M Vänskä
- Tampere University, Faculty of Social Sciences, Department of Psychology, 33014 Tampere University, Tampere, Finland
| | - J Lindblom
- Tampere University, Faculty of Social Sciences, Department of Psychology, 33014 Tampere University, Tampere, Finland
- University of Turku, Department of Clinical Medicine, 20014 University of Turku, Turku, Finland
| | - J Minkkinen
- Tampere University, Faculty of Social Sciences, Department of Psychology, 33014 Tampere University, Tampere, Finland
| | - A Tiitinen
- University of Helsinki, Faculty of Medicine, Department of Obstetrics and Gynecology, 00014 University of Helsinki, Helsinki, Finland
- Helsinki University Hospital, 00029 Helsinki University Hospital, Helsinki, Finland
| | - P Poikkeus
- University of Helsinki, Faculty of Medicine, Department of Obstetrics and Gynecology, 00014 University of Helsinki, Helsinki, Finland
- Helsinki University Hospital, 00029 Helsinki University Hospital, Helsinki, Finland
| | - Z Biringen
- Colorado State University, Department of Human Development and Family Studies, Fort Collins, Colorado, 80523, USA
| | - R-L Punamäki
- Tampere University, Faculty of Social Sciences, Department of Psychology, 33014 Tampere University, Tampere, Finland
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Interpersonal dynamics of women in midlife living with involuntary childlessness. JOURNAL OF ADULT DEVELOPMENT 2022. [DOI: 10.1007/s10804-022-09393-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Lu Y, Su H, Zhang J, Wang Y, Li H. Treatment of Poor Sperm Quality and Erectile Dysfunction With Oral Pentoxifylline: A Systematic Review. Front Pharmacol 2022; 12:789787. [PMID: 35095501 PMCID: PMC8790020 DOI: 10.3389/fphar.2021.789787] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 12/22/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Pentoxifylline (PTX) is a member of methylxanthine chemicals and a type of non-selective phosphodiesterase-5 inhibitors, which has been used in male infertility treatment to improve sperm quality and erectile dysfunction (ED) treatment. Mutually tight associations existed between ED and male infertility. Using PTX might kill two birds with one stone by improving sperm quality and erectile function in infertile men with ED. Methods: PubMed, Cochrane Library, EMBASE, and Web of Science were searched by October 2021. Based on available evidence from observational studies and randomized-controlled trials (RCTs), we conducted a systematic review to summarize the efficacy and safety of PTX in treating ED and male infertility. The protocol of the article was registered and updated in PROSPERO (CRD42021291396). Results: From 202 records, eight studies (7 RCTs) evaluating the role of PTX in ED and three studies (2 RCTs) assessing the efficacy of PTX in male infertility were included in the systematic review. Three studies (100.00%) and two studies (100.00%) reported the beneficial role of PTX in improving sperm progressive motility and normal sperm morphology rate, respectively. In contrast, only one study (33.33%) indicated the favorable role of PTX in enhancing sperm concentration. As for ED, three (60.00%) studies supported the treatment role of PTX alone in ED, and two studies (66.67%) favored the combination use of PTX and selective PDE5Is compared with selective PDE5Is alone. Safety analysis showed that PTX was a well-tolerated drug in ED and male infertility treatment. Conclusion: Given the association between ED and male infertility and satisfying findings from available evidence, PTX administration for the simultaneous treatment of poor sperm quality and mild ED in infertile men will highly enhance the treatment compliance. However, the finding should be treated carefully until validated by further studies.
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Affiliation(s)
- Yi Lu
- Department of Urology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Hao Su
- Department of Urology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Jianzhong Zhang
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Yutao Wang
- Department of Urology, China Medical University, The First Hospital of China Medical University, Shenyang, China
| | - Hongjun Li
- Department of Urology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
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Bayoumi RR, Koert E, Boivin J, Viswanath K, McConnell M. Quality of life of Sudanese patients attending a fertility clinic: a mixed methods study. Health Psychol Behav Med 2021; 9:1006-1030. [PMID: 34881115 PMCID: PMC8648023 DOI: 10.1080/21642850.2021.2007773] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 11/13/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Infertility affects over 50 million people globally, the burden is disproportionately borne by women, especially in low and middle-income countries (LMIC). The impact of infertility on quality of life (QoL) has not been well documented or assessed qualitatively in LMIC like Sudan, where infertility is a pervasive problem. Therefore, the purpose of this mixed-methods study was to assess the fertility-related QoL of infertile individuals in Sudan using the fertility quality of life (FertiQoL) tool. METHODS We used explanatory sequential design (surveys and interviews) in a fertility clinic in Sudan (January 2017-May 2018). We collected socio-demographic information, medical/reproductive history and used Arabic FertiQoL. We generated descriptive statistics of FertiQoL (core, domain) scores and independent variables; multiple linear regression models to assess the relationship between FertiQoL and dependent variables; and t-tests to compare mean core/domain scores. We conducted thematic analysis on qualitative data about the subjective experience of being infertile. RESULTS The study included 102 participants (72 women), 70 educated beyond secondary school, mean age 33.89 years (SD = 7.82) and mean duration of infertility was 4.03 years (SD 3.29). Mean FertiQoL core score 76.02 (SD = 16.26), domain scores: emotional 71.61 (SD = 22.04), relational 78.06 (SD = 16.62), mind/body 74.06 (SD 22.53) and social 78.88 (SD = 18.24). Men had better fertility-related QoL. FOUR THEMES EMERGED A sense of something missing because of childlessness; social pressure from peoples' questions; impact on the spousal relationship (which differed amongst participants) and coping (faith-based and non-faith-based) which was necessary when the lived experience led to internal distress. CONCLUSIONS Infertility negatively impacted the QoL of participants in this study, and women were worse off. Cognitive appraisal, social support and pressure may be key factors influencing the QoL of infertile individuals, therefore they should be encouraged to seek social and professional support. FertiQoL is a useful tool to assess fertility QoL in LMIC like Sudan.
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Affiliation(s)
- Rasha R. Bayoumi
- School of Psychology, University of Birmingham Dubai, Dubai International Academic City, Dubai, UAE
| | - Emily Koert
- Department of Educational and Counselling Psychology and Special Education, University of British Columbia, Vancouver, Canada
| | - Jacky Boivin
- Cardiff Fertility Studies Research Group, School of Psychology, Cardiff University, Cardiff, UK
| | - Kasisomayajula Viswanath
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Margaret McConnell
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA, USA
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Kruglova K, O'Connell SBL, Dawadi S, Gelgoot EN, Miner SA, Robins S, Schinazi J, Zelkowitz P. An mHealth App to Support Fertility Patients Navigating the World of Infertility (Infotility): Development and Usability Study. JMIR Form Res 2021; 5:e28136. [PMID: 34636741 PMCID: PMC8548975 DOI: 10.2196/28136] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 07/20/2021] [Accepted: 08/01/2021] [Indexed: 01/25/2023] Open
Abstract
Background The experience of infertility and its treatment engenders considerable stress and is often described as an emotional rollercoaster. A mobile health (mHealth) app may be a novel solution to address the psychoeducational and psychosocial support needs of fertility patients because of its potential to reduce stress and increase patient empowerment. There are a few fertility-related apps that provide information and support to both men and women undergoing fertility treatment; however, none have documented their development and evaluation process. Objective This study aims to describe the development and evaluation process of a bilingual mHealth app, Infotility, designed to meet the psychoeducational and psychosocial support needs of men and women undergoing fertility treatment. Methods To develop the Infotility app, we adhered to the Medical Research Council guidelines for the development and evaluation of complex interventions. First, we conducted literature reviews and needs assessment surveys of fertility patients and health care providers who informed the content and design of the app. Second, we tested the intervention with a small group of end users who provided feedback on the design and appropriateness of the app’s content. Third, we evaluated the uptake and usability of the app using a pre-post study design. Finally, we updated the app’s content based on participants’ feedback and searched for partners to disseminate the app to the broader public. Results This study is the first to describe the development and evaluation process of an mHealth app for men and women undergoing fertility treatment. The app met its goal in providing fertility patients with a clinician-approved, portable resource for reliable information about medical and psychosocial aspects of infertility and its treatments and a confidential peer support forum monitored by trained peer supporters. Participants rated the engagement, functionality, information, and esthetics of the app positively, with an overall app quality mean score of 3.75 (SD 0.53) and a star rating of 3.43 (SD 0.75), with a total possible score and star rating of 5.00. Conclusions By documenting the systematic development and evaluation of the mHealth app for men and women undergoing fertility treatment, this paper can facilitate the replication of the study intervention and the development of similar mHealth apps.
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Affiliation(s)
- Katya Kruglova
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada.,Department of Psychiatry, Jewish General Hospital, Montreal, QC, Canada
| | - Siobhan Bernadette Laura O'Connell
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada.,Department of Psychiatry, Jewish General Hospital, Montreal, QC, Canada
| | - Shrinkhala Dawadi
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada.,Department of Psychiatry, Jewish General Hospital, Montreal, QC, Canada
| | - Eden Noah Gelgoot
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada.,Department of Psychiatry, Jewish General Hospital, Montreal, QC, Canada
| | - Skye A Miner
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
| | - Stephanie Robins
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada.,Department of Psychiatry, Jewish General Hospital, Montreal, QC, Canada
| | - Joy Schinazi
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada.,Department of Psychiatry, Jewish General Hospital, Montreal, QC, Canada
| | - Phyllis Zelkowitz
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada.,Department of Psychiatry, McGill University, Montreal, QC, Canada
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Stevenson EL, Ching-Yu C, Chia-Hao C, McEleny KR. Men's perception and understanding of male-factor infertility in the UK. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2021; 30:S8-S16. [PMID: 33983808 DOI: 10.12968/bjon.2021.30.9.s8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Male-factor infertility is a common but stigmatised issue, and men often do not receive the emotional support and the information they need. This study sought to understand awareness of male fertility issues compared to female fertility among the UK general male public, and also what were perceived as being the optimum methods for providing support for affected men, emotionally and through information. Men feel that male infertility is not discussed by the public as much as female infertility. Lifestyle issues that affect male fertility are not well understood, and men affected by infertility desire more support, including online, from health professionals and through peer support. Health professionals, including those in public health, could offer evidence-based programmes to reduce stigma and increase public knowledge about infertility, as well as offer emotional support to men with infertility problems.
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Affiliation(s)
| | - Cheng Ching-Yu
- Professor and Research Fellow, Department of Nursing, Chang Gung University of Science and Technology and Chang Gung Memorial Hospital at Chiayi, Putz, Chiayi County, Taiwan
| | - Chang Chia-Hao
- Associate Professor, Department of Nursing, Chang Gung University of Science and Technology, Chiayi Campus, Putz, Chiayi County, Taiwan
| | - Kevin R McEleny
- Consultant Urologist, Newcastle Fertility Centre, Newcastle-upon-Tyne Hospitals NHS Foundation Trust, Newcastle-upon-Tyne
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Zurlo MC, Cattaneo Della Volta MF, Vallone F. Infertility-Related Stress and Psychological Health Outcomes in Infertile Couples Undergoing Medical Treatments: Testing a Multi-dimensional Model. J Clin Psychol Med Settings 2021; 27:662-676. [PMID: 31471847 DOI: 10.1007/s10880-019-09653-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The study aims to propose and test a multi-dimensional infertility-related stress model including socio-demographic and fertility-related characteristics, infertility-related stress dimensions, coping strategies and couple's dyadic adjustment dimensions as predictors of anxiety and depression among partners of couples undergoing infertility treatments. Both members of 250 infertile couples filled out a questionnaire consisting of Socio-demographics (Age; Educational level; Employment status), Fertility-related characteristics (Type of diagnosis; Duration of infertility), Fertility Problem Inventory-Short Form, Coping Orientations to Problem Experienced-New Italian Version, Dyadic Adjustment Scale, State-Trait Anxiety Inventory-Y and Edinburgh Depression Scale. Hierarchical Multiple Linear Regressions indicated that the proposed predictive models for anxiety and depression were significant and had good levels of fit with the data. Gender differences emerged in predictor variables. Findings provide valid predictive models that could be adopted to assess psychological health in infertile patients and to develop evidence-based and tailored counselling interventions at centres for assisted reproduction.
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Affiliation(s)
- Maria Clelia Zurlo
- Department of Political Sciences, University of Naples Federico II, Via L. Rodinò 22, 80138, Naples, Italy.
| | | | - Federica Vallone
- Department of Humanities, University of Naples Federico II, Naples, Italy
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Warchol-Biedermann K. The Etiology of Infertility Affects Fertility Quality of Life of Males Undergoing Fertility Workup and Treatment. Am J Mens Health 2021; 15:1557988320982167. [PMID: 33834914 PMCID: PMC8040574 DOI: 10.1177/1557988320982167] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
This panel study explored the effects of male, female, mixed, or idiopathic factor of infertility on the fertility quality of life (FertiQoL) in involuntarily childless males undergoing fertility workup for the first time. A convenience sample of 255 married males (age range = 22–51 years, mean = 30.24 years), 254 (99.6%) of whom suffered from primary infertility were assessed (1) at the baseline, before their initial fertility evaluation (T1); (2) before their second andrological appointment, 2–3 months after diagnostic disclosure (T2); and (3) before subsequent treatment-related/ follow-up appointments (T3, T4). The timing of psychological assessment was strictly related to andrological appointments and routine medical procedures. Respondents completed Emotional, Mind–Body, Relational, and Social subscales of the Polish version of FertiQoL and a baseline demographic survey. The research demonstrated that the FertiQoL scores across the Emotional, Mind–Body, and Relational subscales markedly decreased after the diagnostic disclosure, particularly in the subgroups with male and concurrent male and female factor. Social subscale scores in all subgroups remained stable after the diagnostic disclosure (at T2) but significantly decreased in the follow-up (at T3 and T4). Significant differences in FertiQoL scores associated with respondents’ infertility factor could be demonstrated at each time point. The study identifies the FertiQoL in unintentionally childless males is significantly affected by their factor of infertility and evolves across the pathway of treatment-related/follow-up appointments.
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Ma J, Zhang Y, Bao B, Chen W, Li H, Wang B. Prevalence and associated factors of erectile dysfunction, psychological disorders, and sexual performance in primary vs. secondary infertility men. Reprod Biol Endocrinol 2021; 19:43. [PMID: 33750412 PMCID: PMC7942006 DOI: 10.1186/s12958-021-00720-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 02/17/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Many infertile couples might experience erectile dysfunction (ED) and significant changes in the quality of sexual life and psychological state though information is limited in secondary infertile men in China. To determine whether primary or secondary infertility is associated with ED, psychological disorders, and sexual performance. METHODS This was a cross-sectional survey conducted at the Dongzhimen Hospital of Beijing University of Chinese Medicine (06/2019-01/2020). The participants completed a questionnaire including general information, sexual life, simplified International Index of Erectile Function (IIEF-5), Patient Health Questionnaire-9 (PHQ-9), and 7-item Generalized Anxiety Disorder Scale (GAD-7). Multivariable logistic regression was used to identify the factors associated with ED, depression, and anxiety. RESULTS ED was more frequent in secondary vs. primary infertility (46.5 % vs. 26.7 %, P < 0.001). Compared with men with primary infertility, those with secondary infertility showed lower IIEF-5 scores (P < 0.001), higher occurrence of TOIF (P = 0.001), had a higher awareness of partner's ovulation when having ED (P = 0.001), lower GAD-7 scores (P = 0.016), lower libido (P = 0.005), fewer intercourses per month (P = 0.001) and a lower sexual satisfaction score (P = 0.027). In the multivariate analysis, primary infertility was found to be an independent risk factor of anxiety (OR: 1.812, 95 %CI: 1.015-3.236). Some overlap is observed in factors associated with ED, psychological disorders, and sexual performance between primary and secondary infertility, but some factors are distinct. CONCLUSIONS The prevalence of ED in secondary infertility men was higher than that of primary infertility men, and the quality of sexual life was decreased. Primary infertility is an independent risk factor of anxiety.
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Affiliation(s)
- Jianxiong Ma
- grid.268505.c0000 0000 8744 8924The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
- grid.24695.3c0000 0001 1431 9176Department of Andrology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
- Key Laboratory of Integrative Chinese and Western Medicine for Prevention and Treatment of Sexual Dysfunction of Zhejiang Province, Hangzhou, China
| | - Yingying Zhang
- grid.268505.c0000 0000 8744 8924The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Binghao Bao
- grid.24695.3c0000 0001 1431 9176Department of Andrology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Wangqiang Chen
- Department of Reproductive Medicine, Zhejiang Provincial Integrated Chinese and Western Medicine Hospital, Hangzhou, China
| | - Haisong Li
- grid.24695.3c0000 0001 1431 9176Department of Andrology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Bin Wang
- grid.24695.3c0000 0001 1431 9176Department of Andrology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
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Fieldsend M, Smith JA. Exploring the Experiences of Four Men Living with Involuntary Childlessness in Midlife. JOURNAL OF LOSS & TRAUMA 2021. [DOI: 10.1080/15325024.2021.1892942] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Megumi Fieldsend
- Department of Psychological Sciences, Birkbeck University of London, London, UK
| | - Jonathan A. Smith
- Department of Psychological Sciences, Birkbeck University of London, London, UK
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Babul-Hirji R, Hirji R, Chitayat D. Genetic counselling for infertile men of known and unknown etiology. Transl Androl Urol 2021; 10:1479-1485. [PMID: 33850782 PMCID: PMC8039627 DOI: 10.21037/tau-2019-gcmi-09] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Of the couples trying to conceive (had frequent, unprotected sexual intercourse for a year or longer) 15% will experience infertility with the annual incidence of infertility estimated at 1.2 couples per 1,000 total in the general population. Male factors contribute to over 50% of the cases with 7% of the male population experiencing infertility. Not being able to conceive a child is emotionally traumatic and frustrating and can affect the person’s self esteem and the couple’s relationship. Major progress has been achieved in identifying the etiology of male infertility and especially the genetic causes. However, in about 40% of the male infertility cases, the etiology remains unknown and both the diagnosis and/or treatment are a challenge. Genetic testing to determine the underlying genetic cause of infertility is not 100% and genes involved are still being discovered. Consequently, negative genetic test results do not rule out a genetic cause. Thus, genetic counselling should include information regarding the genetic etiology, if known, and the treatment options available. Furthermore, when the infertile couple/male is seeking assisted reproductive technology (ART) using intracytoplasmic sperm injection (ICSI), genetic counselling should include information regarding the risk of transmitting the genetic disorder, causing the male infertility, to the offspring. Therefore, the provision of genetic counselling is an integral component in the investigation and treatment of male infertility. This article will discuss the genetic counselling approach in cases with male infertility.
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Affiliation(s)
- Riyana Babul-Hirji
- Division of Clinical and Metabolic Genetics, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.,Department of Genetic Counselling, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Ruqayya Hirji
- The Prenatal Diagnosis and Medical Genetics Program, Department of Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada
| | - David Chitayat
- Division of Clinical and Metabolic Genetics, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.,The Prenatal Diagnosis and Medical Genetics Program, Department of Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada
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38
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Park J, Shin N. Predictive Model for the Quality of Life of Infertile Men. Open Nurs J 2021. [DOI: 10.2174/1874434602115010009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Purpose:
This study explores factors influencing the quality of life of infertile men, and attempts to construct a structural model to predict their quality of life.
Methods:
Data was collected via questionnaires from 242 infertile male outpatients from 3 infertile clinics at general hospital urologist departments, with the subjects’ confidentiality was ensured. The self-reported questionnaires were collected for 7 months from February to August 2016 in the outpatient centers. The collected data was analyzed using SPSS/WIN 21.0 Program and Mplus 6.0 Program.
Results:
Hypothesis test of the quality of life as the endogenous variable identified infertility-related stress (β=-0.79, t=-9.41), depression (β=-0.20, t=-2.58), and spirituality (β=0.21, t=2.90) as statistically significant variables. Marital adjustment (β=-0.06, t=-0.69) and social support (β=-0.12, t=-1.79) were not statistically significant. The variables accounted for 84.1% of the variation.
Conclusion:
The results of the study show that infertility-related stress and depression have negative correlation, and spirituality has a positive correlation with infertile men’s quality of life. As such, there needs to be a development of practical and multi-faceted nursing intervention programs to control infertility-related stress and depression levels so as to sustain infertile men’s quality of life.
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Doğan Yüksekol Ö, Duman M, Durgun Ozan Y. The relationship between gender perception levels and infertility distress of infertile women in a university hospital, Turkey. JOURNAL OF HEALTH RESEARCH 2020. [DOI: 10.1108/jhr-04-2020-0088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PurposeThis study was conducted to analyze the correlation between gender perception and infertility distress of infertile women.Design/methodology/approachThis was a descriptive-analytical study conducted with 255 women receiving treatment in the in vitro fertilization unit of a medical faculty hospital in Turkey. Study data were collected using sociodemographic questions as well as the Perception of Gender Scale (PGS) and the Infertility Distress Scale (IDS).FindingsIt was found that the PGS mean score was 69.65 and the IDS mean score was 53.1. It was determined that there was a negative, moderate and significant correlation between gender perception and infertility distress levels of women in the infertility treatment process (r = −0.263, p < 0.001).Originality/valueAs a result of the study, a negative, moderate, significant correlation was detected between gender perception and infertility distress.
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40
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Bayrami R, Janghorban R, Effati-Daryani F, Hajshafiha M. Supportive care: men's expectations who undergoing in vitro fertilization treatment. BMC Res Notes 2020; 13:552. [PMID: 33287902 PMCID: PMC7720556 DOI: 10.1186/s13104-020-05407-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 11/28/2020] [Indexed: 11/28/2022] Open
Abstract
Objective Infertile couples perceive some needs and expectations during treatment. Most studies have focused on infertile women’s needs. The study was done to explore the expectations of men who undergoing in in vitro fertilization (IVF) treatment. Participants were men whose wives undergo IVF treatment in the IVF clinic of Shahid Motahhri hospital in Urmia. Purposive sampling was performed and data collection was done through in-depth semi-structured interviews until data saturation. Results “Supportive care” was emerged as the main theme consisted of two categories. The first category was “to be treated with attention in healthcare setting” which included three subcategories: Receiving couple based care, establishing counseling centers, and continuous care. The second category was “to be welcomed in the society” which included two subcategories: Financial support from community and close family, and changing community views about IVF treatment. Expectations of men undergoing IVF focuses on supportive care. They seek to receive the kind of care from health care setting and society. A deep understanding of the needs could help practitioners to consider men’s expectations, and assist policy makers and researchers to design and implement interventions and programs in infertility clinics which enhance the partnership of infertile men and fulfill their expectations.
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Affiliation(s)
- Roghieh Bayrami
- Department of Midwifery, Reproductive Health Research Center, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Roksana Janghorban
- Department of Midwifery, School of Nursing and Midwifery, Community Based Psychiatric Care Research Center, Shiraz University of Medical Sciences, 7193613119, Shiraz, Iran.
| | - Fatemeh Effati-Daryani
- Department of Midwifery, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Masoumeh Hajshafiha
- Department of Obstetrics and Gynecology, School of Medicine, Reproductive Health Research Center, Urmia University of Medical Sciences, Urmia, Iran
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Harlow AF, Zheng A, Nordberg J, Hatch EE, Ransbotham S, Wise LA. A qualitative study of factors influencing male participation in fertility research. Reprod Health 2020; 17:186. [PMID: 33228762 PMCID: PMC7684935 DOI: 10.1186/s12978-020-01046-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 11/12/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Although fertility is a couple-based outcome, fertility studies typically include far fewer males than females. We know little about which factors facilitate or inhibit male participation in fertility research. In this study we aimed to explore factors that influence male participation in fertility research among North American couples trying to conceive. METHODS We conducted a qualitative research study of male participation in Pregnancy Study Online (PRESTO), a prospective preconception cohort of couples actively trying to conceive in Canada and the United States. Between January-August 2019, we carried out 14 online one-on-one in-depth interviews and one online focus group of males and females with varying levels of participation. The in-depth interviews included females who enrolled in PRESTO but declined to invite their male partners to participate (n = 4), males who enrolled in PRESTO (n = 6), and males who declined to participate in PRESTO (n = 4). The focus group included 10 males who enrolled in PRESTO. We analyzed the transcriptions using inductive content analysis. RESULTS Male and female participants perceived that fertility is a women's health issue and is a difficult topic for men to discuss. Men expressed fears of infertility tied to masculinity. However, men were motivated to participate in fertility research to support their partners, provide data that could help others, and to learn more about their own reproductive health. CONCLUSIONS Male participation in fertility studies will improve our understanding of male factors contributing to fertility and reproductive health issues. Results indicate a need for more education and health communication on male fertility to normalize male participation in fertility and reproductive health research. Men are much less likely than women to participate in research on fertility and pregnancy. However, it is important for men to participate in fertility research so that we gain a better understanding of male factors that impact fertility and pregnancy outcomes. In this qualitative study, we interviewed men and women from Canada and the United States who were trying to become pregnant to understand why men choose to participate in fertility research, why men choose not to participate in fertility research, and why women choose not to invite their male partners to participate in fertility research. We found that both men and women believe fertility is a woman's health issue. Men find it difficult to talk about pregnancy and fertility and have fears of infertility tied to masculinity. However, men are motivated to participate in fertility research to support their partners, to help others, and to learn more about their own reproductive health.
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Affiliation(s)
- Alyssa F Harlow
- Department of Epidemiology, Boston University School of Public Health, 715 Albany Street, Boston, MA, 02188, USA.
| | - Amy Zheng
- Department of Epidemiology, Boston University School of Public Health, 715 Albany Street, Boston, MA, 02188, USA
| | - John Nordberg
- Department of Epidemiology, Boston University School of Public Health, 715 Albany Street, Boston, MA, 02188, USA
| | - Elizabeth E Hatch
- Department of Epidemiology, Boston University School of Public Health, 715 Albany Street, Boston, MA, 02188, USA
| | - Sam Ransbotham
- Department of Information Systems, Boston College Carroll School of Management, Chestnut Hill, MA, 02467, USA
| | - Lauren A Wise
- Department of Epidemiology, Boston University School of Public Health, 715 Albany Street, Boston, MA, 02188, USA
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Bhamani SS, Zahid N, Zahid W, Farooq S, Sachwani S, Chapman M, Asad N. Association of depression and resilience with fertility quality of life among patients presenting to the infertility centre for treatment in Karachi, Pakistan. BMC Public Health 2020; 20:1607. [PMID: 33097027 PMCID: PMC7585180 DOI: 10.1186/s12889-020-09706-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 10/14/2020] [Indexed: 12/21/2022] Open
Abstract
Background In Pakistan there is a dire need to explore the quality of life in infertile males and females and its undesirable psychological outcomes. This, study aimed to compare the quality of life (QoL) of males and females visiting an infertility centre for treatment and to assess its association with resilience, depression, and other socio-demographic factors. Methods An Analytical Cross-Sectional study was conducted amongst infertile males and females at the Australian Concept Infertility Medical Centre (ACIMC), Karachi, Pakistan. The non-probability (purposive) sampling strategy was used to recruit the participants. The sample size was 668. Data was analysed using STATA version 12. FertiQoL tool, Beck II Depression Inventory Tool and Resilience Scale 14 (RS-14) were used for assessing the quality of life, depression and resilience respectively of infertile patients. Results Total 668 infertile patients, 334 males and 334 females participated in the study. The mean age was 35.53 ± 6.72, among males, and 30.87 ± 6.12 among females. The mean resilience scores were significantly higher among males, (77.64 ± 8.56), as compared to females (76.19 ± 8.69) (95% CI; − 2.757, − 0.1347). However, a significantly higher proportion of females were depressed (13.8%) as compared to males (6%). The mean QoL scores for the general health domain, emotional domain, mind and body domain, and relational domain, and the total QoL were significantly higher in males as compared to females (p value< 0.001); however, QoL for the social domain was not significantly different in both the groups. On multivariable linear regression resilience and depression among males had a significant association with QoL, after adjusting for the covariates educational status, monthly income, and number of friends. Similar association was observed among females after adjusting for the covariate monthly income only. Conclusion Fertility related QoL of men and women has a significant association with no formal education, number of friends, income, depression and resilience. Therefore, health care professionals in the field of infertility must be adequately trained to respond to the needs of individuals going through these psychological problems.
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Affiliation(s)
| | - Nida Zahid
- Department of Surgery, Aga Khan University, Stadium Road, Karachi, 74800, Pakistan.
| | - Wajeeha Zahid
- Community Health Sciences Department Aga Khan University, Karachi, Pakistan
| | - Salima Farooq
- School of Nursing and Midwifery, Aga Khan University, Karachi, Pakistan
| | - Saima Sachwani
- School of Nursing and Midwifery, Aga Khan University, Karachi, Pakistan
| | | | - Nargis Asad
- Department of Psychiatry, Aga Khan University, Karachi, Pakistan
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Hogg K, Rizio T, Manocha R, McLachlan RI, Hammarberg K. Men's preconception health care in Australian general practice: GPs' knowledge, attitudes and behaviours. Aust J Prim Health 2020; 25:353-358. [PMID: 31554536 DOI: 10.1071/py19069] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 06/28/2019] [Indexed: 01/04/2023]
Abstract
Potentially modifiable factors can affect male fertility and reproductive outcomes, including smoking, obesity, and older paternal age. This study surveyed GPs' knowledge about, attitudes towards, and needs for promoting fertility and preconception health to male patients. The survey, conducted February to June 2018 and completed by 304 GPs, included questions relating to men's preconception health, the potential barriers and enablers to discussing preconception health with male patients, and the types of resources that would enable GPs to discuss parenthood intentions with men of reproductive age. Most GPs (90%) did not feel confident in their knowledge about modifiable factors that affect male fertility. Two-thirds agreed that it was their role to discuss these factors with male patients, but nearly 80% practised this only occasionally. Lack of knowledge, the sensitivity of the subject and fertility being perceived as a female issue, were identified as barriers to discussing fertility and preconception health with male patients. To facilitate discussions, GPs wanted trustworthy websites and factsheets to refer patients to. Men do not typically receive fertility or preconception health advice in general practice. A national framework for preconception health care that includes men, GP education and training, and reproductive health resources for men is needed.
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Affiliation(s)
- Kirsten Hogg
- Healthy Male (Andrology Australia), Department of Epidemiology and Preventive Medicine, Public Health and Preventive Medicine, Monash University, Vic. 3004, Australia; and Corresponding author.
| | - Taletha Rizio
- Healthy Male (Andrology Australia), Department of Epidemiology and Preventive Medicine, Public Health and Preventive Medicine, Monash University, Vic. 3004, Australia
| | | | - Robert I McLachlan
- Healthy Male (Andrology Australia), Department of Epidemiology and Preventive Medicine, Public Health and Preventive Medicine, Monash University, Vic. 3004, Australia; and Department of Obstetrics and Gynaecology, Monash University, Vic. 3168, Australia; and Hudson Institute of Medical Research, 27-31 Wright Street, Clayton, Vic. 3168, Australia; and Monash IVF Group, 21-31 Goodwood Street, Richmond, Vic. 3121, Australia
| | - Karin Hammarberg
- Global and Women's Health, Public Health and Preventive Medicine, Monash University, Vic. 3004, Australia; and Victorian Assisted Reproductive Treatment Authority, 30/570 Bourke Street, Melbourne, Vic. 3000, Australia
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Gelgoot EN, Kelly-Hedrick M, Miner SA, Robins S, Chan P, Ells C, Holzer H, Lo K, Mahutte N, Ouhilal S, Tulandi T, Zelkowitz P. Predictors of infertility-related concerns in a Canadian survey of men and women seeking fertility treatment. PATIENT EDUCATION AND COUNSELING 2020; 103:1812-1820. [PMID: 32273146 DOI: 10.1016/j.pec.2020.03.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 02/26/2020] [Accepted: 03/17/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To examine if and how factors associated with infertility-related concerns and opportunity to discuss concerns differ between male and female fertility patients. METHODS A cross-sectional survey of 313 female and 254 male patients recruited from Canadian fertility clinics. An online survey asked about sociodemographic characteristics, psychological distress, the severity of psychosocial concerns on a scale of 0 (not concerned) to 5 (very concerned) related to fertility treatment, and their opportunity and desire to discuss concerns with healthcare providers (HCPs). RESULTS For women, higher stress, educational attainment and being childless were associated with higher concern (F(6, 287) = 14.73, p < .001). For men, higher stress, being religious and longer treatment duration were associated with higher concern (F(8, 222) = 9.87, p < .001). No significant difference existed between men's and women's average concern scores (t(558) = -1.62, p = .11) or opportunity to discuss concerns (t(149) = 0.28, p = .78). CONCLUSION Our results indicate an unmet need and desire for support among subgroups of patients who were concerned about psychosocial issues related to infertility, but did not have the opportunity to discuss these issues with HCPs. PRACTICE IMPLICATIONS There is a need to tailor resources to address the concerns of male and female fertility patients from diverse sociodemographic backgrounds and with different fertility histories.
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Affiliation(s)
- Eden Noah Gelgoot
- Department of Psychiatry, McGill University, Montréal, Canada; Department of Psychiatry, Jewish General Hospital, Montréal, Canada
| | - Margot Kelly-Hedrick
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Skye A Miner
- Department of Psychiatry, Jewish General Hospital, Montréal, Canada; Department of Sociology, McGill University, Montréal, Canada
| | - Stephanie Robins
- Department of Psychiatry, Jewish General Hospital, Montréal, Canada; Lady Davis Institute for Medical Research, Montréal, Canada
| | - Peter Chan
- McGill University Health Centre, Montréal, Canada; Department of Surgery, McGill University, Montréal, Canada
| | - Carolyn Ells
- Lady Davis Institute for Medical Research, Montréal, Canada; Department of Medicine, Biomedical Ethics Unit, McGill University, Montréal, Canada
| | - Hananel Holzer
- McGill University Health Centre, Montréal, Canada; Department of Medicine, Biomedical Ethics Unit, McGill University, Montréal, Canada; Department of Obstetrics and Gynecology, McGill University, Montréal, Canada; Hebrew University School of Medicine, Jerusalem, Israel; Fertility Department, Obstetrics & Gynecology Division, Hadassah University Hospitals, Jerusalem, Israel
| | - Kirk Lo
- Department of Surgery, Mount Sinai Hospital, Toronto, Canada; Department of Surgery, University of Toronto, Toronto, Canada
| | | | | | - Togas Tulandi
- McGill University Health Centre, Montréal, Canada; Department of Obstetrics and Gynecology, McGill University, Montréal, Canada; Department of Obstetrics and Gynecology, Jewish General Hospital, Montréal, Canada
| | - Phyllis Zelkowitz
- Department of Psychiatry, McGill University, Montréal, Canada; Department of Psychiatry, Jewish General Hospital, Montréal, Canada; Lady Davis Institute for Medical Research, Montréal, Canada.
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Vasudevan VK, Unnikrishnan P, Muraleedharan A, Krishnarajabhatt HS. A comprehensive Ayurvedic treatment along with counseling in oligoasthenozoospermia with previous intrauterine insemination failure-A case report. J Ayurveda Integr Med 2020; 12:148-150. [PMID: 32741654 PMCID: PMC8039349 DOI: 10.1016/j.jaim.2020.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 02/12/2020] [Accepted: 05/07/2020] [Indexed: 11/16/2022] Open
Abstract
Male infertility contributes for 50% of infertility globally, and several etiological factors contribute to it. Oligoasthenozoospermia and anxiety, forms a vicious cycle, resulting in male infertility. A man advised for assisted reproductive techniques, even after correcting seminal parameters has poor success rate if the symptoms of anxiety is left untreated. The signs and symptoms of oligoasthenozoospermia can be compared with Kshina shukra of Ayurvedic classics. The present case report presents, the role of an indigenous combination of drugs in improving the quantity and quality of semen, along with the reduction in anxiety levels through counseling. The patient with low sperm motility and volume was subjected to Ayurvedic management protocol of initially Counseling, followed by Shodhana treatment and then administration of Mashadi choornam for 90 days. A marked improvement was observed in seminal parameters and anxiety levels and patient could undergo natural conception, a few months after the treatment, thus focusing on an integrative approach.
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Affiliation(s)
- Vandana K Vasudevan
- Department of Stri Roga and Prasuti Tantra (Gynaecology& Obstetrics), Amrita School of Ayurveda, Amritapuri, Amrita Vishwa Vidyapeetham, India
| | - Parvathy Unnikrishnan
- Department of Stri Roga and Prasuti Tantra (Gynaecology& Obstetrics), Amrita School of Ayurveda, Amritapuri, Amrita Vishwa Vidyapeetham, India
| | - Anjaly Muraleedharan
- Department of Stri Roga and Prasuti Tantra (Gynaecology& Obstetrics), Amrita School of Ayurveda, Amritapuri, Amrita Vishwa Vidyapeetham, India
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Renzi A, Di Trani M, Solano L, Minutolo E, Tambelli R. Success of assisted reproductive technology treatment and couple relationship: A pilot study on the role of romantic attachment. Health Psychol Open 2020; 7:2055102920933073. [PMID: 32637146 PMCID: PMC7323283 DOI: 10.1177/2055102920933073] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Infertility is a deeply distressing experience, which can threaten important personal and martial goals, frequently affecting the psychophysical health. A supportive relationship and a secure romantic attachment appear to reduce infertility stress, as well as play a relevant role in the success of assisted reproductive technology treatments. The principal aim of the study is to investigate the predictive effect of romantic attachment, couple characteristics, quality of life and age on assisted reproductive technology outcome. A total of 88 infertile women, enrolled in an assisted reproductive technology Centre of Rome, completed the Experience in Close Relationship-Revised, the Couple Relationship Inventory, the Fertility Quality of Life and a socio-demographic questionnaire. The participants completed the questionnaires at the beginning of the medical treatment. Data analyses showed significant associations among Experience in Close Relationship-Revised dimensions, Couple Relationship Inventory and Fertility Quality of Life Scales. Assisted reproductive technology outcome was negatively correlated to Experience in Close Relationship-Revised Avoidance and positively related to Couple Relationship Inventory Dependence. A multi-variable logistic regression revealed that Experience in Close Relationship-Revised Avoidance decreased the probability of pregnancy. The present findings partially confirmed the study hypotheses since several associations among couple characteristics, attachment anxiety and avoidance dimensions, infertility-related quality of life in infertile women were found. Furthermore, according to a definition of Avoidance, assisted reproductive technology positive outcome appears to be associated to lower levels of fear of dependence and interpersonal intimacy, and to a low need both for self-reliance and for reluctance to self-disclose within the romantic relationship. Further investigations are needed both to confirm this preliminary finding and for promoting focused therapeutic interventions for couples facing assisted reproductive technology.
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Affiliation(s)
- Alessia Renzi
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
| | - Michela Di Trani
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
| | - Luigi Solano
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
| | | | - Renata Tambelli
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
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Sejbaek CS, Pinborg A, Hageman I, Sørensen AM, Koert E, Forman JL, Schmidt L. Depression among men in ART treatment: a register-based national cohort study. Hum Reprod Open 2020; 2020:hoaa019. [PMID: 32529048 PMCID: PMC7275636 DOI: 10.1093/hropen/hoaa019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Revised: 03/07/2020] [Accepted: 03/11/2020] [Indexed: 11/20/2022] Open
Abstract
STUDY QUESTION Are male factor infertility or remaining childless risk factors for unipolar depression among men in assisted reproductive technology (ART) treatment? SUMMARY ANSWER Male factor infertility was not associated with a significantly increased risk of unipolar depression and men remaining childless did not have a significantly increased risk of developing unipolar depression compared to men in ART treatment who became fathers. WHAT IS KNOWN ALREADY Men in medically assisted reproduction due to male factor infertility are more distressed and have more negative emotions such as feelings of loss, stigma and low self-esteem compared to men in fertility treatment due to other infertility diagnosis. Stress is in general a risk factor for depression. However, previous studies show conflicting results whether male factor infertility is a risk factor for depression. STUDY DESIGN, SIZE, DURATION This national, register-based cohort study consisted of 37 913 cohabitant male partners of women in ART treatment recorded in the Danish IVF register (1994–2009). Via a national register, the men’s personal identification number data were linked to the Danish Psychiatric Central Research Register (PCRR) (1969–2009) which records psychiatric diagnoses including unipolar depression, based on the ICD-8 and ICD-10 classification system. PARTICIPANTS/MATERIALS, SETTING, METHODS The full cohort of male partners (n = 37 913) was included in the initial analysis on prevalence of unipolar depression before or after ART treatment initiation. The association between male factor infertility and unipolar depression diagnosis after initiating ART treatment was analysed with Cox regression analysis in a sub-study population of men with the exclusion of men having a depression prior to ART treatment or not having full data on educational level and infertility diagnosis (n = 34 817). MAIN RESULTS AND THE ROLE OF CHANCE Overall, 1.2% (n = 446) of the men were diagnosed with unipolar depression either before initiating ART treatment (n = 146) or during follow-up (n = 300). In all, 76.0% of men with depression prior to or after ART treatment achieved fatherhood compared to 82.3% of men without depression (P < 0.001). In the sub-study population (n = 34 817, which included 266 men with a unipolar depression diagnosis), male factor infertility was not associated a significantly increased risk of depression (adjusted hazard ratio (aHR) = 1.04, 95% CI: 0.79–1.36, P = 0.804), and ART-treated men who remained childless did not have a significantly increased risk of developing depression compared to ART treated men who became fathers (aHR = 1.13, 95% CI: 0.87–1.48, P = 0.355). LIMITATIONS, REASONS FOR CAUTIONS Only severe cases of depression are recorded and included in this national register-based study given that only men with clinically diagnosed unipolar depression recorded in a psychiatric hospital (in-patient and out-patient) are included in the Danish PCRR. It is difficult to completely rule out an association between the exposures and depression as this outcome is so rare, and therefore the results are still statistically uncertain despite a large cohort. Furthermore, only men in ART treatment were included in this study, and caution should be taken in generalising findings to the total population of men in all areas of medically assisted reproduction or infertile men who have not sought treatment. WIDER IMPLICATIONS OT THE FINDINGS This large national cohort study suggests that despite evidence showing that male factor infertility is a potential severe stressor for men, which can increase psychological distress and negative emotions, infertile men in ART treatment and men remaining childless after ART are not at a significantly increased risk of developing clinically diagnosed unipolar depression. STUDY FUNDING/COMPETING INTERESTS C.S.S. was funded by unrestricted research grants received by Lone Schmidt from The Danish Health Insurance Foundation (J.nr. 2008B105) and Merck Sharp & Dohme (MSD). The sponsors had no influence on how data were retrieved and analysed or on the conclusions of the study. C.S.S. and L.S. have declared conflicts of interests; the remaining co-authors have no conflicts of interests to declare. TRIAL REGISTRATION NUMBER Not applicable.
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Affiliation(s)
- C S Sejbaek
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Øster Farimagsgade 5, P.O. Box 2099, DK-1014 Copenhagen K, Denmark.,Permanent address: National Research Centre for the Working Environment, Lersø Parkallé 105, DK-2100 Copenhagen Ø, Denmark
| | - A Pinborg
- Fertility Clinic, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen Ø, Denmark
| | - I Hageman
- Mental Health Services, Capital Region, DK-2100 Copenhagen Ø, Denmark
| | - A Ms Sørensen
- Department of Clinical Pharmacology, Bispebjerg and Frederiksberg Hospital, DK-2200 Copenhagen N, Denmark
| | - E Koert
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Øster Farimagsgade 5, P.O. Box 2099, DK-1014 Copenhagen K, Denmark
| | - J L Forman
- Department of Public Health, Section of Biostatistics, University of Copenhagen, Øster Farimagsgade 5, P.O. Box 2099, DK-1014 Copenhagen K, Denmark
| | - L Schmidt
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Øster Farimagsgade 5, P.O. Box 2099, DK-1014 Copenhagen K, Denmark
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Gonen LD, Bokek-Cohen Y. The experience of being an in vitro fertilization (IVF) patient in a pro-natalist society - a form of emotional labor. SOCIAL WORK IN HEALTH CARE 2020; 59:273-299. [PMID: 32369421 DOI: 10.1080/00981389.2020.1749214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 02/24/2020] [Accepted: 03/23/2020] [Indexed: 06/11/2023]
Abstract
Israel is known as a highly pronatalist society. We conceptualize the pro-natalist state as the employer of in vitro fertilization (IVF) patients in the labor of procreation. We characterize the unique Israeli religio-cultural environment regarding infertility using the concepts of emotional labor, surface acting, deep acting, emotional dissonance, and burnout. One hundred and forty-two women and 62 men undergoing IVF in eight public IVF units were asked to describe their emotions on the Positive and Negative Affect Schedule (PANAS). We discuss the patients' emotional responses in light of the religio-cultural and the emotional labor context. Evidence was found for gender differences whereby women suffer more negative emotional outcomes than male partners of IVF patients. The pro-natalist state poses greater emotional stress for female IVF patients in comparison with that experienced by the male spouses of IVF patients. Consulting professionals should offer psycho-social care if necessary, focusing on strategies taken from emotional labor theory.
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Affiliation(s)
- Limor Dina Gonen
- Department of Economics and Business Administration, Ariel University , Ariel, Israel
| | - Ya'Arit Bokek-Cohen
- School of Nursing, Efrata Academic College , Tel Aviv, Israel
- School of Nursing, Tel Aviv Yaffo Academic College , Tel Aviv, Israel
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Fieldsend M, Smith JA. 'Either stay grieving, or deal with it': the psychological impact of involuntary childlessness for women living in midlife. Hum Reprod 2020; 35:876-885. [PMID: 32268357 DOI: 10.1093/humrep/deaa033] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 01/29/2020] [Accepted: 02/10/2020] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION What is it like for women to be involuntarily childless in midlife? SUMMARY ANSWER Involuntarily childless women may be suffering from prolonged grief due to its ambiguous and intangible nature; however, they are also striving to find ways of dealing with their internal pain in order to live with their loss. WHAT IS KNOWN ALREADY Many studies examining issues around human reproduction have tended to place childlessness in the realm of medicalised infertility and report generalised mental issues, such as depression and psychological distress, existing amongst women undergoing fertility treatments. Few studies, however, have focused on the individual with regard to the experiential significance of involuntary childlessness and living beyond the phase of trying for a baby. STUDY DESIGN, SIZE, DURATION A phenomenologically oriented person-centred qualitative design was used. In-depth semi-structured interviews were conducted with 12 White British women, who identified themselves as involuntarily childless, recruited via three leading childless support networks in the UK. PARTICIPANTS/MATERIALS, SETTING, METHODS In order to retain an idiographic commitment to the detailed account of a person's experience, a homogeneous and purposive sampling was used applying the following criteria: women aged between 45 and 55; in long-term heterosexual relationships with no adopted children, stepchildren or children of a partner from a previous marriage or relationship; and no longer trying to have a child. Considering the homogeneity of ethnic background and wishing to respect cultural differences, this study focused on White British women living in the UK. Of the 12, one woman was found to not meet the criteria, and therefore, the experiential data of 11 interviews were used for the study and analysed using interpretative phenomenological analysis (IPA). MAIN RESULTS AND THE ROLE OF CHANCE Two higher-order levels of themes that illustrate intrapersonal features were identified: the intrapersonal consequences of loss and confronting internal pain. The former explicated the depth of internal pain while the latter revealed ways in which the participants deal with it in their everyday lives. The important finding here is that both themes are co-existing internal features and dynamically experienced by the participants as they live with the absence of much-hoped-for children. LIMITATIONS, REASONS FOR CAUTION Given the homogeneous sampling and the small number of participants, which is consistent with IPA, we want to be cautious in generalising our study findings. WIDER IMPLICATIONS OF THE FINDINGS This study offers the view that there might be potential mental health issues surrounding involuntary childlessness that are currently overlooked. Particularly because the loss of hope cannot be pathologised, and the grief is ambiguous and intangible, it might make people's grieving process more complicated. An ongoing sense of uncertainty also may persist in that involuntarily childless people may develop symptoms similar to those diagnosed with prolonged grief disorder (PGD). The overall findings elucidate the need for clinicians, counsellors and health professionals to be aware of the possible association with PGD and promote long-term support and care in helping to maintain psychological well-being for people dealing with involuntary childlessness. Furthermore, this research points to an educational application for younger people by offering information beyond an explanation of infertility and fertility treatment, helping to understand the lived experience of involuntary childlessness. STUDY FUNDING/COMPETING INTEREST(S) No funding was obtained for this study. The authors have no conflicts of interest to declare. TRIAL REGISTRATION NUMBER Not applicable.
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Affiliation(s)
- Megumi Fieldsend
- Department of Psychological Sciences, Birkbeck, University of London, Malet Street, London WC1E 7HX, UK
| | - Jonathan A Smith
- Department of Psychological Sciences, Birkbeck, University of London, Malet Street, London WC1E 7HX, UK
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Warchol-Biedermann K. The Risk of Psychiatric Morbidity and Course of Distress in Males Undergoing Infertility Evaluation Is Affected by Their Factor of Infertility. Am J Mens Health 2020; 13:1557988318823904. [PMID: 30819064 PMCID: PMC6440055 DOI: 10.1177/1557988318823904] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
This panel study aimed to explore the effects of male, female, mixed or idiopathic factor of infertility on the course of clinical distress and possible psychiatric morbidity in involuntarily childless males undergoing fertility evaluation for the first time. A sample of 255 males completed the General Health Questionnaire-28 (GHQ-28) (a) at the baseline, before their initial fertility evaluation (T1); (b) before their second andrological appointment 2-3 months after diagnostic disclosure (T2); and (c) before subsequent treatment-related/follow-up appointments (T3, T4) to be screened for clinically significant distress and risk for psychiatric morbidity. Then they were dichotomized as non-cases and cases. The timing of psychological testing was strictly related to andrological appointments and medical procedures. The research demonstrated that the baseline prevalence of clinical distress and psychiatric morbidity in all the subgroups was similar to reference values, but then significantly surged after the diagnostic disclosure, particularly in male and mixed factor respondents. However, the percentage of clinically distressed mixed or idiopathic factor of infertility respondents remained stable after diagnostic disclosure and during the entire follow-up. The prevalence of clinically significant distress and risk for psychiatric morbidity in the male factor of infertility, female factor of infertility, and mixed factor subgroups decreased during the follow-up but remained higher than at the baseline. The study identifies that the course of distress and risk of psychiatric morbidity of males is significantly affected by their factor of infertility and changes across the pathway of treatment-related/follow-up appointments.
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