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Pellerone M, Martinez-Torvisco J, Razza SG, Commodari E, Miccichè S. Precursors of Prenatal Attachment and Anxiety during Pregnancy in Women Who Procreate Naturally and Pregnant Women following Assisted Reproduction Technology. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6945. [PMID: 37887682 PMCID: PMC10606198 DOI: 10.3390/ijerph20206945] [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: 04/14/2023] [Revised: 07/21/2023] [Accepted: 10/17/2023] [Indexed: 10/28/2023]
Abstract
The process of adaptation of the woman to pregnancy seems to be influenced by many factors, such as the type of conception, the mother's age, the possible presence of other children, and socio-cultural factors. Women who conceived with an assisted reproductive technique are emotionally vulnerable; compared with pregnant women who procreated naturally, they manifest elevated anxiety, which seems to be correlated to the fright of being separated from their child. Objectives of the present research are as follows: (1) to analyze the relationship between age, gestational age, time expectancy, previous failed attempts, perception of a high-risk pregnancy, and presence of other children, with the level of maternal-fetal attachment (MFA); (2) explore the level of maternal-infant attachment and anxiety by comparing the control and experimental group; (3) to measure a possible relationship between anxiety levels and MFA in ART pregnant women; (4) to identify variables predictive of prenatal attachment. The study group is formed by ninety-five women aged between 18-42 years (M = 30.57; S.D. = 5.47), pregnant from the 23rd to the 37th week (M = 28.95; S.D. = 3.99); on which 50 women who procreate naturally and 45 pregnant women following assisted reproductive technology. They completed: Maternal-Fetal Attachment Scale (MFAS), State-Trait Anxiety Inventory (STAI), and ad hoc questionnaire to collect anamnestic data. The results show the presence of a correlation between gestational age and waiting period, between the number of assisted fertilization attempts with the worry about their ability to become pregnant, but a negative correlation between pregnancy weeks and the level of maternal-fetal attachment. The study shows the predictive role of anxiety on the MFA. The applications and indications for future research are analyzed.
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Affiliation(s)
- Monica Pellerone
- Faculty of Human and Social Sciences, Kore University of Enna, 94100 Enna, Italy; (S.G.R.); (S.M.)
| | - Juan Martinez-Torvisco
- Department of Cognitive, Social and Organizational Psychology, La Laguna University, 38200 Santa Cruz de Tenerife, Spain;
| | - Stesy Giuseppa Razza
- Faculty of Human and Social Sciences, Kore University of Enna, 94100 Enna, Italy; (S.G.R.); (S.M.)
| | - Elena Commodari
- Department of Educational Sciences, University of Catania, 95126 Catania, Italy;
| | - Sandra Miccichè
- Faculty of Human and Social Sciences, Kore University of Enna, 94100 Enna, Italy; (S.G.R.); (S.M.)
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Dourou P, Gourounti K, Lykeridou A, Gaitanou K, Petrogiannis N, Sarantaki A. Quality of Life among Couples with a Fertility Related Diagnosis. Clin Pract 2023; 13:251-263. [PMID: 36826165 PMCID: PMC9955447 DOI: 10.3390/clinpract13010023] [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: 12/31/2022] [Revised: 01/30/2023] [Accepted: 02/05/2023] [Indexed: 02/11/2023] Open
Abstract
Fertility-related stress can negatively impact infertile couples' quality of life (QoL). Most previous studies have concentrated on the effects of stress and infertility on individual persons, especially women, though infertility affects the QoL of both spouses. Our research aimed to investigate the roles of infertility and stress in couples' quality of life as a single unit. The research sample consisted of 202 spouses, i.e., 101 couples, with a mean age of 39.5 years (SD = 4.9 years) undergoing fertility treatment at Athens Naval Hospital-Assisted Reproduction Unit. Data collection was completed via self-administered questionnaires: the FertiQoL International Questionnaire for measuring the quality of life in infertility and The Demographic Information and Medical History Questionnaire. Data collection was conducted between January and November 2022. Quantitative variables are expressed as mean values (standard deviation) and as median interquartile range, and qualitative variables are expressed as absolute and relative frequencies. Pearson's (r) and Spearman's (rho) correlations coefficients were used to explore the association of two continuous variables. Multiple linear regression analysis was used with dependence on the Ferti-QoL's subscales. The regression equation included terms for participants' demographics and information from their medical history. Adjusted regression coefficients (β) with standard errors (SE) were computed from the results of the linear regression analyses. All reported p values are two-tailed. Statistical significance was set to p < 0.05, and analyses were conducted using SPSS statistical software (version 22.0). We found that greater anxiety and depression were significantly associated with worse quality of life. Additionally, quality of life, according to Ferti-QoL, was significantly worse in women, participants with a high level of education, those with greater depressive symptoms, and those with greater state scores. Findings of this study highlight the need for implementing interventions of supportive care methods, counseling, stress reduction methods, and improving the fertility-related quality of life of infertile couples.
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Affiliation(s)
- Panagiota Dourou
- Department of Midwifery, Faculty of Health and Care Sciences, University of West Attica, 12243 Athens, Greece
- Correspondence:
| | - Kleanthi Gourounti
- Department of Midwifery, Faculty of Health and Care Sciences, University of West Attica, 12243 Athens, Greece
| | - Aikaterini Lykeridou
- Department of Midwifery, Faculty of Health and Care Sciences, University of West Attica, 12243 Athens, Greece
| | | | | | - Antigoni Sarantaki
- Department of Midwifery, Faculty of Health and Care Sciences, University of West Attica, 12243 Athens, Greece
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Alson S, Jokubkiene L, Henic E, Sladkevicius P. Prevalence of endometrioma and deep infiltrating endometriosis at transvaginal ultrasound examination of subfertile women undergoing assisted reproductive treatment. Fertil Steril 2022; 118:915-923. [PMID: 36175206 DOI: 10.1016/j.fertnstert.2022.07.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 07/26/2022] [Accepted: 07/28/2022] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To estimate the prevalence of endometrioma and deep infiltrating endometriosis (DIE), assessed by systematic transvaginal ultrasound examination, in women with subfertility accepted for their first assisted reproductive treatment and to describe the prevalence of endometriotic lesions in different anatomical locations of the pelvis. DESIGN Cross-sectional study. SETTING Reproductive Medicine Center, Department of Obstetrics and Gynecology, University hospital. PATIENT(S) A total of 1,191 women with subfertility aged 25-39 years accepted for their first assisted reproductive treatment between December 2018 and May 2021. INTERVENTION(S) All women underwent a systematic transvaginal ultrasound examination. The endometriotic lesions visible on ultrasound examination were described according to the International Deep Endometriosis Analysis group consensus opinion for systematic approach to assess endometriotic lesions. MAIN OUTCOME MEASURE(S) Prevalence of endometrioma and DIE in women with subfertility and prevalence of endometriotic lesions in various anatomical locations of the pelvis. RESULT(S) Endometriosis prevalence was 21.8%, with endometriotic lesions found in 260 of the 1,191 women. Overall, 125 (10.5%) women had endometrioma and 205 (17.2%) women had DIE. Of these 260 women, 197 (75.8% of women with endometriosis) did not have any previous knowledge about having endometriosis. The most common location for endometriotic lesions was the uterosacral ligaments, with lesions found in 151 (12.7%) of all women. The second most common location was the ovaries containing endometrioma, found in 125 (10.5%) women. Most women had 1 (n = 121, 10.2%) or 2 (n = 82, 6.9%) endometriotic lesions. CONCLUSION(S) The prevalence of endometrioma and DIE in women with subfertility, diagnosed by systematic transvaginal ultrasound examination, was 21.8%. Of these, three-fourth of women had no knowledge about the presence of disease.
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Affiliation(s)
- Sara Alson
- Department of Obstetrics and Gynecology, Skåne University Hospital, Malmö, Lund University, Sweden.
| | - Ligita Jokubkiene
- Department of Obstetrics and Gynecology, Skåne University Hospital, Malmö, Lund University, Sweden
| | - Emir Henic
- Reproductive Medicine Center, Skåne University Hospital, Malmö, Lund University, Sweden
| | - Povilas Sladkevicius
- Department of Obstetrics and Gynecology, Skåne University Hospital, Malmö, Lund University, Sweden
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Egan K, Summers E, Limbers C. Perceptions of child vulnerability in first-time mothers who conceived using assisted reproductive technology. J Reprod Infant Psychol 2022; 40:489-499. [PMID: 33703959 DOI: 10.1080/02646838.2021.1896689] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES There has been an absence of research investigating if infertility and the utilisation of Assisted Reproductive Technology (ART) to conceive increases maternal perceptions of child vulnerability. The purpose of the current study was to assess if there were differences in maternal ratings of child vulnerability between first-time mothers who conceived using ART procedures and first-time mothers who conceived spontaneously. METHODS This cross-sectional study was comprised of 171 first-time mothers who conceived using ART and 198 first-time mothers who conceived spontaneously. Study questionnaires were completed online via Qualtrics. RESULTS Mothers who conceived using ART (Mean Vulnerable Child Scale Total Score = 43.85; SD = 9.65) endorsed greater perceptions of child vulnerability compared to mothers who conceived spontaneously (Mean Vulnerable Child Scale Total Score = 49.03; SD = 7.15; p < .001). In a hierarchical multiple linear regression analysis, the dichotomous variable that indicated maternal mode of conception (i.e. ART or spontaneous) was associated with the Vulnerable Child Scale Total Score (standardised beta coefficient = -.25; p < .001). Bivariate correlations revealed a small, negative correlation between using a donor sperm and/or egg and the Vulnerable Child Scale Total Score (r = -.21; p < .01). CONCLUSION Our findings suggest that vulnerable child syndrome may be more likely to occur when mothers conceive using ART, particularly when a donor sperm and/or egg is utilised.
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Affiliation(s)
- Kaitlyn Egan
- Department of Psychology and Neuroscience, Baylor University, Waco, Texas
| | - Emma Summers
- Department of Psychology and Neuroscience, Baylor University, Waco, Texas
| | - Christine Limbers
- Department of Psychology and Neuroscience, Baylor University, Waco, Texas
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Maeda E, Hiraike O, Sugimori H, Kinoshita A, Hirao M, Nomura K, Osuga Y. Working conditions contribute to fertility-related quality of life: A cross-sectional study in Japan. Reprod Biomed Online 2022; 45:1285-1295. [DOI: 10.1016/j.rbmo.2022.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 06/29/2022] [Accepted: 07/11/2022] [Indexed: 10/17/2022]
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McQuillan J, Greil AL, Rybińska A, Tiemeyer S, Shreffler KM, Colaner CW. Is a dyadic stressor experienced as equally distressing by both partners? The case of perceived fertility problems. JOURNAL OF SOCIAL AND PERSONAL RELATIONSHIPS 2021; 38:342-362. [PMID: 38486941 PMCID: PMC10939084 DOI: 10.1177/0265407520953903] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/17/2024]
Abstract
Using data from a population survey, this article explores whether perceptions of having a fertility problem among 926 U.S. couples in heterosexual relationships (women aged 25-45 and male partners) are associated with distress. Most couples did not perceive a fertility problem (58%). In almost a third (30%) of the couples, only women perceived a fertility problem; in 4%, only the men; and in nearly a fifth (19%), both perceived a problem. Adjusted for characteristics associated with fertility problems and depressive symptoms, those who perceived a problem exhibited significantly more depressive symptoms than those who did not. Fertility problems are sometimes experienced as individual because in some couples only one partner perceives a problem or has higher distress in response to their own rather than to their partners' perceived problems. For women, fertility problems are experienced as a couple phenomenon because women were more distressed when both partners perceive a problem. The perception of fertility problems is gendered in that women were more likely to perceive a problem than men. Furthermore, men are most distressed when they perceive a problem and their partner does not.
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Affiliation(s)
| | | | - Anna Rybińska
- Duke University Sanford School of Public Policy, USA
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Zarif Golbar Yazdi H, Aghamohammadian Sharbaf H, Kareshki H, Amirian M. Psychosocial Consequences of Female Infertility in Iran: A Meta-Analysis. Front Psychiatry 2020; 11:518961. [PMID: 33250787 PMCID: PMC7674496 DOI: 10.3389/fpsyt.2020.518961] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 09/16/2020] [Indexed: 12/29/2022] Open
Abstract
Background: Although not a life-threatening condition, infertility does influence various aspects of life. Based on a meta-analysis of the relevant literature, the aim of this study is to identify the psychosocial consequences of infertility in Iranian women. Methods: Comprehensive Portal of Human Sciences, Magiran, Scientific Information Database, Noormags, MEDLIB, ScienceDirect, Google Scholar, Medline, and ProQuest were the databases searched from inception (1999) to 2018. To maximize the comprehensiveness of the search, the reference lists of all the relevant papers identified were manually examined. The evaluation of the content was based on PRISMA guidelines, and Comprehensive Meta-Analysis software was used for data analysis. Results: Based on the analysis of 124 quantitative papers, the psychosocial consequences of infertility in women in Iran can be classified into 14 categories: psychological well-being (effect size = 3.10), adaptation to infertility (effect size = 2.71), quality of life (effect size = 1.83), depression (effect size = 1.80), anxiety (effect size = 1.72), marital relationships (effect size = 1.37), personality disorders (effect size = 1.37), violence (effect size = 1.31), social support (effect size = 0.90), self-efficacy (effect size = 0.90), coping strategies (effect size = 0.84), irrational thoughts (effect size = 0.77), somatization disorders (effect size = 0.65), and sexual dysfunction (effect size = 0.55). Conclusion: Considering the wide-ranging psychosocial consequences of infertility in women, it is necessary for treatment to account for psychological factors.
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Affiliation(s)
| | | | - Hossein Kareshki
- Department of Psychology, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Malihe Amirian
- Department of Reproductive Medicine and Gynecology, Milad (Mashhad) Infertility Center, Mashhad, Iran
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Massarotti C, Gentile G, Ferreccio C, Scaruffi P, Remorgida V, Anserini P. Impact of infertility and infertility treatments on quality of life and levels of anxiety and depression in women undergoing in vitro fertilization. Gynecol Endocrinol 2019; 35:485-489. [PMID: 30612477 DOI: 10.1080/09513590.2018.1540575] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
This study aims to evaluate levels of anxiety and depression in women, correlated with infertility per se and with infertility treatments, highlighting predictors of higher levels of distress. Two validated standardized questionnaires, the Hospital Anxiety and Depression Scale (HADS) and the Fertility Quality of Life (FertiQoL), were administered to 89 women both before their first cycle of infertility treatment and again at the end of the ovarian stimulation for in vitro fertilization (IVF). Women's levels of anxiety were significantly higher before the treatment than during the treatment itself. Stratifying the women in three groups based on principal cause of infertility (male infertility, female infertility, or both male and female), we found significantly higher levels of anxiety and general distress in patients under treatment for female infertility. Higher anxiety levels in our sample before the treatment are probably an effect of not knowing what they are expected to do to solve their problem. Moreover, when the cause of infertility is exclusively female, women experience higher levels of anxiety and general distress both before and during the treatment, probably correlated to a sense of guilt. These data help the treating physician to better counsel patients and to provide a more focused psychological support.
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Affiliation(s)
- Claudia Massarotti
- a Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Academic Unit of Obstetrics and Gynecology , University of Genova , Genova , Italy
- b Physiopathology of Human Reproduction Unit , Ospedale Policlinico San Martino , Genova , Italy
| | - Giulia Gentile
- c Midwifery Course , University of Genova , Genova , Italy
| | - Chiara Ferreccio
- a Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Academic Unit of Obstetrics and Gynecology , University of Genova , Genova , Italy
- b Physiopathology of Human Reproduction Unit , Ospedale Policlinico San Martino , Genova , Italy
| | - Paola Scaruffi
- b Physiopathology of Human Reproduction Unit , Ospedale Policlinico San Martino , Genova , Italy
| | - Valentino Remorgida
- a Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Academic Unit of Obstetrics and Gynecology , University of Genova , Genova , Italy
| | - Paola Anserini
- a Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Academic Unit of Obstetrics and Gynecology , University of Genova , Genova , Italy
- b Physiopathology of Human Reproduction Unit , Ospedale Policlinico San Martino , Genova , Italy
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Passet-Wittig J, Schneider NF. Imaginability of adoption, foster care, and life without a(nother) child and stress in women and men in fertility treatment. J Health Psychol 2018; 25:1462-1471. [PMID: 29493286 DOI: 10.1177/1359105318758857] [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: 11/15/2022] Open
Abstract
We study whether the imaginability of adoption, foster care, and life without a(nother) child protects from stress during fertility treatment. Data from a self-administered prospective cohort study of couples who had just started treatment were used (T1 = 441 respondents; T2 = 142 respondents). Most respondents cannot imagine alternatives to treatment. Adoption/foster care is preferred over life without children. Imaginability of alternatives is associated with lower fertility-related (T1) and treatment-related stress (T2). Experience of a pregnancy/birth does not moderate the association. Thus, the availability of alternatives to treatment turns out to be helpful in terms of self-regulation during fertility treatment.
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Zurlo MC, Cattaneo Della Volta MF, Vallone F. Factor structure and psychometric properties of the Fertility Problem Inventory-Short Form. Health Psychol Open 2018; 4:2055102917738657. [PMID: 29379625 PMCID: PMC5779934 DOI: 10.1177/2055102917738657] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The study analyses factor structure and psychometric properties of the Italian version of the Fertility Problem Inventory–Short Form. A sample of 206 infertile couples completed the Italian version of Fertility Problem Inventory (46 items) with demographics, State Anxiety Scale of State-Trait Anxiety Inventory (Form Y), Edinburgh Depression Scale and Dyadic Adjustment Scale, used to assess convergent and discriminant validity. Confirmatory factor analysis was unsatisfactory (comparative fit index = 0.87; Tucker-Lewis Index = 0.83; root mean square error of approximation = 0.17), and Cronbach’s α (0.95) revealed a redundancy of items. Exploratory factor analysis was carried out deleting cross-loading items, and Mokken scale analysis was applied to verify the items homogeneity within the reduced subscales of the questionnaire. The Fertility Problem Inventory–Short Form consists of 27 items, tapping four meaningful and reliable factors. Convergent and discriminant validity were confirmed. Findings indicated that the Fertility Problem Inventory–Short Form is a valid and reliable measure to assess infertility-related stress dimensions.
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Biringer E, Howard LM, Kessler U, Stewart R, Mykletun A. Is infertility really associated with higher levels of mental distress in the female population? Results from the North-Trøndelag Health Study and the Medical Birth Registry of Norway. J Psychosom Obstet Gynaecol 2016; 36:38-45. [PMID: 25572637 DOI: 10.3109/0167482x.2014.992411] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To explore the effect of ever having tried to conceive for more than 12 months on levels of anxiety and depressive symptoms and to investigate if symptom levels of anxiety and depression in infertile women who remain childless, or go on to have children, respectively, differ from symptom levels in mothers without reports of infertility. METHODS Analyses were based on information from 12 584 Norwegian women aged 19-45 years who participated in the North-Trøndelag Health Study from 1995 to 1997 and data from the Medical Birth Registry of Norway. Anxiety and depressive symptoms were measured by the Hospital Anxiety and Depression Scale. RESULTS Having tried to conceive for more than 12 months (ever) was weakly associated with higher levels of depressive symptoms. In the categorical analyses, women with resolved infertility had higher levels of anxiety symptoms (B = 0.25 (95% confidence interval (CI) = 0.04-0.47)) and voluntarily childfree had lower levels of depressive symptoms (B = -0.05 (95% CI = -0.50 to -0.21)) than mothers without infertility. However, women with current primary or current secondary infertility had levels of anxiety and depression not significantly different from mothers without infertility. CONCLUSION At the population level, and from a longitudinal perspective, unresolved infertility is less burdensome than findings from studies on women seeking help for infertility would suggest.
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Affiliation(s)
- Eva Biringer
- Section of Mental Health Research, Helse Fonna Local Health Enterprise , Haugesund , Norway
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12
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Casu G, Gremigni P. Screening for infertility-related stress at the time of initial infertility consultation: psychometric properties of a brief measure. J Adv Nurs 2015; 72:693-706. [DOI: 10.1111/jan.12830] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Giulia Casu
- Department of Psychology; University of Bologna; Italy
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13
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Gameiro S, Boivin J, Dancet E, de Klerk C, Emery M, Lewis-Jones C, Thorn P, Van den Broeck U, Venetis C, Verhaak CM, Wischmann T, Vermeulen N. ESHRE guideline: routine psychosocial care in infertility and medically assisted reproduction-a guide for fertility staff. Hum Reprod 2015; 30:2476-85. [PMID: 26345684 DOI: 10.1093/humrep/dev177] [Citation(s) in RCA: 159] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 06/11/2015] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION Based on the best available evidence in the literature, what is the optimal management of routine psychosocial care at infertility and medically assisted reproduction (MAR) clinics? SUMMARY ANSWER Using the structured methodology of the Manual for the European Society of Human Reproduction and Embryology (ESHRE) Guideline Development, 120 recommendations were formulated that answered the 12 key questions on optimal management of routine psychosocial care by all fertility staff. WHAT IS ALREADY KNOWN The 2002 ESHRE Guidelines for counselling in infertility has been a reference point for best psychosocial care in infertility for years, but this guideline needed updating and did not focus on routine psychosocial care that can be delivered by all fertility staff. STUDY, DESIGN, SIZE, DURATION This guideline was produced by a group of experts in the field according to the 12-step process described in the ESHRE Manual for Guideline Development. After scoping the guideline and listing a set of 12 key questions in PICO (Patient, Intervention, Comparison and Outcome) format, thorough systematic searches of the literature were conducted; evidence from papers published until April 2014 was collected, evaluated for quality and analysed. A summary of evidence was written in a reply to each of the key questions and used as the basis for recommendations, which were defined by consensus within the guideline development group (GDG). Patient and additional clinical input was collected during the scoping and the review phase of the guideline development. PARTICIPANTS/MATERIALS, SETTING, METHODS The guideline group, comprising psychologists, two medical doctors, a midwife, a patient representative and a methodological expert, met three times to discuss evidence and reach consensus on the recommendations. MAIN RESULTS AND THE ROLE OF CHANCE THE GUIDELINE PROVIDES 120 recommendations that aim at guiding fertility clinic staff in providing optimal evidence-based routine psychosocial care to patients dealing with infertility and MAR. The guideline is written in two sections. The first section describes patients' preferences regarding the psychosocial care they would like to receive at clinics and how this care is associated with their well-being. The second section of the guideline provides information about the psychosocial needs patients experience across their treatment pathway (before, during and after treatment) and how fertility clinic staff can detect and address these. Needs refer to conditions assumed necessary for patients to have a healthy experience of the fertility treatment. Needs can be behavioural (lifestyle, exercise, nutrition and compliance), relational (relationship with partner if there is one, family friends and larger network, and work), emotional (well-being, e.g. anxiety, depression and quality of life) and cognitive (treatment concerns and knowledge). LIMITATIONS, REASONS FOR CAUTION We identified many areas in care for which robust evidence was lacking. Gaps in evidence were addressed by formulating good practice points, based on the expert opinion of the GDG, but it is critical for such recommendations to be empirically validated. WIDER IMPLICATIONS OF THE FINDINGS The evidence presented in this guideline shows that providing routine psychosocial care is associated with or has potential to reduce stress and concerns about medical procedures and improve lifestyle outcomes, fertility-related knowledge, patient well-being and compliance with treatment. As only 45 (36.0%) of the 125 recommendations were based on high-quality evidence, the guideline group formulated recommendations to guide future research with the aim of increasing the body of evidence.
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Affiliation(s)
- S Gameiro
- Cardiff Fertility Studies Research Group, School of Psychology, Cardiff University, CF10 3AT Cardiff, UK
| | - J Boivin
- Cardiff Fertility Studies Research Group, School of Psychology, Cardiff University, CF10 3AT Cardiff, UK
| | - E Dancet
- Leuven University Fertility Centre, University Hospitals Leuven, 3000 Leuven, Belgium Center for Reproductive Medicine, Women's and Children's Hospital, Academic Medical Center, University of Amsterdam, Amsterdam 1105 AZ, The Netherlands
| | - C de Klerk
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC University Medical Centre, Rotterdam 3000 CA, The Netherlands
| | - M Emery
- Centre for Medically Assisted Procreation-CPMA, CH-1003 Lausanne, Switzerland
| | | | - P Thorn
- Practice for Couple and Family Therapy, 64546 Moerfelden, Germany
| | - U Van den Broeck
- Leuven University Fertility Centre, University Hospitals Leuven, 3000 Leuven, Belgium
| | - C Venetis
- Women's and Children's Health, St George Hospital, University of New South Wales, NSW 2217 Sydney, Australia
| | - C M Verhaak
- Department of Psychology, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands
| | - T Wischmann
- Institute of Medical Psychology, Centre for Psychosocial Medicine, Heidelberg University Hospital, 69115 Heidelberg, Germany
| | - N Vermeulen
- European Society for Human Reproduction and Embryology, 1852 Grimbergen, Belgium
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Lakatos E, Szabó G, F Szigeti J, Balog P. [Relationships between psychological well-being, lifestyle factors and fertility]. Orv Hetil 2015; 156:483-92. [PMID: 25778856 DOI: 10.1556/oh.2015.30104] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
INTRODUCTION 10 to 15% of the Hungarian fertile age population struggles with reproductivity problems. Previous researches have shown that psychological well-being and lifestyle factors play a pivotal role in overall health status, which is closely related to fertility. AIM The aim of the study was to examine fertility-related psychological and lifestyle factors in a Hungarian sample. METHOD 194 women (115 infertile and 79 fertile) took part in the study. Standardized, validated questionnaires were used for the assessment of psychological factors and self-administered questions were used for exploring lifestyle factors. RESULTS The results show that infertile women are younger (33.98±4.89 vs. 36.43±5.81 years, p<0.005) and their psychological status is significantly worse compared to their fertile counterparts. The number of their depressive (BDI 14.00±12.21 vs. 7.79±9.17, p<0.005) and anxiety symptoms is higher (STAI-T 48.53±10.56 vs. 40.25±10.65, p<0.005) compared to fertile women. Findings related to lifestyle factors show that lower level of fluid consumption (1.71±0.67 vs. 1.95±0.68, p<0.05) and diet (31.30% vs. 18.42%, p<0.05) is significantly related to infertility. In this sample higher level of fluid consumption was associated with the fertile group (OR = 1.65, CI = 2.58-1.06), independently of body mass index and age. CONCLUSIONS The results confirm the findings of international researches showing that women struggling with infertility are in worse psychological condition than their fertile counterparts. The authors conclude that the findings demand further investigations and follow-up studies in order to more specifically determine the relationship between fluid consumption and fertility.
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Affiliation(s)
- Enikő Lakatos
- Semmelweis Egyetem, Általános Orvostudományi Kar Magatartástudományi Intézet Budapest Nagyvárad tér 4. 1089 Semmelweis Egyetem Mentális Egészségtudományok Doktori Iskola Budapest
| | - Gábor Szabó
- Budapesti Kommunikációs és Üzleti Főiskola Budapest
| | - Judit F Szigeti
- Semmelweis Egyetem, Általános Orvostudományi Kar Klinikai Pszichológia Tanszék Budapest
| | - Piroska Balog
- Semmelweis Egyetem, Általános Orvostudományi Kar Magatartástudományi Intézet Budapest Nagyvárad tér 4. 1089
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Cipolletta S, Faccio E. Time experience during the assisted reproductive journey: a phenomenological analysis of Italian couples’ narratives. J Reprod Infant Psychol 2013. [DOI: 10.1080/02646838.2013.813627] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Perception of control, coping and psychological stress of infertile women undergoing IVF. Reprod Biomed Online 2012; 24:670-9. [DOI: 10.1016/j.rbmo.2012.03.002] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2012] [Revised: 02/29/2012] [Accepted: 03/01/2012] [Indexed: 12/17/2022]
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Gourounti K, Anagnostopoulos F, Alexias G, Vaslamatzis G. Appraisal of life events scale in a sample of Greek infertile women undergoing fertility treatment: a confirmatory factor analysis. Midwifery 2011; 28:385-90. [PMID: 21820777 DOI: 10.1016/j.midw.2011.06.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2011] [Revised: 05/13/2011] [Accepted: 06/21/2011] [Indexed: 11/26/2022]
Abstract
OBJECTIVE to examine the construct validity of the Greek version of the Appraisal of Life Events (ALE) scale, originally developed by Ferguson et al. (1999), in a sample of infertile women. As there are no data concerning the validity of the ALE scale in infertile populations, a special focus was placed on construct validity through confirmatory factor analysis (CFA). SETTING public hospital in Athens, Greece. DESIGN cross-sectional study. PARTICIPANTS 160 women undergoing fertility treatment with in-vitro fertilisation. METHODS the ALE scale was 'forward-backward' translated from English to Greek. The translated instrument was then administered to a set of infertile women for pilot testing. CFA was used to test the construct validity of the ALE scale. FINDINGS CFA supported the superiority of a model with three correlated first-order factors (challenge, threat and loss) and one second-order factor (stress appraisal) that underlay the first-order factors of threat and loss. CONCLUSION the ALE scale was found to have a multidimensional structure. IMPLICATIONS FOR PRACTICE the assessment of infertility appraisal during in-vitro fertilisation through a valid instrument may lead to the identification of women who are at greater risk of experiencing high stress, not only during fertility treatment but also during pregnancy and postnatal period in case of a successful IVF treatment.
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Affiliation(s)
- Kleanthi Gourounti
- Elena Benizelou Hospital, Department of Midwifery, Technological Educational Institution of Athens, 18756 Athens, Greece.
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Galhardo A, Pinto-Gouveia J, Cunha M, Matos M. The impact of shame and self-judgment on psychopathology in infertile patients. Hum Reprod 2011; 26:2408-14. [DOI: 10.1093/humrep/der209] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Gourounti K, Anagnostopoulos F, Vaslamatzis G. The Relation of Psychological Stress to Pregnancy Outcome Among Women Undergoing In-Vitro Fertilization and Intracytoplasmic Sperm Injection. Women Health 2011; 51:321-39. [DOI: 10.1080/03630242.2011.574791] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Greil AL, Shreffler KM, Schmidt L, McQuillan J. Variation in distress among women with infertility: evidence from a population-based sample. Hum Reprod 2011; 26:2101-12. [PMID: 21659313 DOI: 10.1093/humrep/der148] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND We examine variation in fertility-specific distress (FSD) and general distress according to different experiences of infertility among 1027 US women who have experienced infertility within the previous 10 years. METHODS General distress was measured by a short form of the Center for Epidemiological Studies-Depression. Multiple regression analysis was conducted on self-report data (based on a telephone interview) from a probability-based sample of US women aged 25-45 years. We compare women with infertility who have had a prior pregnancy (secondary infertility, n = 628) to women with infertility with no prior pregnancies (primary infertility, n = 399). We further distinguish between women with infertility who were actually 'trying' to become pregnant (the infertile with intent) with those who met the medical definition of infertile but did not describe themselves as trying to become pregnant (infertile without intent). RESULTS Both types of infertility (primary versus secondary) (β = 0.31*) and intentionality (infertile with and without intent) (β = 0.08*) are associated with FSD. These associations persist when we control for resource and demographic variables, life course variables, social support and social pressure variables. General distress does not vary by infertility type or intentionality. CONCLUSIONS Results reveal variation in women's recalled experiences of infertility and that FSD is more sensitive to effects of different experiences than general distress. Women with primary infertility who were explicitly trying to become pregnant at the time of the infertility episode stand out as a particularly distressed group. Caregivers should be aware that the emotional needs of women with primary infertility may differ from those with secondary infertility.
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Affiliation(s)
- Arthur L Greil
- Department of Sociology, Alfred University, 1 Saxon Drive, Alfred, NY 14802, USA.
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Fouché P, Nortjé N, Phillips K, Stroud L. Psychofortology of Women Undergoing Infertility Treatment. JOURNAL OF PSYCHOLOGY IN AFRICA 2011. [DOI: 10.1080/14330237.2011.10820495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Gourounti K, Anagnostopoulos F, Vaslamatzis G. Psychometric properties and factor structure of the Fertility Problem Inventory in a sample of infertile women undergoing fertility treatment. Midwifery 2010; 27:660-7. [PMID: 20359796 DOI: 10.1016/j.midw.2010.02.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2009] [Revised: 01/28/2010] [Accepted: 02/15/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVE to examine the psychometric properties of the Fertility Problem Inventory (FPI) originally developed by Newton et al. (1999); as there are no data concerning the factorial structure of the FPI, a special focus is placed on construct validity through factor analysis. SETTING public hospital in Athens, Greece. DESIGN a cross-sectional study. PARTICIPANTS 108 women undergoing fertility treatment with in-vitro fertilisation. METHODS the FPI was 'forward-backward' translated from English to Greek. The translated instrument was then administered to a set of infertile women for pilot testing. Principal axis factoring with promax rotation was used to test the factor structure of the FPI. Measures of anxiety State Trait Anxiety Inventory, depression (Center for Epidemiologic Studies--Depression Scale) and mood states Profile of Mood States were used to assess the convergent validity of the FPI. Cronbach's α was used to measure internal consistency of the FPI scales. FINDINGS exploratory factor analysis suggested four factors. The majority of relationship and sexual concern items grouped into one solid factor, named 'spousal concern'. The original scales of social concern, need for parenthood and rejection of childfree lifestyle were reproduced after rearranging nine cross-loading items. Construct validity was confirmed by computing correlations between the derived FPI scales and conceptually similar constructions of anxiety, depression and mood states. Internal consistency reliability was satisfactory. CONCLUSION the FPI was found to have a relatively stable factor structure and satisfactory reliability, and convergent and discriminant validity. The FPI may enable researchers and clinicians to apply a reliable measure that focuses on various/many dimensions of infertility-related stress.
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Affiliation(s)
- K Gourounti
- Elena Benizelou Hospital, Department of Midwifery, Technological Educational Institution of Athens, Greece.
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