1
|
Kiani Z, Simbar M, Rashidi F, Zayeri F, Banaderakhsh H. The quality of life of men experiencing infertility: a systematic review. BMC Public Health 2024; 24:1236. [PMID: 38705989 PMCID: PMC11070083 DOI: 10.1186/s12889-024-18758-6] [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: 09/21/2023] [Accepted: 05/02/2024] [Indexed: 05/07/2024] Open
Abstract
BACKGROUND Men experiencing infertility encounter numerous problems at the individual, family, and social levels as well as quality of life (QOL). This study was designed to investigate the QOL of men experiencing infertility through a systematic review. MATERIALS AND METHODS This systematic review was conducted without any time limitation (Retrieval date: July 1, 2023) in international databases such as Scopus, Web of Science, PubMed, and Google Scholar. The search was performed by two reviewers separately using keywords such as QOL, infertility, and men. Studies were selected based on inclusion and exclusion criteria. The quality of the articles were evaluated based on the Newcastle-Ottawa Scale. In the initial search, 308 studies were reviewed, and after removing duplicates and checking the title and abstract, the full text of 87 studies were evaluated. RESULTS Finally, 24 studies were included in the final review based on the research objectives. Based on the results, men's QOL scores in different studies varied from 55.15 ± 13.52 to 91.45 ± 13.66%. Of the total reviewed articles, the lowest and highest scores were related to mental health problems and physical dimensions, respectively. CONCLUSION The reported findings vary across various studies conducted in different countries. Analysis of the factors affecting these differences is necessary, and it is recommended to design a standard tool for assessing the quality of life of infertile men. Given the importance of the QOL in men experiencing infertility, it is crucial to consider it in the health system. Moreover, a plan should be designed, implemented and evaluated according to each country's contex to improve the quality of life of infertile men.
Collapse
Affiliation(s)
- Zahra Kiani
- Midwifery and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoumeh Simbar
- Midwifery and Reproductive Health Research Center, Department of Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Farzaneh Rashidi
- Department of Midwifery, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Farid Zayeri
- Proteomics Research Center, Department of Biostatistics, Faculty of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Homayoon Banaderakhsh
- Department of Anesthesia and Operating Room, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
2
|
Mori LP, Zaia V, Montagna E, Vilarino FL, Barbosa CP. Endometriosis in infertile women: an observational and comparative study of quality of life, anxiety, and depression. BMC Womens Health 2024; 24:251. [PMID: 38654250 PMCID: PMC11036610 DOI: 10.1186/s12905-024-03080-5] [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: 06/30/2023] [Accepted: 04/07/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND A women's chances of getting pregnant decreases in cases of infertility, which may have several clinical etiologies. The prevalence of infertility is estimated as 10-15% worldwide. One of the causes of infertility is endometriosis, defined as the presence of an endometrial gland and/or stroma outside the uterus, inducing a chronic inflammatory reaction. Thus, infertility and endometriosis are diagnoses that significantly affect women's mental health. This study accessed and compared the levels of depression, anxiety, and quality of life in infertile women with and without endometriosis. METHODS was an observational and cross-sectional study which included 201 infertile women, 81 of whom were also diagnosed with endometriosis. The STROBE Guidelines was used. The data were collected using validated scales: Hamilton D Questionnaire, Beck Depression Inventory, and Fertility Quality of Life Questionnaire; The data were collected at the Ideia Fertil Institute (Santo Andre, Brazil), between February 28 and June 8, 2019. RESULTS the infertile women with endometriosis reported higher presence of depressive symptoms and a lower quality of life compared to women with infertility only. Similar presence of anxiety symptoms was observed regardless of being diagnosed with endometriosis. Women with infertility and endometriosis presented lower levels in quality-of-life domains when compared to women with infertility only - Mind and Body (58.33 × 79.17, p < 0.001), Relational (75 × 81.25, p = 0.009), Social (66.67 × 77.08, p = 0.001), Emotional (50.62 × 67.43, p < 0.001). CONCLUSION the findings indicate the need for increased psychosocial support care for women suffering from infertility and endometriosis to assist them in maintaining and managing their own mental health and achieving their reproductive goals.
Collapse
Affiliation(s)
- Lilian Pagano Mori
- Programa de Pós-graduação em Ciências da Saúde, Centro Universitário FMABC, Av. Lauro Gomes, Santo André, 2000, 09060-870, SP, Brazil
| | - Victor Zaia
- Programa de Pós-graduação em Ciências da Saúde, Centro Universitário FMABC, Av. Lauro Gomes, Santo André, 2000, 09060-870, SP, Brazil.
- Instituto Ideia Fertil de Saúde Reprodutiva, , Santo Andre - SP, Brasil.
| | - Erik Montagna
- Programa de Pós-graduação em Ciências da Saúde, Centro Universitário FMABC, Av. Lauro Gomes, Santo André, 2000, 09060-870, SP, Brazil
| | | | - Caio Parente Barbosa
- Programa de Pós-graduação em Ciências da Saúde, Centro Universitário FMABC, Av. Lauro Gomes, Santo André, 2000, 09060-870, SP, Brazil
- Instituto Ideia Fertil de Saúde Reprodutiva, , Santo Andre - SP, Brasil
| |
Collapse
|
3
|
Bahadur A, Kumari S, Mundhra R, Khoiwal K, Das A, Heda A, Pathak A, Heda S. Anxiety, Depression, and Quality of Life Among Infertile Women: A Case-Control Study. Cureus 2024; 16:e55837. [PMID: 38590470 PMCID: PMC10999894 DOI: 10.7759/cureus.55837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2024] [Indexed: 04/10/2024] Open
Abstract
Introduction Pregnancy holds significant cultural and social value for women. However, women facing challenges in conceiving often grapple with emotional distress, including depression and anxiety. The connection between psychological elements (stress, anxiety, and depression) and infertility is complex, influenced by multiple factors, and bidirectional. Infertile women are more likely to develop mental illnesses, marital dissatisfaction, and impaired quality of life compared to the individuals of the fertile group. Thus, the study aimed to assess levels of anxiety, depression, and quality of life among infertile women compared to fertile women. Methods This case-control study conducted at a tertiary care center recruited 100 nulliparous women between the age group of 20 and 38 years with primary or secondary infertility, while those with male factor infertility were excluded. The control group (N=100) comprised normal parous women who had at least one child. The primary objective of the study was to assess the impact of infertility on the mental health and quality of life of women seeking infertility treatment. Outcome measures included standardized tools such as the WHOQOL-BREF questionnaire to assess the quality of life across multiple domains (e.g., physical, psychological, social, and environmental) as well as the Depression Anxiety and Stress Scale (DASS-21) to measure levels of anxiety, depression, and stress. Cronbach's alpha was used to measure the tool's reliability. A P value of <0.05 was considered statistically significant. Results Baseline sociodemographic parameters were comparable between the two groups. The mean age of infertile women was 30.6±3.9 years compared to 31.5±3.2 years in fertile women (P=0.076). Using the WHOQOL-BREF scale, we found that the quality of life was better in the fertile group compared to the infertile group through all the physical, psychological, social, and environmental domains (P<0.001). The infertile group had a significantly higher number of women with anxiety, depression, and stress. The questionnaires showed high internal reliability. Conclusion Infertile women experienced a lower quality of life in various domains, higher levels of anxiety, and increased rates of depression compared to fertile counterparts. The study findings underscore the multidimensional impact of infertility, emphasizing the need for comprehensive healthcare approaches to address the psychosocial challenges faced by women undergoing infertility treatment.
Collapse
Affiliation(s)
- Anupama Bahadur
- Obstetrics and Gynaecology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Sukriti Kumari
- Obstetrics and Gynaecology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Rajlaxmi Mundhra
- Obstetrics and Gynaecology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Kavita Khoiwal
- Obstetrics and Gynaecology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Anindya Das
- Psychiatry, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Ayush Heda
- Obstetrics and Gynaecology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Anjali Pathak
- Obstetrics and Gynaecology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Sakshi Heda
- Obstetrics and Gynaecology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| |
Collapse
|
4
|
Khan NH, Shahnawaz MG, Patel A, Kashyap P, Singh CB. Resilience among involuntarily childless couples and individuals undergoing infertility treatment: a systematic review. HUM FERTIL 2023; 26:1562-1583. [PMID: 37439133 DOI: 10.1080/14647273.2023.2219400] [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: 06/03/2022] [Accepted: 04/18/2023] [Indexed: 07/14/2023]
Abstract
Infertility is regarded as a highly stressful and challenging experience. However, the response to this unexpected moment varies from one individual to the other. The review explores research that studies resilience in the context of infertility and its treatment. The purpose was to study the protective and risk factors associated with resilience and to identify psychosocial factors that could play a crucial role in resilience among infertile couples and individuals who are seeking infertility treatment. Four major databases (PubMed, Scopus, ScienceDirect, and Wiley Online Library) were searched with appropriate keywords. A total of 4101 articles were retrieved from the databases and after following various levels of screening 18 articles were finalized. These articles explored resilience and other psychosocial factors in couples/individuals seeking infertility treatment. The protective factors associated with resilience were quality of life, coping, social support, and posttraumatic growth. The risk factors associated with resilience were infertility-related stress, anxiety and depression. The unexpected diagnosis of infertility might be disturbing for many, still, it may not be extremely agonizing for some. Individuals who are encouraged to utilize their own resources and seek support are able to deal with stressors associated with infertility.
Collapse
Affiliation(s)
- Neda Haseeb Khan
- Department of Psychology, Jamia Millia Islamia, New Delhi, India
| | | | - Ansha Patel
- Department of Psychiatry & Psychology RNT Medical College, Paras & Shantiraj Hospitals, Psychological Clinic for Reproductive Health & Challenges, CMBS, Udaipur, FAIMER at MAHE, Karnataka, India
| | | | | |
Collapse
|
5
|
Shayesteh-Parto F, Hasanpoor-Azghady SB, Arefi S, Amiri-Farahani L. Infertility-related stress and its relationship with emotional divorce among Iranian infertile people. BMC Psychiatry 2023; 23:666. [PMID: 37700231 PMCID: PMC10496378 DOI: 10.1186/s12888-023-05159-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 08/31/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND Infertility affects different aspects of couples' lives, so it may cause problems in couples' emotional relationships by increasing marital conflicts. This study aimed to determine Infertility-related stress and its relationship with emotional divorce among Iranian infertile people. METHODS We conducted a cross-sectional observational study on 200 infertile people. The research environment was one of the well-equipped infertility centers in Tehran, Iran. Continuous sampling was employed. The data collection tools included a general information form, the Fertility Problem Inventory (FPI), and the Emotional Divorce Scale (EDS). RESULTS The findings revealed a significant direct relationship between infertility-related stress and all its subscales with emotional divorce in both infertile women and men. In infertile women, the most concern was the need for parenthood, while the lowest concerns were the relationship and sexual concerns. Multiple linear regression analysis indicated that social and relationship concerns predicted 44% of emotional divorce, with social concern being the more influential factor. In infertile men, the need for parenthood was the most significant concern, while relationship and social concerns were less prominent. Multiple linear regression analysis showed that relationship concern predicted 50% of emotional divorce in infertile men. In both infertile men and women, social and relationship concerns explained 45% of the variance in emotional divorce. Among these two variables, relationship concern had a more impact in predicting emotional divorce. Also, there was no statistically significant difference between women and men regarding infertility-related stress and its subscales, except for sexual concern. CONCLUSION The study highlights the importance of the need for parenthood as a main concern among infertile individuals. Increased infertility-related stress and its subscales contribute to higher levels of emotional divorce among this population. Additionally, relationship concern was the lowest concern in infertile people. But it significantly predicts emotional divorce among infertile individuals.
Collapse
Affiliation(s)
- Fatemeh Shayesteh-Parto
- Department of Midwifery and Reproductive, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Seyedeh Batool Hasanpoor-Azghady
- Department of Midwifery and Reproductive, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.
| | - Soheila Arefi
- Monoclonal Antibody Department, Avicenna Research Institute, Tehran, Iran
| | - Leila Amiri-Farahani
- Department of Midwifery and Reproductive, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
6
|
Al Obeisat S, Hayajneh A, Hweidi I, Abujilban S, Mrayan L, Alfar R, Nashwan A, Hweidi LI. Psychometric properties of the Arabic version of the Fertility Quality of Life (FertiQoL) questionnaire tested on infertile couples in Jordan. BMC Womens Health 2023; 23:283. [PMID: 37231403 DOI: 10.1186/s12905-023-02437-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 05/16/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND The Fertility Quality of Life (FertiQoL) questionnaire assesses the quality of life of people with fertility problems. The present study aimed to assess the psychometric properties of the Arabic version of the FertiQoL in infertile couples in Jordan. METHODS This study used a cross-sectional design among 212 participants with infertility problems. An exploratory factor analysis (EFA) and a confirmatory factor analysis (CFA) were conducted to investigate the underlying structure of the novel Arabic version of the FertiQoL tool. RESULTS The Cronbach's alpha values for the FertiQoL core domain, the FertiQoL treatment domain, and the total FertiQoL scale were 0.93, 0.74, and 0.92, respectively. The EFA indicated a two-domain model, with the first factor having 24 items and measuring "Core QoL". The second factor has 10 items and measures "Treatment QoL" in the context of infertility. The EFA and the CFA supported a two-factor model whereby the two factors explained 48% of the shared covariance between the analyzed quality of life indicators. The indices of goodness-of-fit of the model showed acceptable fit as follows: the chi-squared test (χ2) = 7.943, the comparative fit index (CFI) = 0.999, the root mean square error of approximation (RMSEA) = 0.001, and the Tucker-Lewis index (TLI) = 0.989. CONCLUSION The study's findings demonstrated the reliability and validity of the Arabic version of the FertiQoL for assessing the quality of life of infertile couples or those in Jordan with no pregnancy or childlessness.
Collapse
Affiliation(s)
- Salwa Al Obeisat
- Faculty of Nursing\Maternal-Child Health Nursing Department, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Audai Hayajneh
- Faculty of Nursing\Adult Health Nursing Department, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Issa Hweidi
- Faculty of Nursing\Adult Health Nursing Department, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Sanaa Abujilban
- Department of Maternal, Child and Family Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, 13115, Jordan
| | - Lina Mrayan
- Department of Maternal, Child and Family Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, 13115, Jordan
| | - Rana Alfar
- Faculty of Nursing\Maternal-Child Health Nursing Department, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Abdulqadir Nashwan
- Nursing for Education & Practice Development, Hazm Mebaireek General Hospital (HMGH), Hamad Medical Corporation (HMC), Doha, Qatar.
| | - Lama I Hweidi
- Faculty of Medicine, Jordan University of Science & Technology, Irbid, 22110, Jordan
| |
Collapse
|
7
|
Renzi A, Fedele F, Di Trani M. Assisted Reproductive Treatments, Quality of Life, and Alexithymia in Couples. Healthcare (Basel) 2023; 11:healthcare11071026. [PMID: 37046953 PMCID: PMC10093954 DOI: 10.3390/healthcare11071026] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 03/19/2023] [Accepted: 03/27/2023] [Indexed: 04/14/2023] Open
Abstract
Infertility and related treatments can negatively affect a couple's wellbeing. The aim of this study was to evaluate couples starting assisted reproductive treatment, differences in alexithymia and quality of life levels between partners, and the association of these psychological dimensions within the couple's members. Data was collected in two fertility centres in Rome; 47 couples completed the Fertility Quality of Life (FertiQoL), the 20-item Toronto Alexithymia Scale (TAS-20), and a socio-demographic questionnaire. Data analysis showed a worsened quality of life in women compared with their partners, as well as higher externally oriented thinking in men compared with their spouses. Associations between alexithymia and quality of life levels between women and men emerged. According to the regression analysis, a better quality of life in women was predicted by a greater partner's capabilities in identifying and describing emotion as well as by a better partner's quality of life, whereas for men, a better quality of life was predicted by their spouse's higher levels of quality of life. This study highlights the protective role that couples can play in the perception of the negative impact that infertility can have on their partner's quality of life. Further investigations are needed for the development of specific therapeutic interventions for the promotion of the couples' wellbeing.
Collapse
Affiliation(s)
- Alessia Renzi
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, Via Degli Apuli 1, 00185 Rome, Italy
| | - Fabiola Fedele
- ART Italian National Register, National Centre for Diseases Prevention and Health Promotion, Italian National Health Institute, Viale Regina Elena 299, 00161 Rome, Italy
| | - Michela Di Trani
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, Via Degli Apuli 1, 00185 Rome, Italy
| |
Collapse
|
8
|
Almutawa YM, AlGhareeb M, Daraj LR, Karaidi N, Jahrami H. A Systematic Review and Meta-analysis of the Psychiatric Morbidities and Quality of Life Differences Between Men and Women in Infertile Couples. Cureus 2023; 15:e37327. [PMID: 37181965 PMCID: PMC10168134 DOI: 10.7759/cureus.37327] [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: 04/09/2023] [Indexed: 05/16/2023] Open
Abstract
Infertility is often associated with diverse psychiatric morbidities and quality of life impairments. Hence, this meta-analysis aimed to compare stress, depression, anxiety and quality of life (QoL) among infertile men and women. We retrieved the relevant articles from multiple databases. For the statistical analyses, we used Comprehensive Meta-Analysis software v. 3.7 (Biostat Inc., Englewood, NJ). Standardized mean differences (SMD) with 95% confidence intervals (CI) were calculated and displayed in forest plots. Among the 4123 articles identified, 35 studies met the inclusion criteria. Our results revealed that stress, depression, and anxiety were higher in infertile women compared to men. Similarly, infertile women presented a lower QoL than infertile men. Subgroup analysis revealed that the assessment tool used, study design, and geographical origin were a source of heterogeneity. This meta-analysis showed that psychological disturbances were higher in infertile women compared to men. Physicians need to consider this difference to enable couples to better understand and support each other.
Collapse
Affiliation(s)
- Yaser Mansoor Almutawa
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, BHR
| | - Muneera AlGhareeb
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, BHR
| | - Lateefa Rashed Daraj
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, BHR
| | - Noor Karaidi
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, BHR
| | - Haitham Jahrami
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, BHR
- Department of Psychiatry, Psychiatry Hospital, Ministry of Health, Manama, BHR
| |
Collapse
|
9
|
Antequera-Jurado R, Moreno-Rosset C, Ramírez-Uclés I. The specific psychosocial modulator factors of emotional adjustment in infertile individuals compared to fertile people. CURRENT PSYCHOLOGY 2023. [DOI: 10.1007/s12144-023-04436-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Abstract
Certain psychological and social factors modulate emotional adjustment in infertility. The aims of this study were: analyse whether there are sex and group differences (infertile vs. fertile) in emotional adjustment, and personality, dispositional optimism, coping strategies, personal and interpersonal resources; observe the modulating role of these psychosocial variables in the emotional adjustment of infertile individuals compared to fertile ones; and determine if the modulator variables associated with emotional adjustment are specific to infertile people. Method: A cross-sectional study design was used with a sample of 139 heterosexual Spanish participants (84 infertile, 55 fertile). For the data analysis we performed correlations, multiple regression analysis, MANOVAS and ANOVAS. Results: The multivariate and univariate analyses showed that the infertile group exhibited greater emotional maladjustment, more personal resources, lesser degree of confrontive coping, social support seeking, positive reappraisal, and lower marital satisfaction than the fertile group. In addition, women (infertile and fertile) sought more social support seeking and the infertile ones made more use of self-controlling strategies. Multiple regression analyses showed that for all subjects the emotional adjustment was modulated by dispositional optimism and escape/avoidance. For infertile participants, the remaining significant modulating factors were personal resources and marital satisfaction, whereas, for the fertile group, they were openness and interpersonal resources. Conclusion: Infertile women and men showed no differences in emotional maladjustment, but levels were higher than in the fertile group. We found differences between infertile and fertile subjects in terms of modulating variables of emotional adjustment. For infertile participants, the development of personal resources and increased marital satisfaction are particularly important.
Collapse
|
10
|
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.
Collapse
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
| |
Collapse
|
11
|
Pedro J, Fernandes J, Schmidt L, Costa ME, Martins MV. Mapping intentions to adopt fertility protective behaviours: the role of couple congruence and the importance of relationship and fertility awareness. HUM FERTIL 2022; 25:993-1002. [PMID: 34348572 DOI: 10.1080/14647273.2021.1960436] [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: 01/03/2023]
Abstract
Several studies worldwide have shown that reproductive-aged people often have inadequate fertility awareness (FA). Since attitudes and health behaviours are influenced by the partner, there is a need for studies exploring the role of these influences on the individuals' adoption of fertility protective behaviours (FPB). This study explores the role of FA and relationship quality on couples' intention to adopt FPB. One hundred and twelve childless couples answered an online questionnaire about reproductive life plan, FA and intentions to adopt FPB. The results showed that couples were moderately congruent on their reproductive life plan. The female partners who reported higher female relationship quality and higher female willingness to undergo fertility treatments were more willing to adopt FPB. The male partners who had heightened FA also reported higher intention to adopt FPB. The influences of male and female FA, relationship quality and congruence on reproductive life plan were neither associated with couples' congruence on the intention to adopt FPB. Although the cross-sectional design restricts our ability to draw causal conclusions, these findings emphasize that future interventions should be targeted at couples and designed according to their expectations and reproductive desires.
Collapse
Affiliation(s)
- Juliana Pedro
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal.,Centre for Psychology, University of Porto, Porto, Portugal.,Centre for Reproductive Genetics A. Barros, Porto, Portugal
| | - Joana Fernandes
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | - Lone Schmidt
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Maria E Costa
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal.,Centre for Psychology, University of Porto, Porto, Portugal
| | - Mariana V Martins
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal.,Centre for Psychology, University of Porto, Porto, Portugal
| |
Collapse
|
12
|
Chamorro PP, Herruzo J, Pino MJ. Study on the Interdependent Relationship between the Marital Satisfaction Variable and the Psychosocial Impact of Infertility and Anxiety Disposition, According to Gender. JOURNAL OF SEX & MARITAL THERAPY 2021; 48:461-474. [PMID: 34873994 DOI: 10.1080/0092623x.2021.2008074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This study assessed the relationship between the marital satisfaction variable and the psychosocial impact of infertility and anxiety disposition, testing for possible gender-based differences. Comparisons performed on 87 couples did reveal differences and analyses disclosed that depression, anxiety and quality of life can influence the assessment each partner makes of their relationship, through an interdependent process. One partner's marital satisfaction can be influenced by those variables in the other partner. These findings indicate that psychosocial care for infertile couples must involve both partners and that they should be made aware of the effect of interdependence on marital satisfaction.
Collapse
Affiliation(s)
| | - Javier Herruzo
- Department of Psychology, University of Cordoba, Cordoba, Spain
| | - Maria J Pino
- Department of Psychology, University of Cordoba, Cordoba, Spain
| |
Collapse
|
13
|
Caughey LE, White KM. Psychosocial determinants of women's intentions and willingness to freeze their eggs. Fertil Steril 2021; 115:742-752. [PMID: 33478776 DOI: 10.1016/j.fertnstert.2020.09.150] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 09/15/2020] [Accepted: 09/16/2020] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To examine the psychosocial factors that influence Australian women's intentions to freeze their eggs. DESIGN Initially, a qualitative elicitation study followed by a larger-scale quantitative study. SETTING Both studies were conducted online. PATIENTS A total of 234 Australian women 25-43 years of age, who identifed as heterosexual, had no children, were open to the idea of having children, were currently not pregnant, and did not have a diagnosis of medical infertility. INTERVENTION None. MAIN OUTCOME MEASURE(S) Intentions and willingness of women to freeze their eggs. RESULT(S) Hierarchical multiple regression analyses showed that after accounting for demographic variables, there was strong support for the psychosocial predictors of attitude, pressure from others, and control perceptions as predictors of women's intentions to freeze their eggs. Of the additional variables, cognitive bias (influence of the media) was significant, and the final model accounted for 52.7% of variance in women's intentions to freeze their eggs. CONCLUSION(S) This study was the first to predict women's intentions to freeze their eggs using a well-established decision-making model, the theory of planned behavior. Messages designed to develop a positive attitude toward egg freezing, and to encourage an increased perception of personal control of the egg freezing process, as well as approval from others, could support women to investigate egg freezing, in consultation with appropriate medical advice, as an option when faced with possible future infertility. Effective strategies broaden fertility options for women faced with age-related fertility decline, maximize women's chances of a successful pregnancy, and, critically, prevent the often substantial psychological distress associated with involuntary childlessness.
Collapse
Affiliation(s)
- Lucy E Caughey
- School of Psychology and Counselling, Queensland University of Technology, Brisbane City, Queensland, Australia.
| | - Katherine M White
- School of Psychology and Counselling, Queensland University of Technology, Brisbane City, Queensland, Australia
| |
Collapse
|
14
|
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.
Collapse
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
| |
Collapse
|
15
|
Stellenwert psychotherapeutischer Betreuung im Rahmen der Subfertilitätsbehandlung. GYNAKOLOGISCHE ENDOKRINOLOGIE 2020. [DOI: 10.1007/s10304-020-00323-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
16
|
Ha JY, Ban SH. Effect of resilience on infertile couples' quality of life: an actor-partner interdependence model approach. Health Qual Life Outcomes 2020; 18:295. [PMID: 32873294 PMCID: PMC7466783 DOI: 10.1186/s12955-020-01550-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 08/28/2020] [Indexed: 12/15/2022] Open
Abstract
Background Infertility is an emerging socioeconomic issue affecting an individual’s life and the nation. However, only few studies have examined the influence of resilience on the quality of life (QoL) of spouses as actors and partners. Hence, this study aimed to analyze the influence of resilience, a positive factor that infertile couples may have, on QoL using the actor–partner interdependence model (APIM). Methods By the analyses of couples’ data, we analyzed the effect of resilience on the QoL of infertile couples as actors and partners. This cross-sectional study included 150 infertile couples. The Fertility Quality of Life and Resilience Scale was used to measure couples’ QoL and resilience. APIM was applied to analyze QoL. Results In terms of actor effects, the resilience of both wives (β = 0.201, p < 0.001) and husbands (β = 0.713, p < 0.001) had a significant effect on individual QoL. With regard to partner effects, husbands’ resilience (β = 0.351, p < 0.001) had a significant impact on wives’ QoL and the wives’ resilience (β = 0.219, p = 0.009) had a significant impact on husbands’ QoL. Conclusions The resilience of an infertile actor was found to affect both his/her own QoL and his/her partner’s QoL. In the future, if a program is to be developed to improve couples’ QoL, both spouses should work together to improve their resilience, thereby improving their QoL.
Collapse
Affiliation(s)
- Ju-Young Ha
- College of Nursing, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, 50612, South Korea
| | - Seon-Hwa Ban
- College of Nursing, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, 50612, South Korea.
| |
Collapse
|
17
|
Taebi M, Kariman N, Montazeri A, Majd HA. Development and psychometric evaluation of the female infertility stigma instrument (ISI-F): protocol for a mixed method study. Reprod Health 2020; 17:70. [PMID: 32448294 PMCID: PMC7245766 DOI: 10.1186/s12978-020-0904-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Accepted: 04/01/2020] [Indexed: 11/10/2022] Open
Abstract
Background Infertility stigma is one of the greatest challenges in most societies for reproduction and sexual health of infertile women. Since no specific tool exists for assessing the infertility stigma in women, this study would be conducted to develop and evaluate the psychometric properties of Female Infertility Stigma Instrument (ISI-F). Methods This is a mixed method study with sequential exploratory design (qualitative and quantitative phase). In the first qualitative phase, semi-structured interviews would be performed with infertile female who had experienced infertility whithout any psychological disorder. Women who are eligible for participating in the study will be selected using purposeful sampling method with maximum variation in terms of age, education, occupation and infertility duration. Data would be analyzed using conventional content analysis and in this phase the primary item pool will be developed for the Female Infertility Stigma Instrument (ISI-F). In the quantitative phase, the psychometric properties of the Instrument would be evaluated, including the content, face and construct validity as well as reliability via the internal consistency and stability. The psychometric properties described in the COSMIN checklist will be utilized for designing the instrument. Discussion Developing a valid and reliable scale for Female Infertility Stigma Instrument (ISI-F) would be helpful for future studies to assess the status of this situation. It also helps planning interventional studies for improvement of the reproductive health of infertile women.
Collapse
Affiliation(s)
- Mahboubeh Taebi
- Student Research Committee, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nourossadat Kariman
- Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Ali Montazeri
- Health Metrics Research Centre, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
| | - Hamid Alavi Majd
- Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
18
|
Pasha H, Faramarzi M, Basirat Z, Kheirkha F, Shafee H. Evaluation of sexual dysfunction and its associated risk factors in the male partners of the infertile couples using International Index of Erectile Function. Turk J Obstet Gynecol 2020; 17:1-8. [PMID: 32341823 PMCID: PMC7171543 DOI: 10.4274/tjod.galenos.2019.89801] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 12/28/2019] [Indexed: 01/07/2023] Open
Abstract
Objective: Sexual dysfunction is a major health concern in infertile men. This research aims to evaluate the sexual dysfunction and its associated risk factors in the male partners of infertile couples. Materials and Methods: The cross-sectional study was performed on 204 male partners of infertile couples that were referred to Fatemeh Zahra Infertility & Reproductive Center, Babol, Iran, in 2015. Sexual dysfunction was evaluated using The International Index of Erectile Function (IIEF). Logistic and linear regression tests were used for statis¬tical analyses. Statistical significance was considered with a p value less than 0.05. Results: The mean total IIEF score was 58.30±8.52. The lowest mean of IIEF domains was related to sexual desire and then orgasmic function in the male partners of the infertile couples. Erectile function contributed to the greatest amount of unique variance in the model for sexual function (p<0.001, R2=69.8%). The strongest correlation value was between the domains of overall satisfaction and intercourse satisfaction. There was a positive statistically significant association between sexual function with wife marital intimacy (p<0.002) and wife sexual function (p<0.001). There was a significant association between sexual dysfunction with job conditions (p<0.037, OR=0.094), and coitus count (p<0.009, OR=6.146). After adjusting for other variables, there was a significant association between sexual function and wife sexual function (p<0.005). Also, after adjusting for other variables, there was a significant association between sexual dysfunction and coitus count (p<0.004, OR=2.496), and job condition (p<0.046, OR=0.081). Conclusion: By considering sexual dysfunction and some related factors, early screening is required for distinguishing predictor factors of sexual dysfunction.
Collapse
Affiliation(s)
- Hajar Pasha
- Babol University of Medical Sciences, Health Research Institute, Infertility and Reproductive Health Research Center, Babol, Iran
| | - Mahbobeh Faramarzi
- Babol University of Medical Sciences, Social Determinants of Health Research Center, Babol, Iran
| | - Zahra Basirat
- Babol University of Medical Sciences, Health Research Institute, Infertility and Reproductive Health Research Center, Babol, Iran
| | - Farzan Kheirkha
- Babol University of Medical Sciences, Department of Psychiatry, Babol, Iran
| | - Hamid Shafee
- Babol University of Medical Sciences, Department of Urology, Babol, Iran
| |
Collapse
|
19
|
Wang H, Xu C, Fan X. Effect of marital relationship on women's quality of life: Testing the mediating role of subjective well-being. JOURNAL OF COMMUNITY PSYCHOLOGY 2019; 47:327-337. [PMID: 30295932 DOI: 10.1002/jcop.22123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 06/11/2018] [Accepted: 08/01/2018] [Indexed: 06/08/2023]
Abstract
Because of a large number of Chinese women and the widespread concern about women's living conditions, this study aimed to examine how subjective well-being mediates the association between marital relationship and women's quality of life in Chinese context. The data used in this study were collected by conducting a multi-stage cluster random sampling method of 756 women in Huai'an city of Mainland China. Data included women's basic demographics, women's quality of life and marital quality, and women's subjective well-being. Structural equation modeling was adopted to analyze the data. The results of structural equation modeling analysis suggested a good fit for the sample. Overall findings showed that marital relationship has a significantly direct effect on women's quality of life, and subjective well-being can partially mediate the impact of marital relationship on women's quality of life. The implications on theory and social policy were also discussed.
Collapse
Affiliation(s)
| | - Congde Xu
- Qingdao University of Science and Technology
| | | |
Collapse
|
20
|
Sexty RE, Griesinger G, Kayser J, Lallinger M, Rösner S, Strowitzki T, Toth B, Wischmann T. Psychometric characteristics of the FertiQoL questionnaire in a German sample of infertile individuals and couples. Health Qual Life Outcomes 2018; 16:233. [PMID: 30558633 PMCID: PMC6296013 DOI: 10.1186/s12955-018-1058-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 11/28/2018] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND FertiQoL is a questionnaire internationally developed to measure fertility-specific quality of life. It has been validated with infertile populations in many countries and used in several studies focusing on the psychosocial consequences of infertility in Europe, Asia, and North America. METHODS Over a period of two years, 596 infertile women and men took part in the study conducted at three German fertility clinics. Psychometric properties of FertiQoL were tested by performing confirmatory factor analyses, calculating average variance extracted values, reliability and correlation coefficients. Hierarchical regression analyses were conducted to determine the relations between FertiQoL subscales and both sociodemographic and medical variables. Individual and cross-partner effects were tested for. RESULTS The confirmatory factor analyses conducted on our FertiQoL data supported the original four-factor solution for both women and men but, resulted in some unsatisfactory indices. Family and friends' support items loaded weakly on the Social subscale of FertiQoL (.27 and .34 in women, .32 and .19 in men). The Emotional and Mind/Body subscales revealed a strong intercorrelation (r = .77, p < .001 in women, r = .74, p < .001 in men). Women scored lower than men on the Emotional and Mind/Body subscales only, and they reported better fertility-specific relational QoL. In women, the perceived cause of infertility and already mothering a child related significantly to individual FertiQoL scores, while in men, age, educational level, and the duration of their wish for a child had an impact on the FertiQoL subscales (all p < .05). The men's educational level, the women's educational level, and the subjective perceived medical cause of fertility problems exerted cross-partner effects on QoL (all p < .05). CONCLUSIONS Our study results represent a contribution both to research and clinical practice. The findings suggest the importance of considering the personal experience of infertility in different cultural and gender specific settings and that the strong connections between the emotional, physical, and cognitive aspects of an individual's fertility-specific quality of life should be regarded as a more coherent system. TRIAL REGISTRATION DRKS: DRKS00014707 . Registered 1 May 2018 (retrospectively registered).
Collapse
Affiliation(s)
- R E Sexty
- Institute of Medical Psychology, Centre for Psychosocial Medicine, University Hospital, Bergheimer Strasse 20, 69115, Heidelberg, Germany
| | - G Griesinger
- Department of Gynaecological Endocrinology and Reproductive Medicine, University Hospital of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - J Kayser
- Department of Gynaecological Endocrinology and Reproductive Medicine, University Hospital of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - M Lallinger
- Institute of Medical Psychology, Centre for Psychosocial Medicine, University Hospital, Bergheimer Strasse 20, 69115, Heidelberg, Germany
| | - S Rösner
- Department of Gynaecological Endocrinology and Reproductive Medicine, Women's Hospital, University Hospital, Heidelberg, Germany
| | - T Strowitzki
- Department of Gynaecological Endocrinology and Reproductive Medicine, Women's Hospital, University Hospital, Heidelberg, Germany
| | - B Toth
- Department of Gynaecological Endocrinology and Reproductive Medicine, Medical University Innsbruck, Innsbruck, Austria
| | - T Wischmann
- Institute of Medical Psychology, Centre for Psychosocial Medicine, University Hospital, Bergheimer Strasse 20, 69115, Heidelberg, Germany.
| |
Collapse
|
21
|
Sexty RE, Griesinger G, Kayser J, Lallinger M, Rösner S, Strowitzki T, Toth B, Wischmann T. Psychometric characteristics of the FertiQoL questionnaire in a German sample of infertile individuals and couples. Health Qual Life Outcomes 2018. [DOI: 10.1186/s12955-018-1058-9 2018;16:233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023] Open
|
22
|
Kreuzer VK, Kimmel M, Schiffner J, Czeromin U, Tandler-Schneider A, Krüssel JS. Possible Reasons for Discontinuation of Therapy: an Analysis of 571 071 Treatment Cycles From the German IVF Registry. Geburtshilfe Frauenheilkd 2018; 78:984-990. [PMID: 30364331 PMCID: PMC6195432 DOI: 10.1055/a-0715-2654] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 08/23/2018] [Accepted: 08/23/2018] [Indexed: 11/30/2022] Open
Abstract
Introduction
Numerous couples discontinue fertility treatment before achieving the objective, the birth of a child. The aim of this retrospective data analysis is to identify the reasons for early discontinuation of therapy (drop-out).
Materials and Methods
Retrospective data analysis. With the aid of the German IVF Registry (D·I·R
®
), a total of 122 560 “last cycles” in Germany in the period 2012 – 2015 were identified and the courses were analysed.
Results
From the named cohort of “last cycles”, 37.3% of the female patients (45 699) gave birth to a child and ended the therapy. The remaining 76 861 discontinued the treatment before having a child. The fertility treatment was conducted due to a purely male indication in 46.27% of cases and in 17.96% the cause lay exclusively with the woman. 4.53% of the drop-outs suffered a miscarriage in the last cycle. 73.56% of the drop-out patients ended the therapy after the lack of a positive pregnancy test. After the third therapy cycle, 67% of the couples ended their treatment.
Conclusion
The results make it possible to provide couples with individual counselling. They offer an option for preparing for the emotional and physical hurdles.
Collapse
Affiliation(s)
- Vera K Kreuzer
- Universitätsklinikum Düsseldorf, Klinik für Frauenheilkunde und Geburtshilfe, UniKiD - Universitäres Interdisziplinäres Kinderwunschzentrum Düsseldorf, Düsseldorf, Germany
| | - Markus Kimmel
- Deutsches IVF-Register e. V. (D·I·R)®, Geschäftsstelle und Datenkoordination, Düsseldorf, Germany
| | | | - Ute Czeromin
- Deutsches IVF-Register e. V. (D·I·R)®, Düsseldorf, Germany.,Kinderwunschpraxis Gelsenkirchen, Gelsenkirchen, Germany
| | - Andreas Tandler-Schneider
- Deutsches IVF-Register e. V. (D·I·R)®, Mitglied des Vorstands, Düsseldorf, Germany.,Fertility Center Berlin, Berlin, Germany
| | - Jan-Steffen Krüssel
- Universitätsklinikum Düsseldorf, Klinik für Frauenheilkunde und Geburtshilfe, UniKiD - Universitäres Interdisziplinäres Kinderwunschzentrum Düsseldorf, Düsseldorf, Germany.,Deutsches IVF-Register e. V. (D·I·R)®, Mitglied des Vorstands, Düsseldorf, Germany
| |
Collapse
|
23
|
Madero S, Gameiro S, García D, Cirera D, Vassena R, Rodríguez A. Quality of life, anxiety and depression of German, Italian and French couples undergoing cross-border oocyte donation in Spain. Hum Reprod 2018; 32:1862-1870. [PMID: 28854722 DOI: 10.1093/humrep/dex247] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 06/30/2017] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION What is the quality of life (QoL) and mental health of infertile heterosexual couples from different nations (Italy, Germany and France) undergoing cross-border oocyte donation (OD) in Spain? SUMMARY ANSWER Women have lower QoL and more anxiety than their male partners; overall French couples have lower QoL than their Italian and German counterparts. WHAT IS KNOWN ALREADY In Europe, thousands of couples move across national borders annually to seek ARTs, primarily OD, driven mainly by legal restrictions in their countries of origin. Most research shows that infertility and ARTs affect patients' mental health and QoL. The decision to undergo reproductive care abroad might add further emotional and practical complexity. Reliable information on how this experience affects the mental health and QoL of cross-border reproductive care (CBRC) patients is lacking. Moreover, most research has focused on women, and further research on male partners and intercultural differences is needed. STUDY DESIGN, SIZE, DURATION Cross-sectional study including 548 heterosexual individuals (347 women, 201 men) from Italy, Germany and France seeking IVF with donated oocytes in Barcelona, Spain between March and November 2013. PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 432 couples were invited to participate and handed a questionnaire set. Questionnaires were answered separately and anonymously by each member of the couple on the day of embryo transfer. The questionnaire set included the Fertility Quality of Life (FertiQoL) instrument, the generic Hospital Anxiety and Depression Scale (HADS) instrument and three close-ended questions assessing perceived usefulness, desire, and use of psychological support. The overall response rate was 63.4%. MAIN RESULTS AND THE ROLE OF CHANCE Men reported significantly higher scores than women in the emotional (+13.74; P < 0.001), mind-body (+13.39; P < 0.001) and social (+4.11; P < 0.01) FertiQoL domains, at multilevel analysis controlled for confounder factors. Intercultural differences in QoL of couples were seen. French individuals had significantly lower emotional (-6.44; P < 0.01), mind-body (-7.41; P < 0.001) and relational scores (-6.41; P < 0.001) compared to Italians. Germans showed higher social scores (+6.41; P < 0.001) but lower relational scores (-8.94; P < 0.002) than Italians. Men reported significantly lower anxiety scores for the HADS than their partners (-1.38; P < 0.001), and German couples reported lower anxiety (-1.70; P = 0.003) and depression than their Italian counterparts (-1.56; P < 0.001). French patients were more likely to have required support by a mental health professional due to fertility problems in the past (+0.19; P < 0.001). LIMITATIONS, REASONS FOR CAUTION The scope of this study is limited to heterosexual couples undergoing cross-border OD. Caution on the interpretation of the results in men is advised, mainly because only three men for every five women completed the questionnaire. WIDER IMPLICATIONS OF THE FINDINGS These findings call for further work to identify the true nature of the differences in QoL and mental health observed. STUDY FUNDING/COMPETING INTEREST(S) None.
Collapse
Affiliation(s)
- S Madero
- Clínica EUGIN, Travessera de les Corts 322, Barcelona 08029, Spain
| | - S Gameiro
- Cardiff Fertility Studies Research Group, School of Psychology, Cardiff University, Park Place Cardiff, CF10 3AT, UK
| | - D García
- Fundació Privada EUGIN, Travessera de les Corts 318, Barcelona 08029, Spain
| | - D Cirera
- Clínica EUGIN, Travessera de les Corts 322, Barcelona 08029, Spain
| | - R Vassena
- Clínica EUGIN, Travessera de les Corts 322, Barcelona 08029, Spain
| | - A Rodríguez
- Clínica EUGIN, Travessera de les Corts 322, Barcelona 08029, Spain
| |
Collapse
|
24
|
Maroufizadeh S, Hosseini M, Rahimi Foroushani A, Omani-Samani R, Amini P. The effect of depression on quality of life in infertile couples: an actor-partner interdependence model approach. Health Qual Life Outcomes 2018; 16:73. [PMID: 29690877 PMCID: PMC5937824 DOI: 10.1186/s12955-018-0904-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Accepted: 04/17/2018] [Indexed: 11/30/2022] Open
Abstract
Background Infertility can cause psychological distress and has a negative impact on quality of life (QoL). There have been no studies investigating the effect of depression on QoL in infertile couples at the dyadic level. This study aimed to investigate the effects of actors’ and partners’ depression on QoL in male-female dyads experiencing infertility using an innovative dyadic analysis approach, the Actor–Partner Interdependence Model (APIM). Methods We conducted this cross-sectional study on 180 infertile couples in Tehran, Iran, during August-September 2017. Quality of life and depression were assessed using Fertility Quality of Life and Patient Health Questionnaire-9, respectively. Dyadic data were analyzed by the APIM approach. In this method, actor effect is the impact of a person’s depression on his/her own QoL. Partner effect is the impact of a person’s depression on his/her partner’s QoL. Results Results from APIM revealed that both males and females’ depression exuded an actor effect on their own QoL (β = − 0.589, p < 0.001; β = − 0.588, p < 0.001, respectively). Furthermore, males’ depression exuded a significant partner effect on their wives’ QoL (β = − 0.128, p = 0.030). Although the partner effect of females’ depression on males’ QoL was not statistically significant (β = − 0.108, P = 0.070), males whose wives had higher depression were more to indicate their own QoL was poorer. Based on equality constraint test, both actor and partner effects of depression on QoL were similar between males and females. Conclusions The findings suggest that QoL in infertile patients was influenced by not only their own depression but also their spouses’ depression; therefore, interventions to improve QoL should include both males and females.
Collapse
Affiliation(s)
- Saman Maroufizadeh
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Hosseini
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Abbas Rahimi Foroushani
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Omani-Samani
- Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Payam Amini
- Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| |
Collapse
|
25
|
Role of Withania somnifera (Ashwagandha) in the management of male infertility. Reprod Biomed Online 2018; 36:311-326. [DOI: 10.1016/j.rbmo.2017.11.007] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 11/21/2017] [Accepted: 11/22/2017] [Indexed: 11/17/2022]
|
26
|
Casu G, Ulivi G, Zaia V, Fernandes Martins MDC, Parente Barbosa C, Gremigni P. Spirituality, infertility-related stress, and quality of life in Brazilian infertile couples: Analysis using the actor-partner interdependence mediation model. Res Nurs Health 2018; 41:156-165. [PMID: 29399819 DOI: 10.1002/nur.21860] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 12/22/2017] [Indexed: 12/28/2022]
Abstract
Infertility has a stressful impact on both partners, with adverse effects on the quality of life of infertile couples. Spirituality is a meaning-based strategy that can protect couples against infertility's negative impact on quality of life, but analysis of this mediator relationship in infertile couples has not been reported. We adopted a dyadic approach and used the actor-partner interdependence mediation model to examine whether and how women's and men's spirituality was associated with their own and their partners' infertility-related stress and quality of life. In 2014, 152 infertile couples starting their first fertility treatment at a private clinic in Brazil were recruited and completed self-reports of spirituality, infertility-related stress, and quality of life. Results indicated that women's and men's level of spirituality was positively associated with their own quality of life directly and indirectly, by reducing their own infertility-related stress. Their spirituality was associated with an increase in their partners' quality of life only indirectly, by reducing their partners' infertility-related stress. Findings highlight the importance of assessing and promoting spirituality as a coping resource that infertile women and men might use to deal with the stress of infertility and reduce its adverse effects on quality of life.
Collapse
Affiliation(s)
- Giulia Casu
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Giulia Ulivi
- School of Medical and Health Sciences, Methodist University of São Paulo, São Bernardo do Campo, Brazil
| | - Victor Zaia
- School of Medical and Health Sciences, Methodist University of São Paulo, São Bernardo do Campo, Brazil.,Institute Ideia Fértil of Reproductive Health, Santo André, Brazil.,Faculdade de Medicina do ABC, Santo André, Brazil
| | | | - Caio Parente Barbosa
- Institute Ideia Fértil of Reproductive Health, Santo André, Brazil.,Faculdade de Medicina do ABC, Santo André, Brazil
| | - Paola Gremigni
- Department of Psychology, University of Bologna, Bologna, Italy
| |
Collapse
|
27
|
Namavar Jahromi B, Mansouri M, Forouhari S, Poordast T, Salehi A. Quality of Life and Its Influencing Factors of Couples Referred to An Infertility Center in Shiraz, Iran. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2017; 11:293-297. [PMID: 29043705 PMCID: PMC5641461 DOI: 10.22074/ijfs.2018.5123] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 04/29/2017] [Indexed: 11/11/2022]
Abstract
Background Infertility adversely affects quality of life (QoL). The present study aims to evaluate QoL and its associated factors among infertile couples. Materials and Methods In this cross-sectional study, the Fertility QoL (FertiQoL) instrument was used to measure
QoL among 501 volunteer couples who attended the Infertility Clinic at the Mother and Child Hospital, Shiraz, Iran.
We used an additional questionnaire to assess participants’ demographic and clinical characteristics. The relationship
between the scores of QoL to the sociodemographic and treatment data was analysed. Results The subjects with lower income levels had lower relational, mind/body, emotional, and total core scores. Female participants without academic education had lower scores in the emotional subscale, while the male participants
showed lower scores in emotional, mind/body, relational, social, and total QoL domains. Subjects who had undergone
any type of treatment, including pharmacological treatment, intrauterine insemination (IUI), intra-cytoplasmic sperm
injection (ICSI), and in vitro fertilization (IVF) showed significantly lower scores in the environmental domain. Participants with lower infertility duration obtained significantly greater QoL scores. Finally, tolerability, emotional, and
environmental domains were significantly more desirable when the infertility problem was related to a male factor. Conclusion Infertile couples with shorter duration of infertility and male etiology have higher QoL. Lower academic
education, lower income levels, or prior unsuccessful treatments are associated with lower QoL.
Collapse
Affiliation(s)
- Bahia Namavar Jahromi
- Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Obstetrics and Gynecology, Shiraz School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahsa Mansouri
- Student Research Center, Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sedighe Forouhari
- Shahid Sadoughi University of Medical Sciences, Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Tahere Poordast
- Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Obstetrics and Gynecology, Shiraz School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Salehi
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
| |
Collapse
|
28
|
Masoumi SZ, Khani S, Kazemi F, Kalhori F, Ebrahimi R, Roshanaei G. Effect of Marital Relationship Enrichment Program on Marital Satisfaction, Marital Intimacy, and Sexual Satisfaction of Infertile Couples. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2017; 11:197-204. [PMID: 28868842 PMCID: PMC5582148 DOI: 10.22074/ijfs.2017.4885] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 10/14/2016] [Indexed: 11/25/2022]
Abstract
Background Infertile couples only think of having children during their sexual intercourse,
and their constant concern about this issue increases their stress level. Psychosocial
and social stress leads to decreased life satisfaction, increased marital problems,
and reduced sexual confidence. This study aims to determine the effect of enrichment
program on marital and sexual satisfaction as well as marital intimacy among infertile
couples. Materials and Methods This randomized controlled clinical trial was conducted on
50 infertile couples in 2013 in Hamedan. The marital relationship enrichment program was taught to the experimental group during seven 90 minutes sessions. Enrich
marital satisfaction, Linda Berg sexual satisfaction, and marital intimacy questionnaires were completed by both groups in 3 pretest steps immediately after the end of
training sessions, and 8 weeks later. The results were analyzed in STATA11 software
using t test, Chi-square, ANCOVA, RM-ANOVA, and Bonferroni post-hoc test. To
check the data normality, Kolmogorov-Smirnov test was used. P<0.05 was considered significant. Results Comparison of mean scores related to pretest on the one hand and immediately after the test in 8 week later on the other hand showed marital relationship
enrichment program significantly increased marital and sexual satisfaction (P<0.001).
Also, mean score of marital intimacy immediately after the test (P=0.04) and 8 weeks
after the test (P<0.001) significantly increased in comparison with the pretest under the
influence of the program. Conclusion Enrichment training can increase marital intimacy and also
marital and sexual satisfaction in infertile couples (Registration Number:
IRCT201604299014N97).
Collapse
Affiliation(s)
- Seyedeh Zahra Masoumi
- Department of Midwifery, Mother and Child Care Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Somayeh Khani
- Department of Midwifery, Student Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Farideh Kazemi
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Fatemeh Kalhori
- Department of Midwifery, Student Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Reyhaneh Ebrahimi
- Department of Midwifery, Student Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ghodratollah Roshanaei
- Department of Biostatistics and Epidemiology, Modeling of Noncommunicable Diseases Research Center, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| |
Collapse
|
29
|
Namdar A, Naghizadeh MM, Zamani M, Yaghmaei F, Sameni MH. Quality of life and general health of infertile women. Health Qual Life Outcomes 2017; 15:139. [PMID: 28701163 PMCID: PMC5508693 DOI: 10.1186/s12955-017-0712-y] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Accepted: 06/27/2017] [Indexed: 11/28/2022] Open
Abstract
Background Measuring the quality of life (QOL) is a benchmark in today’s world of medicine. The aim of the present study was to determine the general health and QOL of infertile women and certain affecting conditions. Methods In a cross-sectional study, 161 infertile women referring to Dr. Rostami’s Infertility Center of Shiraz, Southern Iran, in 2013 were enrolled by the convenience sampling method. Data were collected via a socio-demographic, general health (GHQ28), and the QOL Questionnaire of Infertile Couples and analyzed using descriptive and analytical statistics. Results According to 146 completely filled-out questionnaires, the mean age of the participants and their spouses were 29.4 ± 5.4 and 33.8 ± 5.8 years, respectively. Moreover, the general health of 57 (39%) patients was normal and that of 89 (61%) patients showed a degree of impairment. The scores for depression and physical symptoms were the highest and lowest, respectively. In addition, quite positive, positive, neutral, and negative specific QOL of infertile women were detected in 4 (2.8%), 72 (49.3%), 70 (47.9%), and 0 (0%) individuals, respectively. The total QOL scores had maximum correlation with GHQ anxiety (r = −0.596, P < 0.001) and general health scores had the highest correlation with physical QOL (r = −0.637, P < 0.001). The QOL was economically (P = 0.027), emotionally (P = 0.004), sexually (P = 0.017), physically (P = 0.037), and psychologically (P = 0.001) less for the women living in rural areas than other infertile women. However, university education (P = 0.015) and higher income per month (P = 0.008) had positive associations with QOL. Conclusion General health of more than half of the infertile women indicated a degree of disorder. These women face the risk of anxiety, social dysfunction, and depression. Educational status, monthly income, and rural/urban residency are the major factors influencing the QOL.
Collapse
Affiliation(s)
- Azam Namdar
- Department of Health, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
| | | | - Marziyeh Zamani
- Department of Nutrition, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.
| | - Farideh Yaghmaei
- Department of Nursing, School of Nursing and Midwifery, Zanjan Branch, Islamic Azad University, Zanjan, Iran
| | - Mohammad Hadi Sameni
- Department of English, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
| |
Collapse
|
30
|
Pedro J, Frederiksen Y, Schmidt L, Ingerslev HJ, Zachariae R, Martins MV. Comparison of three infertility-specific measures in men and women going through assisted reproductive technology treatment. J Health Psychol 2016; 24:738-749. [PMID: 27881623 DOI: 10.1177/1359105316678669] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
We compared the psychometric properties of COMPI Fertility Problem Stress Scales, Fertility Problem Inventory, and Fertility Quality of Life Tool in 293 patients enrolled for assisted reproductive technology. COMPI Fertility Problem Stress Scales and Fertility Problem Inventory subscales presented higher internal consistency. COMPI Fertility Problem Stress Scales differentiated best between its domains. Fertility Problem Inventory revealed better concurrent validity. Fertility Quality of Life Tool presented better fit. While discrimination for depression was similar between measures, Fertility Quality of Life Tool was better at discriminating anxiety. Results suggest that while all compared measures are reliable and valid in assessing the psychosocial adjustment to infertility, the choice of measure should be based according to the assessment goals.
Collapse
|
31
|
Kim JH, Shin HS, Yun EK. A Dyadic Approach to Infertility Stress, Marital Adjustment, and Depression on Quality of Life in Infertile Couples. J Holist Nurs 2016; 36:6-14. [DOI: 10.1177/0898010116675987] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose: This study was conducted to examine the level of infertility stress, marital adjustment, depression, and quality of life in infertile couples and assess the actor and partner effects in these areas using the actor–partner interdependence model. Design: Cross-sectional study. Method: Participants were 121 infertile couples. After pilot study, data were collected from November 2012 to March 2013 using the following questionnaires: the Fertility Quality of Life, Fertility Problem Inventory, Revised Dyadic Adjustment Scale, and Beck Depression Inventory. Findings: There was a gender difference in infertility stress, depression, and quality of life. Infertility stress had actor and partner effects on the quality of life. Marital adjustment had an actor effect on the quality of life for the wives. Depression had actor and partner effects on quality of life for the wives, but only an actor effect for the husbands. Conclusion: This study found that there were actor and partner effects of infertility stress, marital adjustment, and depression on the quality of life in infertile couples. These findings may help nurses be aware of such effects and can be used as a baseline data in the development of nursing interventions for infertile couples.
Collapse
|
32
|
Psychological Adjustment of Infertile Men Undergoing Fertility Treatments: An Association With Sperm Parameters. Arch Psychiatr Nurs 2016; 30:521-6. [PMID: 27654231 DOI: 10.1016/j.apnu.2016.04.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Revised: 04/24/2016] [Accepted: 04/27/2016] [Indexed: 01/28/2023]
Abstract
BACKGROUND The difficulties in the psychological adaptation to the infertility diagnosis and assisted reproductive technology (ART) treatments have shown influence on the sperm quality. The biological and psychological aspects of infertility seem not to be independent. OBJECTIVE To analyze the impact of depressive symptoms, anxiety, dyadic adjustment and infertility stress on the sperm quality of the men proposed to ART first or repeated experience. MATERIALS AND METHODS This transversal study was conducted in the Medically Assisted Reproduction Unit of Centro Hospitalar de São João, in Porto, Portugal. 112 men with infertility diagnosis were included to initiate an ART cycle. Participants completed the Inventory State-Trait Anxiety-Form Y (STAI-Y), the Beck Depression Inventory-II (BDI-II), the Dyadic Adjustment Scale (DAS) and the Inventory of Fertility Problems (IFP) before the beginning of the treatment. RESULTS The state-anxiety had a negative linear impact on the slow progressive motility (p<0.05). However, depressive symptoms assumed a suppressor effect on this variable, enhancing its importance as a predictor. CONCLUSION Results show that psychopathological symptoms before an ART cycle can influence the sperm motility. However, this association seems to only be present in men undergoing first experience ART treatments. Thus, this research shows the need for mental health professionals to respond to emotional difficulties of the male gender, through the development of psychological interventions adjusted, so as to minimize the impact of exposure to ART treatments.
Collapse
|
33
|
Karaca N, Karabulut A, Ozkan S, Aktun H, Orengul F, Yilmaz R, Ates S, Batmaz G. Effect of IVF failure on quality of life and emotional status in infertile couples. Eur J Obstet Gynecol Reprod Biol 2016; 206:158-163. [PMID: 27693938 DOI: 10.1016/j.ejogrb.2016.09.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 09/09/2016] [Accepted: 09/13/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To investigate the effect of a previous IVF failure on the quality of life and emotional distress, in couples undergoing IVF treatment. Experiencing IVF failure might cause differences on the anxiety-depression and quality of life scores of the couples, compared to the ones who were undergoing IVF treatment for the first time. STUDY DESIGN This study included 64 couples who had previously experienced at least one IVF failure (Group 1) and 56 couples without history of IVF failure (Group 2) in a private Assisted Reproductive Center, Istanbul, Turkey. A sociodemographic data form, the FertiQoL International and Hospital Anxiety (HAD-A) and Depression scale (HAD-D) for evaluating the status of distress, were administered for the study. RESULT(S) FertiQoL scores were compared between the groups, the environment scale of the quality of life in treatment section was found to be significantly higher in Group 1 compared with Group 2 (p=0.009). The HAD-A and HAD-D scores did not differ significantly between the groups. Group-variables were investigated using multilevel analysis, the infertility duration and income level were found to have an effect on the subscales of quality of life (p=0.009 and p=0.001 respectively) in Group 2. Depression scores were higher in couples with infertility duration of below five years in Group 1 and Group 2 compared to couples with infertility duration of five years or above (MANOVA analysis). The level of education was found to affect the scores of HAD-D in Group 2, but not in Group 1 (p=0.011). The score of HAD-D was significantly affected by the family type only in Group 2 (p=0.009); the depression score of the couples living with a nuclear family was found to be higher compared with the couples living in a traditional family (p=0.021). CONCLUSION(S) Fertility-specific quality of life scores reveals better results regarding the orientation to the treatment environment in the couples with a previous IVF failure, compared to first IVF cycle couples. Treatment failure does not elevate the level of anxiety, while the effect on depression scores changes according to duration of infertility.
Collapse
Affiliation(s)
- Nilay Karaca
- Bezmialem Vakif University, School of Medicine, Department of Obstetric and Gynecology, Istanbul, Turkey.
| | - Aysun Karabulut
- Pamukkale University, School of Medicine, Department of Obstetric and Gynecology, Denizli, Turkey
| | - Sevgi Ozkan
- Pamukkale University, Denizli Health Services Vocational College, Denizli, Turkey
| | - Hale Aktun
- Medipol University, School of Medicine, Department of Obstetric and Gynecology, Istanbul, Turkey
| | | | - Rabiye Yilmaz
- Bezmialem Vakif University, School of Medicine, Department of Obstetric and Gynecology, Istanbul, Turkey
| | - Seda Ates
- Bezmialem Vakif University, School of Medicine, Department of Obstetric and Gynecology, Istanbul, Turkey
| | - Gonca Batmaz
- Bezmialem Vakif University, School of Medicine, Department of Obstetric and Gynecology, Istanbul, Turkey
| |
Collapse
|
34
|
Masoumi SZ, Garousian M, Khani S, Oliaei SR, Shayan A. Comparison of Quality of Life, Sexual Satisfaction and Marital Satisfaction between Fertile and Infertile Couples. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2016; 10:290-296. [PMID: 27695611 PMCID: PMC5023039 DOI: 10.22074/ijfs.2016.5045] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Accepted: 08/03/2015] [Indexed: 11/22/2022]
Abstract
Background: Fertility plays an important role in sexual and psychological function in
families. Infertility can result in major emotional, social, and mental disorders, including
a reduction in satisfaction with marital life and quality of life. The present study aimed to
compare the quality of life and marital satisfaction and sexual satisfaction between fertile
and infertile couples. Materials and Methods: This analytical cross-sectional study was conducted on 250
couples at the Fatemiyeh Educational Research Center affiliated to Hamadan University of Medical Sciences, Hamadan, Iran, from May to August in 2014. The subjects
were randomly selected from the patients referred to this center using a table of random
numbers. They were then allocated into two groups of infertile group (n=125) and fertile
group (n=125). The study participants completed World Health Organization Quality of
Life-BREF (WHOQOL-BREF) questionnaire, Linda Berg’s Sexual Satisfaction Scale,
and Enrich Marital Satisfaction Scale. Then, the data were entered into the SPSS version16 for statistical analysis. The Chi-square and Mann-Whitney tests were also applied
to compare the data between the groups. Results: The results revealed no significant difference between the two groups regarding
demographic and general health variables. The mean scores of sexual satisfaction were
63.67 ± 13.13 and 46.37 ± 7.72 in the fertile and infertile couples, respectively. Furthermore, the mean scores of marital satisfaction were also 44.03 ± 9.36 and 36.20 ± 4.03
in the fertile and infertile groups, respectively. Our finding demonstrated that the fertile
couples obtained significantly higher mean scores of quality of life as well as lower mean
scores of sexual satisfaction and marital satisfaction as compared to the infertile ones
(P<0.001). Conclusion: According to the results, the fertile couples obtained significantly higher
quality of life and lower sexual satisfaction and marital satisfaction as compared to the
infertile ones. Therefore, holding consultation programs and conducting more studies are
necessary for improving the quality of life and promoting sexual and marital satisfaction
in infertile couples.
Collapse
Affiliation(s)
- Seyedeh Zahra Masoumi
- Students Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Maryam Garousian
- Fatemieh Hospital, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Somayeh Khani
- Students Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | | | - Arezoo Shayan
- Department of Midwifery, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| |
Collapse
|
35
|
김미옥, 남현아, 박정숙. Factors Associated with Marital Satisfaction of Women Under Infertility Treatments. ACTA ACUST UNITED AC 2016. [DOI: 10.21896/jksmch.2016.20.3.228] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
36
|
Santoro N, Eisenberg E, Trussell JC, Craig LB, Gracia C, Huang H, Alvero R, Casson P, Christman G, Coutifaris C, Diamond M, Jin S, Legro RS, Robinson RD, Schlaff WD, Zhang H. Fertility-related quality of life from two RCT cohorts with infertility: unexplained infertility and polycystic ovary syndrome. Hum Reprod 2016; 31:2268-79. [PMID: 27402910 PMCID: PMC5027926 DOI: 10.1093/humrep/dew175] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Accepted: 06/16/2016] [Indexed: 01/05/2023] Open
Abstract
STUDY QUESTION Does fertility-related quality of life (FertiQOL) differ by infertility diagnosis between women with polycystic ovary syndrome (PCOS) and their partners, compared with couples with unexplained infertility (UI)? SUMMARY ANSWER Women with PCOS report lower QOL than those with UI, whereas males with UI report lower QOL than males with PCOS partners. WHAT IS KNOWN ALREADY The fertility-specific QOL survey, FertiQOL, has been used to examine fertility-related QOL in a number of worldwide cohorts. Few data have addressed fertility-related QOL as a function of infertility diagnosis. Overall, men report better QOL than women with infertility, and there is variation in FertiQOL scores across different samples from different countries. STUDY DESIGN, SIZE, DURATION This was a prospective, cohort study derived from two concurrent, randomized clinical trials, and designed to examine QOL in infertile females with PCOS and UI at the time of enrollment compared with each other and their male partners; to compare concordance FertiQOL scores in this study across other worldwide cohorts; and to determine if baseline FertiQOL was associated with pregnancy outcome. PARTICIPANTS/MATERIALS, SETTING, METHODS Women with PCOS and their partners (n = 733 and n = 641, respectively), and couples with UI (n = 865 women and 849 men) completed a validated fertility-specific QOL survey (FertiQOL) at the time of the study screening visit. PCOS women were randomized to either clomiphene citrate or letrozole treatment; couples with UI were randomized to clomiphene citrate, letrozole or gonadotrophin plus IUI. FertiQOL results were compiled by diagnosis (PCOS or UI) and compared by diagnosis and sex using Wilcoxon Rank-Sum testing. Relationships between baseline FertiQOL and pregnancy outcomes were examined using logistic regression. Multivariable models were performed to assess the association between FertiQOL scores and key participant characteristics. MAIN RESULTS AND THE ROLE OF CHANCE Women with PCOS had lower total FertiQOL scores (72.3 ± 14.8) than those with UI (77.1 ± 12.8; P < 0.001); this was true for each domain (except Relational). These differences were largely explained by variation in BMI, hirsutism, household income and age. Women had lower overall FertiQOL scores than their male partners. Males with PCOS partners had higher scores than males with UI (84.9 ± 10.2 versus 83.3 ± 10.8; P = 0.003). Scores were not consistently associated with conception or pregnancy outcome. LIMITATIONS, REASONS FOR CAUTION The use of multiple tests of association may have resulted in spurious statistically significant findings. Inherent sociodemographic differences between women with PCOS and those with UI largely account for the lower QOL in women with PCOS. Our study was unable to assess if changes in QOL affected pregnancy outcome as FertiQOL data were collected prior to treatment. Finally, the participants for both studies represent their local communities, but are not a population-based sample and thus firm conclusions about how representative these couples are to the general population must be made with caution. WIDER IMPLICATIONS OF THE FINDINGS Women with PCOS with elevated BMI and hirsutism scores and with lower socioeconomic status may require more, targeted psychosocial support than those with other diagnoses. Possible attribution of infertility to the male partner appears to result in a lower QOL. There appears to be substantial national variation in FertiQOL scores, with US-based cohorts reporting overall higher QOL. STUDY FUNDING/COMPETING INTERESTS This work was supported by National Institutes of Health (NIH)/Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Grants U10 HD39005 (to M.D.), U10 HD38992 (to R.S.L.), (to C.C.), U10 HD38998 (to R.A.), U10 HD055942 (to R.D.R.), HD055944 (to P.C.), U10 HD055936 (to G.C.), U10HD055925 (to H.Z.); and U10 U54-HD29834 (to the University of Virginia Center for Research in Reproduction Ligand Assay and Analysis Core of the Specialized Cooperative Centers Program in Reproduction and Infertility Research). Most importantly, this research was made possible by the funding by American Recovery and Reinvestment Act. N.S., E.E., J.C.T., C.G., H.H., R.A., P.C., G.C., C.C., M.D., S.J., W.D.S. and H.Z. report no conflicts of interests/disclosures. L.B.C. reports research support from Ferring Pharmaceuticals and Roche Diagnostics; R.S.L. reports receipt of consulting fees from AstraZeneca, Euroscreen, Sprout Pharmaceuticals, Taken, Kindex, Clarus and Bayer, Inc., and research support from AstraZeneca and Ferring Pharmaceuticals. R.D.R. reports research support from AbbVie. TRIAL REGISTRATION NUMBER Pregnancy in Polycystic Ovary Syndrome II (PPCOS II), NCT00719186; Assessment of Multiple Intrauterine Gestations in Ovulation Stimulation (AMIGOS) NCT01044862, clinicaltrials.gov. TRIAL REGISTRATION DATE PPCOS II 17 July 2008; AMIGOS 7 January 2010. DATE OF FIRST PATIENT'S ENROLMENT PPCOS II 19 February 2009; AMIGOS 2 August 2010.
Collapse
Affiliation(s)
- Nanette Santoro
- Department of Obstetrics and Gynecology, University of Colorado School of Medicine, 12631 E 17th Avenue AO1 Room 4010, Aurora, CO 80045, USA
| | - Esther Eisenberg
- Fertility & Infertility Branch, NICHD, NIH, Bethesda, MD 20892, USA
| | - J C Trussell
- Department of Urology, State University of New York Upstate Medical University, 750 E Adams St, Syracuse, NY 13210, USA
| | - LaTasha B Craig
- Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, PO Box 26901, WP 2410 Oklahoma City, OK 73126, USA
| | - Clarisa Gracia
- Department of Obstetrics and Gynecology, University of Pennsylvania Penn Fertility Center, 3701 Market Street, Philadelphia, PA 19104, USA
| | - Hao Huang
- Collaborative Center for Statistics in Science, Yale School of Public Health, 60 College Street, New Haven, CT 06520-8034, USA
| | - Ruben Alvero
- Department of Obstetrics and Gynecology, University of Colorado School of Medicine, 12631 E 17th Avenue AO1 Room 4010, Aurora, CO 80045, USA Present address: Department of Obstetrics and Gynecology, Warren Alpert Medical School, Brown University, Providence, RI 02903, USA
| | - Peter Casson
- Present address: Northeastern Reproductive Medicine, 105 West View Rd. Suite 305, Colchester, VT 05446, USA
| | - Gregory Christman
- Present address: Department of Obstetrics and Gynecology, University of Florida College of Medicine, 1600 SW Archer Road, Gainesville, FL 32611-0294, USA
| | - Christos Coutifaris
- Department of Obstetrics and Gynecology, University of Pennsylvania Penn Fertility Center, 3701 Market Street, Philadelphia, PA 19104, USA
| | - Michael Diamond
- Present address: Georgia Regents University/Medical College of Georgia, 1120 15th Street, BA-7300, Augusta, GA 30912-3300, USA
| | - Susan Jin
- Collaborative Center for Statistics in Science, Yale School of Public Health, 60 College Street, New Haven, CT 06520-8034, USA
| | - Richard S Legro
- Penn State College of Medicine, 500 University Drive, Hersey, PA 17033, USA
| | - Randal D Robinson
- University of Texas at San Antonio Health Sciences Center, 8300 Floyd Curl Drive, San Antonio, TX 78229, USA
| | - William D Schlaff
- Present address: Department of Obstetrics and Gynecology, Thomas Jefferson University, 834 Chestnut Street, Suite 400, Philadelphia, PA 19107, USA
| | - Heping Zhang
- Collaborative Center for Statistics in Science, Yale School of Public Health, 60 College Street, New Haven, CT 06520-8034, USA
| | | |
Collapse
|
37
|
Donarelli Z, Lo Coco G, Gullo S, Salerno L, Marino A, Sammartano F, Allegra A. The Fertility Quality of Life Questionnaire (FertiQoL) Relational subscale: psychometric properties and discriminant validity across gender. Hum Reprod 2016; 31:2061-71. [PMID: 27343271 DOI: 10.1093/humrep/dew168] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 06/06/2016] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION Is the Fertility Quality of Life Questionnaire (FertiQoL)-Relational Scale a valid measure to assess the relational domain regarding quality of life in women and men undergoing infertility treatment? SUMMARY ANSWER The FertiQoL-Relational scale (FertiQoL-REL) showed good psychometric properties and captured core aspects of couple relationships. WHAT IS KNOWN ALREADY FertiQoL has become a gold standard for the assessment of infertility-related quality of life in patients undergoing assisted reproduction treatment (ART). Despite its growing importance, no previous studies have examined the convergent validity of the FertiQoL-REL and its discriminant validity across gender. STUDY DESIGN, SIZE, DURATION Baseline cross-sectional data as part of a longitudinal study of infertile couples undergoing an ART between February 2013 and January 2015. PARTICIPANTS/MATERIALS, SETTING, METHODS Five hundred and eighty-nine patients (301 females and 288 males), prior to starting an ART in a private clinic, filled in the Fertility Quality of Life Questionnaire (FertiQoL) and several measures of the marital relationship (Dyadic Adjustment Scale, Marital Commitment Inventory and ENRICH Marital Satisfaction Scale) and infertility-related distress (Fertility Problem Inventory). MAIN RESULTS AND THE ROLE OF CHANCE Confirmatory factor analysis showed that the FertiQoL four-factor solution provided a good fit for the observed data. Reliability of the FertiQoL-REL was higher for women than men. Significant correlations between the FertiQoL-REL scores and all the other measures of marital relationship were found for both women and men. FertiQoL-REL scores did not differ significantly in women and men. The FertiQoL-REL was able to differentiate subjects as regards the Dyadic Adjustment Scale and ENRICH Marital Satisfaction Scale threshold. LIMITATIONS, REASONS FOR CAUTION Findings are limited because the data were obtained from only one Italian private clinic. WIDER IMPLICATIONS OF THE FINDINGS FertiQoL-REL threshold scores are useful for identifying those patients undergoing ART who are more likely to report poor or good relationship quality. Clinicians should tailor their counselling strategies to the positive qualities in a couple's relationship, so as to reinforce the overall quality of life, especially among women, and to support patients in tackling the psychological burden, so that they can either continue treatment or choose discontinuation. STUDY FUNDING/COMPETING INTERESTS This research was supported by funds provided by Centro Andros S.r.l., Palermo, Italy. The authors declare no financial or commercial conflicts of interest in this study. TRIAL REGISTRATION NUMBER Not necessary.
Collapse
Affiliation(s)
- Z Donarelli
- ANDROS Day Surgery Clinic, Psychology Unit, Palermo, Italy
| | - G Lo Coco
- Department of Psychology and Educational Sciences, University of Palermo, Palermo, Italy
| | - S Gullo
- ANDROS Day Surgery Clinic, Medical Statistics Unit, Palermo, Italy
| | - L Salerno
- ANDROS Day Surgery Clinic, Psychology Unit, Palermo, Italy
| | - A Marino
- ANDROS Day Surgery Clinic, Reproductive Medicine Unit, Palermo, Italy
| | - F Sammartano
- ANDROS Day Surgery Clinic, Reproductive Medicine Unit, Palermo, Italy
| | - A Allegra
- ANDROS Day Surgery Clinic, Reproductive Medicine Unit, Palermo, Italy
| |
Collapse
|
38
|
Kearney AL, White KM. Examining the psychosocial determinants of women's decisions to delay childbearing. Hum Reprod 2016; 31:1776-87. [PMID: 27240695 DOI: 10.1093/humrep/dew124] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 05/10/2016] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION What are the psychosocial determinants of women's intentions to delay childbearing until after 35 years? SUMMARY ANSWER Attitudes, pressure from important others, perceived self-confidence and anticipated regret all influence the decision-making process of women aged 18-30 years to defer their attempts to conceive their first child until 35+ years. WHAT IS KNOWN ALREADY Research has consistently demonstrated that, for many women, the decision to delay childbearing can lead to 'unintentional childlessness' due to a failure to consider the impact of age-related fertility decline. A large body of literature has also found strong links between age-related involuntary infertility and negative psychological impacts, including an increased prevalence of anxiety, depression, guilt, stigma and poor mental health. STUDY DESIGN, SIZE, DURATION The study initially conducted focus groups designed to ascertain important beliefs informing participants' intentions to delay childbearing. A subsequent larger-scale quantitative questionnaire followed. PARTICIPANTS/MATERIALS, SETTING, METHODS Participants (n = 358) were female, aged between 18 and 30 years, lived in Australia, identified as being open to the idea of having children, were heterosexual, had not already had children, were not already pregnant, and had not received a diagnosis of medical infertility prior to participating. MAIN RESULTS AND THE ROLE OF CHANCE Hierarchical multiple regression analyses showed strong support for psychosocial predictors of attitude, pressure from others and perceived self-confidence as predictors of women's intentions to delay childbearing, accounting for 59% of total variance. The extended model that included anticipated regret, accounted for a significant additional 4.4% variance in intention to delay childbearing past the age of 35 years. LIMITATIONS, REASONS FOR CAUTION Proportionally more participants were younger, Caucasian, and were university students, thus limiting the generalizability of results to the wider Australian community. Future research in this domain is recommended to adopt a prospective design and incorporate a measure of behaviour to investigate the link between intentions to delay childbearing and future fertility behaviour. WIDER IMPLICATIONS OF THE FINDINGS This research augments our understanding of the decision-making process and key beliefs underlying the decision to delay childbearing. Further efforts are needed to advise young women to investigate their fertility options during the peak of their reproductive years in order to prevent negative psychological consequences associated with unintentional childlessness. STUDY FUNDING/COMPETING INTERESTS None.
Collapse
Affiliation(s)
- Allison L Kearney
- School of Psychology and Counselling, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Brisbane, QLD 4059, Australia
| | - Katherine M White
- School of Psychology and Counselling, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Brisbane, QLD 4059, Australia
| |
Collapse
|
39
|
Kim M, Nam H, Youn M. Infertility Stress, Depression, and Resilience in Women with Infertility treatments. ACTA ACUST UNITED AC 2016. [DOI: 10.5932/jkphn.2016.30.1.93] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
40
|
Sexty RE, Hamadneh J, Rösner S, Strowitzki T, Ditzen B, Toth B, Wischmann T. Cross-cultural comparison of fertility specific quality of life in German, Hungarian and Jordanian couples attending a fertility center. Health Qual Life Outcomes 2016. [PMID: 26911144 DOI: 10.1186/s12955-016-0429-3.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Only a few studies have reported cross-cultural comparisons regarding psychosocial consequences of infertility. Differences between societies with different cultural backgrounds were revealed and seemed to be based on the importance of pronatalism. Our aim was to measure cross-cultural differences in fertility specific quality of life of infertile couples in Germany, Hungary and Jordan who attend a fertility center in a cross-sectional study. METHODS A cross-sectional study was conducted in one fertility clinic in Germany, in five fertility clinics in Hungary and in one fertility clinic in Jordan. Overall 750 couples (252 couples in Jordan, 246 couples in Germany and 252 couples in Hungary) attending the first medical infertility consultation were asked to fill out our questionnaire set. Fertility specific quality of life (FertiQoL) and sociodemographic differences were measured between couples from three countries. RESULTS Jordanian couples had the shortest relationship (5.8 ± 4.3 yrs.), though they reported the longest duration of child wish (4.2 ± 3.6 yrs.) and fertility treatments (3.0 ± 3.3 yrs.). The proportion of high education was considerably higher in Jordanian women and men (60 % and 66 %, respectively) compared to the other two samples. First, marked cross-country differences were obtained on Emotional, Mind/Body and Relational subscales of the FertiQoL, indicating that Jordanian couples reported poorer fertility-related quality of life than Germans and Hungarians (p < 0.001). After controlling for the sociodemographic and medical variables, a significant difference only in the Emotional domain was observed (p < 0.001). CONCLUSIONS The study revealed only a few cultural based differences in fertility specific quality of life between the couples of the three countries. Thus, infertility counselors should pay attention to psychosocial problems rooted in individual sociocultural aspects of the infertile couple regardless of cultural stereotypes. Further studies should identify sociocultural factors within different subgroups of infertile patients instead of focusing different societies as a whole because intra-cultural psychosocial differences in experiencing infertility seem to be more important for the individual patient than intercultural differences.
Collapse
Affiliation(s)
- Réka E Sexty
- Institute of Medical Psychology, Center for Psychosocial Medicine, Ruprecht-Karls University Heidelberg, Bergheimer Strasse 20, 69115, Heidelberg, Germany.
| | - Jehan Hamadneh
- Department of Obstetrics and Gynecology, Faculty of Medicine, Jordan University of Science and Technology, King Abdullah University Hospital, Irbid, Jordan.
| | - Sabine Rösner
- Department of Gynecological Endocrinology and Reproductive Medicine, Women's Hospital, Ruprecht-Karls University Heidelberg, Heidelberg, Germany.
| | - Thomas Strowitzki
- Department of Gynecological Endocrinology and Reproductive Medicine, Women's Hospital, Ruprecht-Karls University Heidelberg, Heidelberg, Germany.
| | - Beate Ditzen
- Institute of Medical Psychology, Center for Psychosocial Medicine, Ruprecht-Karls University Heidelberg, Bergheimer Strasse 20, 69115, Heidelberg, Germany.
| | - Bettina Toth
- Department of Gynecological Endocrinology and Reproductive Medicine, Women's Hospital, Ruprecht-Karls University Heidelberg, Heidelberg, Germany.
| | - Tewes Wischmann
- Institute of Medical Psychology, Center for Psychosocial Medicine, Ruprecht-Karls University Heidelberg, Bergheimer Strasse 20, 69115, Heidelberg, Germany.
| |
Collapse
|
41
|
Sexty RE, Hamadneh J, Rösner S, Strowitzki T, Ditzen B, Toth B, Wischmann T. Cross-cultural comparison of fertility specific quality of life in German, Hungarian and Jordanian couples attending a fertility center. Health Qual Life Outcomes 2016; 14:27. [PMID: 26911144 PMCID: PMC4765134 DOI: 10.1186/s12955-016-0429-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 02/12/2016] [Indexed: 12/04/2022] Open
Abstract
Background Only a few studies have reported cross-cultural comparisons regarding psychosocial consequences of infertility. Differences between societies with different cultural backgrounds were revealed and seemed to be based on the importance of pronatalism. Our aim was to measure cross-cultural differences in fertility specific quality of life of infertile couples in Germany, Hungary and Jordan who attend a fertility center in a cross-sectional study. Methods A cross-sectional study was conducted in one fertility clinic in Germany, in five fertility clinics in Hungary and in one fertility clinic in Jordan. Overall 750 couples (252 couples in Jordan, 246 couples in Germany and 252 couples in Hungary) attending the first medical infertility consultation were asked to fill out our questionnaire set. Fertility specific quality of life (FertiQoL) and sociodemographic differences were measured between couples from three countries. Results Jordanian couples had the shortest relationship (5.8 ± 4.3 yrs.), though they reported the longest duration of child wish (4.2 ± 3.6 yrs.) and fertility treatments (3.0 ± 3.3 yrs.). The proportion of high education was considerably higher in Jordanian women and men (60 % and 66 %, respectively) compared to the other two samples. First, marked cross-country differences were obtained on Emotional, Mind/Body and Relational subscales of the FertiQoL, indicating that Jordanian couples reported poorer fertility-related quality of life than Germans and Hungarians (p < 0.001). After controlling for the sociodemographic and medical variables, a significant difference only in the Emotional domain was observed (p < 0.001). Conclusions The study revealed only a few cultural based differences in fertility specific quality of life between the couples of the three countries. Thus, infertility counselors should pay attention to psychosocial problems rooted in individual sociocultural aspects of the infertile couple regardless of cultural stereotypes. Further studies should identify sociocultural factors within different subgroups of infertile patients instead of focusing different societies as a whole because intra-cultural psychosocial differences in experiencing infertility seem to be more important for the individual patient than intercultural differences.
Collapse
Affiliation(s)
- Réka E Sexty
- Institute of Medical Psychology, Center for Psychosocial Medicine, Ruprecht-Karls University Heidelberg, Bergheimer Strasse 20, 69115, Heidelberg, Germany.
| | - Jehan Hamadneh
- Department of Obstetrics and Gynecology, Faculty of Medicine, Jordan University of Science and Technology, King Abdullah University Hospital, Irbid, Jordan.
| | - Sabine Rösner
- Department of Gynecological Endocrinology and Reproductive Medicine, Women's Hospital, Ruprecht-Karls University Heidelberg, Heidelberg, Germany.
| | - Thomas Strowitzki
- Department of Gynecological Endocrinology and Reproductive Medicine, Women's Hospital, Ruprecht-Karls University Heidelberg, Heidelberg, Germany.
| | - Beate Ditzen
- Institute of Medical Psychology, Center for Psychosocial Medicine, Ruprecht-Karls University Heidelberg, Bergheimer Strasse 20, 69115, Heidelberg, Germany.
| | - Bettina Toth
- Department of Gynecological Endocrinology and Reproductive Medicine, Women's Hospital, Ruprecht-Karls University Heidelberg, Heidelberg, Germany.
| | - Tewes Wischmann
- Institute of Medical Psychology, Center for Psychosocial Medicine, Ruprecht-Karls University Heidelberg, Bergheimer Strasse 20, 69115, Heidelberg, Germany.
| |
Collapse
|
42
|
Yangin H, Kukulu K, Gulşen S, Aktaş M, Sever B. A survey on the correlation between sexual satisfaction and depressive symptoms during infertility. Health Care Women Int 2015; 37:1082-95. [PMID: 26492556 DOI: 10.1080/07399332.2015.1107067] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This cross-sectional study has been conducted in a descriptive, correlational design in order to determine the correlation between sexual satisfaction and depressive symptoms. In this respect, sexual satisfaction and depression scores were assessed in 102 infertile couples in a Turkish university hospital. There was a positive and meaningful correlation between Beck Depression scores and educational status and monthly income of infertile women on the one hand, and among marriage, infertility, infertility treatment durations, and the number of assisted-reproduction treatments on the other hand. It was found that there were more sexual dysfunctions in women than in men and that they were affected more deeply. As a result, it might be suggested that infertile couples receive proper guidance from health professionals in the course of treatment.
Collapse
Affiliation(s)
- Hatice Yangin
- a Department of Maternity and Gynecological Nursing , Antalya School of Health, Akdeniz University , Antalya , Turkey
| | - Kamile Kukulu
- a Department of Maternity and Gynecological Nursing , Antalya School of Health, Akdeniz University , Antalya , Turkey
| | - Sözer Gulşen
- a Department of Maternity and Gynecological Nursing , Antalya School of Health, Akdeniz University , Antalya , Turkey
| | - Müzeyyen Aktaş
- a Department of Maternity and Gynecological Nursing , Antalya School of Health, Akdeniz University , Antalya , Turkey
| | - Bariş Sever
- a Department of Maternity and Gynecological Nursing , Antalya School of Health, Akdeniz University , Antalya , Turkey
| |
Collapse
|
43
|
Impact of Gender Infertility Diagnosis on Marital Relationship in Infertile Couples: A Couple Based Study. SEXUALITY AND DISABILITY 2015. [DOI: 10.1007/s11195-015-9417-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
44
|
Samadaee-Gelehkolaee K, McCarthy BW, Khalilian A, Hamzehgardeshi Z, Peyvandi S, Elyasi F, Shahidi M. Factors Associated With Marital Satisfaction in Infertile Couple: A Comprehensive Literature Review. Glob J Health Sci 2015; 8:96-109. [PMID: 26652079 PMCID: PMC4877237 DOI: 10.5539/gjhs.v8n5p96] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 08/31/2015] [Accepted: 07/23/2015] [Indexed: 11/25/2022] Open
Abstract
Background: Many factors impact on marital satisfaction. Related factors include demographic factors, assisted reproductive techniques, psychological health, quality of life, psychological, socioeconomic and family support, and sexual function. Methods: This study is a literature review of research studies conducted on factors associated with marital satisfaction in infertile couples. The current literature review search was undertaken using multiple databases selected from articles pertinent to the study. The selection of subjects was undertaken from1990 through 2015. The methodological quality was analyzed based on a checklist adopted from a systematic review. Quality assessment of full text studies was finally carried out by two reviewers. Results: The initial search yielded a list of 445 papers, and then reviewers studied titles and abstracts. Thereafter, 69 papers were incorporated, and researchers reviewed summaries of all of the searched articles. Finally, the researchers utilized the data gained from 64 full articles so as to compile this review paper. Reviewing the studies conducted on marital satisfaction, they classified related findings into 6 categories: demographic factors, using fertility assisting methods, psychological health, life quality, economic, social, and family support, and sexual function. Conclusion: The results of this review article depicted that various factors play role in creating marriage life satisfaction in an infertile couple, so that paying attention to them can play an important role in continuing their treatment. Thus, to identify such factors is considered essential in their treatment protocol highly based on culture. Of the drawbacks of this research is that it has tried at best to employ the studies belonging to diverse countries with different cultures. Also, the number of the papers was considerably limited.
Collapse
Affiliation(s)
- Keshvar Samadaee-Gelehkolaee
- 1 Department of Reproductive Health and Midwifery, Nasibeh Nursing and Midwifery Faculty, Mazandaran University of Medical Sciences, Sari, Iran 2 Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran.
| | | | | | | | | | | | | |
Collapse
|
45
|
Ghavi F, Jamale S, Mosalanejad L, Mosallanezhad Z. A Study of Couple Burnout in Infertile Couples. Glob J Health Sci 2015; 8:158-65. [PMID: 26573033 PMCID: PMC4873592 DOI: 10.5539/gjhs.v8n4p158] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 06/09/2015] [Indexed: 11/18/2022] Open
Abstract
Introduction: Infertility is a major crisis that can cause psychological problems and emotionally distressing experiences, and eventually affect a couples’ relationship. The objective of this study is to investigate couple burnout in infertile couples who were undergoing treatmentat the Infertility Clinic of Yazd, Iran. Method: The present study is a cross-sectional descriptive one on 98 infertile couples referringto the Infertility Centerof Yazd, Iran, who were chosen on a simple random sampling basis. The measuring tools consisted of the Couple Burnout Measure (CBM) and a demographic questionnaire. The collected data were analyzed using SPSS 16 and the statistical tests of ANOVA and t-test. P-values less than 0.05 were considered as significant. Results: The results show that infertile women experience higher levels of couple burnout than their husbands (p<0.001). Also, a comparison of the scales of couple burnout—psychological burnout (p<0.01), somatic burnout (p<0.01), and emotional burnout (p<0.001)—between wives and husbands show that women are at greater risk. Conclusion: Infertile couples’ emotional, mental, and sexual problems need to be addressed as part of the infertility treatment programs, and psychotherapists should be included in the medical team.
Collapse
Affiliation(s)
- Fatemeh Ghavi
- Faculty of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
| | | | | | | |
Collapse
|
46
|
Borneskog C, Lampic C, Sydsjö G, Bladh M, Svanberg AS. Relationship satisfaction in lesbian and heterosexual couples before and after assisted reproduction: a longitudinal follow-up study. BMC Womens Health 2014; 14:154. [PMID: 25495004 PMCID: PMC4276124 DOI: 10.1186/s12905-014-0154-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Accepted: 11/17/2014] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND More and more lesbian couples are planning parenthood through donor insemination and IVF and the number of planned lesbian families is growing in Sweden and other western countries. Research has shown that lesbian couples report as much overall satisfaction in their relationships as do heterosexual couples. However, although parenthood is highly desired, many parents are unaware of the demands of parenthood and the strain on their relationship that the arrival of the baby might bring. The aim of this study was to compare lesbian and heterosexual couples' perceptions of relationship satisfaction at a three-year follow up after assisted reproduction. METHODS The present study is a part of the Swedish study on gamete donation, a prospective longitudinal cohort study. The present study constitutes a three-year follow up assessment of lesbian and heterosexual couples after assisted reproduction. Participants requesting assisted reproduction at all fertility clinics performing gamete donation in Sweden, were recruited consecutively during 2005-2008. A total of 114 lesbian women (57 treated women and 57 partners) and 126 heterosexual women and men (63 women and 63 men) participated. Participants responded to the ENRICH inventory at two time points during 2005-2011; at the commencement of treatment (time point 1) and about three years after treatment termination (time point 3). To evaluate the bivariate relationships between the groups (heterosexual and lesbian) and socio-demographic factors Pearson's Chi- square test was used. Kolmogorov-Smirnov test was used for testing of normality, Mann-Whitney U- test to examine differences in ENRICH between the groups and paired samples t-test to examine scores over time. RESULTS Lesbian couples reported higher relationship satisfaction than heterosexual couples, however the heterosexual couples satisfaction with relationship quality was not low. Both lesbian and heterosexual couples would be classified accordingly to ENRICH-typology as vitalized or harmonious couples. CONCLUSIONS At a follow-up after assisted reproduction with donated sperm, lesbian couples reported stable relationships and a high satisfaction with their relationships, even when treatment was unsuccessful.
Collapse
Affiliation(s)
- Catrin Borneskog
- Department of Women's and Children's Health, Uppsala University, S-751 85, Uppsala, Sweden.
| | - Claudia Lampic
- Neurobiology, Care Sciences and Society, Karolinska Institutet, S-141 83, Huddinge, Sweden.
| | - Gunilla Sydsjö
- Division of Obstetrics and Gynecology, Department of Clinical and experimental Medicine, Faculty of Health and Science, Linköping University, Linköping, Sweden.
- Department of Gynecology and Obstetrics in Linköping, County Council of Östergötland, Linköping, Sweden.
| | - Marie Bladh
- Division of Obstetrics and Gynecology, Department of Clinical and experimental Medicine, Faculty of Health and Science, Linköping University, Linköping, Sweden.
- Department of Gynecology and Obstetrics in Linköping, County Council of Östergötland, Linköping, Sweden.
| | - Agneta Skoog Svanberg
- Department of Women's and Children's Health, Uppsala University, S-751 85, Uppsala, Sweden.
| |
Collapse
|
47
|
Holter H, Sandin-Bojö AK, Gejervall AL, Wikland M, Wilde-Larsson B, Bergh C. Patient-centred quality of care in an IVF programme evaluated by men and women. Hum Reprod 2014; 29:2695-703. [PMID: 25316450 DOI: 10.1093/humrep/deu254] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
STUDY QUESTION Do men and women value the same aspects of quality of care during IVF treatment when measuring rates of importance by the validated instrument, quality from the patient's perspective of in vitro fertilization (QPP-IVF)? SUMMARY ANSWER Women valued most aspects of care as significantly more important than their partner although men and women evaluated the importance of the different care factors in a similar pattern. WHAT IS KNOWN ALREADY A few validated tools measuring patient-centred quality of care during IVF have been developed. Few studies of gender differences concerning experiences of patient-centred quality of care have been reported in the literature to date. STUDY DESIGN, SIZE AND DURATION A two-centre study was conducted between September 2011 and May 2012. Heterosexual couples (n = 497) undergoing IVF were invited to complete a questionnaire before receiving the result of the pregnancy test. PARTICIPANTS/MATERIALS, SETTING, METHODS In all, 363 women and 292 men evaluated quality of care by answering the QPP-IVF questionnaire. The measurements consisted of two kinds of evaluations: the rating of the importance of various aspects of treatment (subjective importance) and the rating of perceived quality of care (perceived reality). Comparisons between men and women on importance ratings and perceived reality ratings were performed both on factor (subscale) and single item levels by intra-couple analyses and corrected for age. A stepwise multiple logistic regression analysis was performed in order to select baseline variables independently predicting evaluation at factor level. MAIN RESULTS AND THE ROLE OF CHANCE The response rate was 67.5%, with 363 women (74.2%) and 292 men (60.6%) completing the study. Both the woman and man responded in 251 couples. Women rated the different care aspects as significantly more important than their partner in all factors except the factor, 'Responsibility/continuity'. Both genders gave the factors, 'Medical care' and 'Information after treatment', the highest scores. At item level women rated the majority of items as significantly more important than men. Perceived reality for the majority of factors and items was similarly rated by men and women in the couples. For women, receiving embryo transfer, short duration of infertility, IVF as a method and number of previous cycles were independently correlated to the highest score of importance of certain factors. LIMITATIONS, REASON FOR CAUTION The lower response rate of men compared with women (60.6 versus 74.2%, respectively) might have influenced the results through selection bias. Only patients who had adequate fluency in the Swedish language participated. WIDER IMPLICATIONS OF THE FINDINGS This study is an important contribution in comparing the needs of men and women undergoing IVF treatments. The QPP-IVF instrument is a suitable instrument for revealing important care aspects identified by both men and women and a useful tool for stimulating patient-centred quality improvements within and between clinics. STUDY FUNDING/COMPETING INTEREST The study was supported by the LUA/ALF agreement at Sahlgrenska University Hospital, Gothenburg, Sweden, and by Hjalmar Svensson's Research Foundation. None of the authors declared any conflict of interests.
Collapse
Affiliation(s)
- Herborg Holter
- Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Reproductive Medicine, Sahlgrenska University Hospital, Gothenburg SE-413 45, Sweden
| | - Ann-Kristin Sandin-Bojö
- Department of Health Sciences, Nursing Sciences, Faculty of Health, Science and Technology, Karlstad University, Karlstad SE 651 88, Sweden
| | - Ann-Louise Gejervall
- Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Reproductive Medicine, Sahlgrenska University Hospital, Gothenburg SE-413 45, Sweden
| | - Matts Wikland
- Fertility Centre Scandinavia, Box 5418, Gothenburg SE-40229, Sweden
| | - Bodil Wilde-Larsson
- Department of Health Sciences, Nursing Sciences, Faculty of Health, Science and Technology, Karlstad University, Karlstad SE 651 88, Sweden
| | - Christina Bergh
- Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Reproductive Medicine, Sahlgrenska University Hospital, Gothenburg SE-413 45, Sweden
| |
Collapse
|
48
|
Cserepes RE, Kőrösi T, Bugán A. [Characteristics of infertility-specific quality of life in Hungarian couples]. Orv Hetil 2014; 155:783-8. [PMID: 24819187 DOI: 10.1556/oh.2014.29867] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Experiencing involuntary childlessness has a great impact on couples' quality of life. AIM The aim of the authors was to examine the correlations among infertility-specific quality of life and depression on the level of individuals and couples. METHOD 126 couples in five fertility centers in Hungary filled out the FertiQoL and Beck Depression Inventory and answered some sociodemographic questions. RESULTS In gender comparison, women reported about more depressive symptoms and poorer quality of life than men. Both in men and women, the higher depression level correlated with lower level of quality of life. Moreover, the presence of more depressive symptoms in women was related to men's poorer quality of life. CONCLUSIONS The results show that differences may exist in affective responses to infertility between women and men and that female affective problems take effects on the level of the couple relationship. These findings may be useful in psychosocial support of the couples facing infertility, especially in couple counselling or couple therapy.
Collapse
Affiliation(s)
- Réka Eszter Cserepes
- Debreceni Egyetem, Népegészségügyi Kar Magatartástudományi Intézet Debrecen Nagyerdei krt. 98. 4032
| | | | - Antal Bugán
- Debreceni Egyetem, Népegészségügyi Kar Magatartástudományi Intézet Debrecen Nagyerdei krt. 98. 4032
| |
Collapse
|
49
|
Quality of life of infertile Tunisian couples and differences according to gender. Int J Gynaecol Obstet 2014; 125:134-7. [PMID: 24568955 DOI: 10.1016/j.ijgo.2013.10.027] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Revised: 10/23/2013] [Accepted: 01/27/2014] [Indexed: 11/24/2022]
|
50
|
Lopes V, Canavarro M, Verhaak C, Boivin J, Gameiro S. Are patients at risk for psychological maladjustment during fertility treatment less willing to comply with treatment? Results from the Portuguese validation of the SCREENIVF. Hum Reprod 2013; 29:293-302. [DOI: 10.1093/humrep/det418] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|