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Bell SO, Larson E, Bittle D, Moreau C, Omoluabi E, OlaOlorun FM, Akilimali P, Kibira SPS, Makumbi F, Guiella G, Mosso R, Gichangi P, Anglewicz P. Care-seeking for difficulties conceiving in sub-Saharan Africa: findings from population-based surveys in eight geographies. Hum Reprod 2024; 39:1712-1723. [PMID: 38986015 PMCID: PMC11291947 DOI: 10.1093/humrep/deae084] [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: 09/12/2023] [Revised: 03/19/2024] [Indexed: 07/12/2024] Open
Abstract
STUDY QUESTION What is the nature of women's care-seeking for difficulties conceiving in sub-Saharan Africa (SSA), including the correlates of seeking biomedical infertility care at a health facility? SUMMARY ANSWER Care-seeking for difficulties getting pregnant was low, much of which involved traditional or religious sources of care, with evidence of sociodemographic disparities in receipt of biomedical care. WHAT IS KNOWN ALREADY Nearly all research on infertility care-seeking patterns in SSA is limited to clinic-based studies among the minority of people in these settings who obtain facility-based services. In the absence of population-based data on infertility care-seeking, we are unable to determine the demand for services and disparities in the use of more effective biomedical sources of care. STUDY DESIGN, SIZE, DURATION We used cross-sectional, population-based data from the Performance Monitoring for Action (PMA) female survey in eight geographies in SSA, including nationally representative data from Burkina Faso, Côte d'Ivoire, Kenya, and Uganda and regionally representative data from two provinces in the Democratic Republic of the Congo (DRC) (Kinshasa and Kongo Central) and two states in Nigeria (Kano and Lagos). We employed a multi-stage cluster random sampling design with probability proportional to size selection of clusters within each geography to produce representative samples of women aged 15-49. Samples ranged from 1144 in Kano, Nigeria, to 9489 in Kenya. PMA collected these data between November 2021 and December 2022. PARTICIPANTS/MATERIALS, SETTING, METHODS We restricted the sample to women who had ever had sex, with analytic samples ranging from 854 in Kano to 8,059 in Kenya, then conducted descriptive and bivariable analyses to examine characteristics of those who sought care for difficulties getting pregnant. Among those who reported seeking care, we conducted bivariable and multivariable logistic regression analyses to determine factors associated with receipt of biomedical services from a health facility. All analyses were conducted separately by geography. MAIN RESULTS AND THE ROLE OF CHANCE Our study found low levels of care-seeking for difficulties getting pregnant among sexually active women in eight geographies in SSA, ranging from 3.7% (Kenya) to 15.3% (Côte d'Ivoire). Of this, 51.8% (Burkina Faso) to 86.7% (Kinshasa) involved receipt of biomedical services in health facilities. While many factors were consistently associated with infertility care-seeking from any source across geographies, factors associated with receipt of biomedical care specifically were less pronounced. This may be a result of the highly limited sources of infertility services in SSA; thus, even privileged groups may struggle to obtain effective treatment for difficulties getting pregnant. However, we did observe disparities in biomedical care-seeking in our bivariable results in several geographies, with the wealthiest women, those with more education, and those residing in urban areas generally more likely to have sought biomedical care for difficulties getting pregnant. LIMITATIONS, REASONS FOR CAUTION Our data lacked details on the nature of the services received and outcomes, and we do not have information on reasons why women chose the sources they did. Small samples of women who sought care limited our power to detect significant differences in care-seeking by women's characteristics in several geographies. WIDER IMPLICATIONS OF THE FINDINGS Infertility and access to appropriate treatment are issues of reproductive health and human rights. While our results do not indicate to what extent use of non-biomedical sources of care is driven by preferences, cost, or lack of accessible services, it is clear from our results and existing literature that more needs to be done to ensure access to affordable, quality, cost-effective infertility services in SSA. STUDY FUNDING/COMPETING INTEREST(S) This study was supported by grants from the Bill & Melinda Gates Foundation (INV009639) and the National Institute of Child Health and Human Development (K01HD107172). The funders were not involved in the study design, analyses, manuscript writing, or the decision to publish. The authors have no conflicts of interest to declare. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Suzanne O Bell
- Department of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Elizabeth Larson
- Department of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Dory Bittle
- Department of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Caroline Moreau
- Department of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Soins Primaires et Prévention, CESP Centre for Research in Epidemiology and Population Health, U1018, INSERM, Villejuif, France
| | - Elizabeth Omoluabi
- Statistics and Population Studies Department, University of the Western Cape, Cape Town, South Africa
| | - Funmilola M OlaOlorun
- Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Pierre Akilimali
- Patrick Kayembe Research Center, Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Simon P S Kibira
- Department of Community Health and Behavioral Sciences, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Fredrick Makumbi
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Georges Guiella
- Institut Supérieur des Sciences de la Population, Joseph Ki-Zerbo University of Ouagadougou, Ouagadougou, Burkina Faso
| | - Rosine Mosso
- Educational and Teaching Department, École Nationale de Statistiques et d’Economie Appliquee (ENSEA), Abidjan, Cote d'Ivoire
| | - Peter Gichangi
- Department of Environment and Health Sciences, Technical University of Mombasa, Mombasa, Kenya
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Philip Anglewicz
- Department of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Bell SO, Makumbi F, Sarria I, Kibira SPS, Zimmerman LA. Reproductive autonomy and the experience of later-than-desired pregnancy: results from a cross-sectional survey of reproductive-aged women in Uganda. Reprod Health 2024; 21:20. [PMID: 38321541 PMCID: PMC10848551 DOI: 10.1186/s12978-024-01750-z] [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: 08/23/2023] [Accepted: 01/30/2024] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND The focus of reproductive autonomy research has historically been on the experience of unintended pregnancy and use of contraceptive methods. However, this has led to the neglect of a different group of women who suffer from constraints on their reproductive autonomy-women who experience pregnancies later than they desire or who are unable to become pregnant. This study examines the extent of later-than-desired pregnancy among women and evaluates the sociodemographic and reproductive factors associated with this experience in Uganda. METHODS We use data from the Performance Monitoring for Action Uganda 2022 female survey. We restricted the nationally representative sample of reproductive-aged women to those who were currently pregnant or who had ever given birth (n = 3311). We compared the characteristics of women across fertility intention categories (wanted pregnancy earlier, then, later, or not at all) of their current or most recent birth and used multivariable logistic regression to examine factors independently associated with having a pregnancy later than desired compared to at a desired time. RESULTS Overall, 28.3% of women had a later-than-desired pregnancy. Nearly all sociodemographic and reproductive characteristics were associated with the desired pregnancy timing of women's current or most recent pregnancy. Having higher education [adjusted odds ratio (aOR) 2.41, 95% confidence interval (CI) 1.13-5.13], having sought care for difficulties getting pregnant (aOR 2.12, 95% CI 1.30-3.46), and having less than very good self-rated health (good health aOR 1.74, 95% CI 1.12-2.71; moderate health aOR 1.77, 95% CI 1.09-2.86; very bad health aOR 4.32, 95% CI 1.15-16.26) were all independently significantly associated with increased odds of having a later-than-desired pregnancy. Being nulliparous (aOR 1.98, 95% CI 0.99-3.95) was also borderline significantly associated with having a later-than-desired pregnancy. CONCLUSIONS Identifying those who have later-than-desired pregnancies is essential if we seek to make progress towards supporting women and couples in achieving their reproductive goals, not just preventing pregnancies. Research on desired pregnancy timing in sub-Saharan Africa should be expanded to capture later-than-desired pregnancies, a population which is invisible in existing data. This work has public health implications due to commonalities in the factors associated with mistimed and unintended pregnancies and their link to poorer health and potentially poorer pregnancy outcomes.
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Affiliation(s)
- Suzanne O Bell
- Department of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD, 21205, USA.
| | - Fredrick Makumbi
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Isabella Sarria
- Department of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD, 21205, USA
| | - Simon P S Kibira
- Department of Community Health and Behavioral Sciences, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Linnea A Zimmerman
- Department of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD, 21205, USA
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Njogu A, Kaburu F, Njogu J, Barasa E, Mutisya A, Luo Y. The effect of self-compassion-based programs for infertility (SCPI) on anxiety and depression among women pursuing fertility treatment: a three-armed, randomised controlled trial. J Assist Reprod Genet 2023; 40:911-927. [PMID: 36930358 PMCID: PMC10224906 DOI: 10.1007/s10815-023-02771-6] [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: 11/24/2022] [Accepted: 03/06/2023] [Indexed: 03/18/2023] Open
Abstract
PURPOSE To examine the effects of self-compassion training using videos (SCV) versus self-compassion training using digital stories (SC-DS) as compared to a control group (CG) on reducing anxiety and depression symptoms among women pursuing fertility treatment. METHODS A three-armed, randomised controlled trial randomly assigned 200 eligible women to SCV(n = 65), SC-DS (n = 67), and CG (n = 68). All three randomised groups completed questionnaires immediately after randomisation (T1), after completing the interventions (T2), and 10 weeks after the interventions (T3). A generalised estimation equation was used with the intention-to-treat analysis. The primary outcomes were anxiety and depression, and secondary outcomes were self-compassion, infertility self-efficacy, and pregnancy rates. RESULTS SCV and SC-DS participants experienced a significant reduction in anxiety and depression from T1 to T2 and from T1 to T3 (p < 0.001; d > 0.8). SCV and SC-DS participants experienced a significant increase in self-compassion and infertility self-efficacy from T1 to T2 and from T1 to T3 (p < 0.001; d > 0.8). SC-DS seemed to be superior to SCV and CG. No significant differences were found among the three groups in pregnancy rates. SCV and SC-DS participants rated self-compassion training programs positively and said they would highly recommend them to others. CONCLUSION These findings suggest that SCV and SC-DS were effective in reducing anxiety and depression and increasing self-compassion and infertility self-efficacy. Online flexible self-compassion interventions could make psychological support more accessible for women undergoing fertility treatment in resource-poor settings. TRIAL REGISTRATION (ChiCTR2100046065) [12/04/2021].
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Affiliation(s)
- Anne Njogu
- Xiangya School of Nursing, Central South University, Changsha, 410013, Hunan, China
| | - Francis Kaburu
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Julius Njogu
- Jomo Kenyatta University of Agriculture and Technology (JKUAT)/Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Emmanuel Barasa
- Masinde Muliro University of Science and Technology (MMUST), Kakamega, Kenya
| | - Albanus Mutisya
- Jomo Kenyatta University of Agriculture and Technology (JKUAT), Juja, Kenya
| | - Yang Luo
- Xiangya School of Nursing, Central South University, Changsha, 410013, Hunan, China.
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Zhu F, Zhao B, Wu J, Yin S, Ma T, Li Z, Zhu X, Wang T, Yang B, Che D. Effect of transcutaneous electrical acupoint stimulation on pregnancy outcomes in women with in vitro fertilization-embryo transfer: A systematic review and meta-analysis. Front Cell Dev Biol 2022; 10:1068894. [PMID: 36578784 PMCID: PMC9791369 DOI: 10.3389/fcell.2022.1068894] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 11/30/2022] [Indexed: 12/14/2022] Open
Abstract
Objective: The purpose of this systematic review and meta-analysis was to evaluate the efficacy and safety of transcutaneous electrical acupoint stimulation (TEAS) on pregnancy outcomes in women undergoing in vitro fertilization-embryo transfer (IVF-ET), in order to provide evidence-based medical support. Methods: We searched the Cochrane Library, Embase, PubMed, Web of Science, SinoMed, and CNKI for relevant randomized controlled trials (RCTs) from inception to 31 May 2022, using the search terms "transcutaneous electrical acupoint stimulation," "TEAS," "in vitro fertilization-embryo transfer," "IVF-ET," "randomized controlled trial," and "clinical trials." The experimental group was treated with TEAS or combined with ovulation-inducing medication, and the control group was treated with mock TEAS (mTEAS), ovulation-inducing medication, or no intervention. The main outcome was the clinical pregnancy rate. Secondary outcomes were the embryo implantation rate, live birth rate, biochemical pregnancy rate, and number of oocytes retrieved. Stata15.1 software was used for data summary and analysis. Results: This review involved 15 RCTs and 4,281 participants. TEAS were superior to the control group for improving the clinical pregnancy rate [RR: 1.29, 95% CI: 1.19 to 1.40; p < 0.001; I2 = 23.0%], embryo implantation rate [RR: 1.43, 95% CI: 1.22 to 1.69; p < 0.001; I2 = 35.9%], live birth rate [RR: 1.33, 95% CI: 1.14 to 1.54; p < 0.001; I2 = 47.3%], and biochemical pregnancy rate [RR: 1.15, 95% CI: 1.05 to 1.26; p = 0.003; I2 = 49.1%], without significant heterogeneity. TEAS had no statistically significant effect on the number of oocytes retrieved as compared with the control group, and the heterogeneity was high [SMD: 0.34, 95% CI: -0.04 to 0.72; p = 0.081; I2 = 77.6%]. We performed subgroup analysis based on the sample size, interventions and intervention time-point. The results showed that the sample size had no effect on the results. There was no significant difference between TEAS and ovulation-inducing medication in the clinical pregnancy rate or the embryo implantation rate. In addition, TEAS did not significantly increase the embryo implantation rate or the live birth rate, compared with no intervention. In terms of safety, mild allergic symptoms were found in both the experimental group and the control group. Conclusion: In general, existing evidence supports the potential value of TEAS as an adjunctive treatment for improving pregnancy outcomes. High-quality, large-sample RCTs are needed to further support this conclusion. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=334892, identifier PROSPERO CRD42022334892.
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Affiliation(s)
- Fengya Zhu
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China,Traditional Chinese Medicine Department, Zigong First People’s Hospital, Zigong, China
| | - Bo Zhao
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jie Wu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Shao Yin
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Tingting Ma
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Zimeng Li
- The Third People's Hospital of Chengdu, Chengdu, China
| | - Xinyun Zhu
- People's Hospital of Leshan, Leshan, China
| | - Tianyu Wang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Bin Yang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Deya Che
- Traditional Chinese Medicine Department, Zigong First People’s Hospital, Zigong, China,*Correspondence: Deya Che,
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Abdennebi I, Pasquier M, Vernet T, Levaillant JM, Massin N. Fertility Check Up: A concept of all-in-one ultrasound for the autonomous evaluation of female fertility potential: Analysis and evaluation of first two years of experience. J Gynecol Obstet Hum Reprod 2022; 51:102461. [DOI: 10.1016/j.jogoh.2022.102461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 08/15/2022] [Accepted: 08/23/2022] [Indexed: 10/31/2022]
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Williams S, Fido D, Sheffield D. Polycystic Ovary Syndrome (PCOS) and Non-Suicidal Self-Injury (NSSI): A Community-Based Study. Healthcare (Basel) 2022; 10:healthcare10061118. [PMID: 35742167 PMCID: PMC9222400 DOI: 10.3390/healthcare10061118] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 05/31/2022] [Accepted: 06/07/2022] [Indexed: 11/16/2022] Open
Abstract
Polycystic Ovary Syndrome (PCOS) is an endocrine condition that has been associated with atypical emotional regulation strategy use as well as elevated levels of depression, anxiety, self-harm and suicidal ideation. Despite the existence of clinical screening guidance for this population, there is still little to no understanding of how non-suicidal self-injury and suicidal ideation and intention manifest in women with PCOS and how this might differ from women without PCOS. Within this cross-sectional investigation, women with and without a diagnosis of PCOS (n = 418) completed validated metrics of emotion dysregulation, rumination and non-suicidal self-injury (NSSI), as well as self-reported indices of previous suicidal ideation and future suicidal intention. Group comparisons indicated that women with, relative to those without, PCOS reported significantly greater metrics across all variables. Moreover, serial mediation analyses were conducted to test the ideation-to-action framework of suicide in women with PCOS, with the positive relationship between a PCOS diagnosis and future suicidal intention being explained through the indirect pathway of increased emotion dysregulation, recent suicidal ideation and NSSI. Our findings call to action the need for international screening for suicide intention and self-harm in women with PCOS.
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Dayan N, Velez MP, Vigod S, Pudwell J, Djerboua M, Fell DB, Basso O, Nguyen TV, Joseph KS, Ray JG. Infertility treatment and postpartum mental illness: a population-based cohort study. CMAJ Open 2022; 10:E430-E438. [PMID: 35580889 PMCID: PMC9196066 DOI: 10.9778/cmajo.20210269] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Subfertility and infertility treatment can be stressful experiences, but it is unknown whether each predisposes to postpartum mental illness. We sought to evaluate associations between subfertility or infertility treatment and postpartum mental illness. METHODS We conducted a population-based cohort study of individuals without pre-existing mental illness who gave birth in Ontario, Canada, from 2006 to 2014, stratified by fertility exposure: subfertility without infertility treatment; noninvasive infertility treatment (intrauterine insemination); invasive infertility treatment (in vitro fertilization); and no reproductive assistance. The primary outcome was mental illness occurring 365 days or sooner after birth (defined as ≥ 2 outpatient visits, an emergency department visit or a hospital admission with a mood, anxiety, psychotic, or substance use disorder, self-harm event or other mental illness). We used multivariable Poisson regression with robust error variance to assess associations between fertility exposure and postpartum mental illness. RESULTS The study cohort comprised 786 064 births (mean age 30.42 yr, standard deviation 5.30 yr), including 78 283 with subfertility without treatment, 9178 with noninvasive infertility treatment, 9633 with invasive infertility treatment and 688 970 without reproductive assistance. Postpartum mental illness occurred in 60.8 per 1000 births among individuals without reproductive assistance. Relative to individuals without reproductive assistance, those with subfertility had a higher adjusted relative risk of postpartum mental illness (1.14, 95% confidence interval 1.10-1.17), which was similar in noninvasive and invasive infertility treatment groups. INTERPRETATION Subfertility or infertility treatment conferred a slightly higher risk of postpartum mental illness compared with no reproductive assistance. Further research should elucidate whether the stress of infertility, its treatment or physician selection contributes to this association.
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Affiliation(s)
- Natalie Dayan
- Departments of Medicine, and of Obstetrics and Gynaecology (Dayan, Basso, Nguyen), McGill University Health Centre; Research Institute (Dayan, Basso, Nguyen), McGill University Health Centre; Departments of Epidemiology, Biostatistics and Occupational Health (Dayan, Basso), McGill University, Montréal, Que.; Department of Obstetrics and Gynaecology (Velez, Pudwell), Queen's University, Kingston Health Sciences Centre; ICES Queen's (Velez, Djerboua), Kingston, Ont.; ICES Central (Vigod, Ray), Toronto, Ont.; Department of Psychiatry (Vigod), University of Toronto, Toronto, Ont.; ICES uOttawa (Fell); Children's Hospital of Eastern Ontario Research Institute (Fell); School of Epidemiology and Public Health (Fell), University of Ottawa; Better Outcomes Registry & Network (BORN Ontario) (Fell), Ottawa, Ont.; Department of Obstetrics and Gynecology (Joseph), School of Population and Public Health, University of British Columbia, Vancouver, BC; Department of Medicine and Obstetrics and Gynaecology (Ray), University of Toronto, St. Michael's Hospital, Toronto, Ont.
| | - Maria P Velez
- Departments of Medicine, and of Obstetrics and Gynaecology (Dayan, Basso, Nguyen), McGill University Health Centre; Research Institute (Dayan, Basso, Nguyen), McGill University Health Centre; Departments of Epidemiology, Biostatistics and Occupational Health (Dayan, Basso), McGill University, Montréal, Que.; Department of Obstetrics and Gynaecology (Velez, Pudwell), Queen's University, Kingston Health Sciences Centre; ICES Queen's (Velez, Djerboua), Kingston, Ont.; ICES Central (Vigod, Ray), Toronto, Ont.; Department of Psychiatry (Vigod), University of Toronto, Toronto, Ont.; ICES uOttawa (Fell); Children's Hospital of Eastern Ontario Research Institute (Fell); School of Epidemiology and Public Health (Fell), University of Ottawa; Better Outcomes Registry & Network (BORN Ontario) (Fell), Ottawa, Ont.; Department of Obstetrics and Gynecology (Joseph), School of Population and Public Health, University of British Columbia, Vancouver, BC; Department of Medicine and Obstetrics and Gynaecology (Ray), University of Toronto, St. Michael's Hospital, Toronto, Ont
| | - Simone Vigod
- Departments of Medicine, and of Obstetrics and Gynaecology (Dayan, Basso, Nguyen), McGill University Health Centre; Research Institute (Dayan, Basso, Nguyen), McGill University Health Centre; Departments of Epidemiology, Biostatistics and Occupational Health (Dayan, Basso), McGill University, Montréal, Que.; Department of Obstetrics and Gynaecology (Velez, Pudwell), Queen's University, Kingston Health Sciences Centre; ICES Queen's (Velez, Djerboua), Kingston, Ont.; ICES Central (Vigod, Ray), Toronto, Ont.; Department of Psychiatry (Vigod), University of Toronto, Toronto, Ont.; ICES uOttawa (Fell); Children's Hospital of Eastern Ontario Research Institute (Fell); School of Epidemiology and Public Health (Fell), University of Ottawa; Better Outcomes Registry & Network (BORN Ontario) (Fell), Ottawa, Ont.; Department of Obstetrics and Gynecology (Joseph), School of Population and Public Health, University of British Columbia, Vancouver, BC; Department of Medicine and Obstetrics and Gynaecology (Ray), University of Toronto, St. Michael's Hospital, Toronto, Ont
| | - Jessica Pudwell
- Departments of Medicine, and of Obstetrics and Gynaecology (Dayan, Basso, Nguyen), McGill University Health Centre; Research Institute (Dayan, Basso, Nguyen), McGill University Health Centre; Departments of Epidemiology, Biostatistics and Occupational Health (Dayan, Basso), McGill University, Montréal, Que.; Department of Obstetrics and Gynaecology (Velez, Pudwell), Queen's University, Kingston Health Sciences Centre; ICES Queen's (Velez, Djerboua), Kingston, Ont.; ICES Central (Vigod, Ray), Toronto, Ont.; Department of Psychiatry (Vigod), University of Toronto, Toronto, Ont.; ICES uOttawa (Fell); Children's Hospital of Eastern Ontario Research Institute (Fell); School of Epidemiology and Public Health (Fell), University of Ottawa; Better Outcomes Registry & Network (BORN Ontario) (Fell), Ottawa, Ont.; Department of Obstetrics and Gynecology (Joseph), School of Population and Public Health, University of British Columbia, Vancouver, BC; Department of Medicine and Obstetrics and Gynaecology (Ray), University of Toronto, St. Michael's Hospital, Toronto, Ont
| | - Maya Djerboua
- Departments of Medicine, and of Obstetrics and Gynaecology (Dayan, Basso, Nguyen), McGill University Health Centre; Research Institute (Dayan, Basso, Nguyen), McGill University Health Centre; Departments of Epidemiology, Biostatistics and Occupational Health (Dayan, Basso), McGill University, Montréal, Que.; Department of Obstetrics and Gynaecology (Velez, Pudwell), Queen's University, Kingston Health Sciences Centre; ICES Queen's (Velez, Djerboua), Kingston, Ont.; ICES Central (Vigod, Ray), Toronto, Ont.; Department of Psychiatry (Vigod), University of Toronto, Toronto, Ont.; ICES uOttawa (Fell); Children's Hospital of Eastern Ontario Research Institute (Fell); School of Epidemiology and Public Health (Fell), University of Ottawa; Better Outcomes Registry & Network (BORN Ontario) (Fell), Ottawa, Ont.; Department of Obstetrics and Gynecology (Joseph), School of Population and Public Health, University of British Columbia, Vancouver, BC; Department of Medicine and Obstetrics and Gynaecology (Ray), University of Toronto, St. Michael's Hospital, Toronto, Ont
| | - Deshayne B Fell
- Departments of Medicine, and of Obstetrics and Gynaecology (Dayan, Basso, Nguyen), McGill University Health Centre; Research Institute (Dayan, Basso, Nguyen), McGill University Health Centre; Departments of Epidemiology, Biostatistics and Occupational Health (Dayan, Basso), McGill University, Montréal, Que.; Department of Obstetrics and Gynaecology (Velez, Pudwell), Queen's University, Kingston Health Sciences Centre; ICES Queen's (Velez, Djerboua), Kingston, Ont.; ICES Central (Vigod, Ray), Toronto, Ont.; Department of Psychiatry (Vigod), University of Toronto, Toronto, Ont.; ICES uOttawa (Fell); Children's Hospital of Eastern Ontario Research Institute (Fell); School of Epidemiology and Public Health (Fell), University of Ottawa; Better Outcomes Registry & Network (BORN Ontario) (Fell), Ottawa, Ont.; Department of Obstetrics and Gynecology (Joseph), School of Population and Public Health, University of British Columbia, Vancouver, BC; Department of Medicine and Obstetrics and Gynaecology (Ray), University of Toronto, St. Michael's Hospital, Toronto, Ont
| | - Olga Basso
- Departments of Medicine, and of Obstetrics and Gynaecology (Dayan, Basso, Nguyen), McGill University Health Centre; Research Institute (Dayan, Basso, Nguyen), McGill University Health Centre; Departments of Epidemiology, Biostatistics and Occupational Health (Dayan, Basso), McGill University, Montréal, Que.; Department of Obstetrics and Gynaecology (Velez, Pudwell), Queen's University, Kingston Health Sciences Centre; ICES Queen's (Velez, Djerboua), Kingston, Ont.; ICES Central (Vigod, Ray), Toronto, Ont.; Department of Psychiatry (Vigod), University of Toronto, Toronto, Ont.; ICES uOttawa (Fell); Children's Hospital of Eastern Ontario Research Institute (Fell); School of Epidemiology and Public Health (Fell), University of Ottawa; Better Outcomes Registry & Network (BORN Ontario) (Fell), Ottawa, Ont.; Department of Obstetrics and Gynecology (Joseph), School of Population and Public Health, University of British Columbia, Vancouver, BC; Department of Medicine and Obstetrics and Gynaecology (Ray), University of Toronto, St. Michael's Hospital, Toronto, Ont
| | - Tuong Vi Nguyen
- Departments of Medicine, and of Obstetrics and Gynaecology (Dayan, Basso, Nguyen), McGill University Health Centre; Research Institute (Dayan, Basso, Nguyen), McGill University Health Centre; Departments of Epidemiology, Biostatistics and Occupational Health (Dayan, Basso), McGill University, Montréal, Que.; Department of Obstetrics and Gynaecology (Velez, Pudwell), Queen's University, Kingston Health Sciences Centre; ICES Queen's (Velez, Djerboua), Kingston, Ont.; ICES Central (Vigod, Ray), Toronto, Ont.; Department of Psychiatry (Vigod), University of Toronto, Toronto, Ont.; ICES uOttawa (Fell); Children's Hospital of Eastern Ontario Research Institute (Fell); School of Epidemiology and Public Health (Fell), University of Ottawa; Better Outcomes Registry & Network (BORN Ontario) (Fell), Ottawa, Ont.; Department of Obstetrics and Gynecology (Joseph), School of Population and Public Health, University of British Columbia, Vancouver, BC; Department of Medicine and Obstetrics and Gynaecology (Ray), University of Toronto, St. Michael's Hospital, Toronto, Ont
| | - K S Joseph
- Departments of Medicine, and of Obstetrics and Gynaecology (Dayan, Basso, Nguyen), McGill University Health Centre; Research Institute (Dayan, Basso, Nguyen), McGill University Health Centre; Departments of Epidemiology, Biostatistics and Occupational Health (Dayan, Basso), McGill University, Montréal, Que.; Department of Obstetrics and Gynaecology (Velez, Pudwell), Queen's University, Kingston Health Sciences Centre; ICES Queen's (Velez, Djerboua), Kingston, Ont.; ICES Central (Vigod, Ray), Toronto, Ont.; Department of Psychiatry (Vigod), University of Toronto, Toronto, Ont.; ICES uOttawa (Fell); Children's Hospital of Eastern Ontario Research Institute (Fell); School of Epidemiology and Public Health (Fell), University of Ottawa; Better Outcomes Registry & Network (BORN Ontario) (Fell), Ottawa, Ont.; Department of Obstetrics and Gynecology (Joseph), School of Population and Public Health, University of British Columbia, Vancouver, BC; Department of Medicine and Obstetrics and Gynaecology (Ray), University of Toronto, St. Michael's Hospital, Toronto, Ont
| | - Joel G Ray
- Departments of Medicine, and of Obstetrics and Gynaecology (Dayan, Basso, Nguyen), McGill University Health Centre; Research Institute (Dayan, Basso, Nguyen), McGill University Health Centre; Departments of Epidemiology, Biostatistics and Occupational Health (Dayan, Basso), McGill University, Montréal, Que.; Department of Obstetrics and Gynaecology (Velez, Pudwell), Queen's University, Kingston Health Sciences Centre; ICES Queen's (Velez, Djerboua), Kingston, Ont.; ICES Central (Vigod, Ray), Toronto, Ont.; Department of Psychiatry (Vigod), University of Toronto, Toronto, Ont.; ICES uOttawa (Fell); Children's Hospital of Eastern Ontario Research Institute (Fell); School of Epidemiology and Public Health (Fell), University of Ottawa; Better Outcomes Registry & Network (BORN Ontario) (Fell), Ottawa, Ont.; Department of Obstetrics and Gynecology (Joseph), School of Population and Public Health, University of British Columbia, Vancouver, BC; Department of Medicine and Obstetrics and Gynaecology (Ray), University of Toronto, St. Michael's Hospital, Toronto, Ont
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8
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Zaami S, Driul L, Sansone M, Scatena E, Andersson KL, Marinelli E. ART Innovations: Fostering Women's Psychophysical Health between Bioethics Precepts and Human Rights. Healthcare (Basel) 2021; 9:healthcare9111486. [PMID: 34828532 PMCID: PMC8623993 DOI: 10.3390/healthcare9111486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 10/28/2021] [Accepted: 10/29/2021] [Indexed: 12/02/2022] Open
Abstract
Infertility is a highly relevant global issue affecting the reproductive health of at least 15% of reproductive-aged couples worldwide. The scope and severity of the infertility problem is even more prevalent in developing countries, mostly due to untreated reproductive tract infections (RTIs). Infertility, however, goes beyond the mere inability to procreate, but brings about profound psychological, social, and ethical implications of enormous magnitude. In vitro fertilization (IVF) and other assisted reproduction technologies (ARTs) have gradually become widespread therapeutic options. After all, the implementation of medically assisted reproductive procedures in order to overcome infertility is in keeping with the tenets of the reproductive rights agenda laid out at the International Conference on Population and Development (ICPD) in Cairo in 1994. Nonetheless, concerns still linger about how to implement and regulate such interventions in an ethically tenable fashion. The unremitting pace at which such techniques develop have upset the very notion of sexuality relating to reproduction as well as the concept of family itself. That rift risks causing a crisis in terms of bioethics sustainability and enforcement, which is bound to happen when science and innovation outpace the bioethical precepts on which we rely for essential guidance in medical practice. The authors argue in favor of an approach to regulation and policy-making that puts on the forefront a thorough assessment as to potential risks that such interventions might entail for foundational bioethics principles and inalienable human rights.
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Affiliation(s)
- Simona Zaami
- Department of Anatomical, Histological, Medicolegal and Orthopedic Sciences, Sapienza University of Rome, 00161 Rome, Italy;
- Correspondence:
| | - Lorenza Driul
- Clinic of Obstetrics and Gynecology, Hospital of Udine, DAME, University of Udine, 33100 Udine, Italy;
| | - Milena Sansone
- Department of Obstetrics and Gynecology, Sant’Eugenio Hospital, 00144 Rome, Italy;
| | - Elisa Scatena
- Department of Gynecology and Obstetrics, Santo Stefano Hospital, 59100 Prato, Italy;
| | - Karin Louise Andersson
- Department of Territory Health, Azienda Sanitaria Toscana Centro, 50012 Florence, Italy;
| | - Enrico Marinelli
- Department of Anatomical, Histological, Medicolegal and Orthopedic Sciences, Sapienza University of Rome, 00161 Rome, Italy;
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9
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Yang P, Zhang L, Hou X. Incidence of suicide among adolescent and young adult cancer patients: a population-based study. Cancer Cell Int 2021; 21:540. [PMID: 34663328 PMCID: PMC8522157 DOI: 10.1186/s12935-021-02225-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 09/23/2021] [Indexed: 11/14/2022] Open
Abstract
Background As the survival rates of cancer patients continue to increase, most cancer patients now die of non-cancer causes. Several studies have been showing elevated suicide rates among patients with cancer. However, no large-scale study has thoroughly assessed the risk of suicide among adolescent and young adult (AYA) patients with cancer. This study was conducted to characterize suicide mortality among AYA patients in the US and identify risk factors associated with a higher risk of suicide. Methods Patients aged 15–39 years were residents of the US served by the Surveillance, Epidemiology, and End Results (SEER) program, who were diagnosed with cancers from 1973 to 2015. Results We report that 981 of the 572,500 AYA patients with cancer committed suicide, for an age-, sex-, and race-adjusted suicide rate of 17.68/100,000 person-years. The rate of suicide was 14.33/100,000 person-years in the corresponding general population, giving a standardized mortality ratio (SMR) of 1.234 [95% confidence interval (CI) 1.159–1.313]. Higher suicide rates were associated with male sex, white race, unmarried state, distant tumor stage, and single primary tumor. AYA patients with otorhinolaryngologic, gonad, stomach, soft tissue, and nasopharyngeal cancer were at the greatest risk of suicide compared with those with other types of cancer. In older patients (≥ 40 years), the risk was highest in those with lung, stomach, oral cavity and pharynx, larynx, and bone malignancies. SMRs were highest in the first 5 years after diagnosis for most types of cancer. Conclusion AYA patients with cancer in the US have over 20% higher the incidence of suicide of the general population, and most suicides occurred in the first 5 years following diagnosis. Suicide rates vary among patients with cancers of different anatomic sites. Further examination of the psychological experience of these young patients with cancer, particularly that of those with certain types of cancer, is warranted. Supplementary Information The online version contains supplementary material available at 10.1186/s12935-021-02225-y.
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Affiliation(s)
- Pengcheng Yang
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue 1277, Wuhan, 430022, China
| | - Lei Zhang
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue 1277, Wuhan, 430022, China.
| | - Xiaohua Hou
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue 1277, Wuhan, 430022, China.
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10
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Shin H, Lee J, Kim SJ, Jo M. Associations of Symptoms of Depression, Social Support, and Quality of Life Among Korean Women Who Experience Infertility. J Obstet Gynecol Neonatal Nurs 2021; 50:e1-e12. [PMID: 34310903 DOI: 10.1016/j.jogn.2021.06.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2021] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To describe the quality of life (QOL) of Korean women experiencing infertility based on sociodemographic and infertility characteristics and to examine the associations among symptoms of depression, social support, and QOL. DESIGN Cross-sectional, descriptive study. SETTING Participants were recruited from July to August 2019 on one of the largest South Korean websites where individuals share pregnancy and parenthood experiences. PARTICIPANTS Adult women (N = 186) who received infertility treatment. METHODS Participants completed an online survey using the Korean version of the Patient Health Questionnaire 9 to measure symptoms of depression, the Multidimensional Scale of Perceived Support, and the Fertility Quality of Life (FertiQOL) scale. Data were analyzed using descriptive statistics, correlation, analysis of variance, and multiple regression. RESULTS There was a significant negative relationship between scores on the Patient Health Questionnaire 9 and FertiQOL (r = -0.557) and a significant positive relationship between scores on the Multidimensional Scale of Perceived Support and FertiQOL (r = 0.404). The length of time from diagnosis of infertility to data collection, past and current treatments, cost burden, and degree of inhibition of daily life due to infertility also significantly affected participants' FertiQOL scores. Symptoms of depression, the burden of treatment, and inhibition of daily life activities explained 46% of the variance in QOL. CONCLUSION Women experiencing infertility and symptoms of depression had lower FertiQOL scores. Health care providers, who are most familiar with and attentive to patients, could provide a first line of defense against poor QOL in this population. By continuously assessing the levels of psychosocial stress in women with infertility, nurses could provide timely resources and design interventions to improve women's QOL.
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11
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Jones BP, Saso S, Yazbek J, Thum MY, Quiroga I, Ghaem-Maghami S, Smith JR. Uterine Transplantation: Scientific Impact Paper No. 65 April 2021. BJOG 2021; 128:e51-e66. [PMID: 33913235 DOI: 10.1111/1471-0528.16697] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
A uterine transplant, or womb transplant, provides a potential treatment for women who cannot become pregnant or carry a pregnancy because they do not have a womb, or have a womb that is unable to maintain a pregnancy. This is estimated to affect one in 500 women. Options for those who wish to start a family include adoption and surrogacy, but these are associated with legal, cultural, ethical and religious implications that may not be appropriate for some women and their families. A womb transplant is undertaken when the woman is ready to start a family, and is removed following the completion of their family. Womb transplants have been performed all over the world, with more than 70 procedures carried out so far. At least 23 babies have been born as a result, demonstrating that womb transplants can work. While the procedure offers a different option to adoption and surrogacy, it is associated with significant risks, including multiple major surgeries and the need to take medications that help to dampen the immune system to prevent rejection of the womb. To date there has been a 30% risk of a transplant being unsuccessful. Although the number of transplants to date is still relatively small, the number being performed globally is growing, providing an opportunity to learn from the experience gained so far. This paper looks at the issues that have been encountered, which may arise at each step of the process, and proposes a framework for the future. However, long term follow-up of cases will be essential to draw reliable conclusions about any overall benefits of this procedure.
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Affiliation(s)
- B P Jones
- Royal College of Obstetricians and Gynaecologists, 10-18 Union Street, London, SE1 1SZ, UK
| | - S Saso
- Royal College of Obstetricians and Gynaecologists, 10-18 Union Street, London, SE1 1SZ, UK
| | - J Yazbek
- Royal College of Obstetricians and Gynaecologists, 10-18 Union Street, London, SE1 1SZ, UK
| | - M-Y Thum
- Royal College of Obstetricians and Gynaecologists, 10-18 Union Street, London, SE1 1SZ, UK
| | - I Quiroga
- Royal College of Obstetricians and Gynaecologists, 10-18 Union Street, London, SE1 1SZ, UK
| | - S Ghaem-Maghami
- Royal College of Obstetricians and Gynaecologists, 10-18 Union Street, London, SE1 1SZ, UK
| | - J R Smith
- Royal College of Obstetricians and Gynaecologists, 10-18 Union Street, London, SE1 1SZ, UK
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12
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Salway T, Gesink D, Ferlatte O, Rich AJ, Rhodes AE, Brennan DJ, Gilbert M. Age, period, and cohort patterns in the epidemiology of suicide attempts among sexual minorities in the United States and Canada: detection of a second peak in middle adulthood. Soc Psychiatry Psychiatr Epidemiol 2021; 56:283-294. [PMID: 32789562 DOI: 10.1007/s00127-020-01946-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 08/07/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Sexual minority adults experience fivefold greater risk of suicide attempt, as compared with heterosexuals. Establishing age-specific epidemiological patterns of suicide is a prerequisite to planning interventions to redress the sexual orientation suicide inequity, and such patterns must be carefully interpreted in light of correlated period and cohort effects. We, therefore, combined US and Canadian data (1985-2017) from primary (two pooled multi-year national surveys, N = 15,477 and N = 126,463) and secondary (published, meta-analytic, N = 122,966) sources to separately estimate age, period, and cohort trends in self-reported suicide attempts among sexual minorities. METHODS Age- and gender-stratified cross-sectional data were used to infer age and cohort effects. Age-collapsed meta-analyzed data were used to infer period effects among sexual minorities of all genders. RESULTS We identified a bimodal age distribution in recent suicide attempts for sexual minorities across genders, though more pronounced among sexual minority men: one peak in adolescence (18-20 years of age for both genders) and one peak nearing mid-life (30-35 years of age for men; 35-40 years of age for women). This pattern was also apparent using recall data within birth cohorts of sexual minority men, suggesting it is not an artifact of birth cohort effects. Finally, we observed decreasing trends in lifetime suicide attempt prevalence estimates for both sexual minorities and heterosexuals, though these decreases did not affect the magnitude of the sexual orientation disparity. CONCLUSION In the context of exclusively adolescent-focused suicide prevention interventions for sexual minorities, tailored suicide prevention for sexual minority adults should be pursued throughout the life course.
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Affiliation(s)
- Travis Salway
- Faculty of Health Sciences, Simon Fraser University, Blusson Hall 11300, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada. .,Clinical Prevention Services, British Columbia Centre for Disease Control, 655 West 12th Avenue, Vancouver, BC, V5Z 4R4, Canada. .,Centre for Gender and Sexual Health Equity, 1190 Hornby Street, 11th Floor, Vancouver, BC, V6Z 2K5, Canada.
| | - Dionne Gesink
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Room 500, Toronto, ON, M5T 3M7, Canada
| | - Olivier Ferlatte
- École de santé Publique, Université de Montréal, 7101 Park Avenue, Montreal, QC, H3N 1X9, Canada.,Centre de Recherche en santé Publique, Université de Montréal et CIUSS du Centre-Sud-de-l'Île-de-Montréal, 1301, rue Sherbrooke Est, Montreal, QC, H3L 1M3, Canada
| | - Ashleigh J Rich
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Anne E Rhodes
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Room 500, Toronto, ON, M5T 3M7, Canada.,Department of Psychiatry, University of Toronto, 585 University Avenue, Toronto, ON, M5G 2N2, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, St. Joseph's Healthcare Hamilton, West 5th Campus, Administration-B3, 100 West 5th, Hamilton, ON, L8N 3K7, Canada.,Offord Centre for Child Studies, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada
| | - David J Brennan
- Factor-Inwentash School of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON, M5S 1V4, Canada
| | - Mark Gilbert
- Clinical Prevention Services, British Columbia Centre for Disease Control, 655 West 12th Avenue, Vancouver, BC, V5Z 4R4, Canada.,School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada
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13
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Research-supported mobile applications and internet-based technologies to mediate the psychological effects of infertility: a review. Reprod Biomed Online 2020; 42:679-685. [PMID: 33487558 DOI: 10.1016/j.rbmo.2020.12.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 11/09/2020] [Accepted: 12/08/2020] [Indexed: 12/27/2022]
Abstract
Infertility is a chronic condition commonly accompanied by psychological and emotional distress. A significant contributor to the discontinuation of infertility treatment is the psychological burden of treatment. Many individuals experiencing infertility report high levels of depression and anxiety. Unfortunately, barriers to traditional individual and couples counselling include stigmatization, finances, trepidation, challenges of travel and uncertainty. New technology, such as mobile applications and internet-based programmes, may be a feasible option for reducing the emotional distress of infertility diagnoses and treatments. This review focuses on current and developing technologies designed to decrease emotional distress in individuals with infertility.
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14
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Shreffler KM, Greil AL, Tiemeyer SM, McQuillan J. Is infertility resolution associated with a change in women's well-being? Hum Reprod 2020; 35:605-616. [PMID: 32112095 PMCID: PMC7105324 DOI: 10.1093/humrep/dez297] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 12/11/2019] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION Is giving birth associated with improved subjective well-being among involuntarily childless women? SUMMARY ANSWER Resolution of infertility is associated with increased life satisfaction and self-esteem, but not with a decrease in depressive symptoms. WHAT IS KNOWN ALREADY Cross-sectional data and studies of treatment-seekers show that infertility is associated with lower subjective well-being. Childless women with infertility tend to report lower subjective well-being than women who experience secondary infertility, but a prospective study using a random sample of involuntarily childless women over time has not previously been conducted. STUDY DESIGN, SIZE, DURATION The sample for the current study includes all women without children who met medical criteria for infertility or perceived a fertility problem (N = 283) at baseline and who were interviewed in both waves (3 years apart) of the National Survey of Fertility Barriers (NSFB), in a random-digit dialing telephone survey. It is therefore possible to explore here whether there are differences in the association of infertility resolution and subjective well-being among women who do and do not perceive themselves as having a fertility problem. PARTICIPANTS/MATERIALS, SETTING, METHODS Depressive symptoms (as measured by the Center for Epidemiologic Studies-Depression Scale), self-esteem (as measured by a modified version of the Rosenberg Self-esteem Scale) and life satisfaction (as measured by a modified version of the Satisfaction with Life Scale) were assessed for all 283 participants at both waves. For all three variables, change scores of 47 involuntarily childless women who resolved their infertility through a live birth were compared to the scores for the 236 women who remained childless. A number of variables shown to be associated with subjective well-being among infertile women were included as controls. MAIN RESULTS AND THE ROLE OF CHANCE No relationship between infertility resolution and change in depressive symptoms was observed (b = -0.04; P > 0.05). Involuntarily childless women who resolved their infertility improved in self-esteem (b = 0.74; P < 0.01) and life satisfaction (b = 1.06; P < 0.01). LIMITATIONS, REASONS FOR CAUTION Women were measured at only two time points. Only 47 women had a live birth between waves. While it is common practice to make causal interpretations based on panel data, such interpretations should be made with caution. In addition, the NSFB was conducted in the USA where medical expenditures are high and most fertility treatment expenses are not covered by insurance. Thus it may not be possible to generalize the findings to other modern industrialized societies. WIDER IMPLICATIONS OF THE FINDINGS Knowing that resolution of infertility is associated with improved subjective well-being is important for infertile couples and infertility professionals alike. STUDY FUNDING/COMPETING INTEREST(S) This research was supported in part by NICHD grant R01-HD044144 and NIGMS grant P20-GM109097 from the National Institutes of Health. The authors have no competing interests.
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Affiliation(s)
- Karina M Shreffler
- Human Development and Family Science, Oklahoma State University, Tulsa, OK, USA
| | - Arthur L Greil
- Emeritus of Sociology, Alfred University, Alfred, NY, USA
| | - Stacy M Tiemeyer
- Human Development and Family Science, Oklahoma State University, Tulsa, OK, USA
| | - Julia McQuillan
- Sociology, The University of Nebraska at Lincoln, Lincoln, NE, USA
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15
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Payne N, Seenan S, van den Akker O. Experiences of involuntary childlessness and treatment in the UK: what has changed in 20 years? HUM FERTIL 2019; 24:333-340. [DOI: 10.1080/14647273.2019.1687946] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Nicola Payne
- Department of Psychology, Middlesex University, London, UK
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16
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Zhou H, Xian W, Zhang Y, Yang Y, Fang W, Liu J, Shen J, Zhang Z, Hong S, Huang Y, Zhang L. Suicide among cancer patients: adolescents and young adult (AYA) versus all-age patients. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:658. [PMID: 31930059 DOI: 10.21037/atm.2019.10.51] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background Many researchers have studied suicide risk factors of patients with one specific cancer. But there is no comprehensive study to compare suicide issues between adolescents and young adult (AYA) group and all-age groups in a pan-cancer view. Methods Patients diagnosed with 20 solid malignancies were identified from SEER database. Multivariable logistic regression was operated to find out risk factors of suicide. Results Male sex has less impact on AYA than all-age patients (OR 2.72, 95% CI: 2.23-3.31, P<0.001 vs. OR 4.64, 95% CI: 4.37-4.94, P<0.001), while white race (OR 3.28, 95% CI: 2.02-5.77, P<0.001 vs. OR 3.40, 95% CI: 3.02-3.84, P<0.001) and unmarried status (OR 1.51, 95% CI: 1.24-1.83, P<0.001 vs. OR 1.39, 95% CI: 1.33-1.46, P<0.001) have similar impact on AYA and all-age groups. Localized cancer stage may have stronger impact on AYA than all-age (OR 2.90, 95% CI: 1.83-4.84; P<0.001 vs. OR 1.76, 95% CI: 1.61-1.92; P<0.001), while surgery only influence all-age (OR 1.14, P=0.451 vs. 1.24, P<0.001). Within 5 years from cancer diagnosis, longer survival time is associated with higher suicide risk of both all-age and AYA patients. Conclusions Male sex, white race and unmarried status, earlier cancer stage and longer survival time within 5 years are similar prevalent risk factors for both AYA group patients and all-age patients. It is not necessary to pick AYA cancer patients out when considering suicide risk of cancer patients.
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Affiliation(s)
- Huaqiang Zhou
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou 510060, China.,State Key Laboratory of Oncology in South China, Guangzhou 510060, China.,Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China.,Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China
| | - Wei Xian
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China
| | - Yaxiong Zhang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou 510060, China.,State Key Laboratory of Oncology in South China, Guangzhou 510060, China.,Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
| | - Yunpeng Yang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou 510060, China.,State Key Laboratory of Oncology in South China, Guangzhou 510060, China.,Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
| | - Wenfeng Fang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou 510060, China.,State Key Laboratory of Oncology in South China, Guangzhou 510060, China.,Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
| | - Jiaqing Liu
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China
| | - Jiayi Shen
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China
| | - Zhonghan Zhang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou 510060, China.,State Key Laboratory of Oncology in South China, Guangzhou 510060, China.,Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
| | - Shaodong Hong
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou 510060, China.,State Key Laboratory of Oncology in South China, Guangzhou 510060, China.,Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
| | - Yan Huang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou 510060, China.,State Key Laboratory of Oncology in South China, Guangzhou 510060, China.,Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
| | - Li Zhang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou 510060, China.,State Key Laboratory of Oncology in South China, Guangzhou 510060, China.,Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
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17
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Geulayov G, Ferrey A, Hawton K, Hermon C, Reeves GK, Green J, Beral V, Floud S. Body mass index in midlife and risk of attempted suicide and suicide: prospective study of 1 million UK women. Psychol Med 2019; 49:2279-2286. [PMID: 30488817 PMCID: PMC6754262 DOI: 10.1017/s0033291718003239] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND High body mass index (BMI) has been associated with lower risks of suicidal behaviour and being underweight with increased risks. However, evidence is inconsistent and sparse, particularly for women. We aim to study this relationship in a large cohort of UK women. METHODS In total 1.2 million women, mean age 56 (s.d. 5) years, without prior suicide attempts or other major illness, recruited in 1996-2001 were followed by record linkage to national hospital admission and death databases. Cox regression yielded relative risks (RRs) and 95% confidence intervals (CIs) for attempted suicide and suicide by BMI, adjusted for baseline lifestyle factors and self-reported treatment for depression or anxiety. RESULTS After 16 (s.d. 3) years of follow-up, 4930 women attempted suicide and 642 died by suicide. The small proportion (4%) with BMI <20 kg/m2 were at clearly greater risk of attempted suicide (RR = 1.38, 95% CI 1.23-1.56) and suicide (RR = 2.10, 1.59-2.78) than women of BMI 20-24.9 kg/m2; p < 0.0001 for both comparisons. Small body size at 10 and 20 years old was also associated with increased risks. Half the cohort had BMIs >25 kg/m2 and, while risks were somewhat lower than for BMI 20-24.9 kg/m2 (attempted suicide RR = 0.91, 0.86-0.96; p = 0.001; suicide RR = 0.79, 0.67-0.93; p = 0.006), the reductions in risk were not strongly related to level of BMI. CONCLUSIONS Being underweight is associated with a definite increase in the risk of suicidal behaviour, particularly death by suicide. Residual confounding cannot be excluded for the small and inconsistent decreased risk of suicidal behaviour associated with being overweight or obese.
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Affiliation(s)
| | - Anne Ferrey
- Nuffield Department of Primary Care Health Sciences, University of Oxford, UK
| | - Keith Hawton
- Department of Psychiatry, University of Oxford, UK
| | - Carol Hermon
- Nuffield Department of Population Health, University of Oxford, UK
| | | | - Jane Green
- Nuffield Department of Population Health, University of Oxford, UK
| | - Valerie Beral
- Nuffield Department of Population Health, University of Oxford, UK
| | - Sarah Floud
- Nuffield Department of Population Health, University of Oxford, UK
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Becker MA, Chandy A, Mayer JLW, Sachdeva J, Albertini ES, Sham C, Worley LLM. Psychiatric Aspects of Infertility. Am J Psychiatry 2019; 176:765-766. [PMID: 31474128 DOI: 10.1176/appi.ajp.2019.176702] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Stenyaeva NN, Chritinin DF, Chausov AA, Grigoriev VY, Sukhikh GT. [Psychopathological characterisitic of infertile women with sexual dysfunctions in assister reproductive technologies programs]. Zh Nevrol Psikhiatr Im S S Korsakova 2019; 119:51-58. [PMID: 31317890 DOI: 10.17116/jnevro201911905151] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM To study the psychopathological characteristics of infertile women with sexual disorders in assisted reproductive technologies (ART) programs to develop therapeutic and rehabilitative interventions and improve the quality of life of the couple. MATERIAL AND METHODS An open continuous comparative descriptive study of sexual health, psychopathological features and personality characteristics of 589 women with infertility seeking treatment using ART was performed in 2013-2017. Clinical-psychopathological, sexological and psychometric methods were used. RESULTS Non-psychotic mental disorders, predominantly anxiety disorders (28.0%), were identified in 58,9% of patients. Sexual dysfunctions of a disease level, among which prevailed disorder of libido (25.0%), were identified in 18.34% of patients. A high comorbidity of sexual dysfunctions and borderline mental disorders was detected (100% in patients with sexual dysfunctions versus 44.9% in patients without sexual disorders). an analysis of premorbid personality characteristics and severity of psychopathological symptoms based on the results of mpt, scl - 90 showed that patients with sexual disorders scored significantly lower on domains 'extroversion' and 'tolerance to frustration', while scores on 'esoteric tendencies', 'neuroticism', 'obsession', 'sensitivity', 'depression', 'anxiety', 'hostility' and 'psychoticism' were higher; significant positive and negative correlations between domains were noted. Increased or high levels of anhedonia assessed with scale SHAPS were found in 100% of patients, 43.8% had alexithymia according to TAS and 18.19% showed increased and high levels of asthenia (MFI-20). CONCLUSION Characteristics of the psychopathological structure of sexual dysfunctions in women with infertility in ART programs should be taken into account in the development of treatment and rehabilitation options and improvement of quality of life of the couple.
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Affiliation(s)
- N N Stenyaeva
- Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology Moscow, Russia
| | - D F Chritinin
- 'Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation', Moscow, Russia
| | - A A Chausov
- Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology Moscow, Russia
| | - V Yu Grigoriev
- Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology Moscow, Russia
| | - G T Sukhikh
- Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology Moscow, Russia; 'Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation', Moscow, Russia
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Abstract
Our purpose is to identify cancer patients at highest risk of suicide compared to the general population and other cancer patients. This is a retrospective, population-based study using nationally representative data from the Surveillance, Epidemiology, and End Results program, 1973-2014. Among 8,651,569 cancer patients, 13,311 committed suicide; the rate of suicide was 28.58/ 100,000-person years, and the standardized mortality ratio (SMR) of suicide was 4.44 (95% CI, 4.33, 4.55). The predominant patients who committed suicide were male (83%) and white (92%). Cancers of the lung, head and neck, testes, bladder, and Hodgkin lymphoma had the highest SMRs ( > 5-10) through the follow up period. Elderly, white, unmarried males with localized disease are at highest risk vs other cancer patients. Among those diagnosed at < 50 years of age, the plurality of suicides is from hematologic and testicular tumors; if > 50, from prostate, lung, and colorectal cancer patients. Cancer patients are at an increased risk of suicide: elderly, white, unmarried males with localized disease are at highest risk vs other cancer patients. Among those diagnosed at < 50 years of age, the plurality of suicides is from hematologic and testicular tumors; if > 50, from prostate, lung, and colorectal cancer patients.
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21
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Shahraki Z, Tanha FD, Ghajarzadeh M. Depression, sexual dysfunction and sexual quality of life in women with infertility. BMC WOMENS HEALTH 2018; 18:92. [PMID: 29898709 PMCID: PMC6001164 DOI: 10.1186/s12905-018-0584-2] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 06/05/2018] [Indexed: 12/02/2022]
Abstract
Background Women suffering from infertility are at higher risk of experiencing psychological problems. Sexual function and sexual related quality of life is not considered as it should be. We designed this study to assess depression, sexual function and sexual quality of life in Iranian women with infertility. Methods Two hundred and sixty four individuals participated in the study (115 healthy controls, 78 with primary and 71 with secondary infertility). All participants were asked to fill a valid and reliable Persian versions of BDI (Beck depression inventory), FSFIS (Female Sexual Function Index) and sexual quality of life-Female (SQOL-F) questionnaires. Results Mean BDI score was significantly lower in healthy individuals.Individuals with primary infertility suffered more from sexual dysfunction, while BDI score was significantly higher and SQOL-F was significantly lower in cases with sexual dysfunction. There was significant positive correlation between SQOL-F and total FSFI score (r = 0.59, p < 0.001). Linear regression analysis by considering SQOL-F as dependent and age, BDI, duration of marriage, sexual dysfunction (FSFI ≤26.55 or > 26.55) showed that BDI and sexual dysfunction were independent predictors of SQOL-F. Conclusion Sexual function and quality of life related to sexual life should be considered in Iranian infertile ones. Depression as a crucial factor should be focused more in infertile women. Electronic supplementary material The online version of this article (10.1186/s12905-018-0584-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Fatemeh Davari Tanha
- Department of Obstetrics and Gynecology, Yas Hospital, Tehran University of Medical Sciences, Nejatollahi street, Karimkhan, Tehran, Iran
| | - Mahsa Ghajarzadeh
- Universal Council of Epidemiology (UCE), Universal Scientific Education and Research Network (USERN), Imam Hospital, Tehran University of Medical Sciences, Tehran, Iran.
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22
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Yao H, Chan CHY, Chan CLW. Childbearing importance: A qualitative study of women with infertility in China. Res Nurs Health 2017; 41:69-77. [PMID: 29193167 DOI: 10.1002/nur.21846] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 11/08/2017] [Indexed: 11/09/2022]
Abstract
The primary goal of this study was to examine and describe the importance of childbearing as perceived by infertile women in the Chinese familial and social context. We adopted a qualitative descriptive method and conducted semi-structured interviews with female patients diagnosed with infertility. Participants were recruited at a high-volume fertility clinic in Tianjin, China. Fifteen women with a diagnosis of infertility were interviewed for 60-90 min. Data were analyzed by thematic analysis. Two themes supported the importance of childbearing for Chinese women with infertility: childbearing as natural law, and childbearing for relational harmony. Childbearing as natural law referred to intrinsic forces to seek a child, including (i) achieving motherhood and womanhood and (ii) experiencing a developmental transition with childbearing as a landmark. Relational harmony included three primary factors: (i) to maintain marital quality by preventing marital failure and rejuvenating an unsatisfactory marital relationship; (ii) to fulfill both authoritative and reciprocal filial piety; (iii) to build a sense of normalcy within family and social networks. In summary, infertility resulted in loss of motherhood, womanhood, and a smooth developmental transition. Moreover, it threatened relationship harmony in the marriage, family, and social life. These insights on the value of childbearing in the Chinese context can inform healthcare professionals in identify infertility-related demands and developing relevant psychosocial services for people with infertility.
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Affiliation(s)
- Hong Yao
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, Hong Kong
| | - Celia Hoi Yan Chan
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, Hong Kong
| | - Cecilia Lai Wan Chan
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, Hong Kong
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23
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Tremellen K, Wilkinson D, Savulescu J. Should obese women's access to assisted fertility treatment be limited? A scientific and ethical analysis. Aust N Z J Obstet Gynaecol 2017; 57:569-574. [PMID: 28299785 DOI: 10.1111/ajo.12600] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 12/15/2016] [Indexed: 12/12/2022]
Abstract
Obesity is associated with a reduction in fertility treatment success and increased risks to mother and child. Therefore guidelines of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) suggest that a body mass index exceeding 35 kg/m2 should be an absolute contraindication to assisted fertility treatment such as in vitro fertilisation IVF. In this paper we challenge the ethical and scientific basis for such a ban. Livebirth rates for severely obese women are reduced by up to 30%, but this result is still far better than that observed for many older women who are allowed access to IVF. This prohibition is particularly unjust when IVF is the only treatment capable of producing a pregnancy, such as bilateral tubal blockage or severe male factor infertility. Furthermore, the absolute magnitude of risks to mother or child is relatively small, and while a woman has a right to be educated about these risks, she alone should be allowed to make a decision on proceeding with treatment. We do not prohibit adults from engaging in dangerous sports, nor do we force parents to vaccinate their children, despite the risks. Similarly, we should not prohibit obese women from becoming parents because of increased risk to themselves or their child. Finally, prohibiting obese women's access to IVF to prevent potential harms such as 'fetal programing' is questionable, especially when compared to that child never being born at all. As such, we believe the RANZCOG ban on severely obese women's access to assisted reproductive treatment is unwarranted and should be revised.
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Affiliation(s)
- Kelton Tremellen
- Department of Obstetrics Gynaecology and Reproductive Medicine, Flinders University, Adelaide, South Australia, Australia
| | - Dominic Wilkinson
- Oxford Uehiro Centre for Practical Ethics, Faculty of Philosophy, University of Oxford, Oxford, UK.,Department of Neonatology, John Radcliffe Hospital, Oxford, UK
| | - Julian Savulescu
- Oxford Uehiro Centre for Practical Ethics, Faculty of Philosophy, University of Oxford, Oxford, UK
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Bensdorp AJ, Tjon-Kon-Fat R, Verhoeve H, Koks C, Hompes P, Hoek A, de Bruin JP, Cohlen B, Hoozemans D, Broekmans F, van Bomme P, Smeenk J, Mol BW, van der Veen F, van Wely M. Dropout rates in couples undergoing in vitro fertilization and intrauterine insemination. Eur J Obstet Gynecol Reprod Biol 2016; 205:66-71. [DOI: 10.1016/j.ejogrb.2016.08.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 07/25/2016] [Accepted: 08/01/2016] [Indexed: 10/21/2022]
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Shani C, Yelena S, Reut BK, Adrian S, Sami H. Suicidal risk among infertile women undergoing in-vitro fertilization: Incidence and risk factors. Psychiatry Res 2016; 240:53-59. [PMID: 27084991 DOI: 10.1016/j.psychres.2016.04.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2015] [Revised: 03/17/2016] [Accepted: 04/03/2016] [Indexed: 02/03/2023]
Abstract
Despite the fact that depression and other emotional distress are well documented in infertile women, little is known about the relationship between infertility and suicidal risk. The aim of this cross sectional study was to examine the rate of suicide risk (suicidal ideation/suicidal attempts) among 106 infertile women visiting Infertility and In-Vitro Fertilization (IVF) Hospital Unit, and to identify the demographic, medical and clinical correlates to suicidal risk. The incidence of suicide risk was 9.4%. Suicidal women were more likely to be childless or had fewer children and experienced higher levels of depressive symptoms. In addition, they reported more frequently on denial, social withdrawal and self-blame coping strategies compared to participants without suicidal risk. A multiple logistic regression model revealed that being childless, using non-positive reappraisal and exhibiting depressive symptoms were significant predictors of suicide risk in the future. These results suggest that routine assessment of suicidal risk and depression should be provided for infertile women in the course of IVF. Furthermore, future interventions should focus on helping them acquire different emotions regulation strategies and provide alternative skills for positive coping.
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Affiliation(s)
- Chen Shani
- School of Behavioral Sciences, the Academic College of Tel-Aviv yaffo (MTA), Israel.
| | - Stukalina Yelena
- School of Behavioral Sciences, the Academic College of Tel-Aviv yaffo (MTA), Israel.
| | - Ben Kimhy Reut
- IVF Unit, Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba 44281, Israel.
| | - Shulman Adrian
- IVF Unit, Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba 44281, Israel.
| | - Hamdan Sami
- School of Behavioral Sciences, the Academic College of Tel-Aviv yaffo (MTA), Israel.
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Datta J, Palmer MJ, Tanton C, Gibson LJ, Jones KG, Macdowall W, Glasier A, Sonnenberg P, Field N, Mercer CH, Johnson AM, Wellings K. Prevalence of infertility and help seeking among 15 000 women and men. Hum Reprod 2016; 31:2108-18. [PMID: 27365525 PMCID: PMC4991655 DOI: 10.1093/humrep/dew123] [Citation(s) in RCA: 221] [Impact Index Per Article: 27.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 04/29/2016] [Indexed: 12/03/2022] Open
Abstract
STUDY QUESTION What is the prevalence of infertility and of help seeking among women and men in Britain? SUMMARY ANSWER One in eight women and one in ten men aged 16–74 years had experienced infertility, defined by unsuccessfully attempting pregnancy for a year or longer, and little more than half of these people sought medical or professional help. WHAT IS KNOWN ALREADY Estimates of infertility and help seeking in Britain vary widely and are not easily comparable because of different definitions and study populations. STUDY DESIGN, SIZE, DURATION A cross-sectional population survey was conducted between 2010 and 2012 with a sample of 15 162 women and men aged 16–74 years. PARTICIPANTS/MATERIALS, SETTING, METHODS Participants completed the Natsal-3 questionnaire, using computer-assisted personal interviewing (CAPI) and computer-assisted self-interview (CASI). MAIN RESULTS AND THE ROLE OF CHANCE The reported prevalence of infertility was 12.5% (CI 95% 11.7–13.3) among women and 10.1% (CI 95% 9.2–11.1) among men. Increased prevalence was associated with later cohabitation with a partner, higher socio-economic status and, for those who had a child, becoming parents at older ages. The reported prevalence of help seeking was 57.3% (CI 95% 53.6–61.0) among women and 53.2% (CI 95% 48.1–58.1) among men. Help seekers were more likely to be better educated and in higher status occupations and, among those who had a child, to have become parents later in life. LIMITATIONS, REASONS FOR CAUTION These data are cross-sectional so it is not possible to establish temporality or infer causality. Self-reported data may be subject to recall bias. WIDER IMPLICATIONS OF THE FINDINGS The study provides estimates of infertility and help seeking in Britain and the results indicate that the prevalence of infertility is higher among those delaying parenthood. Those with higher educational qualifications and occupational status are more likely to consult with medical professionals for fertility problems than others and these inequalities in help seeking should be considered by clinical practice and public health. STUDY FUNDING/COMPETING INTEREST(S) Funding was provided by grants from the Medical Research Council and the Wellcome Trust, with support from the Economic and Social Research Council and the Department of Health. AMJ is a Governor of the Wellcome Trust. Other authors have no competing interests.
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Affiliation(s)
- J Datta
- Centre for Sexual and Reproductive Health Research, Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK
| | - M J Palmer
- Centre for Sexual and Reproductive Health Research, Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK
| | - C Tanton
- Research Department of Infection and Population Health, University College London, Mortimer Market Centre, London WC1E 6JB, UK
| | - L J Gibson
- Centre for Sexual and Reproductive Health Research, Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK
| | - K G Jones
- Research Department of Infection and Population Health, University College London, Mortimer Market Centre, London WC1E 6JB, UK
| | - W Macdowall
- Centre for Sexual and Reproductive Health Research, Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK
| | - A Glasier
- MRC Centre for Reproductive Health, Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TY, UK Centre for Sexual and Reproductive Health Research, Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK
| | - P Sonnenberg
- Research Department of Infection and Population Health, University College London, Mortimer Market Centre, London WC1E 6JB, UK
| | - N Field
- Research Department of Infection and Population Health, University College London, Mortimer Market Centre, London WC1E 6JB, UK
| | - C H Mercer
- Research Department of Infection and Population Health, University College London, Mortimer Market Centre, London WC1E 6JB, UK
| | - A M Johnson
- Research Department of Infection and Population Health, University College London, Mortimer Market Centre, London WC1E 6JB, UK
| | - K Wellings
- Centre for Sexual and Reproductive Health Research, Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK
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Jones BP, Saso S, Yazbek J, Smith JR. Uterine transplantation: past, present and future. BJOG 2016; 123:1434-8. [PMID: 26931179 DOI: 10.1111/1471-0528.13963] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2016] [Indexed: 12/19/2022]
Affiliation(s)
- BP Jones
- West London Gynaecological Cancer Centre; Imperial College NHS Trust; London UK
- Department of Surgery and Cancer; Imperial College London; London UK
| | - S Saso
- West London Gynaecological Cancer Centre; Imperial College NHS Trust; London UK
- Department of Surgery and Cancer; Imperial College London; London UK
| | - J Yazbek
- West London Gynaecological Cancer Centre; Imperial College NHS Trust; London UK
| | - JR Smith
- West London Gynaecological Cancer Centre; Imperial College NHS Trust; London UK
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28
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Mirblouk F, Asgharnia M, Solimani R, Fakor F, Salamat F, Mansoori S. Comparison of sexual dysfunction in women with infertility and without infertility referred to Al-Zahra Hospital in 2013-2014. Int J Reprod Biomed 2016. [DOI: 10.29252/ijrm.14.2.117] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
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29
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Ying LY, Wu LH, Loke AY. Gender differences in experiences with and adjustments to infertility: A literature review. Int J Nurs Stud 2015; 52:1640-52. [DOI: 10.1016/j.ijnurstu.2015.05.004] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 05/10/2015] [Accepted: 05/10/2015] [Indexed: 11/16/2022]
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30
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Characteristics of Women Who Have Had Cosmetic Breast Implants That Could Be Associated with Increased Suicide Risk: A Systematic Review, Proposing a Suicide Prevention Model. Arch Plast Surg 2015; 42:131-42. [PMID: 25798383 PMCID: PMC4366693 DOI: 10.5999/aps.2015.42.2.131] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 07/21/2014] [Accepted: 07/26/2014] [Indexed: 11/08/2022] Open
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31
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Tremellen K, Savulescu J. Ovarian reserve screening: a scientific and ethical analysis. Hum Reprod 2014; 29:2606-14. [DOI: 10.1093/humrep/deu265] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
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32
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Listijono DR, Mooney S, Chapman M. A comparative analysis of postpartum maternal mental health in women following spontaneous or ART conception. J Psychosom Obstet Gynaecol 2014; 35:51-4. [PMID: 24766532 DOI: 10.3109/0167482x.2014.911281] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To determine whether conception following assisted reproductive technology (ART) predisposes women to increased risk of postnatal depression (PND), compared to women who conceived naturally, when controlling for such factors as: multiple birth, previous maternal psychiatric history and sociodemographic status. PARTICIPANTS A total of 200 women who attended the private antenatal and fertility clinics of a fertility specialist in a large Australian city between January 2009 and December 2011 were contacted via telephone. RESULTS There was no difference in the rate of PND between the two groups (7.5% versus 7.4%, p = ns). Aside from the slightly older maternal age in the ART group (35.4 versus 33, p < 0.05), baseline socio-demographics were similar. There was a significantly higher rate of previous maternal clinical depression in the ART group compared to the controls (17% versus 5%, p < 0.05); however, other known risk factors for PND, including previous PND (10.6% versus 13.7%, p = ns), multiple births (2.1% versus 4.2%, p = ns) and low infant birth weight (3.3 kg versus 3.4 kg, p = ns), were not different in the two cohorts. Women who conceived naturally were also more likely to breastfeed for a longer duration (78% versus 89%, p < 0.05). CONCLUSION Our study demonstrates that when accounting for well-known risk and protective factors for postpartum depression, women who conceive using ART are not at an increased risk PND. In addition, the low rate of multiple births in the ART group further validates the practice of single embryo transfer.
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Sexual function in women with primary and secondary infertility in comparison with controls. Int J Impot Res 2014; 26:132-4. [PMID: 24430276 DOI: 10.1038/ijir.2013.51] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Revised: 11/23/2013] [Accepted: 12/12/2013] [Indexed: 11/09/2022]
Abstract
Infertility is a distressing health condition that has diverse effects on couples' lives. One of the most affected aspects of life in infertile women is sexual function, which is a key factor in physical and marital health. The goal of this study was to evaluate sexual function according to the type of infertility in comparison with controls. In this study, 191 women with primary infertility and 129 with secondary infertility along with 87 age-matched healthy controls were enrolled. They were asked to fill a valid and reliable FSFI (Female Sexual Function Index). Age, partner age and duration of marriage were significantly different between the primary and secondary infertility groups. The score of each FSFI domain was significantly higher in the control group, and the only significant difference between primary and secondary infertility groups was in the desire domain. Multiple linear regression analysis between the total FSFI score as a dependent variable and age, partner age, Body Mass Index and marriage duration as independent variables showed that age is a dependent predictor of FSFI in the primary group. We found significant negative correlation between total FSFI score and age, partner age and marriage duration (r1=-0.21 and P<0.001, r2=-0.14 and P=0.01, r3=-0.19 and P<0.001). Sexual dysfunction is high in all infertile women, and women with secondary infertility suffer more from impaired sexual function compared with those with primary infertility.
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34
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Rafique S, Sterling EW, Nelson LM. A new approach to primary ovarian insufficiency. Obstet Gynecol Clin North Am 2013. [PMID: 23182561 DOI: 10.1016/j.ogc.2012.09.007] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
There is a need for a new approach to managing women with primary ovarian insufficiency. This condition is a serious chronic disease that may have far reaching effects on physical and emotional health. An integrative and collaborative approach to management works best. To maintain wellness, most women with primary ovarian insufficiency need to reassess their primary source of meaning and purpose in life and how this diagnosis may have threatened that part of who they are. They also need assessment with regard to bone health, thyroid and adrenal function, determination of FMR1 premutation and karyotype status, and ongoing estradiol-progestin hormone replacement.
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Affiliation(s)
- Saima Rafique
- Intramural Research Program on Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 10 Center Drive, Building 10, CRC, Room 1-3140, Bethesda, MD 20892-1109, USA
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35
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Huppelschoten AG, van Dongen AJCM, Verhaak CM, Smeenk JMJ, Kremer JAM, Nelen WLDM. Differences in quality of life and emotional status between infertile women and their partners. Hum Reprod 2013; 28:2168-76. [PMID: 23748487 DOI: 10.1093/humrep/det239] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
STUDY QUESTION Do the quality of life (QoL) and the risk factors for emotional problems during and after treatment of infertile women differ from their partners? SUMMARY ANSWER Women have lower levels of fertility-related QoL, and more and differing risk factors for emotional problems during and after treatment than their partners. WHAT IS KNOWN ALREADY?: The psychological impact of infertility in patients negatively affects their QoL and is also related to increased discontinuation of treatment. Moreover, psychological factors might positively affect pregnancy rates. However, it is still unclear if differences in QoL and emotional status exist between infertile women and their partners. So far, research mainly focused on generic instruments to measure patients' QoL in the area of fertility care. STUDY DESIGN, SIZE, DURATION A cross-sectional study of infertile couples within 32 Dutch fertility clinics. PARTICIPANTS/MATERIALS, SETTING, METHODS We included infertile women and their partners (both heterosexual and lesbian couples) under any treatment and at any stage of treatment in one of the 32 participating clinics. Per clinic, 25-75 patients were randomly selected depending on clinic size. In total, 1620 women and their partners were invited separately to complete the FertiQoL and SCREENIVF questionnaires to measure their level of QoL and risk factors for emotional problems during and after treatment, respectively. MAIN RESULTS AND THE ROLE OF CHANCE A total of 946 women (response rate 58%) and 670 partners (response rate 41%) completed the questionnaire set. As 250 women and 150 partners were already pregnant, questionnaires from 696 women and 520 partners could be analysed. Women scored significantly lower on the FertiQoL total scores [B = -6.31; 95% confidence interval (CI) = -7.63 to 4.98] and three of the FertiQoL subscales (Emotional, Mind-Body and Social) than their partners, indicating lower QoL. Scores on the SCREENIVF questionnaire were significantly higher for women (B = 0.22; 95% CI = 0.06-0.38), indicating that women are more at risk for developing emotional problems (and these factors differed from those of their partners) during and after fertility treatment than their partners. LIMITATIONS, REASONS FOR CAUTION Although the number of participants is high (n = 1216), the relatively low response rate, especially for partners (41%), may have influenced the results through selection bias. An analysis of non-responders could not be performed. The FertiQoL and SCREENIVF questionnaires, which have been validated only in women starting a first IVF cycle, should also be validated for studying partners. In addition, the SCREENIVF questionnaire has been validated in Dutch women only and further research in an international setting is also required. WIDER IMPLICATIONS OF THE FINDINGS Our study results represent the Dutch infertile population as more than one-third of all Dutch clinics participated in the study. As the FertiQoL questionnaire is an internationally validated questionnaire already, these results can be put in a more broader and international perspective. STUDY FUNDING/COMPETING INTEREST(S) This work was supported by Merck Sharp & Dohme (MSD), The Netherlands. There are no competing interests.
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Affiliation(s)
- A G Huppelschoten
- Department of Obstetrics and Gynaecology, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands
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Abstract
Assisted reproductive technology (ART) offers patients the hope that they may have a child and provides the primary motivation for treatment. Despite the treatment failure, for many, the hope of conception remains. The decision to abandon treatment is momentous, especially for those couples with a diagnosis of unexplained infertility. The urgency for individuals to pre-empt future regrets and to know they have done enough to do so contributes to a significant amount of pressure. This pressure is further exacerbated by external pressures to conceive. A significant factor intrinsic to the decision-making process is the role of 'hope'. Hope allows women, in particular, to avoid the reality of potential childlessness. Thus, the necessity for psychological support to be offered at the point of ending treatment is crucial. This paper draws on the author's research completed in 2005 and includes a more recent literature search which finds the original evidence still pertinent.
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Affiliation(s)
- Jane Boden
- Department of Psychology, University of Hull, Hull, UK.
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Schmidt L, Hageman I, Hougaard CØ, Sejbaek CS, Assens M, Ebdrup NH, Pinborg A. Psychiatric disorders among women and men in assisted reproductive technology (ART) treatment. The Danish National ART-Couple (DANAC) cohort: protocol for a longitudinal, national register-based cohort study. BMJ Open 2013; 3:bmjopen-2012-002519. [PMID: 23524043 PMCID: PMC3612800 DOI: 10.1136/bmjopen-2012-002519] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION There are complex causal associations between mental disorders, fertility treatment, fertility treatment outcome and infertility per se. Eating disorders cause endocrine disturbances, anovulation and thereby infertility, and research has shown that infertility as well as unsuccessful assisted reproductive technology (ART) treatment are potential risk factors for developing a depression on a long-term basis. Despite the fact that worldwide more than 400 000 ART treatment cycles are performed every year, the causal associations between mental disorders, use of medication for mental disorders and ART treatment in both sexes have only been sparsely explored. METHOD AND ANALYSIS The main objective of this national register-based cohort study is to assess women's and men's mental health before, during, and after ART treatment in comparison with the mental health in an age-matched population-based cohort of couples with no history of ART treatment. Furthermore, the objective is to study the reproductive outcome of ART treatment among women who have a registered diagnosis of a mental disorder or have used medication for mental disorders prior to ART treatment compared with women in ART treatment without a mental disorder. We will establish the Danish National ART-Couple (DANAC) cohort including all women registered with ART treatment in the Danish in vitro fertilisation Register during 1994-2009 (N=42 915) and their partners. An age-matched population-based comparison cohort of women without ART treatment (n=215 290) and their partners will be established. Data will be cross-linked with data from national registers on psychiatric disorders, medical prescriptions for mental disorders, births, causes of deaths and sociodemographic data. Survival analyses and other statistical analyses will be conducted on the development of mental disorders and use of medication for mental disorders for women and men both prior to and after ART treatment.
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Affiliation(s)
- Lone Schmidt
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Ida Hageman
- Psychiatric Center, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Charlotte Ørsted Hougaard
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Camilla Sandal Sejbaek
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Maria Assens
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Ninna Hinchely Ebdrup
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Anja Pinborg
- Fertility Clinic, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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Borneskog C, Sydsjö G, Lampic C, Bladh M, Svanberg AS. Symptoms of anxiety and depression in lesbian couples treated with donated sperm: a descriptive study. BJOG 2013; 120:839-46. [PMID: 23489411 PMCID: PMC3672688 DOI: 10.1111/1471-0528.12214] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2013] [Indexed: 11/30/2022]
Abstract
Objective To investigate symptoms of anxiety and depression in lesbian couples undergoing assisted reproductive treatment (ART), and to study the relationship of demographic data, pregnancy outcome and future reproductive plans with symptoms of anxiety and depression. Design Descriptive, a part of the prospective longitudinal ‘Swedish study on gamete donation’. Setting All university clinics in Sweden performing gamete donation. Population A consecutive sample of 214 lesbian couples requesting assisted reproduction, 165 of whom participated. Methods Participants individually completed three study-specific questionnaires and the Hospital Anxiety and Depression Scale (HADS): time point 1 (T1), at commencement of ART; time point 2 (T2), approximately 2 months after treatment; and time point 3 (T3), 2–5 years after first treatment. Main outcome measures Anxiety and depression (HADS), pregnancy outcome and future reproductive plans. Results The vast majority of lesbian women undergoing assisted reproduction reported no symptoms of anxiety and depression at the three assessment points. A higher percentage of the treated women, compared with the partners, reported symptoms of anxiety at T2 (14% versus 5%, P = 0.011) and T3 (10% versus 4%, P = 0.018), as well as symptoms of depression at T2 (4% versus 0%, P = 0.03) and T3 (3% versus 0%, P = 0.035). The overall pregnancy outcome was high; almost three-quarters of lesbian couples gave birth 2–5 years after sperm donation treatments. Open-ended comments illustrated joy and satisfaction about family building. Conclusion Lesbian women in Sweden reported good psychological health before and after treatment with donated sperm.
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Affiliation(s)
- C Borneskog
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
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Mendez-Bustos P, Lopez-Castroman J, Baca-García E, Ceverino A. Life cycle and suicidal behavior among women. ScientificWorldJournal 2013; 2013:485851. [PMID: 23533350 PMCID: PMC3603326 DOI: 10.1155/2013/485851] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Accepted: 01/23/2013] [Indexed: 11/17/2022] Open
Abstract
It is nowadays accepted that, independently of methodological issues, women commit fewer suicides than men but make more frequent attempts. Yet, female suicidal risk varies greatly along the lifetime and is linked to the most significant moments in it. A wide analysis of the existing literature was performed to provide a narrative description on the evolution of female suicidal rates from childhood to old age, considering the milestones in their life history. A detailed analysis of gender differences in suicidal behavior is key to establish preventive measures and priorities. More specific studies are needed to adapt future interventions on female suicide.
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Affiliation(s)
- Pablo Mendez-Bustos
- Department of Psychology, Catholic University of Maule, Avenida San Miguel 3605, Talca, Chile
| | - Jorge Lopez-Castroman
- Department of Psychiatry, Fundacion Jimenez Diaz Hospital, Autonoma University, CIBERSAM Avenida Reyes Catolicos 2, 28040 Madrid, Spain
| | - Enrique Baca-García
- Department of Psychiatry, Fundacion Jimenez Diaz Hospital, Autonoma University, CIBERSAM Avenida Reyes Catolicos 2, 28040 Madrid, Spain
- Department of Psychiatry, New York State Psychiatric Institute Columbia University, 1051 Riverside Drive, New York, NY 10032, USA
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Furukawa AP, Patton PE, Amato P, Li H, Leclair CM. Dyspareunia and sexual dysfunction in women seeking fertility treatment. Fertil Steril 2012; 98:1544-8.e2. [DOI: 10.1016/j.fertnstert.2012.08.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2012] [Revised: 07/31/2012] [Accepted: 08/07/2012] [Indexed: 01/23/2023]
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