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Jannite UK, Abedin S, Rahman MM. Technology-facilitated sexual harassment and mental health symptoms among young-adult female student sample in Bangladesh. Arch Womens Ment Health 2024:10.1007/s00737-024-01498-2. [PMID: 39103731 DOI: 10.1007/s00737-024-01498-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 07/29/2024] [Indexed: 08/07/2024]
Abstract
PURPOSE To assess the prevalence of technology-facilitated sexual harassment (TFSH) and its relationships to adverse mental health issues among young adult female students in Bangladesh. METHODS We collected data for this cross-sectional study from July to September 2022 from 455 female students at a large university in Bangladesh. The prevalence of TFSH, self-reported distress, stress, anxiety, depression, and suicidal thoughts was assessed. Multivariable logistic regressions were used to assess the identified relationships. RESULTS This study found that nearly half of the respondents (46.1%) reported having experienced TFSH. The prevalence of suicidal thoughts, moderate to severe distress, stress, anxiety, and depression was 34.9%, 47.7%, 78.2%, 36.9%, and 59.8%, respectively. Results also reported that, compared to the respondents who did not experience TFSH, those who experienced it were more likely to report adverse mental health issues with higher odds. For example, after controlling for sociodemographic variables, the odds of moderate to severe distress (Adjusted odds ratio [AOR]: 3.70; 95% confidence interval [CI]: 2.36-5.78), stress (AOR: 2.09; 95% CI: 1.25-3.49), anxiety (AOR: 3.80; 95% CI: 2.40-6.03), depression (AOR: 3.32; 95% CI: 2.12-5.18), and having suicidal thoughts (AOR: 4.86; 95% CI: 2.29-7.89) were higher among female students experiencing TFSH than those who did not experience it. CONCLUSIONS TFSH harassment among young adult female students is common and significantly associated with different adverse mental health issues. Attempts at primary intervention for improving mental health status are required to take TFSH into consideration.
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Affiliation(s)
- Umma Khatamun Jannite
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, 6205, Bangladesh
| | - Sumaiya Abedin
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, 6205, Bangladesh
| | - Md Mosfequr Rahman
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, 6205, Bangladesh.
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Szigeti F J, Kazinczi C, Szabó G, Sipos M, Ujma PP, Purebl G. The clinical effectiveness of the Mind/Body Program for Infertility on wellbeing and assisted reproduction outcomes: a randomized controlled trial in search for active ingredients. Hum Reprod 2024; 39:1735-1751. [PMID: 38852061 PMCID: PMC11291950 DOI: 10.1093/humrep/deae119] [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: 12/19/2023] [Revised: 04/20/2024] [Indexed: 06/10/2024] Open
Abstract
STUDY QUESTION Does the Mind/Body Program for Infertility (MBPI) perform better, due to certain distinctive elements, than a partly matched support group in improving the wellbeing and medically assisted reproduction (MAR) outcomes of women with elevated distress levels in a clinical setting? SUMMARY ANSWER While robust enhancements occurred in the wellbeing overall, the cognitive behavioural and formalized stress management elements of the MBPI allowed a significantly stronger improvement in trait anxiety, but not in other mental health and MAR outcomes, compared with a support group. WHAT IS KNOWN ALREADY Mind-body psychological programmes adjacent to MAR have been found to improve women's mental states and possibly increase chances of pregnancy. However, not enough is known about the programme's effectiveness among patients with elevated distress levels in routine clinical settings, nor is it clear which of its particular ingredients are specifically effective. STUDY DESIGN, SIZE, DURATION A pre-post design, single-centre, randomized controlled trial was performed between December 2019 and October 2022 (start and end of recruitment, respectively). The sample size (n = 168) was calculated to detect superiority of the MBPI in improving fertility-related quality of life. Randomization was computer-based, with random numbers concealing identities of patients until after allocation. PARTICIPANTS/MATERIALS, SETTING, METHODS The trial was conducted at a large university teaching hospital. A total of 168 patients were randomly assigned to the mind-body (MBPI) group (n = 84) and the fertility support (FS) control group (n = 84). Patients received a 10-week, 135-min/week group intervention, with the FS group following the same format as the MBPI group, but with a less restricted and systematic content, and without the presumed effective factors. The number of patients analysed was n = 74 (MBPI) and n = 68 (FS) for post-intervention psychological outcomes, and n = 54 (MBPI) and n = 56 (FS) for pregnancy outcomes at a 30-month follow-up. MAIN RESULTS AND THE ROLE OF CHANCE Significant improvements occurred in both groups in all psychological domains (adjusted P < 0.001), except for treatment-related quality of life. Linear mixed-model regression analysis did not reveal significantly greater pre-post improvements in the MBPI group than in the FS group in fertility-related quality of life (difference in differences (DD) = 4.11 [0.42, 7.80], d = 0.32, adjusted P = 0.124), treatment-related quality of life (DD = -3.08 [-7.72, 1.55], d = -0.20, adjusted P = 0.582), infertility-specific stress (DD = -2.54 [-4.68, 0.41], d = -0.36, adjusted P = 0.105), depression (DD = -1.16 [3.61, 1.29], d = -0.13, adjusted P = 0.708), and general stress (DD = -0.62 [-1.91, 0.68], d = -0.13, adjusted P = 0.708), but it did show a significantly larger improvement in trait anxiety (DD = -3.60 [-6.16, -1.04], d = -0.32, adjusted P = 0.042). Logistic regression showed no group effect on MAR pregnancies, spontaneous pregnancies, or live births. LIMITATIONS, REASONS FOR CAUTION The follow-up only covered MAR-related medical outcomes and no psychological variables, and their rates were not equal in the two groups. Biological factors other than age, aetiology, and duration of infertility may have confounded the study results. Loss to follow-up was between 5% and 10%, which may have led to some bias. WIDER IMPLICATIONS OF THE FINDINGS The psychologically and medically heterogeneous sample, the normal clinical setting and the low attrition rate all raise the external validity and generalizability of our study. The MBPI works not only in controlled conditions, but also in routine MAR practice, where it can be introduced as a cost-effective, low-intensity psychological intervention, within the framework of stepped care. More studies are needed to further identify its active ingredients. STUDY FUNDING/COMPETING INTEREST(S) The authors received no financial support for the research, authorship, and/or publication of this article. The authors have no conflict of interest to disclose. TRIAL REGISTRATION NUMBER ClinicalTrials.gov NCT04151485. TRIAL REGISTRATION DATE 5 November 2019. DATE OF FIRST PATIENT’S ENROLMENT 15 December 2019.
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Affiliation(s)
- Judit Szigeti F
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
- Department of Otorhinolaryngology, Head and Neck Surgery, Semmelweis University, Budapest, Hungary
| | - Csaba Kazinczi
- Department of Clinical Psychology, Semmelweis University, Budapest, Hungary
- Doctoral School of Clinical Medicine, University of Szeged, Szeged, Hungary
| | - Georgina Szabó
- Doctoral School of Mental Health Sciences, Semmelweis University, Budapest, Hungary
- Department of Psychiatry, North Buda Saint John’s Hospital Centre and Outpatient Clinic, Budapest, Hungary
| | - Miklós Sipos
- Department of Obstetrics and Gynecology, Assisted Reproduction Centre, Semmelweis University, Budapest, Hungary
| | | | - György Purebl
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
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Gibson AG, Moenter SM. Early-Life Resource Scarcity in Mice Does Not Alter Adult Corticosterone or Preovulatory Luteinizing Hormone Surge Responses to Acute Psychosocial Stress. eNeuro 2024; 11:ENEURO.0125-24.2024. [PMID: 39009448 PMCID: PMC11287788 DOI: 10.1523/eneuro.0125-24.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 06/27/2024] [Accepted: 07/09/2024] [Indexed: 07/17/2024] Open
Abstract
Early-life stressors can affect reproductive development and change responses to adult stress. We tested if resource scarcity in the form of limited bedding and nesting (LBN) from postnatal days (PND) 4 to 11 delayed sexual maturation in male and female mice and/or altered the response to an acute, layered, psychosocial stress (ALPS) in adulthood. Contrary to the hypotheses, age and mass at puberty were unaffected by the present application of LBN. Under basal conditions and after ALPS, corticosterone concentrations in males, diestrous females, and proestrous females reared in standard (STD) or LBN environments were similar. ALPS disrupts the luteinizing hormone (LH) surge in most mice when applied on the morning of proestrus; this effect was not changed by resource scarcity. In this study, the paucity of effects in the offspring may relate to a milder response of CBA dams to the paradigm. While LBN dams exited the nest more often and their offspring were smaller than STD-reared offspring on PND11, dam corticosterone concentrations were similar on PND11. To test if ALPS disrupts the LH surge by blunting the increase in excitatory GABAergic input to gonadotropin-releasing hormone (GnRH) neurons on the afternoon of proestrus, we conducted whole-cell voltage-clamp recordings. The frequency of GABAergic postsynaptic currents in GnRH neurons was not altered by LBN, ALPS, or their interaction. It remains possible that ALPS acts at afferents of GnRH neurons, changes response of GnRH neurons to input, and/or alters pituitary responsiveness to GnRH and that a more pronounced resource scarcity would affect the parameters studied.
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Affiliation(s)
- Amanda G Gibson
- Neurocience Graduate Program, University of Michigan, Ann Arbor, Michigan 48109-5622
| | - Suzanne M Moenter
- Departments of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, Michigan 48109-5622
- Internal Medicine, University of Michigan, Ann Arbor, Michigan 48109-5622
- Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan 48109-5622
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Li Y, McLeish J, Hardy P, Cole C, Carson C, Alderdice F, Maheshwari A. Anxiety in couples undergoing IVF: evidence from E-Freeze randomised controlled trial. Hum Reprod Open 2024; 2024:hoae037. [PMID: 39055488 PMCID: PMC11272172 DOI: 10.1093/hropen/hoae037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 05/14/2024] [Indexed: 07/27/2024] Open
Abstract
STUDY QUESTION What are the risk factors and impacts of anxiety in women and men in heterosexual couples undergoing IVF as part of a randomised trial, with a delay in embryo transfer in one arm? SUMMARY ANSWER Duration of infertility, ethnicity, and male partner's anxiety levels were associated with women's anxiety at the start of treatment, while initial anxiety score, partner's anxiety score at embryo transfer, ethnicity, and clinic location were associated with women's anxiety levels at embryo transfer; although women undergoing IVF were more anxious than their partners for slightly different reasons, their self-reported state anxiety was not associated with achieving clinical pregnancy, nor with switching from delayed frozen embryo transfer to fresh embryo transfer in an IVF trial. WHAT IS KNOWN ALREADY Use of IVF treatment continues to rise and patients undergoing IVF are anxious. Participating in a randomised controlled trial (RCT) with uncertainty of arm randomisation might increase their anxiety, while a delay in treatment may add further to anxiety. STUDY DESIGN SIZE DURATION A mixed methods study was conducted using data from the multi-centre E-Freeze RCT cohort conducted across 13 clinics in the UK from 2016 to 2019. A regression analysis on anxiety scores of couples undergoing the IVF trial and a qualitative analysis of participant questionnaires were performed. PARTICIPANTS/MATERIALS SETTING METHODS Six hundred and four couples participating in the E-Freeze trial, who had at least one useable State-Trait Anxiety Inventory (STAI) State Anxiety subscale (STAI-S) standardised self-report questionnaire for at least one of the partners, were included in the study. STAI-S scores were measured at consent for trial (T1) and again at embryo transfer (T2). Linear and log-binomial regression were used to explore the association between characteristics and STAI-S scores, and the associations between STAI-S scores and non-compliance and clinical pregnancy, respectively. Responses to the open text question were qualitatively analysed inductively using content analysis. MAIN RESULTS AND THE ROLE OF CHANCE Women's STAI-S scores at T1 (consent) were associated with their ethnicity, duration of infertility, and their male partner's STAI-S score at T1. Women's STAI-S scores at T2 (embryo transfer) were associated with their ethnicity, location of fertility clinic, their STAI-S score at consent, and their male partner's STAI-S score at embryo transfer. The adjusted coefficient (95% CI) for women's STAI-S scores at T2 was -4.75 (-7.29, -2.20, P < 0.001) for ethnic minority versus White, -2.87 (-4.85, -0.89, P = 0.005) for Scotland versus England, 0.47 (0.37, 0.56, P < 0.001) for each point increase in their own score at T1, and 0.30 (0.21, 0.40, P < 0.001) for each point increase in their male partner's score at T2. On average, women had higher STAI-S scores than men at both time points, and a larger increase of scores between the two time points. However, women's STAI-S scores were not associated with either non-compliance with trial allocation in the 'freeze-all' trial arm, or with chances of pregnancy. Both partners, but particularly women, described feeling anxious about the outcome of IVF, with women carrying the added worry of believing that feeling stressed might itself affect the outcome. Participants highlighted the important role of support from staff in helping them to manage their anxiety. LIMITATIONS REASONS FOR CAUTION Data were not available on education level or social support, which might influence anxiety scores. Men's baseline characteristics were not collected. WIDER IMPLICATIONS OF THE FINDINGS Identifying couples at increased risk of emotional distress may be improved by using standardised anxiety measures at the start of the fertility treatment. Women can be reassured that their self-reported state anxiety does not affect their chances of achieving clinical pregnancy through IVF, and this may help to reduce anxiety levels. The psychological wellbeing and experiences of couples undergoing IVF could be supported by patient-centred care: making information about the whole process of treatment and choices available to both partners in accessible formats; ensuring interactions with staff are kind and supportive; and acknowledging and addressing the different concerns of women undergoing IVF and their partners. STUDY FUNDING/COMPETING INTERESTS This study was an NIHR HTA (National Institute for Health and Care Research Health Technology Assessment) funded study. There are no conflicts of interest to declare. TRIAL REGISTRATION NUMBER ISRCTN registry: ISRCTN61225414.
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Affiliation(s)
- Yangmei Li
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Jenny McLeish
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Pollyanna Hardy
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Christina Cole
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Claire Carson
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Fiona Alderdice
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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Hya KM, Huang Z, Chua CMS, Shorey S. Experiences of men undergoing assisted reproductive technology: A qualitative systematic review. Int J Gynaecol Obstet 2024; 165:9-21. [PMID: 37694768 DOI: 10.1002/ijgo.15082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 07/29/2023] [Accepted: 08/17/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND Many infertile couples undergo assisted reproductive technology (ART) to increase pregnancy chances, with many of them experiencing psychosocial distress. Although research has been performed on women's experiences of ART, there is limited focus on men. OBJECTIVE This systematic review consolidated and synthesized men's experiences with ART to better understand their needs and challenges to support them. SEARCH STRATEGY Nine electronic databases were searched from the inception date until November 2022. SELECTION CRITERIA This review included published and unpublished primary studies with qualitative methodologies exploring men's experiences with ART. DATA COLLECTION AND ANALYSIS The screening of studies, methodological assessment, data extraction, and analysis were conducted by two reviewers independently. The data were thematically synthesized. MAIN RESULTS Fifteen studies were included. An overarching theme of "despair to destiny" was identified, with four synthesized themes: (1) "the roller coaster ride," (2) "what made it from bad to worse?", (3) "what kept men going?", and (4) "hopeful for the future." CONCLUSION Men undergoing ART experienced struggles, a transition of emotions, and a need for support as they attempted to cope with unknowns while remaining hopeful for future outcomes. There is a need for health care interventions and policies to address the issue to improve the well-being of male ART patients. Interventions should be tailored to the specific support groups that cater to the emotional and informational needs of male ART patients. Future research should focus on the influence of cultural sensitivities on men's ART experiences, to tailor support programs to address their psychological needs during ART.
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Affiliation(s)
- Kia Min Hya
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Zhongwei Huang
- NUS Bia-Echo Asia Centre for Reproductive Longevity and Equality (ACRLE), Singapore, Singapore
- Undergraduate Medical Education, Department of Obstetrics & Gynaecology, YLLSoM, NUS, Singapore, Singapore
- Departments of Obstetrics & Gynaecology and Physiology, YLLSoM, NUS, Singapore, Singapore
- Department of Obstetrics & Gynaecology, National University Health Systems, Singapore, Singapore
| | - Crystal Min Siu Chua
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Jiang Z, Hou S, Zhang Y, Zong L. The mediating and moderating effects of resilience on the relationship between sleep quality and psychological distress in Chinese women with infertility. BMC Womens Health 2024; 24:192. [PMID: 38515092 PMCID: PMC10956316 DOI: 10.1186/s12905-024-03018-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 03/12/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND Research has widely indicated that the psychological distress experienced by infertile patients during fertility treatments may have a negative effect on the results of assisted reproduction. Although numerous studies have shown that psychological resilience and sleep quality are important influencing factors for psychological distress, the mediating mechanisms of psychological resilience in the relationship between sleep quality and psychological distress for Chinese women in particular remain unclear. Therefore, the current study investigates the association between sleep quality, resilience, and psychological distress in Chinese women with infertility and examines the mediating and moderating roles of resilience on the relationship between sleep quality and psychological distress. METHODS In this cross-sectional study, a total of 595 women with infertility who were undergoing IVF-ET were recruited at the Reproductive Medicine, Shandong University, from April to November 2019. Participants were instructed to complete four questionnaires, including a questionnaire about socio-demographic and clinical-related information, the Pittsburgh Sleep Quality Index (PSQI), the 10-item Connor-Davidson Resilience Scale (CD-RISC-10), and the Kessler-10 (K10). Pearson's correlation analysis was conducted preliminarily to describe the relationships between sleep quality, resilience, and psychological distress. A mediation model and a moderated model were constructed and analyzed using the PROCESS macro for SPSS. The Johnson-Neyman (J-N) technique was then used to identify the regions of significance across the levels of moderator values. RESULTS Patients in the sample had a high prevalence of psychological distress (48.6%, K10 scores > 22), and mediation analysis indicated that resilience played a partially mediating role in the relationship between sleep quality and psychological distress (indict effect = 0.072, P < 0.001). Moderation analysis indicated that resilience also moderated the association between sleep quality and psychological distress. CONCLUSIONS Resilience may play a key role in the relationship between sleep quality and psychological distress. Our findings imply that resilience training may therefore be an effective component of psychological distress intervention in women with infertility.
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Affiliation(s)
- Zhenhua Jiang
- The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jingshi Road, Jinan, 250014, Shandong, China
| | - Sen Hou
- The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jingshi Road, Jinan, 250014, Shandong, China
| | - Yajie Zhang
- Jinan Maternity and Child Care Hospital, Jingsan Road, Jinan, 250000, Shandong, China
| | - Liping Zong
- Jinan Maternity and Child Care Hospital, Jingsan Road, Jinan, 250000, Shandong, China.
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Urata Y, Harada M, Komiya S, Akiyama I, Tuchida C, Nakaoka Y, Fukuda A, Morimoto Y, Kawahara T, Ishikawa Y, Osuga Y. Lifestyle and fertility-specific quality of life affect reproductive outcomes in couples undergoing in vitro fertilization. Front Endocrinol (Lausanne) 2024; 15:1346084. [PMID: 38572478 PMCID: PMC10987689 DOI: 10.3389/fendo.2024.1346084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 02/09/2024] [Indexed: 04/05/2024] Open
Abstract
Objective A Mediterranean dietary pattern, sleeping habits, physical activity, and lifestyle appear to affect reproductive health. There are few reports about whether fertility-specific quality of life (QOL) is linked to infertility treatment outcomes. The aim of this study is to investigate when lifestyle factors and fertility-specific QOL are comprehensively considered, which factors influence assisted reproductive technology (ART) outcomes. Methods This prospective cohort includes 291 women undergoing a first ART treatment at multiple centers in Japan and was designed to evaluate the influence of diet, physical activity, sleeping pattern, computer use duration, and fertility-specific quality of life tool (FertiQoL) score on ART treatment outcomes using a questionnaire. The primary endpoint was the good-quality blastocyst rate per oocyte retrieval and the secondary endpoints were a positive pregnancy test and gestational sac (GS) detection. Results The good-quality blastocyst rate per oocyte retrieval tended to be negatively associated with frequent fish consumption. After all embryo transfer (ET) cycles, a positive pregnancy test tended to be positively associated with longer sleep and longer computer use (OR = 1.6, 95% CI = 0.9-2.7 and OR = 1.7, CI = 1.0-2.8, respectively) and negatively associated with a smoking partner (OR = 0.6, CI = 0.3-1.0). GS detection was positively and significantly associated with frequent olive oil intake and longer computer use (OR = 1.7, CI = 1.0-3.0 and OR = 1.7, CI = 1.0-3.0, respectively). After ET cycles with a single blastocyst, a positive pregnancy test was positively and significantly associated with longer computer use (OR = 2.0, CI = 1.1-3.7), while GS detection was significantly more likely in women with longer computer use (OR = 2.1, CI = 1.1-3.8) and tended to be more likely in women with a higher FertiQoL Total scaled treatment score (OR = 1.8, CI = 1.0-3.3). p < 0.05 was considered statistically significant and 0.05 ≤ p <0.01 as tendency. Conclusions Olive oil may be an important factor in dietary habits. Fertility-specific QOL and smoking cessation guidance for partners are important for infertile couples.
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Affiliation(s)
- Yoko Urata
- Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Miyuki Harada
- Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shinnosuke Komiya
- HORAC Grand Front Osaka Clinic, Osaka, Japan
- Department of Obstetrics and Gynecology, Kansai Medical University Graduate School of Medicine, Osaka, Japan
| | - Ikumi Akiyama
- Department of Obstetrics and Gynecology, The Fraternity Memorial Hospital, Tokyo, Japan
| | - Chihiro Tuchida
- Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | | | | | - Yoshiharu Morimoto
- HORAC Grand Front Osaka Clinic, Osaka, Japan
- IVF Namba Clinic, Osaka, Japan
- IVF Osaka Clinic, Osaka, Japan
| | - Takuya Kawahara
- Clinical Research Promotion Center, The University of Tokyo Hospital, Tokyo, Japan
| | | | - Yutaka Osuga
- Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
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Bogović A, Potkonjak AM, Djaković I, Vraneš HS. Depression, anxiety, and stress in infertile couples during the COVID-19 pandemic: the consequences we face. JBRA Assist Reprod 2024; 28:9-12. [PMID: 37962946 PMCID: PMC10936920 DOI: 10.5935/1518-0557.20230018] [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: 11/11/2022] [Accepted: 05/17/2023] [Indexed: 11/16/2023] Open
Abstract
OBJECTIVE Postponing assisted reproductive technology treatment can cause pronounced mental health problems. The aim of this study was to examine the level of depression, anxiety, stress, and overall infertility-related distress experienced by infertile couples during the pandemic, as well as the differences between men and women in the examined variables and the correlations between them. METHODS A total of 131 participants were included in the study, 65 men and 66 women. They were selected based on their responses in the Fertility Problems Inventory (FPI); the Depression, Anxiety, and Stress Scale-21 (DASS-21); and a general data questionnaire provided to them at the time of IVF. RESULTS The levels of depression, anxiety, and stress in women and men resided within the normal range. Depression (p<0.05), anxiety (p<0.01), stress (p<0.01), and social concern (p<0.05) were more pronounced among women. Significant correlations were found between depression, anxiety, stress, and global stress and its three dimensions: social concern, sexual concern, and relationship concern. CONCLUSIONS During the pandemic, women undergoing assisted reproductive technology treatment experienced significantly higher levels of depression, anxiety, stress, and overall infertility-related stress than men. Furthermore, depression, anxiety, and stress were apparently correlated with overall infertility-related stress.
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Affiliation(s)
- Anamarija Bogović
- Department of Psychiatry, Sestre Milosrdnice University Hospital
Center, Zagreb, Croatia
- Department of Psychology, Catholic University of Croatia, Zagreb,
Croatia
| | - Ana-Meyra Potkonjak
- Department of Gynecology and Obstetrics, Sestre Milosrdnice
University Hospital Center, Zagreb, Croatia
| | - Ivka Djaković
- Clinic for Gynecology, Bethesda Hospital, Basel, Switzerland
| | - Hrvojka Soljačić Vraneš
- Department of Gynecology and Obstetrics, Sestre Milosrdnice
University Hospital Center, Zagreb, Croatia
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9
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Ha JY, Park HJ, Ban SH. Efficacy of psychosocial interventions for pregnancy rates of infertile women undergoing in vitro fertilization: a systematic review and meta-analysis. J Psychosom Obstet Gynaecol 2023; 44:2142777. [PMID: 36480686 DOI: 10.1080/0167482x.2022.2142777] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
PURPOSE This study aimed to analyze the efficacy of psychosocial interventions for improving pregnancy rates in infertile women undergoing in vitro fertilization (IVF) treatment through a systematic review and meta-analysis. METHODS Twelve studies were included in the meta-analysis. To estimate the effect size, a meta-analysis of the studies was performed using RevMan 5.3. The possibility of publication bias was evaluated using funnel plots and Egger's method. RESULTS A statistically significant effect size (standardized mean difference [SMD] = 1.39; 95% confidence interval [CI] = 1.11-1.71; p = 0.004; I2 = 19%) was found for the 12 studies that investigated the effects of psychosocial interventions on clinical pregnancy rates. The psychosocial interventions that had a significant effect on pregnancy rates were mind-body interventions (SMD = 1.37; 95% CI = 1.01-1.85; p = 0.040; I2 = 0%) and cognitive behavioral therapy (SMD = 2.19; 95% CI = 1.17-4.13; p = 0.010). CONCLUSIONS The results suggest that psychosocial interventions affect pregnancy rates. Moreover, they indicate that mind-body interventions and cognitive behavioral therapy are beneficial for improving the pregnancy outcome in infertile women undergoing IVF.
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Affiliation(s)
- Ju-Young Ha
- College of Nursing, Pusan National University, Yangsan, Korea
| | - Hyo-Jin Park
- College of Nursing, Pusan National University, Yangsan, Korea
| | - Seon-Hwa Ban
- Korea Disease Control and Prevention Agency, Cheongju, Korea
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Aghayeva S, Sonmezer M, Şükür YE, Jafarzade A. The Role of Thyroid Hormones, Vitamins, and Microelements in Female Infertility. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2023; 45:e683-e688. [PMID: 38029770 PMCID: PMC10686760 DOI: 10.1055/s-0043-1772478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 04/27/2023] [Indexed: 12/01/2023] Open
Abstract
OBJECTIVE It is well known that female infertility is multifactorial. Therefore, we aimed to compare the effects of thyroid dysfunction, vitamin deficiency, and microelement deficiency in fertile and infertile patients. MATERIALS AND METHODS Between May 1st, 2017, and April 1st, 2019, we conducted a retrospective case-control study with of 380 infertile and 346 pregnant patients (who normally fertile and able to conceive spontaneously). The fertile patients were selected among those who got pregnant spontaneously without treatment, had a term birth, and did not have systemic or obstetric diseases. The levels of thyroid-stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4), anti-thyroid peroxidase (anti-TPO), vitamin D, vitamin B12, folic acid, ferritin, and zinc of both groups were compared. RESULTS There was no difference between patients in the infertile and pregnant groups in terms of low normal and high serum T3 and T4 levels (p = 0.938; p > 0.05) respectively, nor in terms of normal and high anti-TPO levels (p = 0.182; p > 0.05) respectively. There was no significant difference regarding patients with low, insufficient, and sufficient vitamin D levels in the infertile and pregnant groups (p = 0.160; p >0.05) respectively. The levels of folic acid, ferritin, and zinc of the infertile group were significantly lower than those of the pregnant group. CONCLUSION The serum levels of folic acid, ferritin, and zinc in infertile patients presenting to our outpatient clinic were lower than those o the fertile patients.
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Affiliation(s)
- Sveta Aghayeva
- Department of Obstetrics and Gynecology, Koru Hospital Ankara, Ankara, Turkey
| | - Murat Sonmezer
- Department of Obstetrics and Gynecology, Ankara University, Ankara, Turkey
| | - Yavuz Emre Şükür
- Department of Obstetrics and Gynecology, Ankara University, Ankara, Turkey
| | - Aytaj Jafarzade
- Department of Obstetrics and Gynecology, Koru Hospital Ankara, Ankara, Turkey
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11
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Hwang SI, Yoon YJ, Sung SH, Cho SJ, Park JK. Acupuncture Treatment for Emotional Problems in Women with Infertility: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2023; 11:2704. [PMID: 37893778 PMCID: PMC10606758 DOI: 10.3390/healthcare11202704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 10/03/2023] [Accepted: 10/06/2023] [Indexed: 10/29/2023] Open
Abstract
This systematic review and meta-analysis aimed to evaluate the efficacy and safety of acupuncture in treating emotional problems in women with infertility. We searched for randomized controlled trials using acupuncture treatment for emotional problems in women with infertility using 11 databases from their inception to 30 June 2023. The control intervention included no treatment, sham acupuncture treatment, and conventional treatment. The primary outcome was emotion-related rating scales, and the secondary outcomes were total effectiveness rate, quality of life, clinical pregnancy rate, and adverse events. Twelve randomized controlled trials involving 1930 participants were included. A meta-analysis of these studies indicated that, as compared to the control treatment, acupuncture significantly improved the State-Trait Anxiety Inventory, Self-rating Anxiety Scale, Amsterdam Preoperative Anxiety and Information Scale, and Self-rating Depression Scale scores, which were the primary emotion-related outcomes. Furthermore, the meta-analysis demonstrated that acupuncture treatment had a significant effect on the clinical pregnancy rate, which was the secondary outcome. No adverse events were reported in any of the studies. Our findings demonstrate the potential of acupuncture for treating emotional problems in women with infertility. However, well-designed and high-quality randomized clinical trials are required to confirm the effectiveness and safety of acupuncture treatment. The protocol of the current study was registered in PROSPERO (registration number: CRD42020166119).
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Affiliation(s)
- Su-In Hwang
- Department of Korean Medicine, School of Korean Medicine, Pusan National University, Yangsan 50612, Republic of Korea;
| | - Young-Jin Yoon
- Department of Korean Medicine Obstetrics and Gynecology, School of Korean Medicine, Pusan National University, Yangsan 50612, Republic of Korea;
- Department of Korean Medicine Obstetrics and Gynecology, Pusan National University Korean Medicine Hospital, Yangsan 50612, Republic of Korea
| | - Soo-Hyun Sung
- Department of Policy Development, National Institute of Korean Medicine Development, Seoul 04554, Republic of Korea;
| | - Su-Jin Cho
- Research Institute of Nursing Science, Pusan National University, Yangsan 50612, Republic of Korea;
| | - Jang-Kyung Park
- Department of Korean Medicine Obstetrics and Gynecology, School of Korean Medicine, Pusan National University, Yangsan 50612, Republic of Korea;
- Department of Korean Medicine Obstetrics and Gynecology, Pusan National University Korean Medicine Hospital, Yangsan 50612, Republic of Korea
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12
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Zhai J, Zhang J, He J, Li G, Hao G. Declined Live Birth Rate from in vitro Fertilization Fresh Cycles Performed During Chinese New Year Holiday Season. Risk Manag Healthc Policy 2023; 16:1703-1718. [PMID: 37670732 PMCID: PMC10476864 DOI: 10.2147/rmhp.s422969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 08/29/2023] [Indexed: 09/07/2023] Open
Abstract
Purpose This study aims to investigate the impact of the Chinese New Year (CNY) holiday season on the outcomes of In Vitro Fertilization (IVF) fresh embryo transfer cycles. Participants and Methods This retrospective study analyzed 4688 patients who received their first IVF fresh cycle attempt between January 2017 and October 2021. Of these, 4449 women underwent IVF during non-holiday seasons, while 239 women were treated during the CNY holiday season. The study included women who underwent IVF treatment during the specified time frame. The primary outcome was the live birth rate (LBR). Results The study found that the LBR of IVF performed during the CNY holiday season was 32.22%, which is significantly lower than that of the non-holiday season (43.38%, p<0.001). Multivariate logistic regression analysis showed that the CNY holiday season (OR=0.62, 95% CI 0.47-0.82, p=0.001) was an independent factor associated with the live birth rate. Propensity score matching (PSM) data analysis showed that the LBR in the CNY holiday season group was 31.78% compared to 42.64% in the non-holiday season group (p=0.005). Inverse probability of treatment weighting (IPTW) data also indicated that the CNY holiday season had a lower LBR than the non-holiday season (OR=0.64, 95% CI 0.47-0.87, p=0.005). Conclusion IVF performed during the CNY holiday season results in a lower live birth rate, potentially indicating that certain lifestyle adjustments during this period, such as unhealthy dietary, tobacco and alcohol usage, sleep disruption, and emotional stress experienced could have some influence on the outcomes.
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Affiliation(s)
- Jiajia Zhai
- Reproductive Center, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China
| | - Junyan Zhang
- Department of Clinical Epidemiology and Evidence-Based Medicine, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Taiyuan, Shanxi, People’s Republic of China
- Bothwin Clinical Study Consultant, Shanghai, People’s Republic of China
| | - Jingfang He
- Bothwin Clinical Study Consultant, Shanghai, People’s Republic of China
| | - Guanqun Li
- Technoderma Medicines Inc, Shanghai, People’s Republic of China
| | - Guimin Hao
- Reproductive Center, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China
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13
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Bakkensen JB, Smith KS, Cheung EO, Moreno PI, Goldman KN, Lawson AK, Feinberg EC. Childbearing, Infertility, and Career Trajectories Among Women in Medicine. JAMA Netw Open 2023; 6:e2326192. [PMID: 37498595 PMCID: PMC10375303 DOI: 10.1001/jamanetworkopen.2023.26192] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 06/14/2023] [Indexed: 07/28/2023] Open
Abstract
Importance Although women are increasingly represented within medicine, gender disparities persist in time to promotion, achievement of academic rank, and appointment to leadership positions, with no narrowing of this gap over time. Career-specific fertility and family building challenges among women physicians may contribute to ongoing disparities and academic attrition. Objective To evaluate delayed childbearing and infertility among women in medicine and investigate the extent to which women physicians may alter career trajectories to accommodate family building and parenthood. Design, Setting, and Participants This survey study was conducted among women physicians, with surveys distributed through medical society electronic mailing lists (listserves) and social media from March to August 2022. Main Outcomes and Measures Baseline demographic information and fertility knowledge were assessed. Descriptive data on delayed childbearing, infertility, use of assisted reproductive technology, and career alterations to accommodate parenthood were collected. Factors associated with timing of pregnancy and family building regret were assessed using Likert-type scales. Group differences in fertility knowledge, delayed childbearing, infertility, and family building regret were evaluated using χ2 analyses. Results A total of 1056 cisgender women (mean [SD] age, 38.3 [7.7] years) were surveyed across level of training (714 attending physicians [67.6%] and 283 residents or fellows [26.8%]), specialty (408 surgical [38.6%] and 638 nonsurgical [60.4%] specialties), and practice setting (323 academic [45.2%], 263 private [24.9%], and 222 community [21.0%] settings). Among respondents, 1036 individuals [98.1%] resided in the US. Overall, 910 respondents (86.2%) were married or partnered and 690 respondents (65.3%) had children. While 824 physicians (78.0%) correctly identified the age of precipitous fertility decline, 798 individuals (75.6%) reported delaying family building and 389 individuals (36.8%) had experienced infertility. Concerning measures taken to accommodate childbearing or parenthood, 199 women (28.8%) said they had taken extended leave, 171 women (24.8%) said they had chosen a different specialty, 325 women (47.1%) said they had reduced their work hours, 171women (24.8%) said they had changed their practice setting, and 326 women (47.2%) said they had passed up opportunities for career advancement among those with children. Additionally, 30 women with children (4.3%) had left medicine entirely. Conclusions and Relevance In this survey study, women physicians reported that career-related pressures influenced the timing of childbearing and led to marked alterations to career trajectories to accommodate family building and parenthood. These findings suggest that fertility and family building concerns among women in medicine may contribute to ongoing gender disparities and attrition and represent a potentially critical area for policy reform and future change.
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Affiliation(s)
- Jennifer B. Bakkensen
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Kathryn S. Smith
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Elaine O. Cheung
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Hinge, New York, New York
| | - Patricia I. Moreno
- Department of Public Health Sciences at the University of Miami Miller School of Medicine, Miami, Florida
| | - Kara N. Goldman
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Angela K. Lawson
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Eve C. Feinberg
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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14
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Dube L, Bright K, Hayden KA, Gordon JL. Efficacy of psychological interventions for mental health and pregnancy rates among individuals with infertility: a systematic review and meta-analysis. Hum Reprod Update 2023; 29:71-94. [PMID: 36191078 DOI: 10.1093/humupd/dmac034] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/29/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Depression and anxiety are highly prevalent among individuals struggling with infertility. Thus, numerous psychological interventions have been adapted to infertility, with the aim of relieving distress as well as increasing pregnancy rates. OBJECTIVE AND RATIONALE This systematic review and meta-analysis aimed to identify all randomized controlled trials (RCTs) evaluating the effect of psychological interventions on infertility-related distress and pregnancy rates among individuals and/or couples with infertility and to analyse their overall effect. It also sought to examine potential treatment moderators, including intervention length, format and therapeutic approach. SEARCH METHODS An electronic search of 11 databases, including MEDLINE, EMBASE, PsycINFO and Cochrane Central Register of Controlled Trials, was performed for studies published until January 2022. The inclusion criteria were RCTs conducted on humans and published in English. Psychological outcomes of interest included anxiety, depression, infertility-related distress, wellbeing and marital satisfaction. The Cochrane Risk of Bias tool was used to assess study quality, and the Grading of Recommendations Assessment, Development and Evaluation was used to assess the overall quality of the research evidence. OUTCOMES There were 58 RCTs in total, including 54 which included psychological outcomes and 21 which assessed pregnancy rates. Studies originated from all regions of the world, but nearly half of the studies were from the Middle East. Although a beneficial effect on combined psychological outcomes was found (Hedge's g = 0.82, P < 0.0001), it was moderated by region (P < 0.00001) such that studies from the Middle East exhibited large effects (g = 1.40, P < 0.0001), while the effects were small among studies conducted elsewhere (g = 0.23, P < 0.0001). Statistically adjusting for study region in a meta-regression, neither intervention length, therapeutic approach, therapy format, nor participant gender (P > 0.05) moderated the effect of treatment. A beneficial treatment effect on pregnancy (RR (95% CI) = 1.25 (1.07-1.47), P = 0.005) was not moderated by region, treatment length, approach or format (P > 0.05). Largely due to the lack of high quality RCTs, the quality of the available evidence was rated as low to moderate. WIDER IMPLICATIONS This is the first meta-analysis of RCTs testing the effect of psychological interventions on infertility-related distress and pregnancy rates. These findings suggest that in most regions of the world, psychological interventions are associated with small reductions in distress and modest effects on conception, suggesting the need for more effective interventions. These findings must be considered in light of the fact that the majority of the included RCTs were deemed to be at high risk of bias. Rigorously conducted trials are needed.
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Affiliation(s)
- Loveness Dube
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
| | - Katherine Bright
- Department of Outpatient Psychiatry, Alberta Health Services, Calgary, Alberta, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - K Alix Hayden
- Department of Libraries and Cultural Resources, University of Calgary, Calgary, Alberta, Canada
| | - Jennifer L Gordon
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
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15
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Erčulj VI, Žiberna A. The Role of Online Social Support in Patients Undergoing Infertility Treatment - A Comparison of Pregnant and Non-pregnant Members. HEALTH COMMUNICATION 2022; 37:1724-1730. [PMID: 33855925 DOI: 10.1080/10410236.2021.1915517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The role of social support in the online setting is explored in this study. For this purpose, the posts of infertility treatment patients participating in an infertility treatment online support group between 2002 and 2016 were retrieved. Members who contributed at least 100 words were divided into two groups according to the treatment outcome they reported (pregnancy). The association between the length of group membership, type of support provided, intensity of interaction, active support seeking, overall sentiment and the amount of sadness, anxiety and anger words and the treatment outcome was examined. The findings suggest that online social, in particular emotional, support acts as a buffer between the stressor and the treatment outcome. The expression of anger and initiating of communication by new members diminish this relationship.
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Affiliation(s)
- Vanja Ida Erčulj
- Faculty of Criminal Justice and Security, Department of Social Studies, Humanities, and Methodology, University of Maribor
| | - Aleš Žiberna
- Department of Social Informatics and Methodology, Faculty of Social Sciences, University of Ljubljana
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16
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An assessment of coping with infertility stress and eating disorders in women undergoing IVF treatment. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-022-01780-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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17
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Zhang L, Shao H, Huo M, Chen J, Tao M, Liu Z. Prevalence and associated risk factors for anxiety and depression in infertile couples of ART treatment: a cross-sectional study. BMC Psychiatry 2022; 22:616. [PMID: 36123644 PMCID: PMC9483863 DOI: 10.1186/s12888-022-04256-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 09/12/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Infertility now is a public health concern and is associated with increased psychological distress. METHODS We enrolled 1247 infertile couples and assessed their anxiety and depression status before and during assisted reproductive technology (ART) treatment using the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS). The Chi-square or fisher's exact test was used to analyze the prevalence of anxiety and depression in infertile couples. Multivariate logistical regression was performed to analyze the risk factors for anxiety and depression. RESULTS The prevalence of anxiety was 13.5% and 8.7% (p < 0.05), and that of depression was 9.4% and 7.9% (p = 0.2) in female and male partners, respectively. Female SAS and SDS scores were positively associated with male SAS and SDS scores, respectively (r = 0.52 and r = 0.50, respectively, both p < 0.0001), and were positively associated with their own SDS and SAS scores, respectively (r = 0.63 and r = 0.62, respectively, both p < 0.0001). Their own depression or partners' anxiety was associated with the anxiety, and their own anxiety or partners' depression was associated with the depression in infertile couples. No children, unemployment, and low education level were also associated with female anxiety. SAS and SDS scores were significantly decreased during ART treatment. CONCLUSIONS Females were more vulnerable to having anxiety than males in infertile couples. Anxiety and depression in infertile couples could interact, therefore, anxiety and depression would be simultaneously counseled, and their partners also should be given supportive psychotherapy. TRIAL REGISTRATION It was an observational study and had no health care interventions on participants. So it was not registrated.
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Affiliation(s)
- Li Zhang
- grid.412528.80000 0004 1798 5117Department of Reproductive Medicine Center, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, 200233 People’s Republic of China
| | - Hongfang Shao
- grid.412528.80000 0004 1798 5117Department of Reproductive Medicine Center, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, 200233 People’s Republic of China
| | - Mian Huo
- grid.412528.80000 0004 1798 5117Department of Reproductive Medicine Center, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, 200233 People’s Republic of China
| | - Jie Chen
- grid.412528.80000 0004 1798 5117Department of Reproductive Medicine Center, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, 200233 People’s Republic of China
| | - Minfang Tao
- grid.412528.80000 0004 1798 5117Department of Reproductive Medicine Center, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, 200233 People’s Republic of China
| | - Zhangshun Liu
- Department of Reproductive Medicine Center, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, People's Republic of China.
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Performance of Marmoset Monkeys as Embryo Donors Is Reflected by Different Stress-Related Parameters. Animals (Basel) 2022; 12:ani12182414. [PMID: 36139275 PMCID: PMC9494952 DOI: 10.3390/ani12182414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/28/2022] [Accepted: 09/05/2022] [Indexed: 11/29/2022] Open
Abstract
Non-human primates (NHPs) serve as embryo donors for embryo collection in order to mimic genetic diseases in humans by genetic modification. Reproductive health of the embryo donors is crucial, and chronic distress needs to be avoided. Embryo retrieval rates (ERR), anti-Müllerian hormone (AMH) concentrations, cortisol levels, and body weight fluctuations were assessed as markers for fertility and distress. With regard to successful embryo retrievals (total n = 667), the animals were either used for extended periods (long-term group; LTG) or only for short periods (short-term group; STG). Retrospective evaluation expectedly showed that animals in the LTG had a higher ERR than animals in the STG (p < 0.0001). Importantly, ERR in the LTG remained stable throughout the experimental period, and high embryo rates were already encountered during the first year of experimental use (p = 0.0002). High ERR were associated with high AMH and low cortisol levels, and minimal body weight fluctuations following anesthesia, indicating a superior ability of the LTG animals to handle distress. We conclude that the long-term experimental use of marmosets does not impair their fertility or health status per se, supporting the view that animal reuse can be in accordance with the 3R-principle, implying reduction, replacement, and refinement in animal experimentation.
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The association between conception history and subsequent postpartum depression and/or anxiety: Evidence from the Clinical Practice Research Datalink 1991-2013. J Affect Disord 2022; 310:266-273. [PMID: 35508205 DOI: 10.1016/j.jad.2022.04.138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 04/20/2022] [Accepted: 04/22/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND Infertility, and fertility treatment, are associated with psychological distress that may influence subsequent mental health including postpartum depression and anxiety. METHODS Data for women who had a livebirth between 1991 and 2013 were drawn from the Clinical Practice Research Datalink. Conception history prior to their first recorded birth was categorised as 'no fertility problems', 'untreated subfertility', ovulation induction (OI), and assisted reproductive technologies (ART). Depression and/or anxiety in the 12 months postpartum were identified using records of diagnoses, symptoms, and prescriptions. Prevalence was compared, and odds ratios estimated using multivariable logistic regression. RESULTS Of 235,127 mothers, 31,947 (13.6%) had evidence of postpartum depression and/or anxiety. Mothers in the ART group had 22% lower odds of postnatal depression and/or anxiety compared to mothers in the fertile group (OR 0.78; 95% CI [0.70-0.86]; p < 0.0001). Accounting for prior mental health, lifestyle, sociodemographic and pregnancy-related factors reduced the strength of the association (aOR 0.87; 95% CI [0.78-0.97]; p = 0.01). There were no significant associations observed in the untreated subfertility or OI groups. LIMITATIONS As in any analysis of routine data, the quality of recording is important and some information was unavailable (e.g. education, social support). CONCLUSIONS Women with a history of subfertility, OI or ART treatment were not at increased risk of postpartum depression and/or anxiety compared to those with no fertility problems. It is important to explore whether women who underwent ART are less likely to experience depression/anxiety or do not seek help when needed, with implications for their health and care.
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20
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Zhu H, Shi L, Wang R, Cui L, Wang J, Tang M, Qian H, Wei M, Wang L, Zhou H, Xu W. Global Research Trends on Infertility and Psychology From the Past Two Decades: A Bibliometric and Visualized Study. Front Endocrinol (Lausanne) 2022; 13:889845. [PMID: 35903282 PMCID: PMC9317298 DOI: 10.3389/fendo.2022.889845] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 06/13/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives The aim of this study was to evaluate the global scientific output of research on infertility and psychology; explore the current status and trends in this field through the cooperation of authors, countries, and institutions; shed light on the direction of clinical infertility research in the future, and provide inspiration for targeted diagnosis and treatment of infertility. Methods Research publications on infertility and psychology from the past two decades were retrieved from the Web of Science Core Collection (WoSCC). Bibliometric analyses were performed using VOSviewer software and the bibliometrix R package. Network maps were generated to evaluate the collaborations between different authors, countries, institutions, and keywords. Results A total of 151 articles related to the study of infertility and psychology were identified. We observed a gradual increase in the number of publications from 2001 to 2021, and the trend has been relatively stable in the past eight years. Human Reproduction (England), as the leading journal publishing the most papers (29 articles), was cited in the most journals (1208 times). Boivin J was the most prolific author (16 articles), with the largest number of citations (890 times) and the highest h-index (14) during the past decades. Boivin J was also the leader with the highest publication frequency and more active cooperation with other top authors. The United Kingdom (34 papers) and Cardiff University (25 articles) contributed the most publications and were the leading contributors in this field. Active cooperation between countries and between institutions was observed, and analyses of articles and references were also shown. The main hot topics included matters related to women (39 times), in-vitro salt (31 times), infertility (30 times), couples (25 times), and impact (24 times). Conclusion Our study results provide a comprehensive overview of the development of scientific literature, allowing relevant authors and research teams to recognize the current research status in this field. At the same time, infertility and psychology may soon become hotspots and should be closely monitored.
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Affiliation(s)
- Hongkun Zhu
- Nanjing University of Chinese Medicine, Nanjing, China
| | - Lingli Shi
- Department of Reproduction, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Rong Wang
- Department of Laboratory Medicine, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Lijuan Cui
- Department of Pathology, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Jiahui Wang
- Department of Reproduction, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Mengyu Tang
- Department of Reproduction, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Haiqing Qian
- Department of Reproduction, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Minggang Wei
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Lihong Wang
- Department of Reproduction, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Huifang Zhou
- Department of Gynaecology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Wenting Xu
- Nanjing University of Chinese Medicine, Nanjing, China
- Department of Reproduction, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
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21
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Fertility-related quality of life in subfertile women undergoing tubal testing with transvaginal hydrolaparoscopy or hysterosalpingography. Eur J Obstet Gynecol Reprod Biol 2022; 274:19-22. [PMID: 35561566 DOI: 10.1016/j.ejogrb.2022.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 02/19/2022] [Accepted: 04/09/2022] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Both subfertility and its management can have significant impact on quality of life (QoL). Tubal patency testing as part of the fertility work-up, is considered to cause more physical complaints and stress than other tests. Pain scores for HSG are higher than for THL, but acceptability of the procedures was found to be comparable. Fertility-related QoL has not yet been studied in women undergoing tubal patency testing. STUDY DESIGN We performed a standardized questionnaire study alongside a previously reported randomized controlled trial comparing THL and HSG in subfertile women, in which 24-month live birth rates occurred in 58.5% versus 55.4%, respectively. We randomly assigned 300 subfertile women to THL or HSG between May 2013 and October 2016. Women were eligible if they were undergoing a fertility work-up with an indication for evaluation of tubal patency. Fertility-related QoL was measured six weeks after the procedure with the validated FertiQoL questionnaire. The scores for the Core scale and subscales between THL and HSG were compared using Mann-Whitney-U test and multiple linear regression analysis. RESULTS The questionnaire was completed by 84 women in the THL group (56%) and 96 women in the HSG group (64%). Core scores were 74.6 ± 12.8 for THL and 73.4 ± 12.4 for HSG (p = 0.39). Scores for the Emotional domain were 64.5 ± 19.0 for THL versus 66.0 ± 16.3 (p = 0.67) for HSG. Scores for the 'Mind-body' domain for THL were 76.9 ± 15.6 versus 74.1 ± 18.0 for HSG (p = 0.42), while scores for the Relational domain were 79.2 ± 12.9 for THL and 76.9 ± 15.6 for HSG (p = 0.21). Scores for the Social domain for THL were 77.9 ± 15.1 versus 76.7 ± 14.1, (p = 0.42). The multiple linear regression analysis showed only a statistical significant positive effect of older age on the score for the Emotional domain (p = 0.015). CONCLUSION In a preselected group of women with low risk for tubal pathology we did not find differences in fertility-related QoL between tubal patency testing with THL versus HSG.
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Tokgoz VY, Kaya Y, Tekin AB. The level of anxiety in infertile women whose ART cycles are postponed due to the COVID-19 outbreak. J Psychosom Obstet Gynaecol 2022; 43:114-121. [PMID: 32812477 DOI: 10.1080/0167482x.2020.1806819] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
AIM This study evaluated the level of fear and anxiety related to the COVID-19 outbreak, in infertile women whose ART cycles were delayed due to the pandemic. MATERIALS AND METHODS An online survey was sent to women whose ART cycles were postponed due to the COVID-19 outbreak between April and May 2020. The study population were 101 participants. The main outcome measure is to determine the levels of fear and anxiety in infertile women by using the Spielberger State-Trait Anxiety Inventory (STAI-T and STAI-S) and Fear of COVID-19 scale (FCV-19S). The relationship of the COVID-19 outbreak with the willingness to go ahead with the desire for pregnancy was also assessed. RESULTS The state-anxiety levels were significantly higher in women above 35 years (45.0 ± 5.2 vs. 42.2 ± 4.5, p = 0.006). Women with diminished ovarian reserve had a higher state-anxiety compared to other causes, but were not found to be significant (44.7 ± 5.2 vs. 42.5 ± 5.0, p = 0.173). Women who thought that the possibility of not being able to get pregnant was more important than being infected with the COVID-19 had higher anxiety levels than women who thought just the opposite. The diminished ovarian reserve and high duration of infertility were found to be significantly associated with higher anxiety levels (OR = 2.5, p < 0.05). The diminished ovarian reserve and previous ART failure significantly predicted the presence of clinical state-anxiety. CONCLUSION The state-anxiety was found to be higher in women whose cycles were postponed due to the outbreak and the presence of diminished ovarian reserve also significantly affected anxiety levels. Further research is needed to assess whether COVID-19 will have any impact on ART treatments in the next few years.
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Affiliation(s)
- Vehbi Yavuz Tokgoz
- Department of Obstetrics and Gynecology, Eskisehir Osmangazi University, Faculty of Medicine, Eskisehir, Turkey
| | - Yeliz Kaya
- Department Obstetric And Women's Disease Nursing, Eskisehir Osmangazi University, Faculty of Health Sciences, Eskisehir, Turkey
| | - Ahmet Basar Tekin
- Department of Obstetrics and Gynecology, Eskisehir Osmangazi University, Faculty of Medicine, Eskisehir, Turkey
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Mahmoud MY, Labib K, Sileem SA, Mustafa FA, Hamed WM, Abd Elhamid A, Saleh DM, Alanwar A, Riad AAM, Abdelhakim AM, Abbas AM, Mohammed HM. The impact of music therapy on anxiety and pregnancy rate among infertile women undergoing assisted reproductive technologies: a systematic review and meta-analysis. J Psychosom Obstet Gynaecol 2022; 43:205-213. [PMID: 34546118 DOI: 10.1080/0167482x.2021.1977277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Objective: We aimed to perform a systematic review and meta-analysis to evaluate the effect of music therapy on anxiety and pregnancy rates among infertile women undergoing to perform assisted reproductive technologies (ART).Methods: Cochrane Library, PubMed, ISI web of science, and Scopus were searched from inception to May 2021. We included randomized controlled trials (RCTs) that compared music therapy (intervention group) to no music intervention (control group). Our primary outcomes were anxiety score using the State-Trait Anxiety Inventory (STAI) tool and pain score utilizing the Visual Analog Scale (VAS). Our secondary outcomes were the overall satisfaction score and clinical pregnancy rate. We extracted the available data from included studies and pooled them in a meta-analysis model using RevMan software. The overall quality of evidence was assessed through GRADEpro GDT software.Results: Seven RCTs with a total number of 793 patients were included in our study. Music therapy significantly reduced the anxiety score compared to control group (MD= -3.09, 95% CI [-5.57, -0.61], p = 0.01). Moreover, pain score was significantly improved after music treatment (MD= -2.93, 95% CI [-3.86, -2.00], p > 0.001). A significant improvement in the overall satisfaction score was found among music therapy group (MD= 1.51, 95% CI [0.40, 2.61], p = 0.008). Although more women in music therapy group experienced an increase in the clinical pregnancy rate in comparison with control group, the result was not statistically significant (RR= 1.08, 95% CI [0.94, 1.26], p = 0.28). The GRADEpro GDT tool showed a moderate quality of evidence for the evaluated outcomes.Conclusions: There is evidence of moderate quality that music therapy improves anxiety, pain, and satisfaction scores among infertile women undergoing ART. Moreover, it increases the clinical pregnancy rate but without statistical significance. More trials with a larger sample size are needed to investigate the influence of music therapy on the clinical outcomes of ART.
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Affiliation(s)
- Marwa Yahia Mahmoud
- Department of Obstetrics and Gynecology, Faculty of Medicine, Beni Suef University, Beni Suef, Egypt
| | - Kareem Labib
- Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Sileem Ahmed Sileem
- Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
| | - Faisal Ali Mustafa
- Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
| | - Wael M Hamed
- Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
| | - Ahmed Abd Elhamid
- Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
| | - Doaa M Saleh
- Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University for Girls, Cairo, Egypt
| | - Ahmed Alanwar
- Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Amr Ahmed Mahmoud Riad
- Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | | | - Ahmed M Abbas
- Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Heba M Mohammed
- Department of Obstetrics and Gynecology, Faculty of Medicine, Fayoum University, Fayoum, Egypt
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Huri M, Noferi V, Renda I, Piazzini F, Benemei S, Coccia ME. The COVID-19 Pandemic Impact on the Outcome of Medically Assisted Reproduction Pregnancies. FRONTIERS IN REPRODUCTIVE HEALTH 2022; 4:860425. [PMID: 36303677 PMCID: PMC9580677 DOI: 10.3389/frph.2022.860425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 03/17/2022] [Indexed: 01/23/2023] Open
Abstract
Background The impact of the Coronavirus Disease-2019 (COVID-19) pandemic on pregnancy is not well-understood. During the outbreak, the initial approach suggested by the major societies was to postpone all non-urgent assisted reproductive technology (ART) treatments. Nevertheless, the Italian Society of Fertility and Sterility and Reproductive Medicine considered ethically correct to proceed with ART treatments, as the infertility rate is increasing over time, with a consistent decline in the live birth rate. The objective of our study was to assess the impact of the COVID-19 pandemic on the outcomes of ART pregnancies, in terms of early pregnancy loss, overall success rate, and live birth rate. Methods We conducted a single-center retro-prospective cohort study. Patients who underwent ART treatments from 1 March 2020 to 28 February 2021 (pandemic ART cohort, pART; n = 749) and from 1 March 2019 to 29 February 2020 (control cohort, CTR; n = 844) were enrolled. The study had a duration of 24 months. Patients underwent baseline severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) nasopharyngeal swab; quantitative serum beta human chorionic gonadotropin (β-hCG) to assess pregnancy; pelvic transvaginal ultrasound; and follow-up until delivery. The study took place at the ART Center of the University Hospital in Florence, Italy. Results There were not statistically significant differences on implantation rate (pART 0.348 ± 0.034 vs. CTR 0.365 ± 0.033, CI = 95%, p = 0.49), clinical pregnancy rate (pART 0.847 ± 0.044 vs. CTR 0.864 ± 0.038, CI = 95%, p = 0.56), and ectopic pregnancy rate (pART 0.008 ± 0.011 vs. CTR 0.01 ± 0.011, CI = 95%, p = 0.79). Neither first trimester miscarriage rate was different between the groups (pART 0.224 ± 0.056 vs. CTR 0.213 ± 0.05, CI = 95%, p = 0.77) nor second trimester miscarriage rate (pART 0.018 ± 0.018 vs. CTR 0.019 ± 0.017, CI = 95%, p = 0.95). Live birth rate remained unchanged during the pandemic (pART 0.22 ± 0.03 vs. CTR 0.239 ± 0.029, CI = 95%, p = 0.37) and stable even when compared to our center rate between 2015 and 2019 (pART 0.222 ± 0.03 vs. general rate 0.224 ± 0.014, CI = 95%, p = 0.83). Conclusion The COVID-19 pandemic did not cause a statistically significant change in the live birth rate and in the pregnancy loss rate. ART during the COVID-19 pandemic can be considered fair and safe, ethically and medically appropriate. Patients and physicians should be reassured that ART pregnancy outcomes do not seem to be jeopardized by the pandemic state.
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Affiliation(s)
- Mor Huri
- Assisted Reproductive Technology Center, Careggi Hospital, University of Florence, Florence, Italy
- *Correspondence: Mor Huri
| | - Virginia Noferi
- Assisted Reproductive Technology Center, Careggi Hospital, University of Florence, Florence, Italy
| | - Irene Renda
- Assisted Reproductive Technology Center, Careggi Hospital, University of Florence, Florence, Italy
| | - Francesca Piazzini
- Assisted Reproductive Technology Center, Careggi Hospital, University of Florence, Florence, Italy
| | - Silvia Benemei
- Clinical Trial Unit for Phase 1 Trials, Headache Centre, Careggi University Hospital, Florence, Italy
| | - Maria Elisabetta Coccia
- Assisted Reproductive Technology Center, Careggi Hospital, University of Florence, Florence, Italy
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Patel A, Nair BVS, Das SK, Kumar P, Sharma PSVN. Re-examining Psychometric Properties of Fertility Problem Inventory: A Clinic-Based Study from India. J Hum Reprod Sci 2022; 15:177-186. [PMID: 35928468 PMCID: PMC9345276 DOI: 10.4103/jhrs.jhrs_154_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 05/18/2022] [Accepted: 05/26/2022] [Indexed: 11/16/2022] Open
Abstract
Background: The fertility problem inventory (FPI) is one of the most widely used measures that tap the diverse psychological problems faced by infertile couples. Research on translated versions of FPI has also reflected its high clinical significance. Aim: This research aimed to explore the psychometric properties and the clinical validity of the original 46-item FPI in an Indian sample. Setting and Design: This cross-sectional study was conducted in a tertiary hospital setup of a medical college. Materials and Methods: The original FPI was translated and pilot tested. The translated FPI was taken by 205 consenting infertile patients (113 women and 92 men). The psychometric properties of FPI were thus explored. Statistical Analysis: Exploratory factor analysis with minimum residual method of extraction followed by oblimin rotation was performed. Perceived Stress Scale was used to establish the convergent validity of the newly developed FPI-Kannada version (FPI-K). A cut-off score for the FPI-K was obtained separately for males and females using ROC analysis in which hamilton anxiety scale was used as the gold standard. Results: Only 32 items of the original FPI had factor loadings above 0.3 and overall six factors explained these items with a cumulative percentage variation of 32%. Overall Cronbach's alpha for FPI-K was 0.671 and it had a good convergent validity. Conclusions: The new FPI-K had 6 sub-domains and the clinical utility of same is discussed.
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Affiliation(s)
- Ansha Patel
- Department of Psychiatry & Psychology, Rabindra Nath Tagore Medical College, Shantiraj Hospital (Psychological Counselling & Psychotherapy Clinic for Couples with Infertility, IUI, IVF Stress) & Parasjk Hospitals, Udaipur, Rajasthan, India.,Post Doc FAIMER Fellow at Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Binu Valsalakumari Sreekumaran Nair
- Department of Biostatistics, Dr. MV Govindaswamy Centre, National Institute of Mental Health and Behavioural Sciences, Bengaluru, Karnataka, India
| | - Sumit Kumar Das
- Department of Biostatistics, Dr. MV Govindaswamy Centre, National Institute of Mental Health and Behavioural Sciences, Bengaluru, Karnataka, India
| | - Pratap Kumar
- Department of Reproductive Medicine and Surgery, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
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26
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Impact of Stress and Financials on Romanian Infertile Women Accessing Assisted Reproductive Treatment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063256. [PMID: 35328944 PMCID: PMC8948966 DOI: 10.3390/ijerph19063256] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 02/25/2022] [Accepted: 03/08/2022] [Indexed: 11/17/2022]
Abstract
Around 20% of couples worldwide are affected by infertility issues, with numbers in the European Union reaching as high as 25%, while access to reproductive care varies significantly by geopolitical and country-specific variables. The purpose of this research is to shed light on the unique social, psychological, and financial difficulties faced by Romanian couples seeking access to assisted reproductive therapy (ART). A cross-sectional study was conducted between 2017 and 2019 to involve women who accessed ART at fertility clinics in Romania by completing two infertility surveys. We analyzed the data in terms of all facets of infertility and ART, including the effect of personal background and stress levels on succeeding to conceive, the impact of treatment costs, and household income. A total of 829 participants completed the survey. We observed that high stress exposure leads to a substantially higher duration to conceive using ART, although the proportions of successful pregnancies did not differ between low-stress and high-stress groups. A significantly higher number of couples achieved pregnancy when their monthly household income was higher than EUR 1000 and if the ART method was more expensive. Additionally, we observed that advanced age, high stress levels, and the high cost of ART had a negative association with achieving pregnancy using ART. The findings indicated that Romanian couples experiencing infertility must contend with significant expenses for specialist infertility treatments, as well as treatment-related stress, both of which have a detrimental effect on their odds of attaining conception.
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Ceran MU, Yilmaz N, Ugurlu EN, Erkal N, Ozgu-Erdinc AS, Tasci Y, Gulerman HC, Engin-Ustun Y. Psychological domain of quality of life, depression and anxiety levels in in vitro fertilization/intracytoplasmic sperm injection cycles of women with endometriosis: a prospective study. J Psychosom Obstet Gynaecol 2022; 43:66-73. [PMID: 32635772 DOI: 10.1080/0167482x.2020.1787978] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To evaluate the psychological domain of quality of life (PDQoL), anxiety and depression levels of infertile women with endometriosis versus non endometriosis who applied for Assisted Reproductive Technologies (ART). METHOD This prospective case-control study compromised a total of 105 women who applied for IVF/ICSI program. Ninety-three women were divided into two groups as endometriosis (n = 37) and non-endometriosis (n = 56) after 12 patients who refused to participate in the study were excluded. The WHOQOL-BREF questionnaire, Beck Depression and Anxiety Inventory scales were used to determine the psychological stress levels. RESULTS A significant difference was found between the endometriosis and non-endometriosis groups regarding depression scores, while no significant difference was reported with respect to PDQoL and anxiety (p < 0.01, p = 0.897 and p = 0.058, respectively). A weak but significant correlation was observed between depression and endometriosis (CC: 0.435, p < 0.01). Though anxiety scores were found to be higher in endometriosis group this can not reach statistical significance (p = 0.058). Impact of PDQoL, depression and anxiety scores on pregnancy outcomes were found to be insignificant. CONCLUSION Women with endometriosis seem to be more susceptible to depression and anxiety than women without endometriosis. Although infertility treatment outcomes are not found to be significantly affected, the impact of depression and anxiety over ART treatment success merit further research.
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Affiliation(s)
- M U Ceran
- Department of Gynecology and Obstetrics, Baskent University School of Medicine, Konya, Turkey
| | - N Yilmaz
- Department of Reproductive Endocrinology, Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - E N Ugurlu
- Department of Gynecology and Obstetrics, Forum Yasam Hospital, Mersin, Turkey
| | - N Erkal
- Department of Gynecology and Obstetrics, Health Science University Antalya Education and Research Hospital, Antalya, Turkey
| | - A S Ozgu-Erdinc
- Department of Reproductive Endocrinology, Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Y Tasci
- Department of Reproductive Endocrinology, Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - H C Gulerman
- Department of Reproductive Endocrinology, Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Y Engin-Ustun
- Department of Reproductive Endocrinology, Etlik Zübeyde Hanım Women's Health, Education and Research Hospital, Ankara, Turkey
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Beroukhim G, Esencan E, Seifer DB. Impact of sleep patterns upon female neuroendocrinology and reproductive outcomes: a comprehensive review. Reprod Biol Endocrinol 2022; 20:16. [PMID: 35042515 PMCID: PMC8764829 DOI: 10.1186/s12958-022-00889-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 01/06/2022] [Indexed: 12/17/2022] Open
Abstract
Sleep is vital to human bodily function. Growing evidence indicates that sleep deprivation, disruption, dysrhythmia, and disorders are associated with impaired reproductive function and poor clinical outcomes in women. These associations are largely mediated by molecular-genetic and hormonal pathways, which are crucial for the complex and time sensitive processes of hormone synthesis/secretion, folliculogenesis, ovulation, fertilization, implantation, and menstruation. Pathologic sleep patterns are closely linked to menstrual irregularity, polycystic ovarian syndrome, premature ovarian insufficiency, sub/infertility, and early pregnancy loss. Measures of success with assisted reproductive technology are also lower among women who engage in shift work, or experience sleep disruption or short sleep duration. Extremes of sleep duration, poor sleep quality, sleep disordered breathing, and shift work are also associated with several harmful conditions in pregnancy, including gestational diabetes and hypertensive disorders. While accumulating evidence implicates pathologic sleep patterns in impaired reproductive function and poor reproductive outcomes, additional research is needed to determine causality and propose therapeutic interventions.
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Affiliation(s)
- Gabriela Beroukhim
- Department of Obstetrics, Gynecology, and Reproductive Sciences at Yale School of Medicine, 333 Cedar St, New Haven, CT, 06510, USA.
| | - Ecem Esencan
- Department of Obstetrics, Gynecology, and Reproductive Sciences at Yale School of Medicine, 333 Cedar St, New Haven, CT, 06510, USA
| | - David B Seifer
- Department of Obstetrics, Gynecology, and Reproductive Sciences at Yale School of Medicine, 333 Cedar St, New Haven, CT, 06510, USA
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Huang CY, Chuang HL, Tsai LY, Lu YC, Liou CF, Lee MS, Kuo CP, Lee SH. Differences in sexual activities and information seeking behaviors between women who underwent in vitro fertilization (IVF) and who conceived without IVF. SEXUAL AND RELATIONSHIP THERAPY 2022. [DOI: 10.1080/14681994.2021.2023736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Cheng-Yi Huang
- Department of Nursing, Chung Shan Medical University, Taichung, Taiwan
- Department of Nursing, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Hsiao-Ling Chuang
- Department of Nursing, Chung Shan Medical University, Taichung, Taiwan
- Department of Nursing, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Li-Ya Tsai
- Department of Nursing, Asia University, Taichung, Taiwan
| | - Yen-Chiao Lu
- Department of Nursing, Chung Shan Medical University, Taichung, Taiwan
- Department of Nursing, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Chiou-Fang Liou
- Department of Nursing, Chung Shan Medical University, Taichung, Taiwan
- Department of Nursing, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Maw-Sheng Lee
- Lee Women’s Hospital, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Ching-Pyng Kuo
- Department of Nursing, Chung Shan Medical University, Taichung, Taiwan
- Department of Nursing, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Shu-Hsin Lee
- Department of Nursing, Chung Shan Medical University, Taichung, Taiwan
- Department of Nursing, Chung Shan Medical University Hospital, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
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Philipsen MT, Knudsen UB, Zachariae R, Ingerslev HJ, Hvidt JEM, Frederiksen Y. Sleep, psychological distress, and clinical pregnancy outcome in women and their partners undergoing in vitro or intracytoplasmic sperm injection fertility treatment. Sleep Health 2021; 8:242-248. [PMID: 34949542 DOI: 10.1016/j.sleh.2021.10.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 10/20/2021] [Accepted: 10/21/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To explore the prevalence of poor sleep quality in couples undergoing fertility treatment and study possible associations. PARTICIPANTS 163 women and 132 partners receiving in vitro (IVF) or intracytoplasmic sperm injection (ICSI) fertility treatment. SETTING Three public Danish fertility clinics. DESIGN AND MEASUREMENTS Participants completed the Pittsburgh Sleep Quality Index (PSQI) at three time-points as part of a larger RCT. Additional data from patient records and questionnaires were included to evaluate possible associations with treatment protocol type, psychological distress, and pregnancy outcome. RESULTS Mean PSQI global scores before treatment were 8.1 (standard deviation = 2.3), with 91% of participants having PSQI scores > 5, indicating poor sleep quality. Scores did not differ between women and their partners and did not change during treatment. Statistically significant associations were found between sleep quality and depressive symptoms and state anxiety (p < .001). No difference in PSQI scores was found between protocol types. While there was a trend towards higher clinical pregnancy rates among women with good sleep quality (PSQI ≤ 5 = 72.7%, PSQI 6-10 = 52.6% and PSQI ≥ 11 = 42.3%), the differences did not reach statistical significance (p = .10-.21). CONCLUSIONS Poor sleep quality is a prevalent problem among couples undergoing fertility treatment and is associated with psychological distress and possibly with pregnancy outcomes. Success rates after fertility treatment remain moderate, and poor sleep quality, a potentially modifiable factor, could be relevant to screen for and treat among couples undergoing fertility treatment. The high prevalence of poor sleep quality calls for further investigation.
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Affiliation(s)
- Marie Tholstrup Philipsen
- Faculty of Health, Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark; Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark.
| | - Ulla Breth Knudsen
- Faculty of Health, Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark; Horsens Fertility Clinic, Horsens Hospital, Horsens, Denmark
| | - Robert Zachariae
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark; Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Hans Jakob Ingerslev
- Faculty of Health, Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark; Department of Gynaecology and Obstetrics, Aarhus University Hospital, Aarhus, Denmark
| | - Julius Edward Miller Hvidt
- Faculty of Health, Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark; Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Yoon Frederiksen
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark; The Sexology Unit, Department of Affective Disorders, Aarhus University Hospital, Aarhus, Denmark
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Köneş MÖ, Yıldız H. The level of grief in women with pregnancy loss: a prospective evaluation of the first three months of perinatal loss. J Psychosom Obstet Gynaecol 2021; 42:346-355. [PMID: 32370579 DOI: 10.1080/0167482x.2020.1759543] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
OBJECTIVE To prospectively investigate perinatal grief in women with pregnancy loss. METHODS A total of 215 women (mean (SD) age: 30.7 (5.9) years) who experienced pregnancy loss were included. Data on sociodemographic, marital and obstetric characteristics and Perinatal Grief Scale (PGS) (first 48 h, 1 week, 1 month and 3 months after the loss) were recorded. RESULTS Active grief scores were lower (p ranged < .05 to <.01), while difficulty coping (p < .05 for each) and despair (p < .05 for each) scores were higher in the 3rd month as compared with prior assessments. All PGS scores at the 48 h and 3rd month assessments were significantly higher in assisted and planned pregnancies (p < .01 for each). Maternal age was positively correlated with 48 h active grief (r = 0.19, p < .001), despair (r = 0.13, p < .05) and total PGS (r = 0.13, p < .05) scores. Parity and the number of children were negatively correlated (r ranged from -0.35 to -0.20, p < .01 for each) with all PGS scores. CONCLUSION Our findings revealed decrease in active grief levels, whereas gradual increase in difficulty coping and despair in women with pregnancy loss within the first 3 months of losing a child. Our finding indicate association of older maternal age, primiparity, assisted and planned pregnancies with regular antenatal follow up with higher total PGS scores as well as active grief, difficulty coping and despair scores in women regardless of the time of assessment within 3 months after the pregnancy loss.
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Affiliation(s)
- Miray Özgür Köneş
- Department of Obstetrics and Gynecology Nursing, Istanbul Faculty of Medicine Hospital, Istanbul University, Istanbul, Turkey
| | - Hatice Yıldız
- Department of Obstetrics and Gynecology Nursing, Division of Nursing, Faculty of Health Sciences, Marmara University, Istanbul, Turkey
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Li YQ, Shi Y, Xu C, Zhou H. Cognitive behavioural therapy improves pregnancy outcomes of in vitro fertilization-embryo transfer treatment: a systematic review and meta-analysis. J Int Med Res 2021; 49:3000605211050798. [PMID: 34772315 PMCID: PMC8593307 DOI: 10.1177/03000605211050798] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE The study aim was to examine the effects of cognitive behavioural therapy (CBT) on the pregnancy outcomes of women receiving in vitro fertilization-embryo transfer (IVF-ET) treatment. METHODS A literature review was performed using the databases MEDLINE, the Cochrane Database, Embase, Chinese National Knowledge Infrastructure (CNKI) and WANFANG. Eligible studies were selected according to inclusion and exclusion criteria. Relevant data were extracted and the quality of studies assessed. Odds ratios with 95% confidence intervals were pooled to statistically analyse the difference between intervention and control groups. RESULTS Ten studies were selected for the systematic review and meta-analysis. The findings showed that CBT and cognitive-related therapy significantly improved the pregnancy rate of women undergoing IVF-ET treatment. Subgroup analysis showed that patients who received CBT, rather than complex psychological interventions, and those who received interventions delivered by professional psychologists, were more likely to become pregnant during IVF-ET treatment. CONCLUSION CBT and cognitive-related interventions had significant effects on the pregnancy outcomes of women receiving IVF-ET treatment. CBT treatment (rather than complex psychological interventions) provided by professional psychologists is strongly recommended.
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Affiliation(s)
- Ya-Qin Li
- Department of Obstetrics and Gynecology, Suzhou Ninth People's Hospital, Soochow University, Suzhou, China
| | - Yun Shi
- Department of Obstetrics and Gynecology, Suzhou Ninth People's Hospital, Soochow University, Suzhou, China
| | - Chen Xu
- Department of Urology, Suzhou Ninth People's Hospital, Soochow University, Suzhou, China
| | - Hong Zhou
- Department of Obstetrics and Gynecology, Suzhou Ninth People's Hospital, Soochow University, Suzhou, China
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Yoldemir T, Yassa M, Atasayan K. Comparison of anxiety scores between unexplained primary and secondary infertile couples. Gynecol Endocrinol 2021; 37:1008-1013. [PMID: 34036863 DOI: 10.1080/09513590.2021.1929149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVE To investigate the anxiety levels among infertile women and their partners also factors that may affect the anxiety status. STUDY DESIGN A total of 403 infertile couples who applied to Infertility Outpatient Clinics of a University-affiliated Teaching and Research Hospital were included in the study. The infertile group was divided into two groups as primary and secondary infertile. One hundred and thirty-two fertile couples who applied to Gynecology Outpatient Clinics composed the control group. Hamilton Anxiety Rating Scale (HAM-A) form was filled by the infertile couples to evaluate the anxiety status before they started their treatment. RESULTS Three hundred and twenty infertile and 84 fertile couples completed the study. The mean total scores of HAM-A of women were similar between the groups. So were the scores of their husbands. In all groups, women had significantly higher mean total HAM-A scores than their husbands. There was no association between the mean HAM-A score of women and age, BMI, AFC, duration of marriage, duration of infertility, number of previous treatment cycles. Education status, working status and family structure of women did not correlate with the mean HAM-A score. CONCLUSION Unexplained primary and secondary infertile couples had similar anxiety scores before the commencement of fertility treatments. However, the scores were higher in women than their male partners. Since the burden of treatment and the likelihood of treatment failure might increase the level of anxiety the women could be offered proper cognitive coping and relaxation interventions.
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Affiliation(s)
- Tevfik Yoldemir
- Obstetrics and Gynecology Department, Marmara University School of Medicine, Istanbul, Turkey
| | - Mahmut Yassa
- Diyarbakir Selahaddin Eyyubi State Hospital, Clinic of Obstetrics and Gynecology, Diyarbakir, Turkey
| | - Kemal Atasayan
- Department of Medical Services and Techniques, Vocational School of Health Services, Bezmialem Vakıf Üniversitesi, Istanbul, Turkey
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Raad G, Tanios J, Kerbaj S, Mourad Y, Fakih F, Shamas F, Azouri J, Fakih C. Stress Management during the Intracytoplasmic Sperm Injection Cycle May Slow Down First Embryo Cleavage and Accelerate Embryo Compaction: A Pilot Randomized Controlled Trial. PSYCHOTHERAPY AND PSYCHOSOMATICS 2021; 90:119-126. [PMID: 33333526 DOI: 10.1159/000512530] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 10/21/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION A firm consensus on the effectiveness of psychological interventions during infertility treatment has not been reached yet in terms of mental health and pregnancy rates. Moreover, the influence of these interventions on embryo cleavage kinetics has not been investigated. OBJECTIVE The aim of this work was to study whether stress management in couples undergoing an intracytoplasmic sperm injection (ICSI) cycle influences stress levels, mitochondrial DNA (mtDNA) levels in granulosa cells, and cleavage-stage embryos. METHODS Infertile couples were randomized into a treatment as usual (TAU) group (n = 30) and stress management program (SMP) group (n = 29) at the beginning of an ICSI cycle. Couples in the SMP group attended education and relaxation sessions at each visit to the clinic for folliculometry. The perceived stress scale (PSS) was used to assess stress levels at the beginning and end of the cycle. Moreover, mtDNA levels of granulosa cells and embryo morphokinetics were evaluated. RESULTS Post-intervention, women in the SMP group had significantly lower PSS scores than their initial PSS (p < 0.001; effect size, ES = 0.5) and than the final PSS of the TAU group (p = 0.02; ES = 0.09). Additionally, mtDNA levels were significantly lower in luteal granulosa cells of the SMP group than the TAU group (p = 0.02). An earlier time of pronuclei appearance (p = 0.03) and time to 2 cells (p = 0.015) and a faster time to full compaction (p = 0.045) were detected in the embryos of the SMP group compared with the TAU group. CONCLUSION(S) The implemented program may reduce stress levels, retard first embryo cleavage, and accelerate embryo compaction. Further studies with an active control group are needed to confirm these results.
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Affiliation(s)
- Georges Raad
- Al-Hadi Laboratory and Medical Center, Beirut, Lebanon,
| | | | - Simone Kerbaj
- Azoury IVF Clinic, Mount-Lebanon Hospital, Hazmieh, Lebanon
| | - Youmna Mourad
- Al-Hadi Laboratory and Medical Center, Beirut, Lebanon
| | - Fadi Fakih
- Al-Hadi Laboratory and Medical Center, Beirut, Lebanon
| | - Fatmeh Shamas
- Al-Hadi Laboratory and Medical Center, Beirut, Lebanon
| | - Joseph Azouri
- Azoury IVF Clinic, Mount-Lebanon Hospital, Hazmieh, Lebanon
| | - Chadi Fakih
- Al-Hadi Laboratory and Medical Center, Beirut, Lebanon.,Obstetrics and Gynecology Department, Faculty of Medicine, Lebanese University, Beirut, Lebanon
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Kiyak S, Kocoglu-Tanyer D. Effectiveness of progressive muscle relaxation and laughter therapy on mental health and treatment outcomes in women undergoing in vitro fertilization: A randomized controlled trial. Res Nurs Health 2021; 44:945-956. [PMID: 34605040 DOI: 10.1002/nur.22187] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 09/18/2021] [Accepted: 09/23/2021] [Indexed: 11/05/2022]
Abstract
A majority of infertile women experience emotional problems, such as anxiety and depression. Nurses need nonpharmacological methods rather than drugs to address women's emotional distress during the in vitro fertilization (IVF) process. The purpose of this study was to examine the effect of progressive muscle relaxation exercises and laughter therapy on the mental health and treatment outcomes of women receiving IVF treatment. This parallel-group, randomized controlled trial was conducted in a private IVF center. Participants were randomly assigned to the intervention group (IG; n = 71) and control group (CG; n = 70). The IG received progressive muscle relaxation and laughter therapy for 40 min in each session for 3-4 sessions, whereas the CG received routine care. Data were obtained from the patient information form, State-Trait Anxiety Inventory, Beck Depression Inventory, and medical records. The questionnaire was completed at recruitment (T1) and oocyte pick-up day (T2). In the evaluation performed on the day of the oocyte pick-up, depression and trait anxiety scores of the IG were found to be lower than those in the CG, and the effect size was small. Group × time interaction was significant for depression (large effect size) and trait anxiety (small effect size). The estradiol levels, the number of oocytes, transfer status, and pregnancy rates (according to a blood test) were similar between groups. Women receiving IVF treatment who received progressive muscle relaxation and laughter therapy demonstrated psychological changes; however, the treatment did not affect medical outcomes.
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Affiliation(s)
- Sibel Kiyak
- Department of Obstetrics and Gynecology Nursing, Seydişehir Kamil Akkanat Faculty of Health Sciences, Necmettin Erbakan University, Seydişehir, Konya, Turkey
| | - Deniz Kocoglu-Tanyer
- Department of Public Health Nursing, Faculty of Nursing, Selcuk University, Konya, Turkey
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Boedt T, Matthys C, Lie Fong S, De Neubourg D, Vereeck S, Seghers J, Van der Gucht K, Weyn B, Geerts D, Spiessens C, Dancet EAF. Systematic development of a mobile preconception lifestyle programme for couples undergoing IVF: the PreLiFe-programme. Hum Reprod 2021; 36:2493-2505. [PMID: 34379119 DOI: 10.1093/humrep/deab166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 06/04/2021] [Indexed: 12/14/2022] Open
Abstract
STUDY QUESTION Can we develop a preconception lifestyle programme for couples undergoing IVF that is in line with their needs. SUMMARY ANSWER A mobile preconception lifestyle programme was systematically developed based on expert opinion, literature and needs of IVF-patients. WHAT IS KNOWN ALREADY A healthy lifestyle prior to conception is not only beneficial for the general health of couples, but evidence on its importance for their reproductive health and the health of their children is also emerging. So far, the vast majority of fertility clinics do not offer a lifestyle programme for couples undergoing IVF. Therefore, the present study aimed to develop a lifestyle programme for IVF-couples. STUDY DESIGN, SIZE, DURATION The development of the PreLiFe-programme was guided by the steps of the Medical Research Council (MRC) framework for developing complex interventions, a systematic approach for developing theory- and evidence-based health promotion interventions. PARTICIPANTS/MATERIALS, SETTINGS, METHODS First, the evidence base on lifestyle programmes for IVF-couples was reviewed. Second, several iterations between an expert panel, the literature, and quantitative and qualitative data from IVF-patients identified the content, the format, behaviour change techniques and theory of the programme. Third, the PreLiFe-programme was produced and the expected process and outcomes of a randomized controlled trial assessing it were modelled. Finally, user tests among experts and patients and pilot tests among patients were conducted. MAIN RESULTS AND ROLE OF CHANCE The finally developed PreLiFe-programme is a mobile application to be used autonomously by both partners of IVF-couples during the first year of IVF, in combination with motivational interviewing over the telephone every three months (i.e. blended care). The PreLiFe-programme provides advice and skills training on physical activity, diet and mindfulness based stress reduction and is in part tailored based on monitoring and tracking the lifestyle of patients. Based on the literature the expert panel considers it plausible that all three components contribute to IVF-success rates. The PreLiFe-programme is likely to be acceptable to patients as it meets the need of patients for lifestyle advice and treatment information. LIMITATIONS, REASON FOR CAUTION The pilot in IVF-couples had a 3-month duration. The feasibility of the PreLiFe-programme in other infertile populations and/or upon longer use is yet to be examined. Whether the PreLiFe-programme effectively improves lifestyle and IVF-success rates is currently being examined in a trial randomizing heterosexual couples starting IVF to the PreLiFe-programme or an attention-control group for 12 months. WIDER IMPLICATIONS OF THE FINDINGS If the PreLiFe-programme improves lifestyle and the chance of IVF-success, it will be a powerful tool and provide guidance for implementing lifestyle programmes in fertility clinics. STUDY FUNDING/COMPETING INTEREST(S) Funded by the Research Foundation Flanders (FWO-TBM (Applied Biomedical Research with a Primary Social finality); reference: T005417N). The authors have no conflict of interest to report. TRIAL REGISTRATION NUMBER NCT03790449.
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Affiliation(s)
- T Boedt
- Department of Chronic Diseases and Metabolism, Clinical and Experimental Endocrinology, KU Leuven, Leuven, Belgium.,Leuven University Fertility Centre, University Hospitals Leuven, Leuven, Belgium
| | - C Matthys
- Department of Chronic Diseases and Metabolism, Clinical and Experimental Endocrinology, KU Leuven, Leuven, Belgium.,Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium
| | - S Lie Fong
- Leuven University Fertility Centre, University Hospitals Leuven, Leuven, Belgium.,Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - D De Neubourg
- Centre for Reproductive Medicine, Antwerp University Hospital, Edegem, Belgium
| | - S Vereeck
- Centre for Reproductive Medicine, Antwerp University Hospital, Edegem, Belgium
| | - J Seghers
- Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - K Van der Gucht
- Leuven Mindfulness Centre, KU Leuven, Leuven, Belgium.,Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - B Weyn
- Department of Electric Engineering, Leuven, Belgium
| | - D Geerts
- Meaningful Interactions Lab, KU Leuven, Leuven, Belgium
| | - C Spiessens
- Leuven University Fertility Centre, University Hospitals Leuven, Leuven, Belgium.,Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - E A F Dancet
- Leuven University Fertility Centre, University Hospitals Leuven, Leuven, Belgium.,Department of Development and Regeneration, KU Leuven, Leuven, Belgium
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Objective sleep duration and timing predicts completion of in vitro fertilization cycle. J Assist Reprod Genet 2021; 38:2687-2696. [PMID: 34374922 DOI: 10.1007/s10815-021-02260-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 06/10/2021] [Indexed: 10/20/2022] Open
Abstract
PURPOSE To examine associations between objectively measured sleep duration and sleep timing with odds of completion of an in vitro fertilization (IVF) cycle. METHODS This prospective cohort study enrolled 48 women undergoing IVF at a large tertiary medical center between 2015 and 2017. Sleep was assessed by wrist-worn actigraphy, 1-2 weeks prior to initiation of the IVF cycle. Reproductive and IVF cycle data and demographic and health information were obtained from medical charts. Sleep duration, midpoint, and bedtime were examined in relation to IVF cycle completion using logistic regression models, adjusted for age and anti-Müllerian hormone levels. A sub-analysis excluded women who worked non-day shifts to control for circadian misalignment. RESULTS The median age of all participants was 33 years, with 29% of women >35 years. Ten women had an IVF cycle cancelation prior to embryo transfer. These women had shorter sleep duration, more nocturnal awakenings, lower sleep efficiency, and later sleep timing relative to those who completed their cycle. Longer sleep duration was associated with lower odds of uncompleted IVF cycle (OR = 0.88; 95%CI 0.78, 1.00, per 20-min increment of increased sleep duration). Women with later sleep midpoint and later bedtime had higher odds of uncompleted cycle relative to those with earlier midpoint and earlier bedtime; OR = 1.24; 95%CI 1.09, 1.40 and OR = 1.33; 95%CI 1.17, 1.53 respectively, for 20-min increments. These results were independent of age, anti-Müllerian hormone levels, or sleep duration, and remained significant after exclusion of shift-working women. CONCLUSIONS Shorter sleep duration and later sleep timing increase the odds of uncompleted cycles prior to embryo transfer.
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Gullo G, Cucinella G, Perino A, Gullo D, Segreto D, Laganà AS, Buzzaccarini G, Donarelli Z, Marino A, Allegra A, Maranto M, Carosso AR, Garofalo P, Tomaiuolo R. The Gender Gap in the Diagnostic-Therapeutic Journey of the Infertile Couple. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126184. [PMID: 34201025 PMCID: PMC8227607 DOI: 10.3390/ijerph18126184] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/28/2021] [Accepted: 06/04/2021] [Indexed: 11/19/2022]
Abstract
Medical procreation impairs both the biological and psychological lives of couples. However, male and female attitudes to infertility are different and require a different approach during the IVF journey. Thus, the gender impact assessment (GIA) method was used to analyse original studies present in the literature. We found some gender-related differences and, subsequently, possible outcomes of intervention to improve healthy reproduction management and prevent infertility. In particular, it became apparent that there was the need for an in-depth male infertility assessment and a gender-specific follow-up.
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Affiliation(s)
- Giuseppe Gullo
- Department of Obstetrics and Gynecology, Villa Sofia Cervello Hospital, IVF UNIT, University of Palermo, 90146 Palermo, Italy; (G.G.); (G.C.); (A.P.); (M.M.)
| | - Gaspare Cucinella
- Department of Obstetrics and Gynecology, Villa Sofia Cervello Hospital, IVF UNIT, University of Palermo, 90146 Palermo, Italy; (G.G.); (G.C.); (A.P.); (M.M.)
| | - Antonio Perino
- Department of Obstetrics and Gynecology, Villa Sofia Cervello Hospital, IVF UNIT, University of Palermo, 90146 Palermo, Italy; (G.G.); (G.C.); (A.P.); (M.M.)
| | - Domenico Gullo
- Technical Panel on Gender Medicine-Sicily Regional Health Service, 90143 Palermo, Italy; (D.G.); (D.S.); (P.G.)
| | - Daniela Segreto
- Technical Panel on Gender Medicine-Sicily Regional Health Service, 90143 Palermo, Italy; (D.G.); (D.S.); (P.G.)
| | - Antonio Simone Laganà
- Department of Obstetrics and Gynecology, “Filippo Del Ponte” Hospital, University of Insubria, 21100 Varese, Italy;
| | - Giovanni Buzzaccarini
- Department of Women’s and Children’s Health, Padova Hospital, University of Padova, 35128 Padova, Italy
- Correspondence:
| | - Zaira Donarelli
- Psychology Unit, Andros Day Surgery Clinic-Palermo, 90144 Palermo, Italy;
| | - Angelo Marino
- Reproductive Medicine Unit, Andros Day Surgery Clinic-Palermo, 90144 Palermo, Italy; (A.M.); (A.A.)
| | - Adolfo Allegra
- Reproductive Medicine Unit, Andros Day Surgery Clinic-Palermo, 90144 Palermo, Italy; (A.M.); (A.A.)
| | - Marianna Maranto
- Department of Obstetrics and Gynecology, Villa Sofia Cervello Hospital, IVF UNIT, University of Palermo, 90146 Palermo, Italy; (G.G.); (G.C.); (A.P.); (M.M.)
| | - Andrea Roberto Carosso
- Division of Gynecology and Obstetrics 1, Department of Surgical Sciences, City of Health and Science, University of Turin, 10126 Turin, Italy;
| | - Piernicola Garofalo
- Technical Panel on Gender Medicine-Sicily Regional Health Service, 90143 Palermo, Italy; (D.G.); (D.S.); (P.G.)
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DI Pietro ML, Zaçe D, Poscia A, Marana R. Perceived knowledge, coping and diagnostic-therapeutic pathways of infertile couples trying to conceive: an Italian survey. Minerva Obstet Gynecol 2021; 74:279-287. [PMID: 33944525 DOI: 10.23736/s2724-606x.21.04800-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The last decades' increasing infertility risk factors have brought to a growing number of infertile couples. Knowledge regarding infertility and possible treatments ishowever-poor, leading to difficulty in coping and understanding. Knowing infertile couples' perceptions and needs may help clinicians develop services that better address these needs. METHODS This study aimed at assessing perceived knowledge, coping mechanisms and diagnostic-therapeutic pathways concerning infertility and Assisted Reproductive Technology (ART) in a sample of Italian infertile couples trying to conceive. In this cross-sectional study, 199 subjects aged 25-55 years old who had difficulties conceiving were asked to fill a questionnaire regarding infertility and ART perceived knowledge, coping and diagnostic-therapeutic pathways they had been through. RESULTS The perceived knowledge score was 42.5%. Couples had difficulties understanding ART's success rate and the potential risks for the woman and foetus. Subjects from North of Italy, who were previously engaged in an ART procedure, those who had signed a written informed consent and were offered a specific counselling session had significantly higher mean score of perceived knowledge. Couples were handling the situation in a satisfactory way, supported also by their family, but the procedures, clinical examinations, therapies, medications, were considered complex and stressful by 66.5% of the respondents. CONCLUSIONS Healthcare providers should consider the couples' previous experience with infertility, the important role of informed consent and personalized counselling sessions. Counselling for infertile couples should have a broader, comprehensive approach, integrating psychological, social, ethical support, as well as health literacy, taking into consideration the infertile couples' preferences and needs.
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Affiliation(s)
- Maria Luisa DI Pietro
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Drieda Zaçe
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy -
| | - Andrea Poscia
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Riccardo Marana
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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Ha JY, Ban SH, Lee HJ, Lee M. [Effects of First Assisted Reproductive Technologies on Anxiety and Depression among Infertile Women: A Systematic Review and Meta-Analysis]. J Korean Acad Nurs 2021; 50:369-384. [PMID: 32632071 DOI: 10.4040/jkan.19187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 03/23/2020] [Accepted: 03/23/2020] [Indexed: 11/09/2022]
Abstract
PURPOSE The purpose of this study was to analyze anxiety and depression among infertile women at different time points during the first In Vitro Fertilization (IVF) or Intracytoplasmic Sperm Injection (ICSI) treatment through a systematic review and meta-analysis. METHODS Seven out of 3,011 studies were included for meta-analysis. To estimate the effect size, a meta-analysis of the studies was performed using the RevMan 5.3 program. We compared the measurement outcomes at three time points: before the start of treatment (T0), cancellation of treatment after pregnancy detection (T2), one to six months after treatment (T3). The effect size used was the standardized mean difference (SMD). RESULTS In comparing the different time points of the pregnant women from their cycle, significantly lower levels of depression were found at T2 than at T0. In non-pregnant women, anxiety at T2 and depression at T2 and T3 were significantly higher than those at T0. At T2 and T3, the non-pregnant women reported higher levels of anxiety and depression compared with the pregnant women. CONCLUSION Anxiety and depression in infertile women undergoing the first IVF or ICSI are associated with the time points and pregnancy status after treatment. These findings suggest that attention should be paid to helping infertile women prepare for and cope with treatment and treatment failure.
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Affiliation(s)
- Ju Young Ha
- College of Nursing, Pusan National University, Yangsan, Korea
| | - Seon Hwa Ban
- College of Nursing, Pusan National University, Yangsan, Korea.
| | - Hae Jung Lee
- College of Nursing, Pusan National University, Yangsan, Korea
| | - Misoon Lee
- Department of Nursing, Changshin University, Changwon, Korea
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Kato T, Sampei M, Saito K, Morisaki N, Urayama KY. Depressive symptoms, anxiety, and quality of life of Japanese women at initiation of ART treatment. Sci Rep 2021; 11:7538. [PMID: 33824373 PMCID: PMC8024276 DOI: 10.1038/s41598-021-87057-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 03/23/2021] [Indexed: 02/04/2023] Open
Abstract
Assisted reproductive technology (ART) treatment accounted for 6% of total births in 2017 and is increasing which places Japan among the top worldwide in number of treatments performed. Although ART treatment patients often experience heavy physical and psychological burden, few epidemiologic studies have been conducted in Japan. We examined mental health and health-related quality of life (QOL) among women at early stages of treatment. We recruited 513 women who have initiated ART treatment, either in-vitro fertilization or intracytoplasmic sperm injection, from four medical facilities in the Tokyo area and through web-based approaches. At baseline, we collected socio-demographic information and assessed depressive symptoms, anxiety, and QOL. Descriptive analyses were performed overall and stratified by factors such as age. Mild depressive symptoms or worse, assessed with Quick Inventory of Depressive Symptoms, were observed among 54% of participants. Mean score for State-Trait Anxiety Inventory was 52 with a standard deviation of 11 for the state, and 39% were categorized as high anxiety. QOL results, assessed with SF-12, showed the same negative tendency for social functioning and role (emotional), while general health and physical functioning were consistent with the national average. Young participants appeared to suffer mentally more than older participants (p < 0.01 for depressive symptoms). Our findings suggest that patients may be at high risk of depressive symptoms, high anxiety, and low QOL even from the early stages of ART treatment.
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Affiliation(s)
- Tsuguhiko Kato
- Department of Social Medicine, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan.
| | - Makiko Sampei
- Department of Social Medicine, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Kazuki Saito
- Department of Pediatrics, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Naho Morisaki
- Department of Social Medicine, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Kevin Y Urayama
- Department of Social Medicine, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan.,Graduate School of Public Health, St. Luke's International University, 3-6-2 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
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Negris O, Lawson A, Brown D, Warren C, Galic I, Bozen A, Swanson A, Jain T. Emotional stress and reproduction: what do fertility patients believe? J Assist Reprod Genet 2021; 38:877-887. [PMID: 33548005 PMCID: PMC8079591 DOI: 10.1007/s10815-021-02079-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 01/18/2021] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To better understand the beliefs about a causal role of emotional stress maintained by women seeking fertility care. METHODS A cross-sectional, self-administered survey was distributed to fertility care patients at an academic fertility center in Illinois. Of 5000 consecutive patients, 1460 completed the survey and were included in the study sample. RESULTS Members of our sample (N = 1460) were between 20 and 58 years (mean = 36.2, SD = 4.4). Most respondents were White (72.2%), were in a heterosexual relationship (86.8%), and felt that their physician understood their cultural background (79.4%). Of the sample, 28.9% believed emotional stress could cause infertility, 69.0% believed emotional stress could reduce success with fertility treatment, and 31.3% believed that emotional stress could cause a miscarriage, with evidence of significant racial differences. Less than a quarter (23.8%) of the sample believed emotional stress had no impact on fertility. Lower household income and educational attainment were associated with a greater belief in emotional stress as a causative factor in reproduction with regard to infertility, fertility treatment, and miscarriage. CONCLUSION The majority of women seeking fertility care believe emotional stress could reduce the success of fertility treatment. Furthermore, beliefs about emotional stress and reproduction significantly differ based on race/ethnicity, income, and education. Particular attention should be paid to specific groups of women who may more likely not be aware of the lack of a proven biological relationship between emotional stress and reproduction.
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Affiliation(s)
- Olivia Negris
- Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Angela Lawson
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Dannielle Brown
- Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Christopher Warren
- Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Stanford University School of Medicine, Stanford, CA, USA
| | - Isabel Galic
- Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Alexandria Bozen
- Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Amelia Swanson
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Tarun Jain
- Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
- Northwestern Center for Fertility and Reproductive Medicine, 676 North St Clair St, Suite 2310, Chicago, IL, 60611, USA.
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Matorras R, Pijoan JI, Perez‐Ruiz I, Lainz L, Malaina I, Borjaba S. Meta-analysis of the embryo freezing transfer interval. Reprod Med Biol 2021; 20:144-158. [PMID: 33850447 PMCID: PMC8022104 DOI: 10.1002/rmb2.12363] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/18/2020] [Accepted: 12/12/2020] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND The decision of whether frozen embryo transfer (FET) should be performed in the cycle immediately after OPU or at least one cycle later is controversial. FET could improve pregnancy rates in IVF; however, how much time is needed for the endometrium to return to optimal receptivity after ovarian stimulation is not known. METHODS Electronic search in MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials to identify studies providing data on the influence of the interval between embryo freezing (or OPU) and FET in FET cycles published between January 1, 2007, and February 1, 2020. MAIN FINDINGS Data analyzed indicated that in the immediate FET cycles, there was a trend to an increased biochemical pregnancy rate (RR = 1.08; CI = 1.00-1.18), whereas the clinical pregnancy rate was somewhat higher, but without reaching statistical significance (RR = 1.07; CI = 0.99-1.15). The live birth rate was similar in the two groups (RR = 1.05; CI = 0.95-1.15), as was the implantation rate (RR = 0.98; CI = 0.83-1.16). Stratifying by embryo stage or FET type (freeze-all or FET after failed fresh transfer) showed no differences. CONCLUSION Systematically delaying FET does not offer benefits to IVF outcomes. In addition, immediate transfer is associated with a nonsignificant trend to better clinical pregnancy rate and it also avoids the psychological effects of prolonging the stress on prospective parents.
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Affiliation(s)
- Roberto Matorras
- Reproduction UnitCruces HospitalBiocruces Health Research InstituteBIOEFVizcayaSpain
- Department of Gynecology and ObstetricsFaculty of Medicine and NursingUniversity of the Basque CountryVizcayaSpain
- IVI BilbaoVizcayaSpain
| | - Jose Ignacio Pijoan
- Clinical Epidemiological UnitCruces HospitalBiocruces Health Research InstituteBIOEFVizcayaSpain
| | - Irantzu Perez‐Ruiz
- Reproduction UnitCruces HospitalBiocruces Health Research InstituteBIOEFVizcayaSpain
| | - Lucía Lainz
- Reproduction UnitCruces HospitalBiocruces Health Research InstituteBIOEFVizcayaSpain
| | - Iker Malaina
- Clinical Epidemiological UnitCruces HospitalBiocruces Health Research InstituteBIOEFVizcayaSpain
- Department of MathematicsFaculty of Science and TechnologyUniversity of the Basque CountryVizcayaSpain
| | - Sonia Borjaba
- Reproduction UnitCruces HospitalBiocruces Health Research InstituteBIOEFVizcayaSpain
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Zhou R, Cao YM, Liu D, Xiao JS. Pregnancy or Psychological Outcomes of Psychotherapy Interventions for Infertility: A Meta-Analysis. Front Psychol 2021; 12:643395. [PMID: 33868114 PMCID: PMC8044306 DOI: 10.3389/fpsyg.2021.643395] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 02/02/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The pregnancy and psychological status of infertile couples has always been a concern, but there is no clear evidence for the efficacy of psychotherapy for infertile couples. This study aimed to summarize the current evidence of the effects of psychotherapy on psychological and pregnancy outcomes for infertile couples. Method: We searched Ovid MEDLINE, Ovid EMbase, The Cochrane Library, and Web of Science (ISI) for articles published from 1946 to June 26, 2020. The pregnancy outcomes, psychological outcomes, and acceptability were involved in the study. Results: Overall, 29 studies with a combined total of 3,522 adult participants were included in the meta-analysis. Compared with a placebo, psychotherapy was associated with the pregnancy rate [risk ratio (RR) = 1.43, 95% CI [1.07, 1.93]], total psychological scales associated with infertility [standardized mean difference (SMD) = −0.33 95% CI [−0.63, −0.02]], subsymptoms of psychological scores using the 28-item version of GHQ (including social function [MD = −3.10, 95% CI [−4.30, −1.90]] and depression [MD = −3.90, 95% CI [−5.36, −2.44]], and depression [MD = 3.60, 95% CI [2.25, 4.95]] using the 14-item version of Hospital Anxiety and Depression Scale, but it had no statistically significant association with the other outcomes. In the stratified analyses, the pregnancy rate using assisted reproduction, cognitive behavioral therapy (CBT), and the integrative body–mind–spirit (BMS); total psychological scales associated with infertility using other treatments and more than a month; and anxiety using BMS had significant statistical significance. The funnel plots of all outcomes were approximately symmetrical, and no significant publication bias was found. Conclusions: The study showed that psychotherapy can lead to improvements in the pregnancy rate for infertile patients, especially for patients receiving assisted fertility. In addition, it may help improve total psychological scales associated with infertility and depression. CBT and BMS play an important role in improving rate of pregnancy, and BMS is associated with reducing anxiety. Although psychological interventions had limited effects on the pregnancy outcomes of infertility, our study still recommended that psychotherapies, in particular CBT and BMS, were applied to the therapeutic regimen for infertility, especially for patients receiving assisted fertility.
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Affiliation(s)
- Rong Zhou
- Department of Reproductive Medicine Center, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China
| | - Yu-Ming Cao
- The Second Clinical College of Wuhan University, Wuhan, China
| | - Dan Liu
- Department of Obstetrics and Gynecology, Wuhan Ninth Hospital, Wuhan, China
| | - Jing-Song Xiao
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China
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Trolice MP. Linking stress and infertility-more than a chicken and egg conundrum. J Assist Reprod Genet 2021; 38:873-875. [PMID: 33723749 PMCID: PMC7959297 DOI: 10.1007/s10815-021-02145-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 03/04/2021] [Indexed: 12/02/2022] Open
Affiliation(s)
- Mark P Trolice
- Department of Obstetrics and Gynecology, University of Central Florida College of Medicine, Orlando, FL, USA. .,Fertility CARE: The IVF Center, Winter Park, FL, USA.
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Ha JY, Ban SH. Effects of Mind-Body Programs on Infertile Women: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Asian Nurs Res (Korean Soc Nurs Sci) 2021; 15:77-88. [PMID: 33607300 DOI: 10.1016/j.anr.2021.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 01/23/2021] [Accepted: 02/08/2021] [Indexed: 11/25/2022] Open
Abstract
PURPOSE This study was to systematically review randomized controlled trials and conduct a meta analysis. The results of randomized controlled trials were integrated and analyzed to assess the effects of mind-body programs on anxiety, depression, quality of life, and pregnancy rate in infertile women. METHODS Using electronic databases (i.e., Research Information Sharing Service, Korean Studies Information Service System, Korean Medical Database, National Digital Science Library, Cochrane Library, PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature, and PsycARTICLES), 10 of 2,259 studies were included for meta-analysis. To estimate the effect size, a meta-analysis of the studies was performed using RevMan 5.3. RESULTS The mind-body program was effective in relieving anxiety [standardized mean difference (SMD) = -3.44; 95% confidence interval (CI) = -5.94, -0.95; p = .007; I2 = 69%] and depression (SMD = -5.79; 95% CI = -10.36, -1.22; p = .010; I2 = 86%). Furthermore, it was effective in enhancing the quality of life (SMD = 7.40; 95% CI = 2.92, 11.88; p = .001; I2 = 53%) and pregnancy rate (SMD = 2.06; 95% CI = 1.08, 3.95; p = .030; I2 = 73%). The mind-body program was found to relieve anxiety and depression in infertile women and improve their quality of life, thereby positively affecting the pregnancy rate. CONCLUSION The mind-body program was found to relieve anxiety and depression in infertile women and improve their quality of life, thereby positively affecting the pregnancy rate. The mind-body program needs to be considered to a wider audience for positive effects on emotions and pregnancy outcomes of infertile women.
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Affiliation(s)
- Ju-Young Ha
- College of Nursing, Pusan National University, Busan, Republic of Korea
| | - Seon-Hwa Ban
- College of Nursing, Pusan National University, Busan, Republic of Korea.
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Zurlo MC, Cattaneo Della Volta MF, Vallone F. Re-examining the Role of Coping Strategies in the Associations Between Infertility-Related Stress Dimensions and State-Anxiety: Implications for Clinical Interventions With Infertile Couples. Front Psychol 2020; 11:614887. [PMID: 33414752 PMCID: PMC7782436 DOI: 10.3389/fpsyg.2020.614887] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 11/18/2020] [Indexed: 12/22/2022] Open
Abstract
Research has shown a direct relationship between infertility-related stress and anxiety in infertile patients. The present study goes into this relationship in depth, testing the moderating role of coping strategies (Seeking Social Support, Avoidant, Positive Attitude, Problem-Solving, Turning to Religion) in the associations between specific infertility-related stress dimensions (Social Concern, Need for Parenthood, Rejection of Childfree Lifestyle, Couple’s Relationship Concern) and State-Anxiety among male and female partners of infertile couples. Gender differences were also explored. Both members of 254 infertile couples completed a questionnaire consisting of Socio-demographics, Fertility Problem Inventory–Short Form (FPI-SF), Coping Orientation to Problem Experienced–New Italian Version (COPE-NIV), and State-Trait Anxiety Inventory-Y (STAI-Y). The results revealed that Social Concern and Couple’s Relationship Concern, in both partners, and Need for Parenthood, in female partners, had positive correlations with State-Anxiety. Seeking Social Support and Avoidant coping were related to increasing levels of State-Anxiety in both partners, whereas Positive Attitude coping strategies were related to lower levels of State-Anxiety in female partners. Problem-Solving and Avoidant coping played moderating roles between specific infertility-related stress dimensions and State-Anxiety in unexpected directions. Problem-Solving exacerbated the negative effects of Social Concern, whereas Avoidant coping buffered the negative effects of several infertility-related stress dimensions in both partners. Interventions to improve stress management and psychological health in infertile couples should consider that the adequacy of coping strategies is inherently situation specific. It therefore follows that patient-centered clinical interventions should consider the potential inadequacy of promoting Problem-Solving strategies, and that even Avoidance can be an efficient strategy for dealing with specific infertility-related stress dimensions.
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Affiliation(s)
- Maria Clelia Zurlo
- Dynamic Psychology Laboratory, Department of Political Science, University of Naples Federico II, Naples, Italy
| | - Maria Francesca Cattaneo Della Volta
- Dynamic Psychology Laboratory, Department of Political Science, University of Naples Federico II, Naples, Italy.,Department of Humanities, University of Naples Federico II, Naples, Italy
| | - Federica Vallone
- Dynamic Psychology Laboratory, Department of Political Science, University of Naples Federico II, Naples, Italy.,Department of Humanities, University of Naples Federico II, Naples, Italy
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Aimagambetova G, Issanov A, Terzic S, Bapayeva G, Ukybassova T, Baikoshkarova S, Aldiyarova A, Shauyen F, Terzic M. The effect of psychological distress on IVF outcomes: Reality or speculations? PLoS One 2020; 15:e0242024. [PMID: 33315878 PMCID: PMC7735622 DOI: 10.1371/journal.pone.0242024] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 10/26/2020] [Indexed: 02/03/2023] Open
Abstract
Introduction Infertility is a problem that affects millions of people worldwide. The aim of this study was to assess the effect of stress, depression and anxiety on the IVF outcomes in Kazakhstan. Methods The prospective cohort study was performed using questionnaires to assess psychological distress in 304 infertile female in three different cities in Kazakhstan. Results The average age of participants was 33.7 years with infertility duration of 5.9 years. Regarding stress, depression and anxiety we found that more than 80% of all respondents had CES-D score higher than 16, indicating that they are at risk of developing clinical depression. On average, FPI subscales’ scores, global stress score and anxiety scale (STAI-S and STAI-T) scores were statistically significantly higher among not pregnant women than pregnant women. Similarly, in simple logistic regression analysis all FPI subscales scores, global stress scale score and anxiety scales’ scores were negatively associated with clinical pregnancy. Conclusion Rates of stress, anxiety and depression among IVF patients are higher than in general population. If the level of infertility-related stress is higher, IVF success rate is lower. Findings of our study indicate the need for the specific psychological interventions for all infertility women, to improve IVF success rate.
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Affiliation(s)
- Gulzhanat Aimagambetova
- Department of Biomedical Sciences, Nazarbayev University School of Medicine, Nur-Sultan, Kazakhstan
- * E-mail:
| | - Alpamys Issanov
- Department of Medicine, Nazarbayev University School of Medicine, Nur-Sultan, Kazakhstan
| | - Sanja Terzic
- Department of Medicine, Nazarbayev University School of Medicine, Nur-Sultan, Kazakhstan
| | - Gauri Bapayeva
- Clinical Academic Department of Women’s Health, National Research Center of Mother and Child Health, University Medical Center, Nur-Sultan, Kazakhstan
| | - Talshyn Ukybassova
- Clinical Academic Department of Women’s Health, National Research Center of Mother and Child Health, University Medical Center, Nur-Sultan, Kazakhstan
| | | | - Aidana Aldiyarova
- Clinical Academic Department of Women’s Health, National Research Center of Mother and Child Health, University Medical Center, Nur-Sultan, Kazakhstan
| | - Fariza Shauyen
- Clinical Academic Department of Women’s Health, National Research Center of Mother and Child Health, University Medical Center, Nur-Sultan, Kazakhstan
| | - Milan Terzic
- Department of Medicine, Nazarbayev University School of Medicine, Nur-Sultan, Kazakhstan
- Clinical Academic Department of Women’s Health, National Research Center of Mother and Child Health, University Medical Center, Nur-Sultan, Kazakhstan
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America
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Raad G, Tanios J, Azoury J, Daher A, Fakih C, Bakos HW. Neurophysiology of cognitive behavioural therapy, deep breathing and progressive muscle relaxation used in conjunction with ART treatments: a narrative review. Hum Reprod Update 2020; 27:324-338. [PMID: 33238001 DOI: 10.1093/humupd/dmaa048] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 09/13/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Infertility is defined as the failure to achieve clinical pregnancy after 12 months of regular unprotected intercourse. It could be due to male or female factors, each requiring different treatment options. ART treatment exposes couples to numerous psychological stressors. Therefore, it has been recommended by the ESHRE Psychology and Counselling Guideline Development Group recently that psychosocial support should be offered as a complementary therapy during infertility treatments. In this context, the efficiency of different psychological interventions, such as cognitive behaviour therapy (CBT), deep breathing (DB), and progressive muscle relaxation (PMR), was evaluated in several clinical trials in terms of couples' mental health and pregnancy outcomes. OBJECTIVE AND RATIONALE The neurophysiology of CBT, DB and PMR, which are used in interventional studies, in both men and women undergoing ART, has not yet been fully elucidated. This review represents a comprehensive report, aiming to collate novel insights into the neurobiological processes and physiological mechanisms that occur during the practice of CBT, DB and PMR. SEARCH METHODS PubMed, Google Scholar and Cochrane Library were interrogated to conduct this comprehensive literature review. The search was carried out using combinations of MeSH terms and keywords: infertility, assisted reproductive techniques, IVF, ICSI, emotions, psychological stress, cognitive behavioural therapy, mind-body therapies and relaxation. Relevant information related to the mechanism of action of stress management techniques were obtained from original articles and reviews published in English without taking into consideration the time of publication. Moreover, as it was not the major focus of the review, only recent systematic reviews (2015-2019) pinpointing the effects of psychological interventions on infertility treatment outcomes were also retrieved from the above-mentioned databases. OUTCOMES CBT, DB and PMR may modify the activity of stress-related brain regions such as the prefrontal cortex, amygdala, hypothalamus and hippocampus, as demonstrated by functional MRI and electroencephalogram studies. Furthermore, applying these techniques was associated with mood improvements and a decline in stress biomarkers, and, hypothetically, reducing stress biomarkers attenuates the stress-induced effects on ART outcomes. WIDER IMPLICATIONS Increasing the knowledge of fertility staff, researchers and physicians regarding the mechanisms of action of these stress management techniques has several advantages. For instance, understanding the underlying neurophysiological pathways would assist practitioners to engage ART couples in the practice of these techniques. Also, it may enhance the quality of the support programmes and psychological research. Accordingly, this will ensure that these interventions reach their full potential and therefore improve clinical outcomes.
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Affiliation(s)
- Georges Raad
- IVF Department, Al-Hadi Laboratory and Medical Center, Beirut, Lebanon
| | - Judy Tanios
- Embryology Department, IVF Lebanon, Hazmieh, Lebanon
| | - Joseph Azoury
- Azoury IVF clinic, Mount-Lebanon Hospital, Hazmieh, Lebanon
| | - Alain Daher
- Ob-Gyn department, St Joseph University, Beirut, Lebanon
| | - Chadi Fakih
- IVF Department, Al-Hadi Laboratory and Medical Center, Beirut, Lebanon
| | - Hassan W Bakos
- Monash IVF Group, Sydney, NSW, Australia.,School of Environmental and Life Sciences Faculty of Science, University of Newcastle, NSW, Australia
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Conception after early IVF pregnancy loss: should we wait? Reprod Biomed Online 2020; 42:413-419. [PMID: 33303365 DOI: 10.1016/j.rbmo.2020.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 10/11/2020] [Accepted: 10/29/2020] [Indexed: 11/23/2022]
Abstract
RESEARCH QUESTION Is the interval length between an early pregnancy loss and the following treatment cycle a predictor for achieving clinical pregnancy among IVF patients? DESIGN This retrospective cohort study of 257 women who reinitiated treatment after first-trimester IVF pregnancy loss was conducted at a tertiary, university-affiliated medical centre between 1 January 2014 to 1 January 2018. Women aged 18-40 years, with normal uterine cavity, who experienced first-trimester pregnancy loss at less than 14 weeks after IVF, were included. Miscarriages were classified as spontaneous, biochemical, medical or surgical. RESULTS Among 257 women, interval to subsequent IVF treatment was not associated with achieving pregnancy. Patients after biochemical pregnancy (72.7 ± 56.4, median 60 days) or spontaneous miscarriage (97.7 ± 93.1, median 66 days) had shorter intervals to next cycle, compared with medical (111.9 ± 103.2, median 65 days) or surgical (123.4 ± 111.1, median 84 days) (Kaplan-Meier, P = 0.03) miscarriages. Logistic regression analysis showed that the chance of subsequent pregnancy was affected by the number of embryos transferred (P = 0.009) and the type of miscarriage. Medical (P = 0.005) and surgical (P = 0.017) miscarriages were related to lower likelihood of pregnancy compared with biochemical pregnancy (reference group). When pregnancy was achieved in the first post-miscarriage cycle, the chance of live birth increased with shorter intervals (median 57.5 days), whereas second miscarriage was related to longer intervals (median 82.5 days) between miscarriage and subsequent IVF cycle (P = 0.03). CONCLUSION On the basis of this cohort, IVF should not be postponed after pregnancy loss, as shorter intervals were associated with greater likelihood of live birth.
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