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Asseler JD, de Nie I, van Rooij FB, Steensma TD, Mosterd D, Verhoeven MO, Goddijn M, Huirne JAF, van Mello NM. Transgender persons' view on previous fertility decision-making and current infertility: a qualitative study. Hum Reprod 2024; 39:2032-2042. [PMID: 39008827 PMCID: PMC11373325 DOI: 10.1093/humrep/deae155] [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: 08/22/2023] [Revised: 06/13/2024] [Indexed: 07/17/2024] Open
Abstract
STUDY QUESTION How do adult transgender and gender diverse (TGD) people, who are infertile due to prior gender-affirming treatment, view their current infertility and their reproductive decisions made in the past? SUMMARY ANSWER In a time where sterilization was mandatory, transgender adolescents prioritized gender-affirming treatment over their future fertility and would make the same choice today despite emotional challenges related to infertility experienced by some. WHAT IS KNOWN ALREADY Under transgender law in the Netherlands, sterilization was required for legal gender recognition until 2014, resulting in permanent infertility. The long-term consequences of this iatrogenic infertility in transgender adolescents who have now reached adulthood remain underexplored. STUDY DESIGN, SIZE, DURATION Qualitative study design based on 21 in-depth one-on-one semi-structured interviews. PARTICIPANTS/MATERIALS, SETTING, METHODS TGD people in a stage of life where family planning may be a current topic were eligible for participation. They all received gender-affirming treatment in adolescence prior to the legislation change in 2014. A purposeful sampling technique was used from participants of another ongoing study. Eleven people assigned female at birth and ten people assigned male at birth were included. Interview transcripts were thematically analysed using a modified version of Braun and Clarke's six steps theory. MAIN RESULTS AND THE ROLE OF CHANCE Six main themes were generated: (i) personal considerations regarding fertility and fertility preservation in the past; (ii) external considerations regarding fertility and fertility preservation in the past; (iii) current vision on past considerations and decisions; (iv) Current experiences and coping with infertility; (v) future family building; (vi) advice regarding fertility and fertility preservation decision-making. LIMITATIONS, REASONS FOR CAUTION Selection, recall, and choice supportive bias may play a role in interpreting our results. WIDER IMPLICATIONS OF THE FINDINGS This study highlights the importance of tailored counselling and comprehensive information on fertility preservation for transgender individuals, especially adolescents, undergoing gender-affirming treatment. STUDY FUNDING/COMPETING INTEREST(S) N/A. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- J D Asseler
- Department of Obstetrics and Gynaecology, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Centre of Expertise on Gender Dysphoria, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - I de Nie
- Department of Obstetrics and Gynaecology, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Centre of Expertise on Gender Dysphoria, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
- Department of Endocrinology, Amsterdam UMC, Amsterdam, The Netherlands
| | - F B van Rooij
- Research Institute Child Development and Education, Faculty of Social and Behavioural Sciences, University of Amsterdam, Amsterdam, The Netherlands
| | - T D Steensma
- Centre of Expertise on Gender Dysphoria, Amsterdam UMC, Amsterdam, The Netherlands
- Department of Medical Psychology, Amsterdam UMC, Amsterdam, The Netherlands
| | - D Mosterd
- Department of Obstetrics and Gynaecology, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - M O Verhoeven
- Department of Obstetrics and Gynaecology, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - M Goddijn
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
- Centre for Reproductive Medicine, Amsterdam UMC, Location University of Amsterdam, Amsterdam, The Netherlands
| | - J A F Huirne
- Department of Obstetrics and Gynaecology, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - N M van Mello
- Department of Obstetrics and Gynaecology, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Centre of Expertise on Gender Dysphoria, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
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Ain NU, Ali A, Sitwat A. Differences in social support, emotion invalidation, psychological needs, cognitive emotion regulation in maritally adjusted and maladjusted women in Pakistan: A matched pairs design. JOURNAL OF COMMUNITY PSYCHOLOGY 2024; 52:929-949. [PMID: 39102313 DOI: 10.1002/jcop.23137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 07/17/2024] [Accepted: 07/22/2024] [Indexed: 08/07/2024]
Abstract
The present study aimed to find out differences of social support, perceived emotion invalidation, psychological needs, and use of adaptive and maladaptive cognitive emotion regulation strategies in maritally adjusted and maladjusted after controlling for age, education, employment status, and depressive symptomatology. The cross-sectional study uses a matched pairs design. The sample was divided into two groups; maritally adjusted and maladjusted women (n = 40 pairs) on basis of scores obtained on revised-dyadic adjustment scale. Forty maritally adjusted women were matched with 40 maritally maladjusted women according to age, education, and employment status. Social support questionnaire, perceived invalidation of emotion scale, basic psychological need satisfaction frustration scale, cognitive emotion regulation questionnaire, and center for epidemiologic studies depression scale were administered. One-way ANCOVA revealed that maritally maladjusted women had lower level of social support [mean difference; -5.65(-9.97, -1.33), p < 0.05, partial η2 = 0.08] and more emotional invalidation [mean difference; 15.36(13.08, 17.65), p < 0.001, partial η2 = 0.71] compared to maritally adjusted women after controlling for the effect of depressive symptomatology. Maritally maladjusted women had more need frustration [mean difference; 10.75(7.59, 13.92), p < 0.001, partial η2 = 0.38] compared to maritally adjusted women. However, maritally adjusted women had more need satisfaction [mean difference; 13.36(9.67, 17.05), p < 0.001, partial η2 = 0.41] compared to maritally maladjusted women. Maritally adjusted women used more adaptive CER strategies (acceptance, refocus on planning and putting into perspective) [mean difference; 4.66(2.36, 6.95), p < 0.001, partial η2 = 0.18] compared to maritally maladjusted women whereas, maritally maladjusted women used more maladaptive strategies (self-blame, catastrophizing and blaming others) [mean difference; 4.66(2.77, 6.54), p < 0.001, partial η2 = 0.25] compared to maritally adjusted women. Maladjusted women had less social support and more emotional invalidation of emotions and psychological needs frustration. They used more maladaptive strategies to manage their negative emotions in comparison to maritally adjusted women. Identification of these cognitive emotion regulation strategies will help clinicians and counselors to devise psychological intervention targeting the use of adaptive strategies to minimize the negative mental health consequences.
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Affiliation(s)
- Noor Ul Ain
- Department of Developmental & Behavioral Pediatrics, The Children's Hospital (UCHS-CH), University of Child Health Sciences, Lahore, Pakistan
| | - Anam Ali
- Department of Developmental & Behavioral Pediatrics, The Children's Hospital (UCHS-CH), University of Child Health Sciences, Lahore, Pakistan
| | - Aisha Sitwat
- Center for Clinical Psychology, University of the Punjab, Lahore, Pakistan
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3
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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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Cherven B, Ivankova NV, Spencer JB, Fitzpatrick AM, Burns KC, Demedis J, Hoefgen HR, Mertens AC, Klosky JL. Examining decisional needs and contextual factors influencing fertility status assessment among young female survivors of childhood cancer: A sequential mixed methods study protocol. PLoS One 2023; 18:e0286511. [PMID: 37315007 PMCID: PMC10266625 DOI: 10.1371/journal.pone.0286511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 05/17/2023] [Indexed: 06/16/2023] Open
Abstract
INTRODUCTION Female cancer survivors who received gonadotoxic cancer treatment are at risk for profound diminished ovarian reserve and/or primary ovarian insufficiency with resulting infertility, which can be associated with distress and decreased quality of life.. Despite prioritizing future parenthood, many survivors are unsure of the impact of their treatment on their future fertility, and little is known about the perceived reproductive health needs and factors associated with receipt of a fertility status assessment (FSA). There is a lack of developmentally appropriate reproductive health decisional support interventions available for emerging adult cancer survivors. This study will explore the perceived reproductive health needs of emerging adult female survivors of childhood cancer and to identify decisional and contextual factors that influence pursuit of FSA using an explanatory sequential quantitative to qualitative mixed methods design. METHODS AND ANALYSIS This study will enroll 325 female survivors (aged 18 to 29 years and >1-year post treatment; diagnosed with cancer < age 21 years) from four cancer centers in the United States. Sociodemographic and developmental factors, reproductive knowledge and values, decisional needs, and receipt of an FSA will be assessed through a web-based survey. Informed by survey findings, a subset of participants will be recruited for qualitative interviews to explore decisional factors associated with uptake of an FSA. Clinical data will be abstracted from the medical records. Multivariable logistic regression models will be developed to identify factors associated with FSA and qualitative descriptive analysis will be used to develop themes from the interviews. Quantitative and qualitative findings will be merged using a joint display to develop integrated study conclusions and direct future interventional research.
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Affiliation(s)
- Brooke Cherven
- Aflac Cancer and Blood Disorders Center at Children’s Healthcare of Atlanta, Atlanta, GA, United States of America
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States of America
| | - Nataliya V. Ivankova
- Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, AL, United States of America
| | - Jessica B. Spencer
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, United States of America
| | - Anne M. Fitzpatrick
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States of America
| | - Karen C. Burns
- University of Cincinnati College of Medicine, Cincinnati, OH, United States of America
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States of America
| | - Jenna Demedis
- Center for Cancer and Blood Disorders at Children’s Hospital Colorado, Aurora, CO, United States of America
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, United States of America
| | - Holly R. Hoefgen
- Aflac Cancer and Blood Disorders Center at Children’s Healthcare of Atlanta, Atlanta, GA, United States of America
- Washington University School of Medicine, St. Louis, MO, United States of America
| | - Ann C. Mertens
- Aflac Cancer and Blood Disorders Center at Children’s Healthcare of Atlanta, Atlanta, GA, United States of America
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States of America
| | - James L. Klosky
- Aflac Cancer and Blood Disorders Center at Children’s Healthcare of Atlanta, Atlanta, GA, United States of America
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States of America
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Di Mattei VE, Taranto P, Perego G, Desimone S, Rancoita PMV, Catarinella A, Cioffi R, Mangili G, Vanni VS, Candiani M. Identification of Psychological Profiles of Cancer Patients Undergoing Fertility Preservation Counseling. J Clin Med 2023; 12:4011. [PMID: 37373703 DOI: 10.3390/jcm12124011] [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: 05/08/2023] [Revised: 05/29/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023] Open
Abstract
Gonadotoxicity is one of the most distressing side effects of cancer treatment. Fertility preservation strategies should be included during the treatment pathway to prevent the risk of infertility, but the decision to preserve fertility often represents a challenging process that carries an emotional decision-making burden. The aim of this study is to characterize the psychological profiles of women undergoing fertility preservation counseling and to better understand their features. Eighty-two female cancer patients were included in the study. They were asked to complete a battery of self-administered tests which evaluated socio-demographic characteristics, defense mechanisms, depression, anxiety, and representations regarding the importance of parenthood. Based on the psychometric variables, cluster analysis identified four groups which showed significantly different combinations of these psychological characteristics. An additional analysis was performed to evaluate if sociodemographic variables were associated with the four groups, but the results did not show significant differences. These results suggest that very diverse psychological profiles may lead cancer patients to attend oncofertility counseling and choose fertility preservation. For this reason, all patients in childbearing age should have the opportunity to receive appropriate fertility preservation counseling in order to make an informed decision that could have an important impact on their long-term quality of life.
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Affiliation(s)
- Valentina Elisabetta Di Mattei
- School of Psychology, Vita-Salute San Raffaele University, 20132 Milan, Italy
- Clinical and Health Psychology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Paola Taranto
- Clinical and Health Psychology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Gaia Perego
- School of Psychology, Vita-Salute San Raffaele University, 20132 Milan, Italy
- Clinical and Health Psychology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Serena Desimone
- Clinical and Health Psychology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Paola Maria Vittoria Rancoita
- University Centre for Statistics in Biomedical Sciences (CUSSB), Vita-Salute San Raffaele University, 20132 Milan, Italy
- School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Antonio Catarinella
- School of Psychology, Vita-Salute San Raffaele University, 20132 Milan, Italy
- Clinical and Health Psychology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Raffaella Cioffi
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Giorgia Mangili
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Valeria Stella Vanni
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Massimo Candiani
- School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
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6
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Mojahed BS, Ghajarzadeh M, Khammar R, Shahraki Z. Depression, sexual function and sexual quality of life in women with polycystic ovary syndrome (PCOS) and healthy subjects. J Ovarian Res 2023; 16:105. [PMID: 37254195 DOI: 10.1186/s13048-023-01171-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 04/25/2023] [Indexed: 06/01/2023] Open
Abstract
BACKGROUND Women with polycystic ovary syndrome (PCOS) suffer from a wide range of psychological problems. The goal of this study is to assess depression, sexual dysfunction and sexual quality of life in women with PCO compared with healthy subjects. METHODS One hundred and six PCO cases and 106 healthy subjects enrolled. They were asked to fill out valid and reliable Persian versions of BDI (Beck depression inventory), FSFIS (Female Sexual Function Index), and sexual quality of life-Female (SQOL-F) questionnaires. RESULTS One hundred and six PCO cases and 106 healthy subjects enrolled. Mean BDI was significantly higher while FSFI and its subscales as well as SQOL-F were significantly lower in PCO group than controls. There were significant negative correlation between FSFO and BDI (r=-0.43, p < 0.001) and also positive correlation between FSFI and SQOL-F (r = 0.438, p < 0.001) in whole population of the study. In PCO group, 77 (72.6%) had FSFI less than 26.55 and 29 (27.4%) had score more than 26.55. mean BDI was significantly higher in the group with FSFI < = 26.55 than the other group (33 ± 14.4 vs. 12 ± 11.6, p < 0.001) while SLQL-F was significantly lower in the first group (57 ± 16 vs. 74.9 ± 17.6, p < 0.001). Linear regression analysis by considering SQOL-F as dependent and FSFI, age and BDI as independent variables showed that BDI and FSFI are independent predictors. CONCLUSION Women with PCO, suffer more from depression and sexual dysfunction than healthy subjects.
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Affiliation(s)
| | - Mahsa Ghajarzadeh
- Universal Council of Epidemiology (UCE), Universal Scientific Education and Research Network (USERN), Tehran University of Medical Sciences, Tehran, Iran
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Abulizi M, Xu H, Abuduguli A, Zhao W, He L, Zhang C. Dual mediating effects of social support and fertility stress on mindfulness and fertility quality of life in infertile men: A case-control study. Front Psychol 2023; 14:1138282. [PMID: 36993895 PMCID: PMC10042135 DOI: 10.3389/fpsyg.2023.1138282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 02/21/2023] [Indexed: 03/14/2023] Open
Abstract
BackgroundInfertility is one of the three major public health problems in the world, bringing immense physical and psychological damage to men and affecting the quality of men’s fertility life. Thus, the purpose of this study was to analyze the status of social support, fertility stress, mindfulness, and fertility quality of life in infertile men, and to explore the dual mediating effects of social support and fertility stress on mindfulness and fertility quality.MethodsA case–control group study was conducted, with 246 men in the case group and 149 in the control group. The Social Support Scale, Fertility Stress Scale, Mindfulness Scale, and Fertility Quality of Life Scale were used to establish a structural equation model using Mplus 8.3 to explore social support and fertility stress. Pathway relationships were drawn between mindfulness and fertility quality of life in infertile men.ResultsThere were significant differences between infertile and healthy men in each dimension of the core module of fertility quality of life, in the total score of the treatment module, in the total score of social support, in subjective and objective support, and in the total score of fertility stress, social pressure, sexual pressure, marital relationship, and childless pressure (p < 0.05 in each case). Further, the fertility quality of life in infertile men was positively correlated with mindfulness and social support, and negatively correlated with fertility stress (p < 0.05); mindfulness could directly affect the core and treatment modules of fertility life quality, and indirectly affect the core of fertility life quality through social support (mediation effect accounted for 19.0%), while the treatment module (mediation effect accounted for 13.7%), and the core module indirectly affected fertility life quality through fertility stress (mediation effect accounted for 16.8%).ConclusionThe fertility quality of life of infertile men is not optimistic. Mindfulness-related interventions and programs can improve their fertility quality of life.
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Affiliation(s)
- Maierhaba Abulizi
- School of Public Health, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Hua Xu
- The First Affiliated Hospital of Xinjiang Medical University Reproductive and Fertility Centre, Urumqi, Xinjiang, China
| | - Alapate Abuduguli
- School of Public Health, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Wanzhu Zhao
- School of Public Health, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Lijuan He
- School of Public Health, Xinjiang Medical University, Urumqi, Xinjiang, China
- Postdoctoral Station, School of Pharmacy, Xinjiang Medical University, Urumqi, Xinjiang, China
- *Correspondence: Lijuan He,
| | - Chen Zhang
- School of Public Health, Xinjiang Medical University, Urumqi, Xinjiang, China
- Chen Zhang,
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Zhang Z, Yang YZ, Zhang HT, Xi Y, Wang CT, Liu DF, Mao JM, Lin HC, Tang WH, Zhao LM, Zhang XS, Dai YT, Jiang H. Psychological status of infertile men during the Coronavirus Disease 2019 Pandemic in China: a cross-sectional investigation. Basic Clin Androl 2023; 33:8. [PMID: 36792987 PMCID: PMC9931448 DOI: 10.1186/s12610-022-00177-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 11/24/2022] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) outbreak has had a widespread and profound impact on people's mental health. The factors associated with mental symptoms among men diagnosed with infertility, a disease closely related to psychological conditions, remain unclear. The aim of this study is to investigate the risk factors associated with mental symptoms among infertile Chinese men during the pandemic. RESULTS A total of 4,098 eligible participants were recruited in this cross-sectional, nationwide study, including 2,034 (49.6%) with primary infertility and 2,064 (50.4%) with secondary infertility. The prevalence of mental health conditions was 36.3%, 39.6%, and 6.7% for anxiety, depression, and post-pandemic stress, respectively. Sexual dysfunction is associated with a higher risk with adjusted odds ratios (ORs) of 1.40 for anxiety, 1.38 for depression, and 2.32 for stress. Men receiving infertility drug therapy displayed a higher risk for anxiety (adjusted OR, 1.31) and depression (adjusted OR, 1.28) symptoms, while those receiving intrauterine insemination had a lower risk of anxiety (adjusted OR, 0.56) and depression (adjusted OR, 0.55) symptoms. CONCLUSION The COVID-19 pandemic has had a significant psychological impact on infertile men. Several psychologically vulnerable populations were identified, including individuals with sexual dysfunction, respondents receiving infertility drug therapy, and those experiencing control measures for COVID-19. The findings provide a comprehensive profile of the mental health status of infertile Chinese men during the COVID-19 outbreak and provide potential psychological intervention strategies.
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Affiliation(s)
- Zhe Zhang
- grid.411642.40000 0004 0605 3760Department of Urology, Peking University Third Hospital, Beijing, China ,grid.411642.40000 0004 0605 3760Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing, China
| | - Yu-Zhuo Yang
- grid.411642.40000 0004 0605 3760Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing, China
| | - Hai-Tao Zhang
- grid.411642.40000 0004 0605 3760Department of Urology, Peking University Third Hospital, Beijing, China ,grid.411642.40000 0004 0605 3760Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing, China
| | - Yu Xi
- grid.411642.40000 0004 0605 3760Department of Urology, Peking University Third Hospital, Beijing, China ,grid.411642.40000 0004 0605 3760Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing, China
| | - Cun-Tong Wang
- grid.411054.50000 0000 9894 8211School of Social Development, Central University of Finance and Economics, Beijing, China
| | - De-Feng Liu
- grid.411642.40000 0004 0605 3760Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing, China
| | - Jia-Ming Mao
- grid.411642.40000 0004 0605 3760Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing, China
| | - Hao-Cheng Lin
- grid.411642.40000 0004 0605 3760Department of Urology, Peking University Third Hospital, Beijing, China ,grid.411642.40000 0004 0605 3760Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing, China
| | - Wen-Hao Tang
- grid.411642.40000 0004 0605 3760Department of Urology, Peking University Third Hospital, Beijing, China ,grid.411642.40000 0004 0605 3760Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing, China
| | - Lian-Ming Zhao
- grid.411642.40000 0004 0605 3760Department of Urology, Peking University Third Hospital, Beijing, China ,grid.411642.40000 0004 0605 3760Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing, China
| | - Xian-Sheng Zhang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
| | - Yu-Tian Dai
- Department of Andrology, Nanjing Drum Tower Hospital, Nanjing, China.
| | - Hui Jiang
- Department of Urology, Peking University Third Hospital, Beijing, China. .,Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing, China.
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Foti FL, Karner-Huţuleac A, Maftei A. The value of motherhood and psychological distress among infertile women: The mediating role of coping strategies. Front Public Health 2023; 11:1024438. [PMID: 36817897 PMCID: PMC9931740 DOI: 10.3389/fpubh.2023.1024438] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 01/06/2023] [Indexed: 02/05/2023] Open
Abstract
Introduction The present study investigated psychological distress and coping strategies among infertile women during the COVID-19 pandemic using a multi-dimensional model of infertility-related stress. We explored the associations between individual (i.e., age) and situational characteristics related to infertility (i.e., duration of infertility, cause of infertility, number of lost pregnancies, and assisted reproductive techniques [ART] status), and perceived-infertility-related factors (i.e., the perceived importance of motherhood). Methods Our total sample consisted of 193 women aged 20 to 46 (M= 33.23, SD = 4.58), out of which 102 were undergoing ART procedures (M = 33.60, SD = 4.23), and 91 were not (M= 32.81, SD = 4.94). Participants filled in questionnaires measuring psychological distress, coping strategies, and the importance of motherhood. Results Correlation analyses suggested that the importance of motherhood was positively associated with psychological distress and negative coping strategies. Mediation analysis results indicated that both in the overall sample and in the sample of women undergoing ART procedures, the negative self-perception fully mediated the link between the importance of motherhood on psychological distress. In the non-ART sample, we found a significant mediation effect of denial on the link between the importance of motherhood and psychological distress. Discussion We discuss the theoretical and practical implications of the present findings, focusing on the mental health-related consequences of the social stigma of infertility heightened by the pressure of parenthood.
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Affiliation(s)
- Florentina Larisa Foti
- Faculty of Psychology and Education Sciences, Alexandru Ioan Cuza University, Iaşi, Romania
| | - Adina Karner-Huţuleac
- Faculty of Psychology and Education Sciences, Alexandru Ioan Cuza University, Iaşi, Romania
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Abu-Sharkia S, Taubman - Ben-Ari O, Mofareh A. Personal Growth and Life Satisfaction during Fertility Treatment-A Comparison between Arab and Jewish Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2187. [PMID: 36767553 PMCID: PMC9915886 DOI: 10.3390/ijerph20032187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/20/2023] [Accepted: 01/20/2023] [Indexed: 06/18/2023]
Abstract
Coping with difficulty conceiving and the ensuing fertility treatments is a stressful experience that impacts many aspects of women's lives. On the basis of Lazarus and Folkman's model of stress and coping and Schaefer and Moos's model of personal growth, and in view of the sparse literature on cultural aspects of infertility and personal growth, this study examined the relationship between stress on the one hand and personal growth and life satisfaction on the other among Arab and Jewish Israeli women. Furthermore, it investigated the moderating role played by perceived stigma, coping flexibility, cultural orientation (individualism and collectivism), and ethnicity. Two hundred five Arab and Jewish Israeli women undergoing fertility treatment completed self-report questionnaires. The results show that Arab women reported higher levels of personal growth and individualism than Jewish women. In the whole sample, a linear negative relationship was found between stress and life satisfaction, and a curvilinear relationship was found between stress and personal growth. In addition, perceived stigma, collectivism, individualism, and coping flexibility were found to moderate the association between perceived stress and personal growth. The findings provide further understanding of personal growth in the context of infertility, showing that personal resources and perceptions are more important than cultural differences in this regard.
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Affiliation(s)
- Salam Abu-Sharkia
- The Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Ramat Gan 5290002, Israel
| | - Orit Taubman - Ben-Ari
- The Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Ramat Gan 5290002, Israel
| | - Ali Mofareh
- Clalit Health Services (Kupat Holim Clalit), Jerusalem 9112102, Israel
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11
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Gorman JR, Lyons KS, Harvey SM, Acquati C, Salsman JM, Kashy DA, Drizin JH, Smith E, Flexner LM, Hayes-Lattin B, Reese JB. Opening the Conversation: study protocol for a Phase III trial to evaluate a couple-based intervention to reduce reproductive and sexual distress among young adult breast and gynecologic cancer survivor couples. Trials 2022; 23:730. [PMID: 36056413 PMCID: PMC9438271 DOI: 10.1186/s13063-022-06665-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 08/17/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Reproductive and sexual health (RSH) concerns are common and distressing for young adults diagnosed with breast and gynecologic cancer and their partners. This study evaluates the efficacy of a virtual couple-based intervention called Opening the Conversation (OC). The OC intervention is grounded in theory and evidence-based practice and was adapted to improve coping and communication specifically in relation to RSH concerns after cancer. METHODS This Phase III trial is conducted in a fully remote setting and enrolls young adult couples (current age 18-44 years) with a history of breast or gynecologic cancer (stage 1-4, diagnosed under age 40) within the past 6 months to 5 years. Eligible dyads are recruited from across the USA. The target sample size is 100 couples. Dyads are randomly assigned to receive either the 5-session OC intervention or a 4-session active control intervention (Side by Side). The primary outcomes are change in reproductive distress and sexual distress. Secondary outcomes include communication about reproductive concerns, communication about sexual concerns, depressive symptoms, sexual function, relationship quality, relationship intimacy, sexual satisfaction, self-efficacy to communicate about sex and intimacy, and quality of life. An exploratory aim examines whether dyadic coping and communication quality mediate intervention effects on survivors' and partners' reproductive distress or sexual distress. Self-report outcome measures are assessed for both groups at baseline (T1), 2 weeks post-treatment (T2), and 3 months post-treatment (T3). DISCUSSION Despite the importance of RSH for quality of life for young adult cancer survivors and their partners, evidence-based interventions that help couples navigate RSH concerns are lacking. This randomized controlled trial will determine the efficacy of a novel couple-based intervention to reduce distress related to RSH concerns for younger couples after breast or gynecologic cancer, in comparison to an active control intervention. TRIAL REGISTRATION ClinicalTrials.gov NCT04806724. Registered on Mar 19, 2021.
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Affiliation(s)
- Jessica R Gorman
- College of Public Health & Human Sciences, School of Social & Behavioral Health Sciences, Oregon State University, 2250 SW Jefferson Way, Corvallis, OR, 97330, USA.
| | - Karen S Lyons
- Connell School of Nursing, Boston College, 140 Commonwealth Ave, Chestnut Hill, MA, 02467, USA
| | - S Marie Harvey
- College of Public Health & Human Sciences, School of Social & Behavioral Health Sciences, Oregon State University, 2250 SW Jefferson Way, Corvallis, OR, 97330, USA
| | - Chiara Acquati
- Graduate College of Social Work, University of Houston, 3511 Cullen Blvd, Houston, TX, 77204-4013, USA
- College of Medicine, Department of Clinical Sciences, University of Houston, 4349 Martin Luther King Blvd, Houston, TX, 77004, USA
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - John M Salsman
- Department of Social Sciences & Health Policy, Wake Forest School of Medicine, Medical Center Blvd, Winston Salem, NC, 27157, USA
- Wake Forest Baptist Comprehensive Cancer Center, Medical Center Blvd, Winston Salem, NC, 27157, USA
| | - Deborah A Kashy
- Department of Psychology, Michigan State University, 316 Physics Road, East Lansing, MI, 48824, USA
| | - Julia H Drizin
- College of Public Health & Human Sciences, School of Social & Behavioral Health Sciences, Oregon State University, 2250 SW Jefferson Way, Corvallis, OR, 97330, USA
| | - Ellie Smith
- College of Public Health & Human Sciences, School of Social & Behavioral Health Sciences, Oregon State University, 2250 SW Jefferson Way, Corvallis, OR, 97330, USA
| | - Lisa M Flexner
- Doctor of Physical Therapy Program, Oregon State University- Cascades, 1500 SW Chandler Ave, OR, 97702, Bend, USA
| | - Brandon Hayes-Lattin
- School of Medicine, Oregon Health & Sciences University, 3266 SW Research Dr, Portland, OR, 97239, USA
- OHSU Knight Cancer Institute, 3485 S Bond Ave, Portland, OR, 97239, USA
| | - Jennifer B Reese
- Cancer Prevention and Control Program, Fox Chase Cancer Center, 333 Cottman Ave, Philadelphia, PA, 19111, USA
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12
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Bártolo A, Santos IM, Guimarães R, Reis S, Monteiro S. Attentional Bias Toward Reproduction-Related Stimuli and Fertility Concerns Among Breast Cancer Survivors. Behav Med 2022; 48:273-283. [PMID: 33872117 DOI: 10.1080/08964289.2021.1879725] [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] [Indexed: 12/27/2022]
Abstract
The current study examined whether an attentional bias exists for reproduction-related visual cues among breast cancer survivors and its relationship with fertility concerns and emotional distress. Breast cancer survivors (n = 38) aged 18-40 were compared to 37 healthy women recruited from the general population. Attentional bias was investigated using a visual dot-probe task and response times (RT) were measured. Participants also completed several questionnaires, including the Reproductive Concerns After Cancer Scale (RCACS) and the Hospital Anxiety and Depression Scale (HADS). Biased cognitive processing toward reproduction-related stimuli was observed for all young women. However, attentional bias was a significant predictor of concerns about partner disclosure of fertility status, with higher bias scores associated with higher levels of concern only for breast cancer survivors. The desire to have a (or another) biological child was also a significant predictor of higher concerns related with fertility potential for all young women. Higher vigilance regarding reproduction-related cues seems to lead to higher concerns among women with breast cancer history whose fertility is threatened. This result may have important research and clinical implications. Interventions focused on goal-oriented attention self-regulation and problem-solving can help to manage fertility concerns and distress in the course of the disease.
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Affiliation(s)
- Ana Bártolo
- Center for Health Technology and Services Research (CINTESIS), Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Isabel M Santos
- William James Center for Research, Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Raquel Guimarães
- Breast Center, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Salomé Reis
- Department of Gynecology and Obstetrics, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Sara Monteiro
- Center for Health Technology and Services Research (CINTESIS), Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
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13
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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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14
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Nakić Radoš S, Soljačić Vraneš H, Tomić J, Kuna K. Infertility-related stress and sexual satisfaction: a dyadic approach. J Psychosom Obstet Gynaecol 2022; 43:18-25. [PMID: 32326782 DOI: 10.1080/0167482x.2020.1752658] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
PURPOSE OF THE STUDY to examine whether women's and men's infertility-related stress, and specifically its sexual concerns aspect, is related to their and their partner's sexual satisfaction. MATERIALS AND METHODS In a cross-sectional study, 94 couples experiencing infertility filled out the New Sexual Satisfaction Scale and Fertility Problem Inventory, which measures infertility-related stress with dimensions of social, sexual and relationship concerns, rejection of childfree lifestyle, and need for parenthood. Dyadic analyses were performed following the Actor-Partner Interdependence Model (APIM). RESULTS The dyadic analysis revealed that women's and men's greater infertility-related stress contributed to their lower levels of sexual satisfaction (actor effect). Moreover, women's and men's greater sexual concerns (as the aspect of infertility-related stress) contributed to their own and their partner's lower levels of sexual satisfaction (actor and partner effect). CONCLUSIONS The findings suggest that both individual and relational processes are important in the association between the specific dimension of infertility-related stress and sexual satisfaction. These findings could guide the psychosocial support for couples experiencing infertility.
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Affiliation(s)
- Sandra Nakić Radoš
- Department of Psychology, Catholic University of Croatia, Zagreb, Croatia
| | - Hrvojka Soljačić Vraneš
- Department of Obstetrics and Gynecology, University Hospital Centre Sisters of Mercy, Zagreb, Croatia
| | - Jozo Tomić
- Department of Obstetrics and Gynecology, University Hospital Centre Sisters of Mercy, Zagreb, Croatia
| | - Krunoslav Kuna
- Department of Obstetrics and Gynecology, University Hospital Centre Sisters of Mercy, Zagreb, Croatia
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15
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Chen YH, Zhang XL, Fan JM, Li ZY, Wang J, Wang XP, Wu XQ. The possible window of implantation for embryos in the first frozen embryo transplantation cycle: A retrospective analysis. Transpl Immunol 2022; 72:101582. [DOI: 10.1016/j.trim.2022.101582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 03/13/2022] [Accepted: 03/14/2022] [Indexed: 11/27/2022]
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16
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Di Mattei VE, Perego G, Taranto P, Rancoita PMV, Maglione M, Notarianni L, Mangili G, Bergamini A, Cioffi R, Papaleo E, Candiani M. Factors Associated With a High Motivation to Undergo Fertility Preservation in Female Cancer Patients. Front Psychol 2022; 12:782073. [PMID: 34975672 PMCID: PMC8716366 DOI: 10.3389/fpsyg.2021.782073] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 11/30/2021] [Indexed: 12/27/2022] Open
Abstract
Objective: Fertility loss due to cancer treatment can be a devastating experience for women and the couple. Undergoing fertility preservation can be a complex decision from both a medical and emotional point of view. The aim of the present study was to evaluate which socio-demographic and psychological factors predict a high motivation to undergo fertility preservation. Methods: Fifty-eight female cancer patients who accessed an Oncofertility Unit completed: a questionnaire to collect socio-demographic characteristics and the level of motivation, the Beck-Depression Inventory-II, the State-Trait Anxiety Inventory-Y, and the Fertility Problem Inventory. Results: Almost half of the sample (44.8%) declared a high motivation. At multiple logistic regression analysis only the “Need for parenthood” subscale of the FPI predicted a high motivation. We alternatively evaluated as possible predictor the construct “Representations about the importance of parenthood” (i.e., the sum of the “Need for Parenthood” and “Rejection of childfree lifestyle” subscales) in place of the two separate subscales. At multiple logistic regression analysis, only this variable predicted a high motivation to undergo fertility preservation. Conclusion: The most important predictor of a high motivation to undergo fertility preservation is the individual desire for parenthood. This implies that, regardless of socio-demographic characteristics, any woman of childbearing age should receive an appropriate counseling about fertility preservation.
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Affiliation(s)
- Valentina Elisabetta Di Mattei
- School of Psychology, Vita-Salute San Raffaele University, Milan, Italy.,Clinical and Health Psychology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Gaia Perego
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Paola Taranto
- Clinical and Health Psychology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Paola M V Rancoita
- University Centre for Statistics in the Biomedical Sciences (CUSSB), Vita-Salute San Raffaele University, Milan, Italy.,School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Mariangela Maglione
- Clinical and Health Psychology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Lisa Notarianni
- Clinical and Health Psychology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giorgia Mangili
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alice Bergamini
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Raffaella Cioffi
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Enrico Papaleo
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Massimo Candiani
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.,Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
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17
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Bártolo A, Santos IM, Guimarães R, Reis S, Monteiro S. Reproduction-related cognitive processing and distress among young adult women: the role of personal breast cancer history. Cogn Process 2021; 22:569-578. [PMID: 33797684 DOI: 10.1007/s10339-021-01026-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 03/12/2021] [Indexed: 11/28/2022]
Abstract
Breast cancer diagnosis can threaten fertility and biological motherhood in women of reproductive age due to the gonadotoxic effects of treatments. Much evidence documents these women fertility-related concerns and distress, but no study has attempted to understand how implicit cognitive processes can contribute to this maladjustment. In this research, we explored whether reproduction-related stimuli interfere with cognition among cancer survivors with infertility risk using an emotional Stroop task. Furthermore, we investigated the relationship between reproduction-related cognitive processing and psychological morbidity. Young cancer survivors aged 18-40 years who received anticancer treatments and an age-matched non-cancer control group without known fertility problems were compared. Color-naming times and error rates were assessed. Participants in both groups were slower naming the color of reproduction-related words in comparison to unrelated negative valence words. Although in the same direction, this difference did not reach statistical significance for positive and neutral unrelated word lists. Further analysis suggested that biased attention toward reproduction-related information was associated with higher depression levels in young women with personal breast cancer history, but not in healthy women. These findings suggest that biased processing of reproduction-related cues might be a vulnerability factor after a breast cancer diagnosis. Additionally, this study puts in evidence the potential usefulness of using experimental tasks to investigate attentional bias in a context where fertility is at risk.
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Affiliation(s)
- Ana Bártolo
- Center for Health Technology and Services Research (CINTESIS), Department of Education and Psychology, University of Aveiro, Campus Universitário de Santiago, 3810-193, Aveiro, Portugal.
| | - Isabel M Santos
- William James Center for Research, Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Raquel Guimarães
- Breast Center, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Salomé Reis
- Department of Gynecology and Obstetrics, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Sara Monteiro
- Center for Health Technology and Services Research (CINTESIS), Department of Education and Psychology, University of Aveiro, Campus Universitário de Santiago, 3810-193, Aveiro, Portugal
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18
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Cherven B, Meacham L, Williamson Lewis R, Klosky JL, Marchak JG. Evaluation of the Modified Reproductive Concerns Scale Among Emerging Adult Cancer Survivors. J Adolesc Young Adult Oncol 2021; 10:661-667. [PMID: 33769891 DOI: 10.1089/jayao.2020.0219] [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] [Indexed: 01/05/2023] Open
Abstract
Purpose: The reproductive concerns of emerging adult survivors of childhood cancer are not well described, and valid measurement tools tailored to this population are lacking. The purpose of this analysis was to evaluate a modified version of the Reproductive Concerns Scale (mRCS) among male and female survivors of childhood cancer. Methods: This is a secondary analysis of cross-sectional survey data collected from patients enrolled on an infertility-educational intervention study. Participants completed the mRCS at baseline. Cancer treatment data were abstracted from participant medical records. Principal component analyses were conducted to evaluate the factor structure of the mRCS for males, females, and the entire sample. Internal consistency was evaluated using Cronbach's alpha. Open-ended responses were analyzed and used to assess the validity of relevant quantitative items on the mRCS. Results: The sample consisted of N = 98 participants who were an average of 19.1 (±1.1) years of age, 45.9% were male, and 61.2% were non-Hispanic white. Factor analyses revealed three domains: Fertility Concerns (Cronbach's alpha = 0.77), Health Concerns (α = 0.74), and Information Seeking (α = 0.57). Sex-specific factor analyses identified differences in scale items for males. The open-ended responses aligned well with participant scores on the Fertility Concerns subscale. Conclusion: The mRCS consists of three subscales relevant to emerging adult survivors of childhood cancer. Further analysis by sex suggests that separate scales for males and females are warranted. Future research is warranted to determine the clinical utility of using the mRCS as a screening tool to identify and address reproductive concerns among emerging adult survivors.
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Affiliation(s)
- Brooke Cherven
- Aflac Cancer & Blood Disorders Center at Children's Healthcare of Atlanta, Atlanta, Georgia, USA.,Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Lillian Meacham
- Aflac Cancer & Blood Disorders Center at Children's Healthcare of Atlanta, Atlanta, Georgia, USA.,Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Rebecca Williamson Lewis
- Aflac Cancer & Blood Disorders Center at Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - James L Klosky
- Aflac Cancer & Blood Disorders Center at Children's Healthcare of Atlanta, Atlanta, Georgia, USA.,Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Jordan Gilleland Marchak
- Aflac Cancer & Blood Disorders Center at Children's Healthcare of Atlanta, Atlanta, Georgia, USA.,Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA
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19
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Seyedtabib M, Mahjub H, Mahmoudi M, Moghimbeigi A. Investigating the effect of behavioral and demographic characteristics of Iranian women on the number of children ever born. Med J Islam Repub Iran 2021; 35:38. [PMID: 34211940 PMCID: PMC8236082 DOI: 10.47176/mjiri.35.38] [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: 09/24/2020] [Indexed: 11/09/2022] Open
Abstract
Background: The number of children ever born (CEB) to a woman, as an index of her fertility behavior, are interesting for the governments and demographer policymakers. In recent years, a notable reduction of fertility and population aging in Iran has caused concern among politicians, and it has led to starting new changes in demographic policies. Therefore, to adopting new demographic and health policies programs, identification of factors that affecting CEB is essential.
Methods: To evaluate determinant factors on CEB, information of 20093 married Iranian women aged between 15 and 54 years has been analyzed from the Iranian National Institute of Health Research survey. Based on the structure of data and the possible influential unobserved population heterogeneity on CEB in each city and province, a multilevel count regression model was applied. The analysis was performed using the ‘R’ software (version 3.5) with a significant level of 0.05.
Results: Findings show that the mean and median number of CEB was 2.82 and 2.00 for all women, respectively. Meanwhile, these values were 4.56 and 4.00 for the women who reached menopause. There was a significant unobserved heterogeneity affecting CEB in each province (σp=0.018). Also, the results of the multilevel model show that living in an urban area (RR=0.90), higher age at first marriage (RR=0.96), higher education (RR=0.84, RR=0.81), and exposure to mass media (RR=0.87) decrease the risk ratio of the number of CEB (p <0.001).
Conclusion: It seems that the tendency of women to academic education and their access to mass media has a significant effect on reducing childbearing. Therefore, in future planning, attention to these two factors can be useful and helpful to move to increase fertility.
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Affiliation(s)
- Maryam Seyedtabib
- Department of Biostatistics & Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Hossein Mahjub
- Department of Biostatistics & Epidemiology, School of Public Health and Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mahmood Mahmoudi
- Department of Health Services, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Abbas Moghimbeigi
- Department of Biostatistics and Epidemiology, School of Health, Research Center for Health, Safety and Environment, Alborz University of Medical Sciences, Karaj, Iran
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20
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Ngai FW, Loke AY. Relationships between infertility-related stress, family sense of coherence and quality of life of couples with infertility. HUM FERTIL 2021; 25:540-547. [PMID: 33432870 DOI: 10.1080/14647273.2021.1871781] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
This is a cross-sectional study with the objective to examine the relationships between infertility-related stress, family sense of coherence and quality of life of Chinese couples with infertility in Hong Kong. A convenience sample of 135 Chinese couples were recruited at the subfertility clinics of the Family Planning Association of Hong Kong. Data were collected using the Fertility Problem Inventory, Family Sense of Coherence Scale and Fertility Quality of Life. Path analysis was used for data analysis. The results showed that infertility-related stress had a negative association with the quality of life of infertile couples and family sense of coherence mediated the effect of infertility-related stress on quality of life for both partners. The infertility-related stress of women had a negative association with their husbands' quality of life. Infertile women had more infertility-related stress and a lower quality of life than their husbands. The findings provide new insights into the importance of family sense of coherence in facilitating couples' adjustment to infertility. Culturally competent heath care interventions should be developed to strengthen family sense of coherence among Chinese couples with infertility and help them reduce their infertility-related stress, thus improving their quality of life.
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Affiliation(s)
- Fei-Wan Ngai
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Alice Yuen Loke
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
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21
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Assessing psychological inflexibility in infertility: The development and validation study of the Psychological Inflexibility Scale – Infertility (PIS-I). JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2020. [DOI: 10.1016/j.jcbs.2020.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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22
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Bártolo A, Santos IM, Valério E, Costa A, Reis S, Raposo S, Monteiro S. The European Portuguese version of the Reproductive Concerns After Cancer Scale (RCACS): A psychometric validation for young adult female cancer survivors. Eur J Oncol Nurs 2020; 47:101781. [PMID: 32563843 DOI: 10.1016/j.ejon.2020.101781] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 04/19/2020] [Accepted: 06/04/2020] [Indexed: 12/31/2022]
Abstract
PURPOSE The purpose of this study was to evaluate the psychometric properties of the Portuguese version of the 18-item Reproductive Concerns After Cancer Scale (RCACS) among young adult female cancer survivors. METHODS The psychometric validation was conducted based on a convenience sample of 192 cancer survivors aged between 18 and 40 years. An exploratory factor analysis (EFA) was used to test the factor structure of the Portuguese version of RCACS and reliabilities were examined. Convergent and discriminant validity was also used to assess the construct validity. The Hospital Anxiety and Depression Scale (HADS), the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (EORT QLQ-C30) and the need for parenthood and rejection of child-free lifestyle subscales of the Fertility Problem Inventory (FPI) were used as convergent measures. RESULTS A five-factor model was obtained with acceptable fit indexes and internal consistencies (.72<α<.89): (1) fertility potential, (2) children's health risk and future life, (3) partner disclosure, (4) barriers to getting pregnant/having children and (5) acceptance. Overall, convergent and discriminant validities were confirmed. Levels of anxiety and depression symptoms as well as health-related quality of life (QoL) had weak-to-moderate associations with reproductive concerns. Women who had a child or did not want a biological child were less concerned. CONCLUSION This scale proved to be a reliable and valid measure of reproductive concerns for the Portuguese population with potential relevance for application in clinical practice.
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Affiliation(s)
- Ana Bártolo
- Center for Health Technology and Services Research (CINTESIS), Department of Education and Psychology, University of Aveiro, Aveiro, Portugal.
| | - Isabel M Santos
- William James Center for Research, University of Aveiro, Aveiro, Portugal.
| | - Elisabete Valério
- Breast Clinic, Instituto Português de Oncologia Francisco Gentil, Porto, Portugal.
| | - Antónia Costa
- Department of Gynecology and Obstetrics, Centro Hospitalar Universitário de São João, Porto, Portugal; Department of Women and Children, Faculty of Medicine, University of Porto, Porto, Portugal; i3S - Institute for Research and Innovation in Health, University of Porto, Porto, Portugal.
| | - Salomé Reis
- Department of Gynecology and Obstetrics, Centro Hospitalar Universitário de São João, Porto, Portugal.
| | - Sofia Raposo
- Department of Gynecology, Instituto Português de Oncologia Francisco Gentil, Coimbra, Portugal.
| | - Sara Monteiro
- Center for Health Technology and Services Research (CINTESIS), Department of Education and Psychology, University of Aveiro, Aveiro, Portugal.
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Tasker F, Gato J. Gender Identity and Future Thinking About Parenthood: A Qualitative Analysis of Focus Group Data With Transgender and Non-binary People in the United Kingdom. Front Psychol 2020; 11:865. [PMID: 32435224 PMCID: PMC7218755 DOI: 10.3389/fpsyg.2020.00865] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 04/07/2020] [Indexed: 01/21/2023] Open
Abstract
The idea that people who are transgender or non-binary are not interested in becoming parents has been refuted by several studies. However, both medical unknowns and cisnormativity surround the process of becoming a parent for transgender or non-binary people, with little known about the psychosocial impact on the family formation dilemmas of transgender and non-binary adults. Employing Life Course Theory as our theoretical framework, three focus group interviews were conducted with eleven transgender or non-binary adults. Qualitative data analysis of focus group interview transcripts was conducted through Thematic Analysis. Four overarching interlinked themes were identified concerning the dilemmas perceived by the nine participants who contemplated future parenthood: (i) Balancing a desire for parenthood and desires for other life goals; (ii) Feeling that who I am doesn't fit into the cisgender system of accessing fostering, adoption or fertility services; (iii) Experiencing the conjoined challenges of gender and fertility embodiment as I see them; (iv) Searching for a non-binary or gender appropriate self and the need for flexible future planning centered on reproductive capacity. Overall, thoughts about gender transition were often interwoven with parenthood plans and in a dialectical fashion the desire and intention to have, or not have, children was implicated in satisfaction with gender transition. The significance of these themes is discussed in relation to how hopes for parenthood could be realized without jeopardizing gender identity and the need for a future focused, flexible, and open-minded approach on the part of fertility and adoption services.
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Affiliation(s)
- Fiona Tasker
- Department of Psychological Sciences, Birkbeck, University of London, London, United Kingdom
| | - Jorge Gato
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
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Bártolo A, Santos IM, Valério E, Monteiro S. Depression and Health-Related Quality of Life Among Young Adult Breast Cancer Patients: The Mediating Role of Reproductive Concerns. J Adolesc Young Adult Oncol 2020; 9:431-435. [PMID: 32208042 DOI: 10.1089/jayao.2019.0144] [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] [Indexed: 12/31/2022] Open
Abstract
Biological motherhood plays an important role in the lives of many young women facing breast cancer and threats to reproduction may be disruptive. In this study, we explored the indirect effects of the importance of parenthood and childlessness on depression and health-related quality of life (HRQoL) among cancer patients 18-40 years of age (n = 104) through reported reproductive concerns. These specific concerns fully mediated the relationship between the importance of parenthood in women's lives and HRQoL. Greater importance of parenthood was directly associated with higher depression symptoms. Interventions should address the reproductive needs and concerns of patients to improve their HRQoL.
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Affiliation(s)
- Ana Bártolo
- Center for Health Technology and Services Research (CINTESIS), Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Isabel M Santos
- William James Center for Research, Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Elisabete Valério
- Breast Clinic, Instituto Português de Oncologia Francisco Gentil, Porto, Portugal
| | - Sara Monteiro
- Center for Health Technology and Services Research (CINTESIS), Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
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Chazan L, Kushnir T. Losses and Gains of Psychosocial Resources: Effects on Stress Among Women Undergoing Infertility Treatments and Participating in Social Network Systems. Psychiatr Q 2019; 90:717-732. [PMID: 31342254 DOI: 10.1007/s11126-019-09661-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This theory-driven study assessed the association between infertility-related stress and perceived losses of psycho-social resources; and the buffering effect of resource gains and type of infertility (primary/secondary) on this relationship, among women who participate in online infertility-related social network systems (SNS). Ninety women participating in infertility-related SNS completed online questionnaires assessing resource losses and gains and stress levels. Results: Resource loss significantly predicted stress (β = .66, p < .001). Resource loss and the number of children were correlated negatively (r = -.22, p < .05). Residency was significantly related to resource loss (r = -.23, p < .05) and perceived stress (r = -.23, p < .05). Israeli participants reported lesser resource loss and lesser perceived stress, compared to participants from other countries. Surprisingly, neither resource gains related to SNS participation nor infertility-type served as moderators in the relationship between resource loss and stress. The association between resource loss and stress supports COR theory formulation of stress etiology. However, while participants noted significant resource gains from use of SNS, these did not buffer the effects of resource loss on stress. Thus, although it may be enticing to turn to SNS for social support, individuals with infertility need to be encouraged to use face-to-face social support too.
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Affiliation(s)
- Leigh Chazan
- Department of Psychology, Ariel University, Ariel, Israel
| | - Talma Kushnir
- Department of Psychology, Ariel University, Ariel, Israel.
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26
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van Elten TM, van de Beek C, Geelen A, Gemke RJBJ, Groen H, Hoek A, Mol BW, van Poppel MNM, Roseboom TJ. Preconception Lifestyle and Cardiovascular Health in the Offspring of Overweight and Obese Women. Nutrients 2019; 11:nu11102446. [PMID: 31615021 PMCID: PMC6835651 DOI: 10.3390/nu11102446] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Revised: 10/10/2019] [Accepted: 10/11/2019] [Indexed: 01/21/2023] Open
Abstract
Women’s lifestyle has important implications for the development and health of their offspring. Yet little is known about the association between women’s preconception dietary intake and physical activity with cardiovascular health of the offspring. We therefore examined this association in a group of Dutch women with overweight or obesity (BMI ≥ 29 kg/m2) and infertility, who participated in a 6-month randomized preconception lifestyle intervention trial, and their offspring (n = 46). Preconception dietary intake and physical activity were assessed during the 6-month intervention using a food frequency questionnaire and the Short QUestionnaire to ASsess Health-enhancing physical activity (SQUASH), respectively. Offspring cardiovascular health (i.e., BMI, waist:height ratio, systolic and diastolic blood pressure, fat and fat free mass, and pulse wave velocity) was measured at age 3–6 years. Multivariable linear regression analyses were used to examine the associations between preconception lifestyle and offspring cardiovascular health. Higher preconception vegetable intake (per 10 g/day) was associated with lower offspring diastolic blood pressure (Z-score: −0.05 (−0.08; −0.01); p = 0.007) and higher preconception fruit intake (per 10 g/day) was associated with lower offspring pulse wave velocity (−0.05 m/s (−0.10; −0.01); p = 0.03). Against our expectations, higher preconception intake of sugary drinks was associated with a higher offspring fat free mass (0.54 kg (0.01; 1.07); p = 0.045). To conclude, preconception dietary intake is associated with offspring health.
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Affiliation(s)
- Tessa M van Elten
- Amsterdam UMC, Department of Public and Occupational Health, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1105 AZ Amsterdam, The Netherlands.
- Amsterdam UMC, Department of Clinical Epidemiology, University of Amsterdam, Biostatistics and Bioinformatics, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
- Amsterdam UMC, Department of Obstetrics and Gynecology, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
- Amsterdam Public Health Research Institute, 1105 AZ Amsterdam, The Netherlands.
- Amsterdam Reproduction and Development, 1105 AZ Amsterdam, The Netherlands.
| | - Cornelieke van de Beek
- Amsterdam UMC, Department of Obstetrics and Gynecology, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
- Amsterdam Public Health Research Institute, 1105 AZ Amsterdam, The Netherlands.
- Amsterdam Reproduction and Development, 1105 AZ Amsterdam, The Netherlands.
| | - Anouk Geelen
- Division of Human Nutrition, Wageningen University & Research, 6700 AA Wageningen, The Netherlands.
| | - Reinoud J B J Gemke
- Amsterdam Public Health Research Institute, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Reproduction and Development, 1105 AZ Amsterdam, The Netherlands
- Department of Pediatrics, Emma Children's Hospital, Vrije Universiteit Amsterdam, Amsterdam UMC, 1081 HV Amsterdam, The Netherlands
| | - Henk Groen
- Department of Epidemiology, University of Groningen, University Medical Centre Groningen, 9700 RB Groningen, the Netherlands.
| | - Annemieke Hoek
- Department of Obstetrics and Gynecology, University of Groningen, University Medical Centre, Groningen, 9700 RB Groningen, the Netherlands.
| | - Ben Willem Mol
- Department of Obstetrics and Gynecology, Monash University, 3800 Melbourne, Australia.
| | - Mireille N M van Poppel
- Amsterdam UMC, Department of Public and Occupational Health, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1105 AZ Amsterdam, The Netherlands.
- Amsterdam Public Health Research Institute, 1105 AZ Amsterdam, The Netherlands.
- Institute of Sport Science, University of Graz, 8010 Graz, Austria.
| | - Tessa J Roseboom
- Amsterdam UMC, Department of Clinical Epidemiology, University of Amsterdam, Biostatistics and Bioinformatics, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
- Amsterdam UMC, Department of Obstetrics and Gynecology, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
- Amsterdam Public Health Research Institute, 1105 AZ Amsterdam, The Netherlands.
- Amsterdam Reproduction and Development, 1105 AZ Amsterdam, The Netherlands.
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Pedro J, Vassard D, Malling GMH, Hougaard CØ, Schmidt L, Martins MV. Infertility-related stress and the risk of antidepressants prescription in women: a 10-year register study. Hum Reprod 2019; 34:1505-1513. [DOI: 10.1093/humrep/dez110] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 05/29/2019] [Indexed: 01/02/2023] Open
Abstract
Abstract
STUDY QUESTION
Is the first-time redeemed prescription of antidepressants predicted by the level of infertility-related stress in women seeking ART treatment?
SUMMARY ANSWER
Infertility-related stress in the personal and marital domains and general physical stress reactions were significant predictors of a first redeemed prescription of antidepressants after ART treatment in this 10-year follow-up cohort study.
WHAT IS KNOWN ALREADY
The literature has found inconsistent findings regarding the association between infertility-related stress and later psychological adjustment in fertility patients. The association between infertility-related stress and later prescription of antidepressants had never been explored in long-term cohort studies.
STUDY DESIGN, SIZE, DURATION
All women (n = 1169) who participated in the Copenhagen Cohort Multi-centre Psychosocial Infertility (COMPI) cohort study in the year 2000 (questionnaire data) were linked with the register-based Danish National ART-Couple (DANAC) I cohort, which includes women and their partners having received ART treatment from 1 January 1994 to 30 September 2009. The study population were among other national health and sociodemographic registers further linked with the Danish National Prescription Registry.
PARTICIPANTS/MATERIALS, SETTING, METHODS
Women initiating ART treatment were followed until they had redeemed the first prescription of antidepressants or until 31 December 2009. Logistic regression analyses were conducted to test the association between general physical stress reactions and infertility-related stress in the personal, marital and social domains, respectively, and a future redeemed prescription of antidepressants. Age, education level, marital status, number of fertility treatments prior to study inclusion and female infertility diagnosis were included as covariates in the adjusted analyses. Further, the analysis was stratified according to childbirth or no childbirth during follow-up.
MAIN RESULTS AND THE ROLE OF CHANCE
The final sample consisted of 1009 women with a mean age of 31.8 years. At study inclusion, women had tried to conceive for an average of 3.45 years. At 10-year follow-up, a total of 13.7% of women had a first redeemed prescription of antidepressant medication. The adjusted odds ratio (OR) showed that high general physical stress predicted the later prescription of antidepressants (adjusted (adj) OR = 2.85, 95% confidence interval (CI) 1.96–4.16). Regarding infertility-related stress domains, high personal stress (adj OR = 2.14, 95% CI 1.46–3.13) and high marital stress (adj OR = 1.80, 95% CI 1.23–2.64) were significantly associated with the later prescription of antidepressants. Social stress was not significantly associated with the future redeemed prescription of antidepressants (adj OR = 1.10, 95% CI 0.76–1.61). Among women not having achieved childbirth during follow-up, the risk of a first-time prescription of antidepressants associated with infertility-specific stress was higher compared to the risk among women having childbirth during follow-up.
LIMITATIONS, REASONS FOR CAUTION
This study did not account for potential mediating factors, such as negative life events, which could be associated with the prescription of antidepressants. Second, we are not able to know if these women had sought psychological support during follow-up. Additionally, antidepressants might be prescribed for other health conditions than depressive disorders.
WIDER IMPLICATIONS OF THE FINDINGS
Our results suggest that women presenting high infertility-related stress in the personal and marital domains were at higher risk of redeemed first-time prescription of antidepressants after ART, independently of having delivered a child or not after initiation of ART treatment. Women would benefit from an initial screening specifically for high infertility-related stress. The COMPI Fertility Problem Stress Scales can be used by clinical staff in order to identify women in need of psychological support before starting ART treatments.
STUDY FUNDING/COMPETING INTEREST(S)
This study was supported by the Portuguese Foundation for Science and Technology (FCT) under an individual doctoral grant attributed to the first author (SFRH/BD/103234/2014). The establishment of the DANAC I cohort was funded by Rosa Ebba Hansen’s Fund. The COMPI Infertility Cohort project was supported by The Danish Health Insurance Fund (J.nr. 11/097–97), the Else and Mogens Wedell-Wedellsborgs Fund, the manager E. Danielsens and Wife’s Fund, the merchant L.F. Foghts Fund, the Jacob Madsen and Wife Olga Madsens Fund. The authors have no conflicts of interest.
TRIAL REGISTRATION NUMBER
NA
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Affiliation(s)
- Juliana Pedro
- Faculty of Psychology and Education Sciences, University of Porto, 4200-135 Porto, Portugal
- Centre for Psychology at University of Porto, 4200-135 Porto, Portugal
| | - Ditte Vassard
- Department of Public Health, University of Copenhagen, 1014 Copenhagen K, Denmark
| | | | | | - Lone Schmidt
- Department of Public Health, University of Copenhagen, 1014 Copenhagen K, Denmark
| | - Mariana Veloso Martins
- Faculty of Psychology and Education Sciences, University of Porto, 4200-135 Porto, Portugal
- Centre for Psychology at University of Porto, 4200-135 Porto, Portugal
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28
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Chaves C, Canavarro MC, Moura-Ramos M. The Role of Dyadic Coping on the Marital and Emotional Adjustment of Couples With Infertility. FAMILY PROCESS 2019; 58:509-523. [PMID: 29709057 DOI: 10.1111/famp.12364] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Infertility is a challenging experience, affecting individual and couples' adjustment. However, the way the members of the couple support each other may affect the experience of infertility and their adjustment. This study aimed to investigate the role of dyadic coping by oneself and by the partner in the association between the impact of infertility and dyadic and emotional adjustment (anxiety and depression) to infertility. In this cross-sectional study, a total of 134 participants (67 couples with infertility) completed self-report questionnaires assessing infertility-related stress, dyadic coping, dyadic adjustment, and depression and anxiety symptoms. A path analysis examined the direct and indirect effects between the impact of infertility in one's life and dyadic and emotional adjustment. There is an indirect effect of the impact of infertility in one's life on dyadic adjustment through men's perceived dyadic coping efforts employed by the self (dyadic coping by oneself) and women's perceived dyadic coping efforts of the partner (dyadic coping by the partner). Regarding the emotional adjustment of infertile couples, infertility stress impact had an indirect effect only on depressive symptoms through men's dyadic coping by oneself. The results highlight the importance of men's dyadic coping strategies for the marital adjustment of couples as well as for men's emotional adjustment. Findings emphasize the importance of involving men in the fertility treatment process, reinforcing the dyadic nature of infertility processes.
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Affiliation(s)
- Catarina Chaves
- Department of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | | | - Mariana Moura-Ramos
- Reproductive Medicine Unit of Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
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Sahraeian M, Lotfi R, Qorbani M, Faramarzi M, Dinpajooh F, Ramezani Tehrani F. The Effect of Cognitive Behavioral Therapy on Sexual Function in Infertile Women: A Randomized Controlled Clinical Trial. JOURNAL OF SEX & MARITAL THERAPY 2019; 45:574-584. [PMID: 30912475 DOI: 10.1080/0092623x.2019.1594476] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Infertility and its consequences can have effects on various aspects of a couple's life and also in their marital relationships. This study aimed to investigate the effect of cognitive behavioral therapy (CBT) on sexual function in infertile women. The participants included 52 infertile women randomly assigned to intervention and control groups. A group-based, six-session sexual counseling using a CBT approach was also performed for the intervention group. Sexual functions of the participants in both groups were then assessed via the Female Sexual Function Index (FSFI) at three points in time. The findings revealed no statistically significant difference in the baseline FSFI mean scores of both groups. A significant difference was also reported for FSFI mean scores in the intervention group (29.35 ± 2.71) in comparison with those in the control group (25.84 ± 2.52) (p < 0.001) one month after intervention, with an effect size of 0.32. The mean scores of all the sexual-function domains, including sexual desire (p < 0.001), arousal (p < 0.001), lubrication (p < 0.001), orgasm (p < 0.001), satisfaction (p < 0.001), and pain (p < 0.001), among the participants in the intervention group had also significantly increased following CBT implementation. The results of this study could be used to promote sexual health in infertile women.
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Affiliation(s)
- Maryam Sahraeian
- Student Research Committee, Alborz University of Medical Sciences , Karaj , Iran (the Islamic Republic of)
| | - Razieh Lotfi
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences , Karaj , Iran (the Islamic Republic of)
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences , Karaj , Iran (the Islamic Republic of)
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences , Tehran , Iran
| | - Mahbobeh Faramarzi
- Infertility and Health Reproductive Research Center, Health Research Institute, Babol University of Medical Sciences , Babol , Iran (the Islamic Republic of)
| | - Fatemeh Dinpajooh
- Midwifery and Reproductive Health Department, School of Nursing and Midwifery, Alborz University of Medical Sciences , karaj , Iran (the Islamic Republic of)
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences , Tehran , Iran (the Islamic Republic of)
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Galhardo A, Alves J, Moura-Ramos M, Cunha M. Infertility-related stress and depressive symptoms - the role of experiential avoidance: a cross-sectional study. J Reprod Infant Psychol 2019; 38:139-150. [PMID: 31046433 DOI: 10.1080/02646838.2019.1612046] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: The current study aimed to explore the mediating role of experiential avoidance in the relationship between infertility-related stress (impact of infertility in women's life and representations about the importance of parenthood) and depressive symptoms.Background: Infertility is a stress inducing condition presenting many challenges to individuals facing this diagnosis, particularly to the ones who decide to pursue medical treatment. One of its consequences may be the experience of depressive symptoms which have also been associated with increased infertility-related stress. Moreover, experiential avoidance, conceptualised as an emotion regulation process, has also been connected to psychopathological symptoms, particularly depressive symptoms.Methods: The sample consisted of 124 women presenting an infertility diagnosis who were pursuing medical treatment for fertility problems. Participants were recruited through the national patients' association website and completed the following self-report instruments: a sociodemographic and clinical questionnaire, the Acceptance and Action Questionnaire-II (AAQ-II), the Fertility Problem Inventory (FPI) and the Depression, Anxiety and Stress Scales 21 (DASS-21).Results: Results showed that representations about the importance of parenthood were associated with depressive symptoms indirectly, throughout the association with the impact of infertility in women's life and use of experiential avoidance.Conclusions: Experiential avoidance can be considered a relevant emotion regulation process to be targeted in psychological intervention programs for women facing infertility.
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Affiliation(s)
- Ana Galhardo
- Instituto Superior Miguel Torga, Coimbra, Portugal.,Faculty of Psychology and Educational Sciences, University of Coimbra-CINEICC, Coimbra, Portugal
| | - Joana Alves
- Instituto Superior Miguel Torga, Coimbra, Portugal
| | - Mariana Moura-Ramos
- Faculty of Psychology and Educational Sciences, University of Coimbra-CINEICC, Coimbra, Portugal.,Coimbra Hospital and Universitary Centre-Reproductive Medicine Unit
| | - Marina Cunha
- Instituto Superior Miguel Torga, Coimbra, Portugal.,Faculty of Psychology and Educational Sciences, University of Coimbra-CINEICC, Coimbra, Portugal
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31
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Li X, Ye L, Tian L, Huo Y, Zhou M. Infertility-Related Stress and Life Satisfaction among Chinese Infertile Women: A Moderated Mediation Model of Marital Satisfaction and Resilience. SEX ROLES 2019. [DOI: 10.1007/s11199-019-01032-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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32
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Li Y, Zhang X, Shi M, Guo S, Wang L. Resilience acts as a moderator in the relationship between infertility-related stress and fertility quality of life among women with infertility: a cross-sectional study. Health Qual Life Outcomes 2019; 17:38. [PMID: 30770738 PMCID: PMC6377764 DOI: 10.1186/s12955-019-1099-8] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 01/24/2019] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Infertility-related stress can seriously impact the fertility quality of life (QoL) of infertile women. Resilience, as a coping resource, can effectively combat psychological stress. This study aimed to evaluate the fertility QoL of infertile women and to examine whether resilience moderates the association of infertility-related stress with fertility QoL. METHODS This cross-sectional study was conducted in northeast of China from December 2017 to February 2018. Out of 559 women outpatients with infertility, 498 (89.1%) completed self-reported questionnaires including the FertiQoL Scale, Fertility Problem Inventory (FPI) and Connor-Davidson Resilience Scale (CD-RISC). Hierarchical multiple regression analysis and simple slope analysis were applied to explore the influencing factors related to fertility QoL as well as to examine the moderating effect of resilience on the association of infertility-related stress with fertility QoL. RESULTS The mean FertiQoL score was 64.54 ± 16.90 among the participants. Household monthly income and causes of infertility were significantly related to fertility QoL. In addition, infertility-related stress was negatively related to fertility QoL, and resilience was positively associated with fertility QoL, explaining 36.3% of the variance. Resilience moderated the association of infertility-related stress with fertility QoL. Specifically, the effect of infertility-related stress on fertility QoL varied by low(1 SD below the mean, B = - 0.496, β = - 0.714, P < 0.001), mean (B = - 0.293, β = - 0.422, P < 0.001) and high (1 SD above the mean, B = - 0.090, β = - 0.130, P < 0.001) levels of resilience. The higher resilience was, the weaker the effect of infertility-related stress on fertility QoL was. CONCLUSIONS Overall, women with infertility in China had relatively low FertiQoL scores. Resilience influenced the association of infertility-related stress with fertility QoL. Infertile patients' psychological status must be addressed and adequate resilience-based interventions such as mindfulness-based skills should be provided to improve fertility QoL of women with infertility.
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Affiliation(s)
- Yifei Li
- Department of Social Medicine, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122 China
| | - Xin Zhang
- Department of Social Medicine, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122 China
| | - Meng Shi
- English Department, School of Fundamental Sciences, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122 China
| | - Shuaishuai Guo
- Reproductive Medicine Center, Shenyang Women’s and Children’s Hospital, No.87 Danan Road, Shenhe Area, Shenyang, 110000 China
| | - Lie Wang
- Department of Social Medicine, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122 China
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33
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Ussher JM, Perz J. Infertility‐related distress following cancer for women and men: A mixed method study. Psychooncology 2019; 28:607-614. [DOI: 10.1002/pon.4990] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 01/03/2019] [Accepted: 01/09/2019] [Indexed: 11/12/2022]
Affiliation(s)
- Jane M. Ussher
- Translational Health Research Institute, School of Medicine Western Sydney University Penrith Australia
| | - Janette Perz
- Translational Health Research Institute, School of Medicine Western Sydney University Penrith Australia
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Parton C, Ussher JM, Perz J. Hope, burden or risk: a discourse analytic study of the construction and experience of fertility preservation in the context of cancer. Psychol Health 2019; 34:456-477. [DOI: 10.1080/08870446.2018.1543764] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Chloe Parton
- Western Sydney University, Translational Health Research Institute, Campbelltown Campus, Sydney, Australia
| | - Jane M. Ussher
- Western Sydney University, Translational Health Research Institute, Campbelltown Campus, Sydney, Australia
| | - Janette Perz
- Western Sydney University, Translational Health Research Institute, Campbelltown Campus, Sydney, Australia
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Palomba S, Daolio J, Romeo S, Battaglia FA, Marci R, La Sala GB. Lifestyle and fertility: the influence of stress and quality of life on female fertility. Reprod Biol Endocrinol 2018; 16:113. [PMID: 30501641 PMCID: PMC6275085 DOI: 10.1186/s12958-018-0434-y] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 10/24/2018] [Indexed: 12/13/2022] Open
Abstract
There is growing evidence that lifestyle choices account for the overall quality of health and life (QoL) reflecting many potential lifestyle risks widely associated with alterations of the reproductive function up to the infertility. This review aims to summarize in a critical fashion the current knowledge about the potential effects of stress and QoL on female reproductive function. A specific literature search up to August 2017 was performed in IBSS, SocINDEX, Institute for Scientific Information, PubMed, Web of Science and Google Scholar. Current review highlights a close relationship in women between stress, QoL and reproductive function, that this association is more likely reported in infertile rather than fertile women, and that a vicious circle makes them to have supported each other. However, a precise cause-effect relationship is still difficult to demonstrate due to conflicting results and the lack of objective measures/instruments of evaluation.
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Affiliation(s)
- Stefano Palomba
- Unit of Obstetrics and Gynecology, Grande Ospedale Metropolitano “Bianco – Melacrino - Morelli”, Reggio Calabria, Italy
| | - Jessica Daolio
- Center of Reproductive Medicine “P. Bertocchi” Department of Obstetrics and Gynecology, Azienda Unità Sanitaria Locale – IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Sara Romeo
- Unit of Obstetrics and Gynecology, Grande Ospedale Metropolitano “Bianco – Melacrino - Morelli”, Reggio Calabria, Italy
| | - Francesco Antonino Battaglia
- Unit of Obstetrics and Gynecology, Grande Ospedale Metropolitano “Bianco – Melacrino - Morelli”, Reggio Calabria, Italy
| | - Roberto Marci
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of Obstetrics and Gynecology, University Hospital of Geneva, Geneva, Switzerland
| | - Giovanni Battista La Sala
- Center of Reproductive Medicine and Surgery, Arcispedale Santa Maria Nuova (ASMN) - Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Reggio Emilia, Italy
- University of Modena and Reggio Emilia, Modena, Italy
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Donarelli Z, Salerno L, Lo Coco G, Allegra A, Marino A, Kivlighan DM. From telescope to binoculars. Dyadic outcome resulting from psychological counselling for infertile couples undergoing ART. J Reprod Infant Psychol 2018; 37:13-25. [DOI: 10.1080/02646838.2018.1548757] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
| | - Laura Salerno
- Psychology Unit, ANDROS Day Surgery Clinic, Palermo, Italy
| | - Gianluca Lo Coco
- Department of Psychology and Educational Sciences, University of Palermo, Palermo, Italy
| | - Adolfo Allegra
- Reproductive Medicine Unit, ANDROS Day Surgery Clinic, Palermo, Italy
| | - Angelo Marino
- Reproductive Medicine Unit, ANDROS Day Surgery Clinic, Palermo, Italy
| | - Dennis M. Kivlighan
- Department of Counseling, Higher Education, and Special Education, University of Maryland, College Park, USA
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Li X, Wang K, Huo Y, Zhou M. The effect of infertility-related stress on Chinese infertile females' mental health: The moderating role of marital adjustment. Psych J 2018; 8:232-239. [PMID: 30468007 DOI: 10.1002/pchj.255] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Revised: 09/11/2018] [Accepted: 10/02/2018] [Indexed: 11/09/2022]
Abstract
Although the impacts of infertility-related stress on mental health have been testified in the literature, the underlying mechanism between them is still not clear. In response to this issue, 286 Chinese women who were pursuing medical treatment for fertility problems in two state-owned hospitals were invited to complete the survey, including the 7-item Dyadic Adjustment Scale (DAS), the Fertility Problem Inventory (FPI), the 5-item Mental Health Inventory (MHI-5), and demographic variables (e.g., age). The multiple linear regression method (SPSS 16) was used to investigate the impact of infertility-related stress and marital satisfaction on infertile women's mental health. Results showed that the total FPI score-and the specific domains of Social Concern, Relationship Concern, and Rejection of Child-Free Lifestyle in particular-had a significant negative relation with infertile women's mental health and marital satisfaction as a moderator between them. Therefore, the core of marital relationship and specific infertility-related stress should be addressed in psychological intervention programs for people facing infertility in mainland China.
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Affiliation(s)
- Xiaoshan Li
- School of Psychology, Jiangxi Normal University, Nanchang, China.,Center of Mental Health Education and Research, School of Psychology, Jiangxi Normal University, Nanchang, China
| | - Kaikai Wang
- School of Psychology, Jiangxi Normal University, Nanchang, China
| | - Yafen Huo
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Mingjie Zhou
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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Patel A, Sharma PSVN, Kumar P. "In Cycles of Dreams, Despair, and Desperation:" Research Perspectives on Infertility Specific Distress in Patients Undergoing Fertility Treatments. J Hum Reprod Sci 2018; 11:320-328. [PMID: 30787515 PMCID: PMC6333040 DOI: 10.4103/jhrs.jhrs_42_18] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
"Emotional distress in infertility" is a broad expression that loosely denotes anxiety, depression, grief, crisis, depleting psychological well-being, and all forms of affective and interpersonal disturbances faced by individuals with infertility. The distress is usually associated with involuntary childlessness as it is an unwelcoming event. The developmental crisis associated with childlessness poses a threat to one's sense of self at all levels (individual, family and social). Distress may begin before or during treatments as a person experiences the loss of control over attaining parenthood, anxiety or dejection after the diagnosis, treatments, its complications particularly its limited success rates. This paper reviews the basic concepts, theoretical models related to infertility specific distress (ISD). It elaborates on the effects of individual and treatment-specific variables on ISD with special highlights gathered from the national and international research.
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Affiliation(s)
- Ansha Patel
- Department of Psychiatry, Kasturba Medical College, Manipal, Karnataka, India
| | - P. S. V. N. Sharma
- Department of Psychiatry, Kasturba Medical College, Manipal, Karnataka, India
| | - Pratap Kumar
- Department of Obstetrics and Gynaecology, Kasturba Medical College, Manipal, Karnataka, India
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The Role of Attachment Anxiety and Attachment Avoidance on the Psychosocial Well-being of Infertile Couples. J Clin Psychol Med Settings 2018; 24:132-143. [PMID: 28536903 DOI: 10.1007/s10880-017-9496-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This study's objective was to explore the mediating role of attachment orientation in infertile women and their partners as a mediator of the relationship between need for parenthood and psychosocial well-being. Ninety participants (45 couples) undergoing in vitro fertilization completed self-report questionnaires that assessed representations of the importance of parenthood, attachment orientations, and psychosocial well-being. Path analysis was used to examine the direct and indirect effects. The results indicated that women's attachment anxiety mediated the effect of need for parenthood on the psychological well-being of themselves and their partner. Although causality cannot be assumed, this study highlights the importance of considering attachment orientations and related strategies of emotion regulation in clinical settings and the need to address the meaning of parenthood for promoting couples' well-being.
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Zurlo MC, Cattaneo Della Volta MF, Vallone F. Factor structure and psychometric properties of the Fertility Problem Inventory-Short Form. Health Psychol Open 2018; 4:2055102917738657. [PMID: 29379625 PMCID: PMC5779934 DOI: 10.1177/2055102917738657] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The study analyses factor structure and psychometric properties of the Italian version of the Fertility Problem Inventory–Short Form. A sample of 206 infertile couples completed the Italian version of Fertility Problem Inventory (46 items) with demographics, State Anxiety Scale of State-Trait Anxiety Inventory (Form Y), Edinburgh Depression Scale and Dyadic Adjustment Scale, used to assess convergent and discriminant validity. Confirmatory factor analysis was unsatisfactory (comparative fit index = 0.87; Tucker-Lewis Index = 0.83; root mean square error of approximation = 0.17), and Cronbach’s α (0.95) revealed a redundancy of items. Exploratory factor analysis was carried out deleting cross-loading items, and Mokken scale analysis was applied to verify the items homogeneity within the reduced subscales of the questionnaire. The Fertility Problem Inventory–Short Form consists of 27 items, tapping four meaningful and reliable factors. Convergent and discriminant validity were confirmed. Findings indicated that the Fertility Problem Inventory–Short Form is a valid and reliable measure to assess infertility-related stress dimensions.
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Agostini F, Monti F, Andrei F, Paterlini M, Palomba S, La Sala GB. Assisted reproductive technology treatments and quality of life: a longitudinal study among subfertile women and men. J Assist Reprod Genet 2017; 34:1307-1315. [PMID: 28733802 PMCID: PMC5633563 DOI: 10.1007/s10815-017-1000-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 07/12/2017] [Indexed: 10/19/2022] Open
Abstract
PURPOSE Quality of life (QoL) may represent a comprehensive indicator for the assessment of the psychological impact of complex clinical conditions, such as infertility. Infertile women have a worse QoL compared to both infertile men and non-infertile controls. However, the initial phases of infertility treatments have been frequently investigated using cross-sectional study designs. This prospective longitudinal study aimed at assessing the health-related QoL change across different phases of assisted reproductive technology (ART) treatments in subfertile women and men. METHODS Eighty-five subfertile women and men undergoing ART cycles were assessed at the beginning of the ovarian stimulation, during oocyte retrieval before discharging, and around 14 days after the embryo transfer. QoL was assessed through the Short Form 36. RESULTS Irrespective of the cause of infertility, work status, and age, QoL levels decreased from the first to the third assessment, and women scored significantly lower than men to each QoL indicator. Additionally, a higher number of previous ART failures had a negative impact on QoL, irrespective of gender and the phase of treatment. ART outcome marginally affected women's QoL across time. CONCLUSION Infertile women have a worse QoL throughout all phases of ARTs compared to men, and this difference increases in infertile patients with more than one previous ART failure.
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Affiliation(s)
- Francesca Agostini
- Department of Psychology, University of Bologna, Viale Berti Pichat 5, 40127, Bologna, Italy.
| | - Fiorella Monti
- Department of Psychology, University of Bologna, Viale Berti Pichat 5, 40127, Bologna, Italy
| | - Federica Andrei
- Department of Psychology, University of Bologna, Viale Berti Pichat 5, 40127, Bologna, Italy
| | - Marcella Paterlini
- Unit of Obstetrics and Gynecology, IRCCS - ASMN of Reggio Emilia, Reggio Emilia, Italy
| | - Stefano Palomba
- Unit of Obstetrics and Gynecology, IRCCS - ASMN of Reggio Emilia, Reggio Emilia, Italy
| | - Giovanni Battista La Sala
- Unit of Obstetrics and Gynecology, IRCCS - ASMN of Reggio Emilia, Reggio Emilia, Italy
- University of Modena and Reggio Emilia, Modena, Italy
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Valdes CT, Schutt A, Simon C. Implantation failure of endometrial origin: it is not pathology, but our failure to synchronize the developing embryo with a receptive endometrium. Fertil Steril 2017; 108:15-18. [PMID: 28668151 DOI: 10.1016/j.fertnstert.2017.05.033] [Citation(s) in RCA: 96] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 05/24/2017] [Indexed: 11/19/2022]
Abstract
Repeated implantation failure (RIF) is an intriguing, massive failure of reproductive treatment in otherwise healthy women leading to the introduction of empirical adjuvant interventions that are costly, inefficient, and frustrating for our patients. In this article, we will try to convince the readers that RIF is neither a stigma nor a mysterious pathology but rather our failure to diagnose and properly synchronize the euploid blastocyst with the patient's personalized window of implantation.
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Affiliation(s)
- Cecilia T Valdes
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas
| | - Amy Schutt
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas
| | - Carlos Simon
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas; Department of Obstetrics and Gynecology, Valencia University and INCLIVA, Valencia, Spain; Igenomix, Parc Cientific Valencia University, Valencia, Spain; Department of Obstetrics and Gynecology, Stanford University, Stanford, California.
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Khakpour M, Nejat H, Karimian F, Mehrafarid M, Mortazavi S, Chenari T. Effect of Fordyce Happiness Model on Hardiness and Marital Adjustment in Infertile Couples. J Nurs Educ 2017. [DOI: 10.21859/jne-06026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Kitchen H, Aldhouse N, Trigg A, Palencia R, Mitchell S. A review of patient-reported outcome measures to assess female infertility-related quality of life. Health Qual Life Outcomes 2017. [PMID: 28449717 DOI: 10.1186/s12955-017-0666-0.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Infertility has a negative impact on quality of life (QoL) and well-being of affected individuals and couples. A variety of patient-reported outcome (PRO) measures to assess infertility-related QoL are available; however, there is a concern regarding potential issues with their development methodology, validation and use. This review aimed to i) identify PRO measures used in infertility interventional studies ii) assess validation evidence to identify a reliable, valid PRO measure to assess changes in QoL or treatment satisfaction in clinical studies with female patients following treatment with novel therapies iii) identify potential gaps in evidence for validity. METHODS A structured literature search of Medline, Embase, and the Cochrane Library (accessed in September 2015) was conducted using pre-defined search terms. The identified publications were reviewed applying eligibility criteria to select interventional female infertility studies using PROs. Infertility-specific PRO measures assessing QoL, treatment satisfaction or psychiatric health, and included in studies by ≥2 research groups were selected and critically reviewed in light of scientific and regulatory guidance (e.g. FDA PRO Guidance for Industry) for evidence of content validity, psychometric strength, and patient acceptability. RESULTS The literature search and hand-searching yielded 122 publications; 78 unique PRO measures assessing QoL, treatment satisfaction or psychiatric health were identified. Five PRO measures met the selection criteria for detailed review: Fertility Quality of Life (FertiQoL); Fertility Problem Inventory (FPI); Fertility Problem Stress (FPS); Infertility Questionnaire (IFQ); Illness Cognitions Questionnaire adapted for Infertility (ICQ-I). None of the PRO measures met all validation criteria. The FertiQoL was the most widely used infertility-specific PRO measure to assess QoL in interventional studies, with reasonable evidence for adequate content validity, psychometric strength, and linguistic validation. However, gaps in evidence remain including test-retest reliability and thresholds for interpreting clinically important changes. While the FPI demonstrated reasonable evidence for content and psychometric validity, its utility as an outcome measure is limited by a lack of recall period. CONCLUSION The FertiQoL and the FPI are potentially useful measures of infertility-related QoL in interventional studies. Further research is recommended to address gaps in evidence and confirm both PRO measures as reliable assessments of patient outcomes.
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Kitchen H, Aldhouse N, Trigg A, Palencia R, Mitchell S. A review of patient-reported outcome measures to assess female infertility-related quality of life. Health Qual Life Outcomes 2017; 15:86. [PMID: 28449717 PMCID: PMC5408488 DOI: 10.1186/s12955-017-0666-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 04/21/2017] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Infertility has a negative impact on quality of life (QoL) and well-being of affected individuals and couples. A variety of patient-reported outcome (PRO) measures to assess infertility-related QoL are available; however, there is a concern regarding potential issues with their development methodology, validation and use. This review aimed to i) identify PRO measures used in infertility interventional studies ii) assess validation evidence to identify a reliable, valid PRO measure to assess changes in QoL or treatment satisfaction in clinical studies with female patients following treatment with novel therapies iii) identify potential gaps in evidence for validity. METHODS A structured literature search of Medline, Embase, and the Cochrane Library (accessed in September 2015) was conducted using pre-defined search terms. The identified publications were reviewed applying eligibility criteria to select interventional female infertility studies using PROs. Infertility-specific PRO measures assessing QoL, treatment satisfaction or psychiatric health, and included in studies by ≥2 research groups were selected and critically reviewed in light of scientific and regulatory guidance (e.g. FDA PRO Guidance for Industry) for evidence of content validity, psychometric strength, and patient acceptability. RESULTS The literature search and hand-searching yielded 122 publications; 78 unique PRO measures assessing QoL, treatment satisfaction or psychiatric health were identified. Five PRO measures met the selection criteria for detailed review: Fertility Quality of Life (FertiQoL); Fertility Problem Inventory (FPI); Fertility Problem Stress (FPS); Infertility Questionnaire (IFQ); Illness Cognitions Questionnaire adapted for Infertility (ICQ-I). None of the PRO measures met all validation criteria. The FertiQoL was the most widely used infertility-specific PRO measure to assess QoL in interventional studies, with reasonable evidence for adequate content validity, psychometric strength, and linguistic validation. However, gaps in evidence remain including test-retest reliability and thresholds for interpreting clinically important changes. While the FPI demonstrated reasonable evidence for content and psychometric validity, its utility as an outcome measure is limited by a lack of recall period. CONCLUSION The FertiQoL and the FPI are potentially useful measures of infertility-related QoL in interventional studies. Further research is recommended to address gaps in evidence and confirm both PRO measures as reliable assessments of patient outcomes.
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Donarelli Z, Lo Coco G, Gullo S, Marino A, Volpes A, Salerno L, Allegra A. Infertility-related stress, anxiety and ovarian stimulation: can couples be reassured about the effects of psychological factors on biological responses to assisted reproductive technology? REPRODUCTIVE BIOMEDICINE & SOCIETY ONLINE 2016; 3:16-23. [PMID: 29774246 PMCID: PMC5952838 DOI: 10.1016/j.rbms.2016.10.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 08/04/2016] [Accepted: 10/24/2016] [Indexed: 06/08/2023]
Abstract
The aim of this prospective, longitudinal study was to examine the association between couples' pre-treatment psychological characteristics (state anxiety and infertility-related stress levels of both partners) and ovarian response during assisted reproductive technology treatment in a well-controlled sample. A total of 217 heterosexual couples (434 patients), suffering from primary infertility and undergoing their first assisted reproductive technology treatment at the Reproductive Medicine Unit of ANDROS Day Surgery Clinic in Palermo (Italy), were recruited. Psychological variables were assessed using the State Scale of State-Trait Anxiety Inventory (STAI-S) and the Fertility Problem Inventory (FPI). The number of follicles ≥ 16 mm in diameter, evaluated by transvaginal ultrasound scan on the eleventh day of the workup, was chosen as the outcome measure. No association between women's level of anxiety and infertility-related stress, and the number of follicles ≥ 16 mm in diameter was found. Moreover, the male partner's infertility stress and anxiety did not influence the relationship between the woman's infertility-related stress, anxiety level and ovarian response. Fertility staff should reassure couples that the woman's biological response to ovarian stimulation is not influenced by either partner's level of psychological distress.
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Affiliation(s)
| | - Gianluca Lo Coco
- Department of Psychological and Educational Sciences, University of Palermo, Palermo, Italy
| | - Salvatore Gullo
- ANDROS Day Surgery Clinic, Medical Statistics Unit, Palermo, Italy
| | - Angelo Marino
- ANDROS Day Surgery Clinic, Reproductive Medicine Unit, Palermo, Italy
| | - Aldo Volpes
- ANDROS Day Surgery Clinic, Reproductive Medicine Unit, Palermo, Italy
| | - Laura Salerno
- ANDROS Day Surgery Clinic, Psychology Unit, Palermo, Italy
| | - Adolfo Allegra
- ANDROS Day Surgery Clinic, Reproductive Medicine Unit, Palermo, Italy
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Couples' discontinuation of fertility treatments: a longitudinal study on demographic, biomedical, and psychosocial risk factors. J Assist Reprod Genet 2016; 34:217-224. [PMID: 27900611 DOI: 10.1007/s10815-016-0844-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 11/14/2016] [Indexed: 10/20/2022] Open
Abstract
PURPOSE This study aims to explore the role of infertility-psychosocial variables on treatment discontinuation after controlling for demographic and biomedical variables in couples seeking reimbursed fertility treatment. METHODS A prospective study was conducted in 139 couples seeking fertility treatment. Between February 2010 and March 2011, participants completed measures of anxiety (STAI-State), depression (BDI-II), infertility-stress (FPI), and infertility coping strategies (COMPI-CSS). Medical data related to diagnosis, treatment, and discontinuation were collected in December 2013. A multiple logistic regression was performed to identify the predictors of discontinuation. RESULTS The discontinuation rate was 29.5%. Female education level, engagement in ART procedures, and female causation decreased the likelihood of treatment discontinuation, whereas female age and depression increased the likelihood of discontinuation. Female depression was the strongest predictor in this model. The model correctly identified 75.5% of cases. CONCLUSIONS Female age and female depression are associated with a higher likelihood of treatment discontinuation in couples seeking treatment. Reproductive health professionals should therefore inform couples about the link between the fertility treatment discontinuation and both female age and female depression. Couples in which female partners present clinically relevant depression should be referred to a mental health professional to prevent premature abandonment of fertility treatments and thus increase success rates.
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Pedro J, Frederiksen Y, Schmidt L, Ingerslev HJ, Zachariae R, Martins MV. Comparison of three infertility-specific measures in men and women going through assisted reproductive technology treatment. J Health Psychol 2016; 24:738-749. [PMID: 27881623 DOI: 10.1177/1359105316678669] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
We compared the psychometric properties of COMPI Fertility Problem Stress Scales, Fertility Problem Inventory, and Fertility Quality of Life Tool in 293 patients enrolled for assisted reproductive technology. COMPI Fertility Problem Stress Scales and Fertility Problem Inventory subscales presented higher internal consistency. COMPI Fertility Problem Stress Scales differentiated best between its domains. Fertility Problem Inventory revealed better concurrent validity. Fertility Quality of Life Tool presented better fit. While discrimination for depression was similar between measures, Fertility Quality of Life Tool was better at discriminating anxiety. Results suggest that while all compared measures are reliable and valid in assessing the psychosocial adjustment to infertility, the choice of measure should be based according to the assessment goals.
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49
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Psychological Adjustment of Infertile Men Undergoing Fertility Treatments: An Association With Sperm Parameters. Arch Psychiatr Nurs 2016; 30:521-6. [PMID: 27654231 DOI: 10.1016/j.apnu.2016.04.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Revised: 04/24/2016] [Accepted: 04/27/2016] [Indexed: 01/28/2023]
Abstract
BACKGROUND The difficulties in the psychological adaptation to the infertility diagnosis and assisted reproductive technology (ART) treatments have shown influence on the sperm quality. The biological and psychological aspects of infertility seem not to be independent. OBJECTIVE To analyze the impact of depressive symptoms, anxiety, dyadic adjustment and infertility stress on the sperm quality of the men proposed to ART first or repeated experience. MATERIALS AND METHODS This transversal study was conducted in the Medically Assisted Reproduction Unit of Centro Hospitalar de São João, in Porto, Portugal. 112 men with infertility diagnosis were included to initiate an ART cycle. Participants completed the Inventory State-Trait Anxiety-Form Y (STAI-Y), the Beck Depression Inventory-II (BDI-II), the Dyadic Adjustment Scale (DAS) and the Inventory of Fertility Problems (IFP) before the beginning of the treatment. RESULTS The state-anxiety had a negative linear impact on the slow progressive motility (p<0.05). However, depressive symptoms assumed a suppressor effect on this variable, enhancing its importance as a predictor. CONCLUSION Results show that psychopathological symptoms before an ART cycle can influence the sperm motility. However, this association seems to only be present in men undergoing first experience ART treatments. Thus, this research shows the need for mental health professionals to respond to emotional difficulties of the male gender, through the development of psychological interventions adjusted, so as to minimize the impact of exposure to ART treatments.
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50
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Donarelli Z, Lo Coco G, Gullo S, Salerno L, Marino A, Sammartano F, Allegra A. The Fertility Quality of Life Questionnaire (FertiQoL) Relational subscale: psychometric properties and discriminant validity across gender. Hum Reprod 2016; 31:2061-71. [PMID: 27343271 DOI: 10.1093/humrep/dew168] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 06/06/2016] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION Is the Fertility Quality of Life Questionnaire (FertiQoL)-Relational Scale a valid measure to assess the relational domain regarding quality of life in women and men undergoing infertility treatment? SUMMARY ANSWER The FertiQoL-Relational scale (FertiQoL-REL) showed good psychometric properties and captured core aspects of couple relationships. WHAT IS KNOWN ALREADY FertiQoL has become a gold standard for the assessment of infertility-related quality of life in patients undergoing assisted reproduction treatment (ART). Despite its growing importance, no previous studies have examined the convergent validity of the FertiQoL-REL and its discriminant validity across gender. STUDY DESIGN, SIZE, DURATION Baseline cross-sectional data as part of a longitudinal study of infertile couples undergoing an ART between February 2013 and January 2015. PARTICIPANTS/MATERIALS, SETTING, METHODS Five hundred and eighty-nine patients (301 females and 288 males), prior to starting an ART in a private clinic, filled in the Fertility Quality of Life Questionnaire (FertiQoL) and several measures of the marital relationship (Dyadic Adjustment Scale, Marital Commitment Inventory and ENRICH Marital Satisfaction Scale) and infertility-related distress (Fertility Problem Inventory). MAIN RESULTS AND THE ROLE OF CHANCE Confirmatory factor analysis showed that the FertiQoL four-factor solution provided a good fit for the observed data. Reliability of the FertiQoL-REL was higher for women than men. Significant correlations between the FertiQoL-REL scores and all the other measures of marital relationship were found for both women and men. FertiQoL-REL scores did not differ significantly in women and men. The FertiQoL-REL was able to differentiate subjects as regards the Dyadic Adjustment Scale and ENRICH Marital Satisfaction Scale threshold. LIMITATIONS, REASONS FOR CAUTION Findings are limited because the data were obtained from only one Italian private clinic. WIDER IMPLICATIONS OF THE FINDINGS FertiQoL-REL threshold scores are useful for identifying those patients undergoing ART who are more likely to report poor or good relationship quality. Clinicians should tailor their counselling strategies to the positive qualities in a couple's relationship, so as to reinforce the overall quality of life, especially among women, and to support patients in tackling the psychological burden, so that they can either continue treatment or choose discontinuation. STUDY FUNDING/COMPETING INTERESTS This research was supported by funds provided by Centro Andros S.r.l., Palermo, Italy. The authors declare no financial or commercial conflicts of interest in this study. TRIAL REGISTRATION NUMBER Not necessary.
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Affiliation(s)
- Z Donarelli
- ANDROS Day Surgery Clinic, Psychology Unit, Palermo, Italy
| | - G Lo Coco
- Department of Psychology and Educational Sciences, University of Palermo, Palermo, Italy
| | - S Gullo
- ANDROS Day Surgery Clinic, Medical Statistics Unit, Palermo, Italy
| | - L Salerno
- ANDROS Day Surgery Clinic, Psychology Unit, Palermo, Italy
| | - A Marino
- ANDROS Day Surgery Clinic, Reproductive Medicine Unit, Palermo, Italy
| | - F Sammartano
- ANDROS Day Surgery Clinic, Reproductive Medicine Unit, Palermo, Italy
| | - A Allegra
- ANDROS Day Surgery Clinic, Reproductive Medicine Unit, Palermo, Italy
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