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Montecalvo M, Vegni E, Balestrieri R, Leone D, Borghi L. The elephant in the room: a study on the dialogue about sexuality during Assisted Reproductive Technology visits. J Psychosom Obstet Gynaecol 2024; 45:2372565. [PMID: 38965685 DOI: 10.1080/0167482x.2024.2372565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 06/22/2024] [Indexed: 07/06/2024] Open
Abstract
Despite ongoing medical advancements in infertility treatment, the significant impact of sexuality on this journey often goes unaddressed. The present research aims to examine sexual conversations during ART visits, including who initiate the conversation and their content.This quali-quantitative study delves into analyzed video-recorded ART visits to explore how "sex" conversations are broached during healthcare interactions. Our findings reveal a strikingly low proportion of utterances related to sexuality, accounting for only 1.3% of the total 14,372 utterances analyzed. Sex utterances were mainly introduced by physicians (72%), while regarding those introduced by the couple, 64% were reported by men. From the qualitative analysis on the utterances emerged three distinct levels of communication about sex: explicit, almost explicit, and implicit. While physicians and males exhibit an almost balanced distribution across the 3 levels, female patients primarily respond to explicit and almost explicit communication initiated by physicians. The low percentage of sexual utterances underscores the rarity of these conversations during ART interactions, despite the clinical field where sexual health should deserve a crucial attention. Opening the door to conversations about sexuality could help to create a safe and supportive space for patients to talk about sex, with a potential impact on well-being and quality of care during the ART process.
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Affiliation(s)
- Michele Montecalvo
- Clinical Psychology, Department of Health Science, University of Milan, Milan, Italy
| | - Elena Vegni
- Clinical Psychology, Department of Health Science, University of Milan, Milan, Italy
- Unit of Clinical Psychology, Santi Paolo and Carlo Hospital, Milan, Italy
| | - Raffaella Balestrieri
- Clinical Psychology, Department of Health Science, University of Milan, Milan, Italy
| | - Daniela Leone
- Unit of Clinical Psychology, Santi Paolo and Carlo Hospital, Milan, Italy
| | - Lidia Borghi
- Clinical Psychology, Department of Health Science, University of Milan, Milan, Italy
- Unit of Clinical Psychology, Santi Paolo and Carlo Hospital, Milan, Italy
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2
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Cevik Dogan M, Yoldemir T. The association between female sexual function and metabolic features of the polycystic ovary syndrome in Turkish women of reproductive age. Gynecol Endocrinol 2024; 40:2362249. [PMID: 38913084 DOI: 10.1080/09513590.2024.2362249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 05/27/2024] [Indexed: 06/25/2024] Open
Abstract
OBJECTIVE To investigate the association between female sexual function and metabolic features among women with polycystic ovary syndrome (PCOS) during reproductive age. METHOD This was a cross-sectional study in which 288 women with PCOS and 180 women without PCOS between the ages of 20 and 40 years were evaluated. All women had serum total testosterone, androstenedione, DHEA-S, fasting glucose, total cholesterol, HDL-C, LDL-C, and triglyceride levels analyzed. The McCoy Female Sexual Questionnaire (MFSQ) was applied to all studied women. Exploratory factor analysis and reliability analysis were done after data collection. The factor loadings of MFSQ domains were compared between women with PCOS and controls. RESULTS Average factor loadings of the MFSQ sexuality domain and MFSQ sexual partner domain were significantly lower in the PCOS group when compared to controls. There was no correlation between the two sexual function domains of the MFSQ and the PCOS features either in the PCOS group or the controls. CONCLUSION PCOS is a heterogeneous disease with different metabolic components, such as insulin resistance, obesity, and hyperandrogenism. Although sexual function among women with PCOS was lower than controls, no differences were found in metabolic features of the PCOS and non-PCOS groups with relation to sexual function determined by the MFSQ.
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Affiliation(s)
- Meral Cevik Dogan
- Obstetrics and Gynecology Clinic, Tuzla State Hospital, Istanbul, Turkey
| | - Tevfik Yoldemir
- Obstetrics and Gynecology Department, Marmara University School of Medicine, Istanbul, Turkey
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3
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Yamanaka-Altenstein M, Rauch-Anderegg V, Heinrichs N. The link between infertility-related distress and psychological distress in couples awaiting fertility treatment: a dyadic approach. HUM FERTIL 2022; 25:924-938. [PMID: 34232107 DOI: 10.1080/14647273.2021.1948112] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
While there is broad evidence to suggest that individual stress increases, and that high couple relationship quality reduces the risk for psychological distress, our understanding of these associations in couples dealing with infertility remains limited. In this cross-sectional study, we used dyadic data-analysis (Actor-Partner Interdependence Model; APIM) to examine the effects of infertility-related distress (experienced as an individual risk factor) and couple relationship quality (experienced as a couple-based resource), on psychological distress in a sample of 116 infertile couples. 59% of women and 23% of men reported clinical levels of psychological distress, 71% of women and 45% of men reported infertility-related distress, and 3% of participants reported low couple relationship quality. Infertility-related distress predicted psychological distress at the individual level ('actor effects') while men's infertility-related distress predicted women's psychological distress (partner effect'). Women without medically assisted reproduction (MAR) treatment exposure reported significantly higher couple relationship quality than women with MAR exposure, and men without treatment exposure reported significantly lower infertility-related distress than men with exposure. The level of psychological distress depended on whether both or neither of the partners, or only one partner reported infertility-related distress. Couple relationship quality was not associated with distress, which may imply that dyadic dimensions other than overall satisfaction could be relevant in supporting couples facing infertility.
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Affiliation(s)
| | | | - Nina Heinrichs
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Bremen, Bremen, Germany
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4
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Pastoor H, Both S, Timman R, Laan ETM, Laven JSE. Sexual Function in Women With Polycystic Ovary Syndrome: Design of an Observational Prospective Multicenter Case Control Study. Sex Med 2020; 8:718-729. [PMID: 32798148 PMCID: PMC7691880 DOI: 10.1016/j.esxm.2020.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 06/26/2020] [Accepted: 07/03/2020] [Indexed: 12/23/2022] Open
Abstract
Introduction The prevalence of polycystic ovary syndrome (PCOS) is 10–15% in women of reproductive age. Its characteristics are (i) clinical or biochemical hyperandrogenism, (ii) oligomenorrhea or amenorrhea, and (iii) polycystic ovaries on ultrasound. PCOS is associated with lower quality of life, depression, anxiety, diabetes, and cardiovascular disease. Treatment commonly entails oral contraceptive use to lower endogenous androgen levels. Androgen levels and comorbidities may affect sexual function. Previous studies have addressed a limited range of possible contributing factors. We will assess sexual function as well as genital and self-reported sexual arousal in a laboratory setting in women with PCOS compared to an age-matched healthy control group. Modulation by biopsychosocial factors mentioned will be studied. Methods This is a multicenter prospective case control study. The study population includes healthy women with and without PCOS, aged 18–40 years, in a stable heterosexual relationship for at least 6 months. Power is calculated at 67 participants in each group. Anticipating a drop out of 10%, 150 participants will be recruited. Main outcome measures The main outcomes measured are sexual function using the Female Sexual Function Index, Sexual Desire Inventory, and Female Sexual Distress Scale-Revised; genital sexual arousal measured as vaginal pulse amplitude; and self-reported sexual arousal in response to erotic stimuli in a laboratory setting. The mediators that will be investigated include testosterone, free androgen levels, oral contraceptive use, sensitivity to androgens (using CAG repeat length), body mass index, body image, mental health, and self-esteem. Conclusion Strengths of this study are the inclusion of a broad range of biopsychosocial outcome measures including DNA analysis, a healthy control group, and standardized assessment of genital and self-reported sexual arousal in a laboratory setting. With the design of this study we aim to provide an insight into which biopsychosocial factors associated with PCOS are related to sexual function, and how sexual function may be affected by treatment. These new insights may help to improve clinical management of PCOS while improving the quality of life. Pastoor H, Both S, Timman R, et al. Sexual Function in Women With Polycystic Ovary Syndrome: Design of an Observational Prospective Multicenter Case Control Study. Sex Med 2020;8:718–729.
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Affiliation(s)
- Hester Pastoor
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Erasmus University Medical Center, Rotterdam, the Netherlands.
| | - Stephanie Both
- Department of Psychosomatic Gynecology and Sexology, Leiden University Medical Center, Leiden, the Netherlands
| | - Reinier Timman
- Department of Psychiatry, Section of Medical Psychology and Psychotherapy, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Ellen T M Laan
- Department of Sexology and Psychosomatic OBGYN, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - Joop S E Laven
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Erasmus University Medical Center, Rotterdam, the Netherlands
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Facchin F, Somigliana E, Busnelli A, Catavorello A, Barbara G, Vercellini P. Infertility-related distress and female sexual function during assisted reproduction. Hum Reprod 2020; 34:1065-1073. [PMID: 31090897 DOI: 10.1093/humrep/dez046] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 03/05/2019] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION Is infertility-related distress a risk factor for impaired female sexual function in women undergoing assisted reproduction? SUMMARY ANSWER Infertility-related distress, and especially social, sexual, and relationship concerns, is associated with female sexual dysfunction. WHAT IS KNOWN ALREADY Women with infertility are more likely to present sexual dysfunction relative to those without infertility. Moreover, assisted reproduction is associated with increased risk for female sexual problems. To date, this higher proportion of sexual impairment in infertile women has been simplistically linked to the stress associated with the condition and investigated risk factors included mainly demographic and clinical variables. Quantitative studies aimed at identifying risk factors for sexual dysfunction that also included the evaluation of infertility-related distress are conversely lacking. STUDY DESIGN, SIZE, DURATION This observational study was conducted at the Infertility Unit of the Fondazione Ca' Granda, Ospedale Maggiore Policlinico of Milan between 2017 and 2018. PARTICIPANTS/MATERIALS, SETTING, METHODS We included 269 consecutive patients with infertility aged 24-45 (37.8 ± 4.0 years). Sexual function outcomes were sexual dysfunction (assessed with the Female Sexual Function Index), sexual distress (evaluated with the Female Sexual Distress Scale-Revised), dyspareunia, and number of intercourses in the month preceding ovarian stimulation. Infertility-related distress was measured with the Fertility Problem Inventory (FPI). The effects of potential confounders such as demographic variables (women's and partners' age and level of education) and infertility-related factors (type and cause of infertility, number of previous IVF cycles, and duration of infertility) were also examined. MAIN RESULTS AND THE ROLE OF CHANCE Women with higher infertility-related distress were more likely to report sexual dysfunction (odds ratio = 1.02 per point of score; 95% CI, 1.01-1.03; P = 0.001). Three FPI domains (i.e. social, relational, and sexual concerns) were correlated with almost all sexual function outcomes (Ps < 0.05). LIMITATIONS, REASONS FOR CAUTION Women who were not sexually active were not included, thus reasons for sexual inactivity should be further explored in future studies. Data regarding men (e.g. sexual function and infertility-related distress) were lacking, thus cross-partner effects were not examined. Recall bias (also due to the fact that questionnaires were administered on the day of oocytes retrieval) and social desirability bias may have also affected women's responses to the questionnaires. WIDER IMPLICATIONS OF THE FINDINGS Social, relational, and sexual concerns should be assessed and addressed in psychological counselling with the infertile couple. STUDY FUNDING/COMPETING INTEREST(S) None. TRIAL REGISTRATION NUMBER Not applicable.
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Affiliation(s)
- Federica Facchin
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Edgardo Somigliana
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Andrea Busnelli
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Anita Catavorello
- Department of General Surgery and Medical Surgical Specialities, University of Catania, Catania, Italy
| | - Giussy Barbara
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Vercellini
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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6
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Abord de la sexualité et des dysfonctions sexuelles par les médecins de la reproduction en France. SEXOLOGIES 2020. [DOI: 10.1016/j.sexol.2020.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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7
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Langlade P, Martin C, Robin G, Catteau-Jonard S. Approach to sexuality and sexual dysfunction by reproductive doctors in France. SEXOLOGIES 2020. [DOI: 10.1016/j.sexol.2020.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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8
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Zayed AA, El-Hadidy MA. Sexual satisfaction and self-esteem in women with primary infertility. MIDDLE EAST FERTILITY SOCIETY JOURNAL 2020. [DOI: 10.1186/s43043-020-00024-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Infertility may adversely affect sexual satisfaction and self-esteem of the infertile couples.
Main body
This study aims to assess self-esteem (sexual and general), anxiety, and depression in women with primary infertility. It is a comparative cross-sectional study and data collection covers a 1-year period. The study population consisted of 284 women, of whom 150, who attended the gynecology outpatient clinic of the hospital for contraception in the control group, and 134, who attended the gynecology department asking for treatment from primary infertility in the study group. All participants were examined using Mini-International Neuropsychiatric Interview (MINI), Wechsler Adult Intelligence Scale-Revised (WAIS-R), Hamilton Anxiety Scale ( HAM-A), Hamilton Depression scales, socioeconomic standard using The Egyptian Classification of Socioeconomic Standard by El Gilany 2002, self-esteem using the Arabic translation of Rosenberg Self-esteem Scale, and Self-esteem and Relationship questionnaire (SEAR).
In the present study, women with primary infertility showed a higher prevalence of depression and anxiety with a statistically significant difference from fertile women. In addition, women with primary infertility showed lower general self-esteem, sexual satisfaction, sexual relationship, and sexual self-esteem than women with children and the difference was statistically significant.
Conclusion
Infertility has a negative effect on women's self-esteem, sexual activity, and psychological function.
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Pastoor H, Timman R, de Klerk C, M Bramer W, Laan ET, Laven JS. Sexual function in women with polycystic ovary syndrome: a systematic review and meta-analysis. Reprod Biomed Online 2018; 37:750-760. [PMID: 30420168 DOI: 10.1016/j.rbmo.2018.09.010] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 09/10/2018] [Accepted: 09/13/2018] [Indexed: 01/28/2023]
Abstract
We present the first systematic review and meta-analysis of sexual function in women with polycystic ovary syndrome (PCOS) compared with women without PCOS. Data on this topic are limited and often contradicting. Sexual function is influenced by endocrine, mental and social factors, which are often compromised in women with PCOS. The main outcome measures were validated sexual function questionnaires and visual analogue scales (VAS). We identified and assessed 1925 original articles; 18 articles were included. Significant small effect sizes were found on sexual function subscales (total score: P = 0.006; arousal: P = 0.019; lubrication: P = 0.023; satisfaction: P = 0.015; orgasm: P = 0.028), indicating impaired sexual function in women with PCOS. Large effect sizes for the effect of body hair on sex were shown on VAS (P = 0.006); social effect of appearance (P = 0.007); sexual attractiveness (P < 0.001). Satisfaction with sex life was impaired (P < 0.001), but sexual satisfaction was rated equally important in women with PCOS and controls. We conclude that a satisfying sex life is important for women with PCOS; however, sexual function and feelings of sexual attractiveness are impaired. The findings imply that sexual function, sexual satisfaction and psychosocial functioning need to be part of every clinical assessment of women with PCOS.
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Affiliation(s)
- Hester Pastoor
- Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Room Na-1516, 3000 CA Rotterdam 2040, The Netherlands.
| | - Reinier Timman
- Department of Public Health and Primary Care, Leiden University Medical Center, Postzone V0-P, 2300 RC, Leiden 9600, The Netherlands
| | - Cora de Klerk
- Department of Public Health and Primary Care, Leiden University Medical Center, Postzone V0-P, 2300 RC, Leiden 9600, The Netherlands
| | - Wichor M Bramer
- Medical Library, Erasmus MC, University Medical Center, Room Ae-324, 3000 CA Rotterdam 2040, The Netherlands
| | - Ellen Tm Laan
- Department of Sexology and Psychosomatic OBGYN, Academic Medical Center, University of Amsterdam, Room H4-140, Meibergdreef 9, Amsterdam, AZ 1105, The Netherlands
| | - Joop Se Laven
- Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Room Na-1516, 3000 CA Rotterdam 2040, The Netherlands
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10
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Stenyaeva NN, Chritinin DF, Chausov AA, Sukhikh GT. [Sexual functioning and sexual dysfunction in women with infertility]. Zh Nevrol Psikhiatr Im S S Korsakova 2017; 117:22-27. [PMID: 29171484 DOI: 10.17116/jnevro201711710122-27] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM To study sexual dysfunction and assess the need in sexological care to improve quality of life of women with infertility. MATERIAL AND METHODS Sexual functioning was studied in 329 women with infertility and 722 women who underwent an outpatient gynecological examination using a clinical interview and the Female Sexual Function Index (FSFI). RESULTS In 24.01% of women with infertility, the total FSFI score was correlated with the presence of clinically relevant disorders. Sexual dysfunction was identified in 16.1% of women with infertility including libido disorder (84.9%), dyspareunia (30.2%) and orgasmic dysfunction (13.2%). The latent forms of sexual dysfunction were identified as well. CONCLUSION The study showed a high need for curative and preventive sexological care to improve quality of life of women with infertility.
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Affiliation(s)
- N N Stenyaeva
- Research Center for Obstetrics, Gynecology and Perinatology, Moscow, Russia
| | - D F Chritinin
- Sechenov First Moscow State Medical University, Moscow, Russia
| | - A A Chausov
- Research Center for Obstetrics, Gynecology and Perinatology, Moscow, Russia
| | - G T Sukhikh
- Research Center for Obstetrics, Gynecology and Perinatology, Moscow, Russia; Sechenov First Moscow State Medical University, Moscow, Russia
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11
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Leeners B, Wischmann T, Tschudin S. Unerfüllter Kinderwunsch und Sexualität. GYNAKOLOGISCHE ENDOKRINOLOGIE 2017. [DOI: 10.1007/s10304-017-0142-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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12
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Kızılay F, Şahin M, Altay B. Do sperm parameters and infertility affect sexuality of couples? Andrologia 2017; 50. [PMID: 28766811 DOI: 10.1111/and.12879] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2017] [Indexed: 11/30/2022] Open
Abstract
We aimed to analyse the relationship between sperm parameters and International Index of Erectile Function (IIEF) score, the Female Sexual Function Index (FSFI) score, the testosterone (T) level in infertile men and between FSFI score and partners' fertility. Patients were divided into three groups; (group 1: azoospermia [n = 57], group 2: sperm count <15 million [n = 41], group 3: sperm count >15 million [n = 81]). Patients and their partners filled the IIEF and FSFI forms. The normality of the tests was analysed with Kolmogorov-Smirnov and Shapiro-Wilk tests. Spearman's rho test, a nonparametric test, was used to correlate the data. A value of p < .05 was considered statistically significant. There was a positive correlation between the sperm count, other sperm parameters, morphology and motility and IIEF score, FSFI score and T (p = .037, .028 and .041 respectively). We found a positive correlation between IIEF score and FSFI score (p = .182). Infertile partners' FSFI score was lower than fertile partners' scores (p = .023). Male infertility causes severe sexual dysfunction in couples, and female sexual dysfunction increases in parallel to that of men. Male sexual function also tends to decrease with low sperm count. While the clinician evaluates infertile couples, psychological and sexual functions should also be evaluated and patients should not be deprived of appropriate treatment.
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Affiliation(s)
- Fuat Kızılay
- Urology Department, Ege University Medical Faculty Hospital, İzmir, Turkey
| | - Mehmet Şahin
- Urology Department, Ege University Medical Faculty Hospital, İzmir, Turkey
| | - Barış Altay
- Urology Department, Ege University Medical Faculty Hospital, İzmir, Turkey
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Mendonça CRD, Arruda JT, Noll M, Campoli PMDO, Amaral WND. Sexual dysfunction in infertile women: A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol 2017. [PMID: 28628848 DOI: 10.1016/j.ejogrb.2017.06.013] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE This study aimed to assess the prevalence of sexual dysfunction and Female Sexual Function Index (FSFI) score in women with infertility. STUDY DESIGN A systematic search of the literature was conducted using PubMed, EMBASE, IBECS, and LILACS. The search was limited to articles published from January 2000 to September 2016, without language restriction. Data were analyzed using Stata 12.0. Random effects meta-analyses in weighted mean difference (WMD) were performed for six comparative studies (infertility versus fertility). Heterogeneity was estimated using I2. Moreover, to explore the heterogeneity sources among the studies, meta-regression analyses were also performed. Quality of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation guidelines, and risk of bias, with a graphic funnel. RESULTS Meta-analysis was performed in 11 of 13 comparative studies. The result indicated a significant association between an increase in sexual dysfunction and infertility in women (WMD=-0.16, 95% confidence interval=-0.254 to -0.084, p<0.001), and high heterogeneity between studies was noted (I2=98.6%, p<0.000). Meta-regression analysis did not indicate heterogeneity (I2=0.00%). We also performed a meta-analysis of individual FSFI domains in 10 studies. Infertile women had problems with lubrication, orgasm, and satisfaction. Meta-regression analysis also showed that heterogeneity had no influence on the final results of all the analyses. CONCLUSIONS Infertility was associated with an increase in female sexual dysfunction. The most affected areas of sexual function were lubrication, orgasm, and satisfaction.
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Affiliation(s)
| | | | - Matias Noll
- Federal Institute Goiano, Campus Ceres, Goiás, Ceres, Brazil
| | | | - Waldemar N do Amaral
- Department of Gynaecology and Obstetrics, School of Medicine, Federal University of Goiás, Goiânia, Brazil
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14
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Gremigni P, Casu G, Mantoani Zaia V, Viana Heleno MG, Conversano C, Barbosa CP. Sexual satisfaction among involuntarily childless women: A cross-cultural study in Italy and Brazil. Women Health 2016; 58:1-15. [PMID: 27922291 DOI: 10.1080/03630242.2016.1267690] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Infertility has been negatively associated with sexual satisfaction. This study aimed to estimate the relation of infertility to sexual satisfaction from a cross-cultural perspective, comparing Italian and Brazilian women. Between June 2012 and January 2013, 528 women seeking assisted reproduction technology (ART) treatment in Italy (39%) or Brazil (61%) completed self-reports of sexual satisfaction (ISS) and infertility-related stress in the marital domain (IRS). IRS was the same across countries. ISS differed, with 34.31% of the Italians and 43.52% of the Brazilians being sexually dissatisfied at a clinical level (ISS score >30). Multiple logistic regression models showed that being sexually dissatisfied at a clinical level was associated with lower education and higher IRS among Italian women, regardless of having a diagnosed cause of infertility. It was instead associated with higher IRS only among the Brazilian women who had a diagnosed cause of infertility. These findings suggest that, regardless of nationality, sexual satisfaction and infertility-related stress need to be addressed in the treatment of infertile women turning to ART. However, as factors associated with these dimensions vary across countries, interventions to promote sexual satisfaction among infertile women should be adapted to their specific socio-cultural context.
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Affiliation(s)
- Paola Gremigni
- a Department of Psychology , University of Bologna , Bologna , Italy
| | - Giulia Casu
- a Department of Psychology , University of Bologna , Bologna , Italy
| | - Victor Mantoani Zaia
- b School of Medical and Health Sciences , Methodist University , São Paulo , Brazil
| | | | - Ciro Conversano
- c Department of Surgical, Medical, Molecular & Critical Area Pathology , University of Pisa , Pisa , Italy
| | - Caio Parente Barbosa
- d Ideia Fértil Institute and Graduate Program of Faculdade de Medicina do ABC , São Paulo , Brazil
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15
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Dabaja AA, Goldstein M. When is a varicocele repair indicated: the dilemma of hypogonadism and erectile dysfunction? Asian J Androl 2016; 18:213-6. [PMID: 26696437 PMCID: PMC4770488 DOI: 10.4103/1008-682x.169560] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
In the past, the indications for varicocelectomy are primarily for infertility with abnormal semen parameters, testicular hypotrophy/atrophy in adolescents, and/or pain. The surgical treatment of varicocele for hypogonadism is controversial and debated. Recently, multiple reports in the literature have suggested that varicocele is associated with hypogonadism and varicocele repair can increase testosterone levels. Men with hypogonadal symptoms should have at least two serum testosterone levels. Microsurgical varicocelectomy may be beneficial for men with clinically palpable varicoceles with documented hypogonadism. In this review, we summarize the most recent literature linking varicocele to hypogonadism and sexual dysfunction and the impact of repair on serum testosterone levels. We performed a search of the published English literature. The key words used were “varicocele and hypogonadism” and “varicocele surgery and testosterone.” We included published studies after 1998. We, also, evaluated the effect of surgery on the changes in the serum testosterone level regardless of the indication for the varicocele repair.
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Affiliation(s)
| | - Marc Goldstein
- Department of Male Reproductive Medicine, Weill Cornell Medical College, New York, USA
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Swierkowski-Blanchard N, Alter L, Salama S, Muratorio C, Bergere M, Jaoul M, Vialard F, Bailly M, Selva J, Boitrelle F. To be or not to be [fertile], that is the question. Basic Clin Androl 2016; 26:12. [PMID: 27777778 PMCID: PMC5059960 DOI: 10.1186/s12610-016-0040-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 08/25/2016] [Indexed: 11/24/2022] Open
Abstract
Background According to our literature analysis, there are no data focused on spermatozoa emotional representations in childless men and data on the emotional repercussions of a diagnosis of infertility on men are still scarce. Thus, in this work, we investigated what the presence or absence of spermatozoa in the semen symbolize for men. Material and methods To answer this question, 441 childless heterosexual men participated in an anonymous, prospective, Internet-based survey. Results In response to the question “What would having a high or normal sperm count symbolize for you?” the most frequent answer was “ability to father a child”. Men living with a partner were significantly more likely than single men to answer “ability to father a child” (p < 0.05) and less likely to answer “virility” and/or “ability to have an erection/ejaculation” (p = 0.001). In response to the question “If you found out that you had a low sperm count or no spermatozoa at all, how would you feel?”, most of the men stated that they would be disappointed. Men living with a partner were more likely to state that they would feel ashamed (p < 0.05) or guilty with regard to their partner (p < 0.0001). Conclusions These preliminary results should help us to improve (i) the way that male infertility is announced (it is easier to find the right words if one understands the possible importance of having a high sperm count) and (ii) the psychological, marital and sexual counselling provided to men with a diagnosis of infertility.
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Affiliation(s)
- N Swierkowski-Blanchard
- Department of Reproductive Biology, Cytogenetics and Gynaecology, Poissy General Hospital, F-78303 Poissy, France ; EA7404-GIG, UFR des Sciences de la Santé Simone Veil, Université Paris-Saclay, Montigny le Bretonneux, France
| | - L Alter
- Department of Reproductive Biology, Cytogenetics and Gynaecology, Poissy General Hospital, F-78303 Poissy, France ; EA7404-GIG, UFR des Sciences de la Santé Simone Veil, Université Paris-Saclay, Montigny le Bretonneux, France
| | - S Salama
- Department of Reproductive Biology, Cytogenetics and Gynaecology, Poissy General Hospital, F-78303 Poissy, France ; EA7404-GIG, UFR des Sciences de la Santé Simone Veil, Université Paris-Saclay, Montigny le Bretonneux, France
| | - C Muratorio
- Department of Reproductive Biology, Cytogenetics and Gynaecology, Poissy General Hospital, F-78303 Poissy, France ; EA7404-GIG, UFR des Sciences de la Santé Simone Veil, Université Paris-Saclay, Montigny le Bretonneux, France
| | - M Bergere
- Department of Reproductive Biology, Cytogenetics and Gynaecology, Poissy General Hospital, F-78303 Poissy, France ; EA7404-GIG, UFR des Sciences de la Santé Simone Veil, Université Paris-Saclay, Montigny le Bretonneux, France
| | - M Jaoul
- Department of Reproductive Biology, Cytogenetics and Gynaecology, Poissy General Hospital, F-78303 Poissy, France ; EA7404-GIG, UFR des Sciences de la Santé Simone Veil, Université Paris-Saclay, Montigny le Bretonneux, France
| | - F Vialard
- Department of Reproductive Biology, Cytogenetics and Gynaecology, Poissy General Hospital, F-78303 Poissy, France ; EA7404-GIG, UFR des Sciences de la Santé Simone Veil, Université Paris-Saclay, Montigny le Bretonneux, France
| | - M Bailly
- Department of Reproductive Biology, Cytogenetics and Gynaecology, Poissy General Hospital, F-78303 Poissy, France ; EA7404-GIG, UFR des Sciences de la Santé Simone Veil, Université Paris-Saclay, Montigny le Bretonneux, France
| | - J Selva
- Department of Reproductive Biology, Cytogenetics and Gynaecology, Poissy General Hospital, F-78303 Poissy, France ; EA7404-GIG, UFR des Sciences de la Santé Simone Veil, Université Paris-Saclay, Montigny le Bretonneux, France
| | - F Boitrelle
- Department of Reproductive Biology, Cytogenetics and Gynaecology, Poissy General Hospital, F-78303 Poissy, France ; EA7404-GIG, UFR des Sciences de la Santé Simone Veil, Université Paris-Saclay, Montigny le Bretonneux, France
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Hendriks S, Hessel M, Mochtar MH, Meissner A, van der Veen F, Repping S, Dancet EAF. Couples with non-obstructive azoospermia are interested in future treatments with artificial gametes. Hum Reprod 2016; 31:1738-48. [PMID: 27130613 DOI: 10.1093/humrep/dew095] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 03/23/2016] [Indexed: 12/26/2022] Open
Abstract
STUDY QUESTION Would couples diagnosed with non-obstructive azoospermia (NOA) consider two future treatments with artificial gametes (AGs) as alternatives for testicular sperm extraction followed by ICSI (TESE-ICSI)? SUMMARY ANSWER Most couples with NOA (89%) would opt for treatment with AGs before attempting TESE-ICSI and/or after failed TESE-ICSI. WHAT IS KNOWN ALREADY Couples with NOA who undergo TESE-ICSI have a 25% chance of conceiving a child. Two future treatments that are being developed are 'ICSI with artificial sperm formed from somatic cells' (ICSI with AGs) and 'natural conception after autotransplantation of in vitro proliferated spermatogonial stem cells' (natural conception with AGs). It is unknown what treatment preferences patients have. STUDY DESIGN, SIZE, DURATION A cross-sectional survey conducted in 2012-2013, addressing all 921 couples diagnosed with NOA and treated with TESE-ICSI in Dutch fertility clinics between 2007 and 2012. The coded questionnaires were sent by mail and followed up with two reminders. PARTICIPANTS/MATERIALS, SETTING, METHODS We developed the questionnaire based on a literature review and previous qualitative interviews, and included treatment preference and the valuation of nine treatment characteristics. We assessed reliability of the questionnaires and calculated mean importance scores (MISs: 0-10) of each treatment characteristic. We assessed which patient and treatment characteristics were associated with a couple's hypothetical treatment preference using binominal regression. MAIN RESULTS AND THE ROLE OF CHANCE The vast majority (89%) of the 494 responding couples (response rate: 54%) would potentially opt for AGs as a first and/or a last resort treatment option. More specifically, as a first treatment couples were likely (67%) to prefer natural conception with AGs over TESE-ICSI and less likely to prefer ICSI with AGs over TESE-ICSI (34%). After failed TESE-ICSI, the majority of couples (75%) would want to attempt ICSI with AGs as a last resort option. The most important characteristics of treatment were safety for children (MIS: 8.2), pregnancy rates (MIS: 7.7) and curing infertility (MIS: 6.8). Costs, burden, naturalness and technological sophistication were of about equal importance (MIS: 3.1-4.0). The majority of patients rated conception at home and moral acceptability as not important (MIS: 1.7 and 0.8, respectively), but the importance attributed to these variables did still affect patients' likeliness to opt for AGs. LIMITATIONS AND REASONS FOR CAUTION Couples with NOA not opting for TESE-ICSI were not included and might have other perspectives. Couples' hypothetical choices for AGs might differ from their actual choices once data on the costs, safety and pregnancy rates become available from these new treatment options. WIDER IMPLICATIONS OF THE FINDINGS The interest of couples with NOA in potential future treatments with AGs encourages further pre-clinical research. Priority setting for research and future decision-making on clinical application of AGs should take all characteristics important to patients into account. STUDY FUNDING/COMPETING INTERESTS The authors report no financial or other conflict of interest relevant to the subject of this article.
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Affiliation(s)
- S Hendriks
- Center for Reproductive Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - M Hessel
- Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - M H Mochtar
- Center for Reproductive Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - A Meissner
- Center for Reproductive Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - F van der Veen
- Center for Reproductive Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - S Repping
- Center for Reproductive Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - E A F Dancet
- Center for Reproductive Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands KU Leuven, Department of Development and Regeneration, Leuven University Fertility Clinic, Leuven, Belgium
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Ciocca G, Limoncin E, Mollaioli D, Gravina GL, Carosa E, Di Sante S, Gianfrilli D, Lombardo F, Lenzi A, Jannini EA. SIAMS survey on sexological screening during the assisted reproductive technologies in Italy. J Endocrinol Invest 2015; 38:999-1005. [PMID: 25894866 DOI: 10.1007/s40618-015-0286-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 04/02/2015] [Indexed: 11/29/2022]
Abstract
PURPOSE The assessment of sexual function is fundamental to the Assisted Reproductive Technology (ART). Nevertheless, it is still not a common clinical routine among infertility centres. The aim of this survey is to describe the main aspects of sexological screening that are considered in Italian centres of ART. METHODS After the consensus of the Italian Society of Andrology and Sexual Medicine (SIAMS), a mailing list of reproductive medicine centres was created. Then, we sent a questionnaire concerning the essential characteristics of sexological screening. The respondents to compilers of the questionnaire sent back the information from their centres, and an analysis of absolute frequencies and percentages was performed. RESULTS First, 16 centres completed and returned the questionnaire, while 5 ignored the invitation. The main findings concerned the wide use consideration of vardenafil 10 mg (68.7%; 11/16) for the treatment of erectile dysfunction in comorbidity with reproductive problems, the diffuse administration of International Index of Erectile Function (68.2%; 11/16) and Structured Interview for the Erectile Dysfunction (50%; 8/16) as psychometric tools and lesser use of Female Sexual Function Index (31.2%; 5/16) for the evaluation of female sexuality in the infertile couple. CONCLUSIONS To conclude, we noticed a major focus on male sexuality and the eventual treatment or evaluation of sexual dysfunction compared to female sexuality. This aspect highlights an important issue for clinical practice to strongly consider and eventually reinforce. In this regard, improvement of the assessment and treatment of possible female sexual problems in reproductive medicine seems necessary.
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Affiliation(s)
- G Ciocca
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
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Ghavi F, Jamale S, Mosalanejad L, Mosallanezhad Z. A Study of Couple Burnout in Infertile Couples. Glob J Health Sci 2015; 8:158-65. [PMID: 26573033 PMCID: PMC4873592 DOI: 10.5539/gjhs.v8n4p158] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 06/09/2015] [Indexed: 11/18/2022] Open
Abstract
Introduction: Infertility is a major crisis that can cause psychological problems and emotionally distressing experiences, and eventually affect a couples’ relationship. The objective of this study is to investigate couple burnout in infertile couples who were undergoing treatmentat the Infertility Clinic of Yazd, Iran. Method: The present study is a cross-sectional descriptive one on 98 infertile couples referringto the Infertility Centerof Yazd, Iran, who were chosen on a simple random sampling basis. The measuring tools consisted of the Couple Burnout Measure (CBM) and a demographic questionnaire. The collected data were analyzed using SPSS 16 and the statistical tests of ANOVA and t-test. P-values less than 0.05 were considered as significant. Results: The results show that infertile women experience higher levels of couple burnout than their husbands (p<0.001). Also, a comparison of the scales of couple burnout—psychological burnout (p<0.01), somatic burnout (p<0.01), and emotional burnout (p<0.001)—between wives and husbands show that women are at greater risk. Conclusion: Infertile couples’ emotional, mental, and sexual problems need to be addressed as part of the infertility treatment programs, and psychotherapists should be included in the medical team.
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Affiliation(s)
- Fatemeh Ghavi
- Faculty of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
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20
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Cserepes RE, Bugán A, Korösi T, Toth B, Rösner S, Strowitzki T, Wischmann T. Infertility Specific Quality of Life and Gender Role Attitudes in German and Hungarian Involuntary Childless Couples. Geburtshilfe Frauenheilkd 2014. [PMID: 25484375 DOI: 10.1055/s-0034-1383235.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2022] Open
Abstract
Introduction: As gender role attitudes and the evaluation of parenthood and childlessness have subtle variations in each society, cross-country studies focusing on infertility are needed to draw a complex picture in the psychosocial context of infertility. This study investigates similarities and differences between German and Hungarian infertile couples regarding infertility specific quality of life and personal gender role attitudes. Methods: A cross-sectional study was conducted with data of 540 participants (270 couples) attending the first fertility consultation in one fertility clinic in Germany and in five fertility clinics in Hungary. Data were collected between February 2012 and March 2013. Two psychological questionnaires were applied: The FertiQoL to measure infertility specific quality of life and the PAQ to measure gender role attitudes like "instrumental" acting (as a traditional "masculine" attitude) and "expressive" communicating (as a traditional "femine" attitude) and their combinations "combined" attitude (as both "instrumental" and "expressive") and "neutral" attitude (neither "instrumental" nor "expressive"). Results: German couples seeking assisted reproduction treatment are older aged and have longer lasting relationships than Hungarian couples. Hungarian couples scored higher on all quality of life scales than did German couples. In the Hungarian group, "combined" attitudes (use of both "expressive" and "instrumental" attitudes) is associated with higher levels of quality of life compared with other gender role attitudes. In the German group, individuals with "combined" attitudes seem to show better quality of life than those in "expressive" and "neutral" clusters. Conclusions: The strategy of using combined "expressive" and "instrumental" attitudes proved to act as a buffer against infertility-related stress for both members of the couple in two European countries and can therefore be recommended as helpful in counselling the infertile couple.
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Affiliation(s)
- R E Cserepes
- Department of Behavioural Sciences, University of Debrecen, Debrecen, Hungary
| | - A Bugán
- Department of Behavioural Sciences, University of Debrecen, Debrecen, Hungary
| | | | - B Toth
- Department of Gynaecological Endocrinology and Reproductive Medicine, Women's Hospital, University of Heidelberg, Heidelberg, Germany
| | - S Rösner
- Department of Gynaecological Endocrinology and Reproductive Medicine, Women's Hospital, University of Heidelberg, Heidelberg, Germany
| | - T Strowitzki
- Department of Gynaecological Endocrinology and Reproductive Medicine, Women's Hospital, University of Heidelberg, Heidelberg, Germany
| | - T Wischmann
- Institute of Medical Psychology, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
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21
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Cserepes RE, Bugán A, Korösi T, Toth B, Rösner S, Strowitzki T, Wischmann T. Infertility Specific Quality of Life and Gender Role Attitudes in German and Hungarian Involuntary Childless Couples. Geburtshilfe Frauenheilkd 2014; 74:1009-1015. [PMID: 25484375 DOI: 10.1055/s-0034-1383235] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2014] [Revised: 10/09/2014] [Accepted: 10/10/2014] [Indexed: 10/24/2022] Open
Abstract
Introduction: As gender role attitudes and the evaluation of parenthood and childlessness have subtle variations in each society, cross-country studies focusing on infertility are needed to draw a complex picture in the psychosocial context of infertility. This study investigates similarities and differences between German and Hungarian infertile couples regarding infertility specific quality of life and personal gender role attitudes. Methods: A cross-sectional study was conducted with data of 540 participants (270 couples) attending the first fertility consultation in one fertility clinic in Germany and in five fertility clinics in Hungary. Data were collected between February 2012 and March 2013. Two psychological questionnaires were applied: The FertiQoL to measure infertility specific quality of life and the PAQ to measure gender role attitudes like "instrumental" acting (as a traditional "masculine" attitude) and "expressive" communicating (as a traditional "femine" attitude) and their combinations "combined" attitude (as both "instrumental" and "expressive") and "neutral" attitude (neither "instrumental" nor "expressive"). Results: German couples seeking assisted reproduction treatment are older aged and have longer lasting relationships than Hungarian couples. Hungarian couples scored higher on all quality of life scales than did German couples. In the Hungarian group, "combined" attitudes (use of both "expressive" and "instrumental" attitudes) is associated with higher levels of quality of life compared with other gender role attitudes. In the German group, individuals with "combined" attitudes seem to show better quality of life than those in "expressive" and "neutral" clusters. Conclusions: The strategy of using combined "expressive" and "instrumental" attitudes proved to act as a buffer against infertility-related stress for both members of the couple in two European countries and can therefore be recommended as helpful in counselling the infertile couple.
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Affiliation(s)
- R E Cserepes
- Department of Behavioural Sciences, University of Debrecen, Debrecen, Hungary
| | - A Bugán
- Department of Behavioural Sciences, University of Debrecen, Debrecen, Hungary
| | | | - B Toth
- Department of Gynaecological Endocrinology and Reproductive Medicine, Women's Hospital, University of Heidelberg, Heidelberg, Germany
| | - S Rösner
- Department of Gynaecological Endocrinology and Reproductive Medicine, Women's Hospital, University of Heidelberg, Heidelberg, Germany
| | - T Strowitzki
- Department of Gynaecological Endocrinology and Reproductive Medicine, Women's Hospital, University of Heidelberg, Heidelberg, Germany
| | - T Wischmann
- Institute of Medical Psychology, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
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Wischmann T, Schilling K, Toth B, Rösner S, Strowitzki T, Wohlfarth K, Kentenich H. Sexuality, Self-Esteem and Partnership Quality in Infertile Women and Men. Geburtshilfe Frauenheilkd 2014; 74:759-763. [PMID: 25221344 DOI: 10.1055/s-0034-1368461] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Revised: 04/17/2014] [Accepted: 04/23/2014] [Indexed: 10/24/2022] Open
Abstract
Introduction: Infertile couples often report quality-of-life impairments, especially in terms of sexuality, self-esteem and partnership quality. So far, there have been no systematic studies of the sex lives and behaviour of infertile women and men before and after the emergence of their mutual desire for a child. Materials and Methods: From February 2010 to August 2010 all couples starting treatment either at Heidelberg University's Women's Hospital or at the Fertility Center Berlin were asked to fill out the Self-Esteem and Relationship Questionnaire (SEAR). A total of n = 158 women and n = 153 men participated in the study. Results: Decreasing tendencies were observable for both partners in the domains Sexual Relationship Satisfaction and Confidence and in the subscales Self-Esteem and Overall Relationship Satisfaction. There were especially clear indications of a loss of spontaneous sexuality during the experience of infertility. We were also able to establish that infertility has a negative impact on women's self-esteem. Discussion: The results of this study indicate that SEAR can be used as a feasible instrument for identifying infertile women and men whose infertility has a negative effect on their relationship quality and/or sex lives.
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Affiliation(s)
- T Wischmann
- Institute of Medical Psychology, University Hospital Heidelberg, Heidelberg
| | - K Schilling
- Institute of Medical Psychology, University Hospital Heidelberg, Heidelberg
| | - B Toth
- Gynaecological Endocrinology and Reproductive Medicine, Heidelberg University Women's Hospital, Heidelberg
| | - S Rösner
- Gynaecological Endocrinology and Reproductive Medicine, Heidelberg University Women's Hospital, Heidelberg
| | - T Strowitzki
- Gynaecological Endocrinology and Reproductive Medicine, Heidelberg University Women's Hospital, Heidelberg
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Piva I, Lo Monte G, Graziano A, Marci R. A literature review on the relationship between infertility and sexual dysfunction: Does fun end with baby making? EUR J CONTRACEP REPR 2014; 19:231-7. [DOI: 10.3109/13625187.2014.919379] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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