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Fertility-related quality of life in subfertile women undergoing tubal testing with transvaginal hydrolaparoscopy or hysterosalpingography. Eur J Obstet Gynecol Reprod Biol 2022; 274:19-22. [PMID: 35561566 DOI: 10.1016/j.ejogrb.2022.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 02/19/2022] [Accepted: 04/09/2022] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Both subfertility and its management can have significant impact on quality of life (QoL). Tubal patency testing as part of the fertility work-up, is considered to cause more physical complaints and stress than other tests. Pain scores for HSG are higher than for THL, but acceptability of the procedures was found to be comparable. Fertility-related QoL has not yet been studied in women undergoing tubal patency testing. STUDY DESIGN We performed a standardized questionnaire study alongside a previously reported randomized controlled trial comparing THL and HSG in subfertile women, in which 24-month live birth rates occurred in 58.5% versus 55.4%, respectively. We randomly assigned 300 subfertile women to THL or HSG between May 2013 and October 2016. Women were eligible if they were undergoing a fertility work-up with an indication for evaluation of tubal patency. Fertility-related QoL was measured six weeks after the procedure with the validated FertiQoL questionnaire. The scores for the Core scale and subscales between THL and HSG were compared using Mann-Whitney-U test and multiple linear regression analysis. RESULTS The questionnaire was completed by 84 women in the THL group (56%) and 96 women in the HSG group (64%). Core scores were 74.6 ± 12.8 for THL and 73.4 ± 12.4 for HSG (p = 0.39). Scores for the Emotional domain were 64.5 ± 19.0 for THL versus 66.0 ± 16.3 (p = 0.67) for HSG. Scores for the 'Mind-body' domain for THL were 76.9 ± 15.6 versus 74.1 ± 18.0 for HSG (p = 0.42), while scores for the Relational domain were 79.2 ± 12.9 for THL and 76.9 ± 15.6 for HSG (p = 0.21). Scores for the Social domain for THL were 77.9 ± 15.1 versus 76.7 ± 14.1, (p = 0.42). The multiple linear regression analysis showed only a statistical significant positive effect of older age on the score for the Emotional domain (p = 0.015). CONCLUSION In a preselected group of women with low risk for tubal pathology we did not find differences in fertility-related QoL between tubal patency testing with THL versus HSG.
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Wang YL, Gao HX, Wang JS, Wang JH, Bo L, Zhang TT, Dai YL, Gao LL, Liu Q, Zhang JJ, Cai JM, Yu JQ, Li YX. Immersive virtual reality as analgesia for women during hysterosalpingography: study protocol for a randomized controlled trial. Trials 2020; 21:102. [PMID: 31959220 PMCID: PMC6972014 DOI: 10.1186/s13063-019-4023-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Accepted: 12/21/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Hysterosalpingography (HSG) is an accepted radiologic diagnostic modality for initial infertility workup, and is generally considered uncomfortable and painful. However, the management of pain related to HSG remains inefficient. As an emerging nonpharmacologic and noninvasive pain control strategy, virtual reality (VR) distraction has been successfully used in areas such as burns, blunt force trauma, hospital-based needle procedures, dental/periodontal procedures, and urological endoscopy patients. This study aims to evaluate the analgesic effect of VR during HSG. METHODS/DESIGN A single-center, parallel-group, randomized controlled trial will be carried out in the Radiology Department of Yinchuan Women and Children Healthcare Hospital, Yinchuan. A total of 200 participants who are scheduled for HSG will be enrolled in this study. The participants will be randomized (1:1) into two groups: a VR group and a blank control group. The VR group will receive routine care plus immersive VR intervention and the blank control group will receive routine care. Outcomes will be monitored at baseline, immediately after HSG and 15 min after HSG for each group. The primary outcome is the worst pain score during HSG by a visual analog scale (VAS). The secondary outcomes include: affective pain, cognitive pain, and anxiety during the HSG procedure; worst pain within 15 min after HSG; patient satisfaction and acceptance with pain management; physiological parameters; adverse effects; HSG results; and immersion perception score of the VR system (for the VR condition only). DISCUSSION This study will focus on exploring a simply operated, noninvasive and low-cost analgesia during the HSG procedure. The results of this trial will provide data on the feasibility and safety of VR distraction therapy during HSG. TRIAL REGISTRATION Chinese Clinical Trial Register, ChiCTR1900021342. Registered on 16 February 2019.
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Affiliation(s)
- Yi-Ling Wang
- School of Nursing, Ningxia Medical University, 1160 Sheng Li Street, Yinchuan, 750004 China
- Nursing Department, The First People’s Hospital of Yinchuan, 2 Li Qun Street, Yinchuan, 750004 China
| | - Hai-Xiang Gao
- School of Nursing, Ningxia Medical University, 1160 Sheng Li Street, Yinchuan, 750004 China
| | - Jin-She Wang
- School of Science, Ningxia Medical University, 1160 Sheng Li Street, Yinchuan, 750004 China
| | - Jing-Hui Wang
- Radiology Department, Yinchuan Women and Children Healthcare Hospital, 56 Wen Hua Street, Yinchuan, 750004 China
| | - Lei Bo
- Foreign Language Teaching Department, Ningxia Medical University, 1160 Sheng Li Street, Yinchuan, 750004 China
| | - Ting-Ting Zhang
- School of Nursing, Ningxia Medical University, 1160 Sheng Li Street, Yinchuan, 750004 China
| | - Ya-Liang Dai
- Nursing Department, The First People’s Hospital of Yinchuan, 2 Li Qun Street, Yinchuan, 750004 China
| | - Lu-Lu Gao
- School of Public Health and Management, Ningxia Medical University, 1160 Sheng Li Street, Yinchuan, 750004 China
| | - Qiang Liu
- School of Preclinical Medical Sciences, Ningxia Medical University, 1160 Sheng Li Street, Yinchuan, 750004 China
| | - Jun-Jun Zhang
- School of Nursing, Ningxia Medical University, 1160 Sheng Li Street, Yinchuan, 750004 China
| | - Ju-Min Cai
- School of Nursing, Ningxia Medical University, 1160 Sheng Li Street, Yinchuan, 750004 China
| | - Jian-Qiang Yu
- Department of Pharmacology, Pharmaceutical Institute of Ningxia Medical University, 1160 Sheng Li Street, Yinchuan, 750004 China
| | - Yu-Xiang Li
- School of Nursing, Ningxia Medical University, 1160 Sheng Li Street, Yinchuan, 750004 China
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Guvenc G, Bektas Pardes B, Kinci MF, Karasahin KE. Effect of education and counselling on reducing pain and anxiety in women undergoing hysterosalpingography: A randomised controlled trial. J Clin Nurs 2020; 29:1653-1661. [PMID: 31889350 DOI: 10.1111/jocn.15166] [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: 08/08/2019] [Revised: 10/31/2019] [Accepted: 12/20/2019] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To investigate the effects of education and counselling on anxiety and pain in women undergoing hysterosalpingography (HSG) as part of infertility treatment. BACKGROUND The hysterosalpingography has an important diagnostic role in finding the cause of infertility and making a decision on management of treatment. In addition, it is considered a feared procedure in the infertility process and the one about which very little is known. Women often experience anxiety and pain during the HSG procedure. DESIGN A randomised controlled trial. METHODS The CONSORT guidelines have been used to describe the methods. Women who were diagnosed with infertility between February-October 2016 were included in the study. The participants were randomised and divided into intervention (52) and control (53) groups. The sociodemographic and obstetric data collection form, the State-Trait Anxiety Inventory and a visual analogue scale were used before the procedure. After the questionnaires were applied to the intervention group, individual learning and counselling sessions were given about the hysterosalpingography process. Brochures were also distributed to the patients for their reference after the learning session. The control group received standard care. RESULTS When the intervention and control groups were compared, it was found that the education and counselling given before the HSG procedure significantly decreased the level of pain and anxiety felt by women. In addition, a significant positive correlation was found between pain and anxiety after the training in the intervention group. CONCLUSIONS This study indicates that the education and counselling given to women before the HSG procedure are effective interventions for reducing pain and anxiety in women undergoing HSG. RELEVANCE TO CLINICAL PRACTICE With the application of HSG education and counselling, and the distribution of brochures to each patient, pain and anxiety can be reduced during the HSG procedure.
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Affiliation(s)
- Gulten Guvenc
- Gulhane Faculty of Nursing, University of Health Sciences, Ankara, Turkey
| | - Burcin Bektas Pardes
- Department of Nursing, University of Health Sciences, Gulhane Education and Research Hospital, Ankara, Turkey
| | - Mehmet Ferdi Kinci
- Obstetrics and Gynecology Ankara, University of Health Sciences, Gulhane Education and Research Hospital, Ankara, Turkey
| | - Kazım Emre Karasahin
- Obstetrics and Gynecology Ankara, University of Health Sciences, Gulhane Education and Research Hospital, Ankara, Turkey
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Fernández-Sola C, Martínez-Caba MI, Hernández-Padilla JM, Carmona-Samper E, Granero-Molina J. Experiences of Spanish women undergoing hysterosalpingography as part of the infertility process: a phenomenological study. J Clin Nurs 2016; 25:494-504. [PMID: 26818374 DOI: 10.1111/jocn.13077] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2015] [Indexed: 12/16/2022]
Abstract
AIMS AND OBJECTIVES To describe and understand the experiences and perceptions of women who undergo hysterosalpingography as part of the infertility process. BACKGROUND Nurses and midwives should conduct research into the emotional aspects of caring for patients undergoing infertility treatment. The hysterosalpingography is considered to be the most feared test in the infertility process and the one about which very little is known. DESIGN A phenomenological qualitative study. METHODS Ten Spanish women who had undergone hysterosalpingography participated in this study. In-depth interviews were carried out between October 2012-May 2013. Data analysis was performed with the help of atlas.ti software to identify emerging themes. RESULTS The experience of the participants who underwent hysterosalpingography during the infertility process is represented by the following three themes: (1) becoming a mother to feel complete as a person and as a woman, with the subthemes 'maternity as a life objective' and 'maternity in terms of gender identity'; (2) infertility--an intimate experience which provokes negative feelings, with the subthemes 'negative feelings regarding own infertility' and 'infertility as an experience that is little shared with others'; (3) Undergoing hysterosalpingography, with the subthemes 'feelings regarding hysterosalpingography', 'treatment by medical providers' and 'areas for improvement regarding the service given by the providers'. CONCLUSION For women who undergo hysterosalpingography, maternity may be seen as a life objective that could identify them as women. Results suggest that although infertility is experienced with negative feelings such as anxiety, frustration and sadness, hysterosalpingography seems to be related with both hope and fear when facing the test. RELEVANCE TO CLINICAL PRACTICE Knowing the experiences of these women could help nurses, midwives and physicians to provide better patient-centred care.
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Affiliation(s)
- Cayetano Fernández-Sola
- Department of Nursing Science, Physiotherapy and Medicine, University of Almeria, Almeria, Spain.,Faculty of Health Sciences, Universidad Autónoma de Chile, Temuco, Chile
| | | | | | - Esther Carmona-Samper
- Department of Nursing Science, Physiotherapy and Medicine, University of Almeria, Almeria, Spain.,Torrecardenas Hospital, Almeria, Spain
| | - José Granero-Molina
- Department of Nursing Science, Physiotherapy and Medicine, University of Almeria, Almeria, Spain.,Faculty of Health Sciences, Universidad Autónoma de Chile, Temuco, Chile
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Handelzalts JE, Levy S, Peled Y, Binyamin L, Wiznitzer A, Goldzweig G, Krissi H. Information seeking and perceptions of anxiety and pain among women undergoing hysterosalpingography. Eur J Obstet Gynecol Reprod Biol 2016; 202:41-4. [PMID: 27160813 DOI: 10.1016/j.ejogrb.2016.04.037] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 04/12/2016] [Accepted: 04/23/2016] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Hysterosalpingography (HSG) is an accepted diagnostic tool for infertility workup and is considered an invasive procedure that is generally regarded as uncomfortable and painful, though research on psychological consequences is scarce and outdated. The study objective was to investigate women's experience of HSG in terms of fear, anxiety and pain, as compared to colposcopy. STUDY DESIGN This cross sectional questionnaire study was conducted at two public women's health clinics in Israel between January 2013 and March 2014. 137 women were included in the study. 42 consecutively sampled women referred for outpatient HSG and 95 consecutively sampled women referred for outpatient diagnostic colposcopy. The main outcome measures were: state-trait anxiety, information seeking behavior, fear of pain, fear of the results, retrospective pain. RESULTS Compared to those undergoing colposcopy, women undergoing HSG expressed significantly higher anxiety prior to the procedure, feared the pain involved more, and rated the procedure as more painful retrospectively. HSG patients tended to report a higher degree of information seeking. Information seeking was correlated with higher anxiety among HSG but not colposcopy patients. CONCLUSION(S) HSG is a highly stressful procedure associated with fear, anxiety, pain and information seeking. Research is needed to find possible ways of ameliorating these emotions and behaviors as they may have negative impact on patient cooperation.
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Affiliation(s)
| | - Sigal Levy
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Israel
| | - Yoav Peled
- The Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva, Israel
| | - Liat Binyamin
- The Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva, Israel
| | - Arnon Wiznitzer
- The Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva, Israel
| | - Gil Goldzweig
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Israel
| | - Haim Krissi
- The Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva, Israel
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Stevenson EL, Hershberger PE, Bergh PA. Evidence-Based Care for Couples With Infertility. J Obstet Gynecol Neonatal Nurs 2015; 45:100-10; quiz e1-2. [PMID: 26815804 DOI: 10.1016/j.jogn.2015.10.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2015] [Indexed: 11/29/2022] Open
Abstract
When couples cannot achieve pregnancy, they often seek health care from medical and nursing specialists. The care the couple receives begins with a thorough assessment to determine the possible cause of infertility and to plan appropriate care to ensure the best chance for the couple to have a biological child. In this article, we provide an overview of the etiology and evaluation of infertility, the various treatment options available, and the appropriate clinical implications.
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McLindon LA, Beckmann M, Flenady V, McIntyre HD, Chapman M. Women's views of a fertility awareness and hormonal support approach to subfertility. HUM FERTIL 2013; 16:252-7. [PMID: 24171651 DOI: 10.3109/14647273.2013.843791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The aim of this study was to determine the satisfaction among subfertile women of a fertility awareness-based approach, including hormonal therapy to achieve a pregnancy by natural conception. Eighty four women attending a natural fertility service completed a postal questionnaire exploring (1) the acceptability of the sympto-thermal method and (2) the acceptability of using hormone support. Acceptability rates for the fertility charting, clinical service and clinical care were 64.9-91.6%. Acceptability rates were higher in women who did conceive or had experienced past recurrent miscarriages. Taking hormonal luteal support, by any method, was more acceptable for women over 35 years compared to those under 35 years (100% vs. 69.4%, p = 0.014). Vaginal pessaries were the preferred route of administration. The use of a fertility awareness-based method appears to be acceptable amongst subfertile women intending to conceive naturally. Most women using such a method for conception would be open to the use of hormonal support during the fertility cycle or early pregnancy.
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