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Truong LQ, Luong TB, Khanh HTT. Examining the association between coping strategies and perceived social support among Vietnamese infertile women undergoing IVF treatment. PSYCHOL HEALTH MED 2024:1-14. [PMID: 38697127 DOI: 10.1080/13548506.2024.2345273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 04/15/2024] [Indexed: 05/04/2024]
Abstract
The purpose of the study was to examine the association between coping strategies and perceived social support among women diagnosed with infertility and undergoing IVF treatment. A total of 383 Vietnamese women were invited to participate in this study. Participants completed a questionnaire consisting of The Multidimensional Scale of Perceived Social Support, the Copenhagen Multi-centre Psychosocial Infertility coping scales and the Fertility Problem Inventory, and other relevant questions. The results reveal that coping strategies significantly predict some specific types of perceived social supports among women undergoing IVF treatment. Specifically, passive-avoidance coping (PAC) and active-avoidance coping (AAC) predicts a decrease in receiving support from family and friends, whereas active-confronting coping (ACC) predicts an increase in receiving support from these two sources of support. Women who demonstrate increased meaning-based coping (MBC) received all three sources of support including family, friends, and significant others support. Despite some limitations, this study is useful in understanding how coping strategies among women undergoing IVF treatment affects the social support received in the Vietnamese social context. It also emphasizes the importance of psychological support for women facing IVF treatment distress.
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Affiliation(s)
- Lam Quang Truong
- Faculty of Psychology, Vietnam National University, University of Social Sciences and Humanities, Hanoi, Vietnam
| | - Thuy Bich Luong
- Faculty of Sociology, Vietnam National University, University of Social Sciences and Humanities, Hanoi, Vietnam
| | - Ha Truong Thi Khanh
- Faculty of Psychology, Vietnam National University, University of Social Sciences and Humanities, Hanoi, Vietnam
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Simoni MK, Gilstad-Hayden K, Naqvi SH, Pal L, Yonkers KA. Progression of depression and anxiety symptoms in pregnancies conceived by assisted reproductive technology in the United States. J Psychosom Obstet Gynaecol 2022; 43:214-223. [PMID: 34472405 PMCID: PMC10116357 DOI: 10.1080/0167482x.2021.1971193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
PURPOSE Women who utilize assisted-reproductive technology (ART) to achieve pregnancy experience unique circumstances before and during their pregnancy. This study aims to examine the progression of mental health in pregnant women who conceived via various methods of ART to understand gestational time periods of emotional stability or risk specific to these populations. METHODS Secondary analysis of the Yale Pink and Blue Study - a prospective cohort involving women from 137 obstetrical practices in the northeastern United States between 2005-2009. Depressive and anxiety symptoms among spontaneous, planned pregnancies were compared to ART pregnancies using the Edinburgh Postnatal Depression Scale (EPDS) and its anxiety subscale (EPDS-3A), respectively. Generalized Estimating Equations were used to compare group changes (EPDS and EPDS-3A score threshold ≥10) at timepoints of <17 weeks (T1), 28(±2) weeks (T2), and 8(±4) weeks postpartum (T3). RESULTS 1,466 spontaneous, planned pregnancies were compared to 191 pregnancies conceived via ART. Prevalence of depressive symptoms were similar between conception groups. Change in prevalence over time differed significantly between those groups (from T1 to T3 (β 0.59), as well as between spontaneous pregnancies compared to autologous gamete ART pregnancies (from T1 to T2 (β 0.48) and T1 to T3 (β 0.65). Course of anxiety did not differ between conception groups. CONCLUSIONS Women who conceive via ART have different rates of change in depressive symptoms throughout gestation compared to women with spontaneous pregnancies.
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Affiliation(s)
- Michael K Simoni
- Department of Obstetrics, Gynecology & Reproductive Sciences, Yale School of Medicine, New Haven, CT USA
| | | | - Syed H Naqvi
- Department of Obstetrics, Gynecology & Reproductive Sciences, Yale School of Medicine, New Haven, CT USA
| | - Lubna Pal
- Department of Obstetrics, Gynecology & Reproductive Sciences, Yale School of Medicine, New Haven, CT USA
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Casale M. Improving the health and treatment success rates of in vitro fertilization patients with traditional Chinese medicine: Need for more robust evidence and innovative approaches. JOURNAL OF INTEGRATIVE MEDICINE 2022; 20:187-192. [PMID: 35216931 DOI: 10.1016/j.joim.2022.02.004] [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: 07/10/2021] [Accepted: 01/26/2022] [Indexed: 06/14/2023]
Abstract
Maximising access to and the success of fertility treatments should be a priority for global reproductive health, as should overall patient well-being. The demand for in vitro fertilization (IVF) and other assisted fertility treatments has increased over the past decade and is likely to further increase in years to come. Nevertheless, there is still considerable unmet demand for infertility support worldwide. Moreover, the high emotional, physical and financial burden experienced by individuals undergoing IVF cycles can be a risk for their mental and physical health, which in turn can influence treatment continuation and the likelihood of IVF success. Studies from various parts of the world show that most individuals undergoing IVF also use adjunct alternative medicines and procedures, the most common being traditional Chinese medicine (TCM). The complementary and synergistic role of TCM for individuals undergoing IVF is an area that merits further attention and research, both for its potential positive effects on IVF success rates and for its broader physical and mental health benefits. However, much of the existing evidence is not sufficiently robust or consistent for findings to be adopted with confidence. This commentary argues that much work must be done to understand the efficacy and clinical best practices for these integrated approaches. This can be achieved in part by developing more robust and clinically relevant randomized controlled trial protocols, collecting and triangulating evidence through a variety of study designs and methods, and strengthening the collection and pooling of clinic-level data.
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Affiliation(s)
- Marisa Casale
- School of Public Health, University of the Western Cape, Bellville 7535, South Africa.
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Grunberg PH, Da Costa D, Dennis CL, O'Connell S, Lahuec A, Zelkowitz P. 'How did you cope with such concerns?': insights from a monitored online infertility peer support forum. HUM FERTIL 2021:1-15. [PMID: 34347545 DOI: 10.1080/14647273.2021.1959952] [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: 01/06/2023]
Abstract
The Research Question posed was 'What coping strategies do fertility patients and trained peer supporters discuss in an online infertility peer support forum?' A thematic analysis was used to examine 244 online posts from a sample of 39 users (37 women and two men) for themes in coping with fertility-related stressors. Data were collected from Connect, a monitored online discussion forum with trained peer supporters. Connect users ranged from 27 to 44 years of age (mean = 34.38) and 33 (84.6%) were nulliparous at the time of the study. A variety of cognitive-reappraisal and practical management coping strategies was discussed across four themes: (i) balancing interpersonal relationships; (ii) partner support; (iii) uncertainty and lack of control; and (iv) positivity and negativity. Experiences of uncertainty and lack of control related to time and schedule, outcomes and waiting for physical symptoms, and the clinic. Connect users commonly discussed the helpfulness of coping strategies. Connect users actively requested experiential information about ways of coping from other patients and peer supporters, highlighting the importance of lived experience to those currently in treatment. Findings support conceptualizations of infertility coping as a process that is unique to the infertility treatment context and that may change throughout a patient's treatment. Trained peer supporters may benefit fertility patients by normalizing, reappraising, and providing practical strategies to ameliorate difficult infertility-related challenges.
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Affiliation(s)
- Paul H Grunberg
- Department of Psychology, McGill University, Montreal, Canada.,Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada
| | - Deborah Da Costa
- Department of Medicine, Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, McGill University, Montreal, Canada
| | - Cindy-Lee Dennis
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Siobhan O'Connell
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada
| | - Alix Lahuec
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada
| | - Phyllis Zelkowitz
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada.,Department of Psychiatry, McGill University, Montreal, Canada
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Casale M, Carlqvist A. Is social support related to better mental health, treatment continuation and success rates among individuals undergoing in-vitro fertilization? Systematic review and meta-analysis protocol. PLoS One 2021; 16:e0252492. [PMID: 34061903 PMCID: PMC8168841 DOI: 10.1371/journal.pone.0252492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 05/15/2021] [Indexed: 11/19/2022] Open
Abstract
Infertility and its treatment via in-vitro fertilization (IVF) represent a global health area of increasing importance. However, the physical and psychological burden of IVF can negatively impact psychological wellbeing, as well as treatment retention and success. Social support has been found to have positive health effects among populations facing health-related stressors worldwide, and its potential protective role for IVF patients merits further attention. We present a protocol for a systematic review of peer-reviewed published studies quantitatively investigating associations between social support and i) mental health; ii) the decision to (dis)continue with IVF treatment cycles and; iii) IVF success (pregnancy and birth rates); among individuals who are undertaking or have undertaken IVF cycles. Studies will be included if they work with human subjects, provide correlation coefficients between measures of social support and at least one of the outcomes of interest, and are in the English language. Social support may derive from both naturally occurring networks and more formalized sources or interventions. The protocol for this systematic review was developed according to the PRISMA-P guidelines. Ten health-, psychology- and sociology-related databases will be searched using composite search terms that include keywords for ‘IVF’ and ‘social support’. To assess methodological quality, the authors will use a modified version of the Newcastle-Ottawa Scale. Should three or more moderate or good quality studies be identified for any one outcome of interest, correlation meta-analyses, using the Hedges-Olkin method, will be conducted to pool effect sizes and heterogeneity will be assessed. Should the number, quality and characteristics of eligible studies not allow for reliable quantitative synthesis, the authors will limit the analysis to qualitative synthesis, with a focus on implications of findings for future research and programming.
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Affiliation(s)
- Marisa Casale
- Department of Social Policy and Intervention, University of Oxford, Barnett House, Oxford, United Kingdom
- School of Public Health, University of the Western Cape, Bellville, South Africa
- * E-mail: ,
| | - Anna Carlqvist
- Department of Social Policy and Intervention, University of Oxford, Barnett House, Oxford, United Kingdom
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Psychological coping strategies associated with improved mental health in the context of infertility. Arch Womens Ment Health 2021; 24:73-83. [PMID: 32333112 DOI: 10.1007/s00737-020-01029-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 04/02/2020] [Indexed: 10/24/2022]
Abstract
To examine the use of psychological coping strategies across the menstrual cycle in relation to within-person changes in depressed mood, anxious mood, and infertility-related distress, in a sample of women struggling to conceive. Sixty-five women from Canada and the USA (aged 19-43 years) trying to conceive naturally for ≥ 12 months were recruited via social media. On the first day of each participant's menstrual period, and every 3 days until the end of their cycle, participants completed questionnaires assessing depressed and anxious mood, and infertility-related distress. In addition, participants completed a 13-item coping questionnaire assessing four general coping strategies: emotional suppression, active coping, engagement in activities unrelated to trying to conceive, and downplaying the importance of biological children. The within-person effect of daily coping strategies on person-centred mood and infertility-related distress was examined. Day-to-day use of behavioural engagement was associated with lower person-centred depression scores, β(SEM) = - 3.25(.51), p < .0001, anxiety scores, β(SEM) = - 2.07(.36), p < .0001, and infertility-related daily distress, β(SEM) = - .64(.22), p = .005. Downplaying the importance of biological children was also associated with person-centred depression scores, β(SEM) = 1.14(.47), p = .016. Neither active coping nor emotional suppression was related to depression, anxiety, or distress (ps > .0125). These findings point to promising targets of future intervention studies, including promoting increased engagement in behaviours unrelated to conceiving and promoting acceptance, rather than denial and resistance, of feelings throughout the infertility journey.
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7
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Gordon JL, Balsom AA. The psychological impact of fertility treatment suspensions during the COVID-19 pandemic. PLoS One 2020; 15:e0239253. [PMID: 32946479 PMCID: PMC7500693 DOI: 10.1371/journal.pone.0239253] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 09/03/2020] [Indexed: 12/04/2022] Open
Abstract
Purpose To examine the psychological impact of fertility treatment suspensions resulting from the COVID-19 pandemic and to clarify psychosocial predictors of better or worse mental health. Methods 92 women from Canada and the United States (ages 20–45 years) whose fertility treatments had been cancelled were recruited via social media. Participants completed a battery of questionnaires assessing depressive symptoms, perceived mental health impact, and change in quality of life related to treatment suspensions. Potential predictors of psychological outcomes were also examined, including several personality traits, aspects of social support, illness cognitions, and coping strategies. Results 52% of respondents endorsed clinical levels of depressive symptoms. On a 7-point scale, participants endorsed a significant decline in overall quality of life (M(SD) = -1.3(1.3), p < .0001) as well as a significant decline in mental health related to treatment suspensions on a scale from -5 to +5 (M(SD) = -2.1(2.1), p < .001). Several psychosocial variables were found to positively influence these outcomes: lower levels of defensive pessimism (r = -.25, p < .05), greater infertility acceptance (r = .51, p < .0001), better quality social support (r = .31, p < .01), more social support seeking (r = .35, p < .001) and less avoidance of infertility reminders (r = -.23, p = .029). Conclusion Fertility treatment suspensions have had a considerable negative impact on women’s mental health and quality of life. However, these findings point to several protective psychosocial factors that can be fostered in the future to help women cope.
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Affiliation(s)
- Jennifer L. Gordon
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
- * E-mail:
| | - Ashley A. Balsom
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
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Abstract
SummaryThe World Health Organization (WHO) has indicated that 8–12% of couples worldwide experience infertility, and in recent years the number seeking treatment has dramatically increased. The diagnosis and therapy put a heavy psychological and physical burden on most patients, female and male. The incidence of depression in couples presenting for infertility treatment is significantly higher than in comparable fertile couples. Anxiety is significantly higher in infertile couples than in the general population. Professionals have become aware of the importance of providing educational interventions to address patients' fears and concerns, and to better prepare patients for the demands of treatment. Health professionals should follow a patient-centred approach to provide for the specific needs of the couple. Women in general have a positive attitude to seeking psychological help in the form of cognitive-behavioural therapy, couples counselling and infertility counselling.Learning Objectives•Learn about the incidence rates of infertility and its impact on the mental health of the couple.•Know about infertility treatment and its psychological impact.•Learn about the different management strategies that can be helpful in the treatment of mental illness associated with infertility.
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Patel A, Sharma PSVN, Kumar P, Binu VS. Illness Cognitions, Anxiety, and Depression in Men and Women Undergoing Fertility Treatments: A Dyadic Approach. J Hum Reprod Sci 2018; 11:180-189. [PMID: 30158816 PMCID: PMC6094532 DOI: 10.4103/jhrs.jhrs_119_17] [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: 12/13/2022] Open
Abstract
Background Emotional response to infertility is mediated by numerous interrelated psychological variables such as personality, health perceptions, cognitive appraisals, coping, and social support. While men and women respond to infertility differently, illness cognitions are a vital component of their emotional adjustment. The aim of this study is to compare the infertile men and women undergoing fertility treatments on perceived distress, helplessness, acceptance, benefits, anxiety, and depression. Materials and Methods Eighty-one infertile couples, undergoing intrauterine insemination participated in the study. They were assessed on the presence of infertility distress using the fertility problem inventory, for psychiatric morbidity using the Mini International Neuropsychiatric Interview, for affective disturbances using the Hamilton Anxiety and Depression scales, and for illness cognitions using the Illness Cognition Questionnaire. Statistical Analysis Data are analyzed using SPSS version 15. The paired sample t-test is performed for assessing differences on normally distributed data. The Wilcoxon Signed-Rank test is performed for assessing differences in medians obtained on data that was skewed. Results and Discussion Infertile women (wives) were more emotionally distressed, anxious, and depressed than men (husbands). Gender-wise differences were found for perceptions of helplessness and acceptance of infertility. Infertility was perceived to be a nonbeneficial event for both partners investigated. Conclusion Negative cognitions and affective disturbances may contribute to higher treatment burden in couples seeking-assisted conception. The present study suggests that psychosocial intervention for couples plays a central role and should be integrated within the conventional treatments for infertility.
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Affiliation(s)
- Ansha Patel
- Department of Psychiatry, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
| | - P S V N Sharma
- Department of Psychiatry, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
| | - Pratap Kumar
- Department of Obstetrics and Gynaecology, The Manipal Assisted Reproduction Centre, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.,The Manipal Assisted Reproduction Centre, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
| | - V S Binu
- Department of Biostatistics, Dr. M.V. Govindasamy Centre, National Institute of Mental Health and Neuro Sciences (An Institute of National Importance), Bengaluru, Bengaluru, Karnataka, India
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Apfel RJ, Keylor RG. Psychoanalysis and infertility myths and realities. THE INTERNATIONAL JOURNAL OF PSYCHOANALYSIS 2017. [DOI: 10.1516/4089-jbcw-ynt8-qtcm] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Ahmadizadeh S, Bozorgi AS, Kashani L. The role of information therapy in reducing anxiety in patients undergoingin vitrofertilisation treatment. Health Info Libr J 2017; 34:86-91. [DOI: 10.1111/hir.12169] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 12/01/2016] [Indexed: 11/27/2022]
Affiliation(s)
| | - Ashraf Sadat Bozorgi
- Library and Information Sciences Department; School of Humanities; Islamic Azad University; Tehran North Branch Tehran Iran
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12
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Milazzo A, Mnatzaganian G, Elshaug AG, Hemphill SA, Hiller JE. Depression and Anxiety Outcomes Associated with Failed Assisted Reproductive Technologies: A Systematic Review and Meta-Analysis. PLoS One 2016; 11:e0165805. [PMID: 27835654 PMCID: PMC5106043 DOI: 10.1371/journal.pone.0165805] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 10/18/2016] [Indexed: 11/18/2022] Open
Abstract
Objective Our study examined the psychological outcomes associated with failed ART treatment outcomes in men and women. Search Strategy A systematic search for studies published between January 1980 and August 2015 was performed across seven electronic databases. Inclusion Criteria Studies were included if they contained data on psychosocial outcomes taken pre and post ART treatment. Data Extraction and Synthesis A standardised form was used to extract data and was verified by two independent reviewers. Studies were meta-analysed to determine the association of depression and anxiety with ART treatment outcomes. Narrative synthesis identified factors to explain variations in the size and directions of effects and relationships explored within and between the studies. Main Results Both depression and anxiety increased after a ART treatment failure with an overall pooled standardised mean difference (SMD) of 0.41 (95% CI: 0.27, 0.55) for depression and 0.21 (95% CI: 0.13, 0.29) for anxiety. In contrast, depression decreased after a successful treatment, SMD of -0.24 (95% CI: -0.37,-0.11). Both depression and anxiety decreased as time passed from ART procedure. Nonetheless, these remained higher than baseline measures in the group with the failed outcome even six months after the procedure. Studies included in the narrative synthesis also confirmed an association with negative psychological outcomes in relation to marital satisfaction and general well-being following treatment failure. Conclusion Linking ART failure and psychosocial outcomes may elucidate the experience of treatment subgroups, influence deliberations around recommendations for resource allocation and health policy and guide patient and clinician decision making.
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Affiliation(s)
- Adriana Milazzo
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - George Mnatzaganian
- College of Science, Health and Engineering, La Trobe Rural Health School, La Trobe University, Victoria, Australia
| | - Adam G. Elshaug
- Menzies Centre for Health Policy, The University of Sydney, Sydney, New South Wales, Australia
| | - Sheryl A. Hemphill
- Learning Sciences Institute Australia, Faculty of Education and Arts, Australian Catholic University, Melbourne, Victoria, Australia
- School of Psychology, Faculty of Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia
| | - Janet E. Hiller
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
- School of Health Sciences, Swinburne University of Technology, Melbourne, Victoria Australia
- * E-mail:
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Patel A, Sharma PSVN, Narayan P, Binu VS, Dinesh N, Pai PJ. Prevalence and predictors of infertility-specific stress in women diagnosed with primary infertility: A clinic-based study. J Hum Reprod Sci 2016; 9:28-34. [PMID: 27110075 PMCID: PMC4817284 DOI: 10.4103/0974-1208.178630] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND According to the existing literature on infertility, stress appears to be inevitably associated with infertility diagnosis and treatment in sub-fertile individuals. The epidemiological data on the prevalence and predictors of infertility-specific stress in cultural specific scenario are scarce. The objective of the present study was to estimate the prevalence of infertility-specific stress and identify predictors of infertility-specific stress in women diagnosed with primary infertility. MATERIALS AND METHODS This cross-sectional study was conducted on 300 infertile married women, diagnosed with primary infertility. The tools used for the assessment were "semi-structured questionnaire" compiled by the authors, "ICD-10 Classification of Mental and Behavioral Disorders (Clinical Descriptions and Diagnostic Guidelines)," and "Psychological Evaluation Test for infertility." STATISTICAL ANALYSIS Data were analyzed using SPSS (version 15). Chi-square test was used for univariate analysis followed by multiple logistic regressions between stress and the predictor variables. RESULTS AND DISCUSSION The prevalence of stress among women was 80%. Univariate analysis revealed that predictors of stress were years of marital life, duration of infertility, infertility type, history of gynecological surgery, cycles of ovulation induction with timed intercourse and intra-uterine inseminations, present and past psychiatric morbidity, coping difficulties, gynecological diagnosis, and severity of premenstrual dysphoria. Multivariate analysis showed leading associations of stress with infertility type and coping difficulties.
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Affiliation(s)
- Ansha Patel
- Department of Psychiatry, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
| | - P S V N Sharma
- Department of Psychiatry, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
| | - Pratapkumar Narayan
- Department of Obstetrics and Gynaecology, Manipal Assisted Reproductive Centre, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
| | - V S Binu
- Department of Statistics, Manipal University, Manipal, Karnataka, India
| | - N Dinesh
- Department of Clinical Psychology, School of Allied Health Sciences, Manipal University, Manipal, Karnataka, India
| | - Praveena Joglekar Pai
- Department of Obstetrics and Gynaecology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
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Papadatou D, Papaligoura ZG, Bellali T. From Infertility to Successful Third-Party Reproduction: The Trajectory of Greek Women. QUALITATIVE HEALTH RESEARCH 2016; 26:399-410. [PMID: 25568093 DOI: 10.1177/1049732314566322] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The purpose of our phenomenological hermeneutic study was to explore the lived experiences of Greek infertile women who achieve a pregnancy through the use of sperm, oocyte, or embryo donation or surrogate motherhood. Semistructured interviews were conducted with 15 infertile women. Findings suggest that conceiving a child through assisted reproductive technologies (ART) is lived as a highly distressing experience, comprising long waiting periods for medical results, several failed attempts, and treatment options with uncertain outcomes. The analysis of women's accounts revealed a constitutive pattern, journeying between hope and despair, and three associated themes: (a) coping with uncertainty and treatment failures, (b) exploring options and decision making, and (c) being supported by spouse and professionals. Findings illuminate the specific meaning-based coping processes, decision-making patterns, and sources of support that help women who pursue treatment until they give birth to a child, to manage highly stressful situations and critical decisions.
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Affiliation(s)
- Danai Papadatou
- National and Kapodistrian University of Athens, Athens, Greece
| | | | - Thalia Bellali
- Alexandreio Technological Educational Institute, Thessaloniki, Greece
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Lundin U, Elmerstig E. “Desire? Who needs desire? Let's just do it!”– a qualitative study concerning sexuality and infertility at an internet support group. SEXUAL AND RELATIONSHIP THERAPY 2015. [DOI: 10.1080/14681994.2015.1031100] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Stewart LM, Holman CDJ, Semmens JB, Preen D, Mai Q, Hart R. Hospital mental health admissions in women after unsuccessful infertility treatment and in vitro fertilization: an Australian population-based cohort study. PLoS One 2015; 10:e0120076. [PMID: 25807258 PMCID: PMC4373915 DOI: 10.1371/journal.pone.0120076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Accepted: 01/19/2015] [Indexed: 11/18/2022] Open
Abstract
Objective To examine the association between in vitro fertilization (IVF) and later admission to hospital with a mental health diagnosis in women who remained childless after infertility treatment. Methods This was a population-based cohort study using linked administrative hospital and registry data. The study population included all women commencing hospital treatment for infertility in Western Australia between the years 1982 and 2002 aged 20–44 years at treatment commencement who did not have a recorded birth by the end of follow-up (15 August 2010) and did not have a hospital mental health admission prior to the first infertility admission (n=6,567). Of these, 2,623 women had IVF and 3,944 did not. We used multivariate Cox regression modeling of mental health admissions and compared women undergoing IVF treatment with women having infertility treatment but not IVF. Results Over an average of 17 years of follow-up, 411 women in the cohort were admitted to hospital with a mental health diagnosis; 93 who had IVF and 318 who did not. The unadjusted hazard ratio (HR) for a hospital mental health admission comparing women who had IVF with those receiving other infertility treatment was 0.50 (95% confidence interval [CI] 0.40–0.63). After adjustment for age, calendar year and socio-economic status the HR was 0.56 (95% CI 0.44–0.71). Conclusions IVF treatment is associated with a reduced risk of hospital mental health admissions in women after unsuccessful infertility treatment. This may be explained by the healthy cohort effect.
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Affiliation(s)
- Louise M. Stewart
- Centre for Population Health Research, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia
- * E-mail:
| | - C. D’Arcy J. Holman
- School of Population Health, The University of Western Australia, Crawley, Western Australia, Australia
| | - James B. Semmens
- Centre for Population Health Research, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia
| | - David Preen
- School of Population Health, The University of Western Australia, Crawley, Western Australia, Australia
| | - Qun Mai
- School of Population Health, The University of Western Australia, Crawley, Western Australia, Australia
| | - Roger Hart
- School of Women’s and Infants’ Health, The University of Western Australia, King Edward Memorial Hospital, Subiaco, Western Australia, Australia, and Fertility Specialists of Western Australia, Bethesda Hospital, Claremont, Western Australia, Australia
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17
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Benyamini Y, Gefen-Bardarian Y, Gozlan M, Tabiv G, Shiloh S, Kokia E. Coping specificity: the case of women coping with infertility treatments. Psychol Health 2014; 23:221-41. [PMID: 25160052 DOI: 10.1080/14768320601154706] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Customizing the measurement of coping to a specific situation can answer some of the concerns regarding its measurement by checklist. A context-specific measure of coping with infertility was developed on the basis of theoretical principles of coping, interviews with women and providers, and existing findings. Data on the resulting Coping with Infertility questionnaire was collected from 652 Israeli women undergoing treatment and meta-strategies of coping were identified on the basis of a hierarchical structure of the coping subscales. About half of the women also filled in adjustment measures and findings showed differential associations of coping strategies to negative and positive indicators of psychological adjustment. Taking into account coping specificity can highlight strategies that function in ways that are unique to the context. This approach could be useful as a step in the assessment and understanding of coping with a specific health threat, which can guide further research and interventions designed to improve coping effectiveness.
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Phillips E, Elander J, Montague J. An interpretative phenomenological analysis of men’s and women’s coping strategy selection during early IVF treatment. J Reprod Infant Psychol 2014. [DOI: 10.1080/02646838.2014.915391] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Rockliff HE, Lightman SL, Rhidian E, Buchanan H, Gordon U, Vedhara K. A systematic review of psychosocial factors associated with emotional adjustment in in vitro fertilization patients. Hum Reprod Update 2014; 20:594-613. [PMID: 24676468 DOI: 10.1093/humupd/dmu010] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND IVF treatment is usually stressful for patients, but individual differences in emotional response do exist. Differences in the stress response may be related to reproductive outcomes as well as to the development of psychiatric problems. This review collates research exploring which psychosocial factors (e.g. personality traits and coping strategies) are associated with the emotional adjustment of IVF patients. The aim is to reveal what is currently known about risk and protective factors for coping with the stress of IVF treatment and where further enquiry would be most beneficial. METHODS The databases, MEDLINE/PUBMED (US National Library of Medicine), PsycINFO (American Psychological Association), Web of Science (Social Sciences Citation Index) and EMbase, were searched from 1978 to September 2012 using relevant key words. All published peer-reviewed studies exploring associations between psychosocial factors and emotional adjustment outcomes were considered for inclusion. RESULTS There were 23 studies identified for review. One-third of the psychosocial factors explored were found to be significantly related to emotional adjustment outcome measures. Neuroticism and the use of escapist coping strategies were positively associated with distress by multiple studies. Social support was negatively associated with distress by several studies. A number of other psychosocial variables appear to be associated with distress, including self-criticism, dependency, situation appraisals and attachment style, but these have only been explored by one or two studies at most. There is a paucity of research using positive emotional outcome measures (e.g. well-being, positive affect, happiness or life satisfaction) to quantify emotional adjustment. CONCLUSIONS Whilst some psychosocial variables appear to be consistently associated with distress for IVF patients, two-thirds of the variables tested to date do not appear to be associated with emotional adjustment. This review highlights key psychosocial factors to assist the identification of patients at high risk of psychological distress. These findings highlight at least two psychological factors that may be amenable to alteration with psychological or educational interventions. Future work should explore whether experimental manipulation of such psychosocial factors can provide effective stress reduction in this clinical context.
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Affiliation(s)
- Helen E Rockliff
- Department of Clinical Sciences, University of Bristol, Whitson Street, Bristol BS1 3NY, UK
| | - Stafford L Lightman
- Department of Clinical Sciences, University of Bristol, Whitson Street, Bristol BS1 3NY, UK
| | - Emily Rhidian
- Department of Clinical Sciences, University of Bristol, Whitson Street, Bristol BS1 3NY, UK
| | - Heather Buchanan
- School of Community Health Sciences, University of Nottingham, Nottingham NG7 2RD, UK
| | - Uma Gordon
- Bristol Centre for Reproductive Medicine, Southmead Hospital, Bristol BS10 5NB, UK
| | - Kavita Vedhara
- School of Community Health Sciences, University of Nottingham, Nottingham NG7 2RD, UK
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Chochovski J, Moss SA, Charman DP. Recovery after unsuccessful in vitro fertilization: the complex role of resilience and marital relationships. J Psychosom Obstet Gynaecol 2013; 34:122-8. [PMID: 23952170 DOI: 10.3109/0167482x.2013.829034] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The failure rate of in vitro fertilization (IVF) is around 75% per cycle. These unsuccessful attempts can provoke acute clinical depression and other problems. Although practitioners often recommend cognitive reappraisal, rather than avoidance, to cope with these difficulties, previous research has not established the psychosocial determinants of adaptive coping strategies. Arguably, resilience could encourage cognitive reappraisal, because resilient individuals feel confident they can overcome their emotions, whereas marital quality could prevent avoidance, because individuals feel secure enough to reflect upon their distress. Consequently, resilience and marital quality could facilitate recovery over time. To explore these possibilities, 184 women, all of whom had unsuccessfully completed IVF treatment, completed a questionnaire that gauged their levels of self-reported depression since their last IVF attempt as well as resilience and marital quality. Immediately after the unsuccessful attempt, resilience was inversely, whereas marital quality was positively, related to depression. However, within this cross-sectional sample after greater time had elapsed, marital quality became increasingly beneficial and was negatively associated with depression. These findings imply that resilience can curb the initial distress; in contrast, marital quality may enable individuals to reflect upon their trauma, initially amplifying distress but eventually facilitating recovery. Future research would benefit from longitudinal studies, illustrating whether resilience and marital quality at one time predict changes in distress at subsequent times.
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Brod M, Fennema H. Validation of the controlled ovarian stimulation impact measure (COSI): assessing the patient perspective. Health Qual Life Outcomes 2013; 11:130. [PMID: 23902854 PMCID: PMC3734046 DOI: 10.1186/1477-7525-11-130] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Accepted: 06/27/2013] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Controlled Ovarian Stimulation (COS) is the first step for in vitro fertilization (IVF) treatment, a treatment often described and experienced as stressful to patients and their partners. COS also requires concerted efforts by the patients in administering medication and general compliance to treatment protocols. Little is known about the impacts on patients that may be specific to this important first step in treatment. The absence of a conceptually sound and well-validated measure assessing patient experience and functioning during ovarian stimulation has been an obstacle to understanding the impacts of ovarian stimulation on women pursuing IVF. To address this gap, the Controlled Ovarian Stimulation Impact Measure (COSI) was developed based upon accepted methods for designing patient reported outcome (PRO) measures. The purpose of this study was to psychometrically validate the COSI. METHODS 267 patients from three countries (Ireland, United Kingdom, United States) were administered the COSI. Psychometric validation was conducted according to an a priori statistical analysis plan. RESULTS The final 28-item COSI was found to have robust scale structure with four domains: Interference in Daily Life (Work and Home), Injection Burden, Psychological Health and Compliance Worry. Internal consistency of all domains was adequate (between 0.80 to 0.87) as was test-retest reliability (between 0.72-0.87). All a-priori hypotheses for convergent and known-groups validity tests were met. CONCLUSIONS There is a measurable impact of COS on patient functioning and well-being. The COSI is a well-developed and validated PRO measure of this impact. Future work should include examination of responsiveness and confirmation of concepts in non-western countries.
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Affiliation(s)
- Meryl Brod
- The Brod Group, 219 Julia Avenue, Mill Valley, CA 94941, USA
| | - Hein Fennema
- Merck Sharp & Dohme BV, Molenstraat 11, 5342 CC Oss, The Netherlands
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Penrose R, Beatty L, Mattiske J, Koczwara B. The Psychosocial Impact of Cancer-Related Infertility on Women. Clin J Oncol Nurs 2013; 17:188-93. [DOI: 10.1188/13.cjon.188-193] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Donarelli Z, Lo Coco G, Gullo S, Marino A, Volpes A, Allegra A. Are attachment dimensions associated with infertility-related stress in couples undergoing their first IVF treatment? A study on the individual and cross-partner effect. Hum Reprod 2012; 27:3215-25. [PMID: 22926837 DOI: 10.1093/humrep/des307] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION Are attachment anxiety and avoidance dimensions in female and male partners in couples seeking infertility treatment associated with her and his infertility-related stress? SUMMARY ANSWER Attachment dimensions are significantly associated with several aspects of infertility stress in couples undergoing IVF treatment. WHAT IS KNOWN AND WHAT THIS PAPER ADDS Attachment dimensions of anxiety and avoidance (where highly anxious individuals fear rejection and are preoccupied with maintaining proximity to their partner and highly avoidant individuals are uncomfortable with intimacy and prefer to maintain distance from their partner) may influence the well being of individuals undergoing IVF/ICSI treatment. This study showed that one partner's attachment dimensions had a direct effect on the infertility-related stress of the other partner. DESIGN Cross-sectional study of consecutive couples before starting their first IVF/ICSI treatment in 2009-2011 at the ANDROS clinic in Palermo, Italy. PARTICIPANTS AND SETTING Three hundred and fifty-nine couples undergoing fertility treatments were invited to participate in the research. The final sample comprised 316 females and 316 males who filled out the psychological questionnaires (Experiences in Close Relationships; Fertility Problem Inventory; State scale of State-Trait Anxiety Inventory). The participants included patients who had a primary infertility diagnosis and were about to undergo their first IVF or ICSI treatment. DATA ANALYSIS METHOD Paired t-tests were used to examine gender differences on the study variables (attachment anxiety, attachment avoidance, infertility stress, state anxiety, etc.). Associations between infertility-related stress and the study variables were explored using hierarchical stepwise multivariate linear regression analyses. MAIN RESULTS AND THE ROLE OF CHANCE Attachment anxiety and attachment avoidance were significantly associated with global infertility stress in both women (β = 0.24, P < 0.01 and β = 0.27, P < 0.01) and men (β = 0.23, P < 0.01 and β = 0.37, P < 0.01). Regarding the cross-partner effects, men's infertility stress and relationship concerns were associated with their partners' attachment avoidance (β = 0.10 P < 0.05 and β = 0.12, P < 0.05); and the infertility stress of women and the scores for need of parenthood were associated with their partners' attachment anxiety (β = 0.14 P < 0.05 and β = 0.16, P < 0.05). BIAS, CONFOUNDING AND OTHER REASONS FOR CAUTION The study data are cross sectional, and specifically focus on associations between adult attachment style and infertility stress. Treating the data from couples as independent observations may be a limitation of the analysis. Potential moderators of such relationships (e.g. coping strategies, stress appraisal) are not included in this study. STUDY FUNDING/COMPETING INTEREST(S) 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.
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Psychological distress and in vitro fertilization outcome. Fertil Steril 2012; 98:459-64. [PMID: 22698636 DOI: 10.1016/j.fertnstert.2012.05.023] [Citation(s) in RCA: 99] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2011] [Revised: 05/21/2012] [Accepted: 05/22/2012] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To examine whether psychological distress predicts IVF treatment outcome as well as whether IVF treatment outcome predicts subsequent psychological distress. DESIGN Prospective cohort study over an 18-month period. SETTING Five community and academic fertility practices. PATIENT(S) Two hundred two women who initiated their first IVF cycle. INTERVENTION(S) Women completed interviews and questionnaires at baseline and at 4, 10, and 18 months' follow-up. MAIN OUTCOME MEASURE(S) IVF cycle outcome and psychological distress. RESULT(S) In a binary logistic model including covariates (woman's age, ethnicity, income, education, parity, duration of infertility, and time interval), pretreatment depression and anxiety were not significant predictors of the outcome of the first IVF cycle. In linear regression models including covariates (woman's age, income, education, parity, duration of infertility, assessment point, time since last treatment cycle, and pre-IVF depression or anxiety), experiencing failed IVF was associated with higher post-IVF depression and anxiety. CONCLUSION(S) IVF failure predicts subsequent psychological distress, but pre-IVF psychological distress does not predict IVF failure. Instead of focusing efforts on psychological interventions specifically aimed at improving the chance of pregnancy, these findings suggest that attention be paid to helping patients prepare for and cope with treatment and treatment failure.
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Giardinelli L, Innocenti A, Benni L, Stefanini MC, Lino G, Lunardi C, Svelto V, Afshar S, Bovani R, Castellini G, Faravelli C. Depression and anxiety in perinatal period: prevalence and risk factors in an Italian sample. Arch Womens Ment Health 2012; 15:21-30. [PMID: 22205237 DOI: 10.1007/s00737-011-0249-8] [Citation(s) in RCA: 134] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2011] [Accepted: 12/13/2011] [Indexed: 12/14/2022]
Abstract
Accumulating evidence suggests that pregnancy does not protect women from mental illness. The aim of this study was to assess the prevalence, sociodemographic correlates, and the risks factors for perinatal depression and anxiety. Five hundred ninety women between 28th and the 32nd gestational weeks were recruited and submitted to a sociodemographic, obstetric, and psychological interview. The Edinburgh Postnatal Depression Scale (EPDS) and the state-trait anxiety inventory (STAI-Y) were also administered in antenatal period and 3 months postnatally. The Structured Clinical Interview for DSM-IV (SCID-I) was used to diagnose mood and anxiety disorders. Three months after delivery, EPDS was administered by telephone interview. Women with an EPDS score ≥10 were 129 in antenatal period (21.9%) and 78 in postnatal period (13.2%). During pregnancy 121 women (20.5%) were positive for STAI-Y state and 149 women (25.3%) for STAI-Y trait. The most important risk factors for antenatal depression are: foreign nationality, conflictual relationship with family and partner, and lifetime psychiatric disorders. The principal risk factors for postnatal depression are: psychiatric disorders during pregnancy and artificial reproductive techniques. Psychiatric disorders, during and preceding pregnancy, are the strongest risk factors for antenatal state and trait anxiety. Antenatal depressive and anxiety symptoms appear to be as common as postnatal symptoms. These results provide clinical direction suggesting that early identification and treatment of perinatal affective disorders is particularly relevant to avoid more serious consequences for mothers and child.
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Affiliation(s)
- L Giardinelli
- Psychiatric Unit, Department of Neuropsychiatric Sciences, Florence University School of Medicine, Florence, Italy.
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Abstract
Women who lose desired pregnancies by miscarriage, stillbirth, genetic termination, or unsuccessful in vitro fertilization are at risk of suffering from grief, anxiety, guilt, and self-blame that may even present in subsequent pregnancies. A review of the literature reveals the dilemmas about effective means of helping women deal with these losses. The approach to stillbirth has shifted from immediately removing the child from the mother to encouraging viewing and holding the baby. This approach has been questioned as possibly causing persistent anxiety. Women who miscarry are currently encouraged to find ways to memorialize the lost fetus. Immediate crisis intervention and follow-up care should be available, recognizing that individual women may experience different reactions and their specific postloss needs must be assessed.
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van Minnen A, Wessel I, Verhaak C, Smeenk J. The relationship between autobiographical memory specificity and depressed mood following a stressful life event: A prospective study. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2011; 44:405-15. [PMID: 16238885 DOI: 10.1348/014466505x29648] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES In the present prospective study, the relationship between autobiographical memory specificity and the emotional reactions to a stressful event was investigated. DESIGN AND METHODS The Autobiographical Memory Test (AMT) was administered to 74 women before they underwent an in vitro fertilization (IVF) treatment, which subsequently failed. Symptoms of emotional reactions - depression and anxiety - were measured both before and after the (failed) IVF treatment. RESULTS It was found that the number of reported specific memories at baseline was negatively related to depressive and anxiety symptoms after the treatment, even when initial depressive and anxiety symptoms and verbal fluency were controlled for. CONCLUSIONS Taken together, the findings indicate that a lack of autobiographical memory specificity predicts changes in depressive mood after a stressful event.
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Affiliation(s)
- Agnes van Minnen
- Department of Clinical Psychology, University of Nijmegen, The Netherlands.
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Van den Broeck U, D'Hooghe T, Enzlin P, Demyttenaere K. Predictors of psychological distress in patients starting IVF treatment: infertility-specific versus general psychological characteristics. Hum Reprod 2010; 25:1471-80. [DOI: 10.1093/humrep/deq030] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Verhaak CM, Lintsen AME, Evers AWM, Braat DDM. Who is at risk of emotional problems and how do you know? Screening of women going for IVF treatment. Hum Reprod 2010; 25:1234-40. [PMID: 20228392 DOI: 10.1093/humrep/deq054] [Citation(s) in RCA: 94] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- C M Verhaak
- Department of Medical Psychology, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, The Netherlands
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30
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Lee SH, Wang SC, Kuo CP, Kuo PC, Lee MS, Lee MC. Grief responses and coping strategies among infertile women after failed in vitro fertilization treatment. Scand J Caring Sci 2010; 24:507-13. [DOI: 10.1111/j.1471-6712.2009.00742.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Miles LM, Keitel M, Jackson M, Harris A, Licciardi F. Predictors of distress in women being treated for infertility. J Reprod Infant Psychol 2009. [DOI: 10.1080/02646830802350880] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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32
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A. BRIGHT, PETER HAYWARD & JOHN CLE JENIFER. Dealing with chronic stress: Coping strategies, self-esteem and service use in mothers of handicapped children. J Ment Health 2009. [DOI: 10.1080/09638239719058] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Brod M, Verhaak CM, Wiebinga CJ, Gerris J, Hoomans EHM. Improving clinical understanding of the effect of ovarian stimulation on women's lives. Reprod Biomed Online 2009; 18:391-400. [DOI: 10.1016/s1472-6483(10)60098-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Williams KE, Marsh WK, Rasgon NL. Mood disorders and fertility in women: a critical review of the literature and implications for future research. Hum Reprod Update 2007; 13:607-16. [PMID: 17895237 DOI: 10.1093/humupd/dmm019] [Citation(s) in RCA: 118] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
A medline literature review of fertility and mood disorder articles published since 1980 was performed in order to critically review the literature regarding a relationship between mood disorders, fertility and infertility treatment. Previous studies suggests that mood disorders, both in the bipolar and unipolar spectrum, may be associated with decreased fertility rates. Most studies report that women seeking treatment for infertility have an increased rate of depressive symptoms and possibly major depression (none showed evaluated mood elevations). Many, but not all, studies found that depressive symptoms may decrease the success rate of fertility treatment. Treatments for infertility may independently influence mood through their effects on estrogen and progesterone, which have been shown to influence mood through their actions on serotonin. Studies are limited in scope and confounding variables are many, limiting the strength of the results. In conclusion, a range of existing studies suggests that fertility and mood disorders are related in a complex way. Future studies should use clinical interviews and standardized and validated measures to confirm the diagnosis of mood disorders and control for the variables of medication treatment, desire for children, frequency of sexual intercourse, age, FSH levels, menstrual cycle regularity in assessing an interrelationship between mood disorders and fertility.
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Affiliation(s)
- Katherine E Williams
- Stanford Center for Neuroscience in Women's Health, Department of Psychiatry and Behavioural Sciences, Stanford University and Hospitals, Stanford, CA 94305, USA.
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35
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Knoll N, Kienle R, Bauer K, Pfüller B, Luszczynska A. Affect and enacted support in couples undergoing in-vitro fertilization: When providing is better than receiving. Soc Sci Med 2007; 64:1789-801. [PMID: 17320259 DOI: 10.1016/j.socscimed.2007.01.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2006] [Indexed: 11/30/2022]
Abstract
Although the term social support has positive connotations, research has shown that receiving help may be a double-edged sword. Received support may have no effects or may even be detrimental to recipients' well-being. However, providing support may have beneficial effects for the helper. This paper reports a study of competing and interactive effects of enacted support on affect in couples undergoing assisted reproduction treatments. Sixty-six male/female couples from two German fertility clinics participated in this study. Affect and support were assessed at 3 time points: upon oocyte and sperm collection, after embryo transfer, and following the first pregnancy test (3 weeks after the treatment outcomes were known). Results indicated that depending on the providers' gender, different forms of support provision predicted better affect developments. While women seemed to benefit from providing emotional support, higher positive affect among men was related to their provision of instrumental support. Neither support receipt nor reciprocal support, however, were reliably associated with affect changes. Results partially coincide with predictions from esteem-enhancement theory of supportive exchanges.
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Affiliation(s)
- Nina Knoll
- Charité-Universitätsmedizin Berlin, Institute of Medical Psychology, Germany.
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Psychological characteristics and marital quality of infertile women registered for in vitro fertilization-intracytoplasmic sperm injection in China. Fertil Steril 2007; 87:792-8. [PMID: 17222834 DOI: 10.1016/j.fertnstert.2006.07.1534] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2006] [Revised: 07/31/2006] [Accepted: 07/31/2006] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To assess the psychological health status and marital quality of Chinese women who were referred for IVF-intracytoplasmic sperm injection (ICSI), to compare the results with a control group, and to test the impact of clinical and sociodemographic determinants on psychological health status and marital quality in this cohort. DESIGN A descriptive study of psychological health status and marital relationships, comparing infertile women who are registered for IVF or IVF-ICSI with fertile controls. SETTING An assisted reproductive center of a science and technology institute of family planning. PATIENT(S) Two groups of infertile women (100 registered for IVF, and 100 registered for ICSI), and a control group of 100 women attending a gynecology clinic, who have no known history of infertility. INTERVENTION Psychometric tests were administered at the first visit of the treatment cycle. MAIN OUTCOME MEASURE(S) Psychological status measured by the Hopkins Symptom Checklist-90 (SCL-90), and marital quality measured by the ENRICH (Evaluating & Nurturing Relationship Issues, Communication & Happiness) marital inventory. RESULT(S) Infertile Chinese women planning to undergo IVF-ICSI scored significantly higher on all subscales of the SCL-90 than did controls. In addition, women in the IVF subgroup had significantly higher scores on depression scales than those in the ICSI subgroup. The study group displayed unstable relationships compared to the control group. Age, yearly income, duration of infertility, and history of unsuccessful IVF treatment had a negative correlation with psychological health status and marital quality. CONCLUSION(S) The stresses associated with infertility and IVF treatment had a negative impact on Chinese women's psychological health status and marital quality. These findings emphasize the need to include psychological and sociocultural considerations with any medical interventions for infertility.
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Verhaak CM, Smeenk JMJ, Evers AWM, Kremer JAM, Kraaimaat FW, Braat DDM. Women's emotional adjustment to IVF: a systematic review of 25 years of research. Hum Reprod Update 2006; 13:27-36. [PMID: 16940360 DOI: 10.1093/humupd/dml040] [Citation(s) in RCA: 405] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
This review provides an overview of how women adjust emotionally to the various phases of IVF treatment in terms of anxiety, depression or general distress before, during and after different treatment cycles. A systematic scrutiny of the literature yielded 706 articles that paid attention to emotional aspects of IVF treatment of which 27 investigated the women's emotional adjustment with standardized measures in relation to norm or control groups. Most studies involved concurrent comparisons between women in different treatment phases and different types of control groups. The findings indicated that women starting IVF were only slightly different emotionally from the norm groups. Unsuccessful treatment raised the women's levels of negative emotions, which continued after consecutive unsuccessful cycles. In general, most women proved to adjust well to unsuccessful IVF, although a considerable group showed subclinical emotional problems. When IVF resulted in pregnancy, the negative emotions disappeared, indicating that treatment-induced stress is considerably related to threats of failure. The concurrent research reviewed, should now be underpinned by longitudinal studies to provide more information about women's long-term emotional adjustment to unsuccessful IVF and about indicators of risk factors for problematic emotional adjustment after unsuccessful treatment, to foster focused psychological support for women at risk.
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Affiliation(s)
- C M Verhaak
- Department of Medical Psychology, Radboud University Nijmegen, Medical Centre, Nijmegen, The Netherlands.
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38
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Ng SKS, Keung Leung W. A community study on the relationship between stress, coping, affective dispositions and periodontal attachment loss. Community Dent Oral Epidemiol 2006; 34:252-66. [PMID: 16856946 DOI: 10.1111/j.1600-0528.2006.00282.x] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Psychological factors may increase the risk for periodontal diseases. Contemporary conceptualization of the stress process supports the evaluation of stress at three levels: stressors, moderating and mediating factors, and stress reactions. OBJECTIVE This study was undertaken to investigate the relationship of periodontal disease in terms of clinical attachment level (CAL) to psychosocial stress, making reference to the major components of stress process. METHODS A cross-sectional study of 1000 subjects aged 25-64 years in Hong Kong was conducted. Subjects were asked to complete a set of questionnaires measuring stressors including changes, significant life event and daily strains, stress reactions including physiological and affective responses, and coping and affective dispositions. CAL was assessed. RESULTS Individuals with high mean CAL values had higher scores on the job and financial strain scales than periodontally healthy individuals (P < 0.05), after adjusting for age, gender, cigarette smoking and systemic disease. Depression, anxiety trait, depression trait, problem-focused coping, and emotion-focused coping were also related to CAL. Logistic regression analysis indicated that all these factors were significant risk indicators for periodontal attachment loss, except problem-focused coping, which reduced the odds of CAL. Individuals who were high emotion-focused copers, low problem-focused copers, trait anxious, or trait depressive had a higher odds of more severe CAL. CONCLUSION Chronic job and financial strains, depression, inadequate coping, and maladaptive trait dispositions are significant risk indicators for periodontal attachment loss. Adequate coping and adaptive trait dispositions, evidenced as high problem-focused coping and low anxiety/depression trait, may reduce the stress-associated odds.
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Affiliation(s)
- Sam K S Ng
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
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Peterson BD, Newton CR, Rosen KH, Skaggs GE. The relationship between coping and depression in men and women referred for in vitro fertilization. Fertil Steril 2006; 85:802-4. [PMID: 16500370 DOI: 10.1016/j.fertnstert.2005.09.020] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2005] [Revised: 09/08/2005] [Accepted: 09/08/2005] [Indexed: 10/25/2022]
Abstract
This study examined coping with infertility and how coping is related to depression for men and women. Results showed that both men and women who engage in a disproportionate degree of escape/avoidance behavior and acceptance of responsibility for infertility were more vulnerable to symptoms of depression.
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Affiliation(s)
- Brennan D Peterson
- Department of Psychology, Marriage and Family Therapy Program, Chapman University, Orange, California 92866, USA.
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40
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Verhaak CM, Smeenk JMJ, Evers AWM, van Minnen A, Kremer JAM, Kraaimaat FW. Predicting emotional response to unsuccessful fertility treatment: a prospective study. J Behav Med 2005; 28:181-90. [PMID: 15957573 DOI: 10.1007/s10865-005-3667-0] [Citation(s) in RCA: 96] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The predictive value of a comprehensive model with personality characteristics, stressor related cognitions, coping and social support was tested in a sample of 187 nonpregnant women. The emotional response to the unsuccessful treatment was predicted out of vulnerability factors assessed before the start of the treatment. The results indicated the importance of neuroticism as a vulnerability factor in emotional response to a severe stressor. They also underlined the importance of helplessness and marital dissatisfaction as additional risk factors, and acceptance and perceived social support as additional protective factors, in the development of anxiety and depression after a failed fertility treatment. From clinical point of view, these results suggest fertility-related cognitions and social support should receive attention when counselling women undergoing IVF or ICSI treatment.
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Affiliation(s)
- Christianne M Verhaak
- Department of Medical Psychology, University Medical Center St. Radboud, The Netherlands.
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41
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Bankowski BJ, Lyerly AD, Faden RR, Wallach EE. The social implications of embryo cryopreservation. Fertil Steril 2005; 84:823-32. [PMID: 16213829 DOI: 10.1016/j.fertnstert.2005.02.057] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2004] [Revised: 02/05/2005] [Accepted: 02/05/2005] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To summarize the existing literature regarding the social implications of embryo cryopreservation and outline areas in need of further study. RESULT(S) The potential social impact of oocyte cryopreservation has not been investigated. Embryo cryopreservation has been increasingly used to improve the cost-effectiveness of in vitro fertilization (IVF) and expand the options available to infertile couples, yet its widespread adoption has occurred more rapidly than our ability to study the social consequences for the couples and health professionals involved. For maintaining cryopreserved embryos, the existing literature is fragmented and incompletely explores the effects on an infertile couple's psychosocial health and personal relationships, their family planning strategies, or their preferences for the disposition of the embryos. Managing unclaimed embryos continues to create challenges for assisted reproduction professionals. CONCLUSION(S) We currently lack a thorough understanding of the numerous social implications of cryopreservation. Major areas for future research include the impact of stored embryos on couples' fertility intentions and psychosocial health, factors that affect couples' decisions about embryo disposition, strategies to minimize unclaimed embryos, and the consequences of oocyte/ovarian cryopreservation.
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Affiliation(s)
- Brandon J Bankowski
- Division of Reproductive Endocrinology, Johns Hopkins University, Baltimore, Maryland, USA
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42
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Schmidt L, Holstein BE, Christensen U, Boivin J. Communication and coping as predictors of fertility problem stress: cohort study of 816 participants who did not achieve a delivery after 12 months of fertility treatment. Hum Reprod 2005; 20:3248-56. [PMID: 16006458 DOI: 10.1093/humrep/dei193] [Citation(s) in RCA: 130] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND We investigated coping strategies and communication strategies as predictors of fertility problem stress 12 months after start of fertility treatment. METHODS We used a prospective, longitudinal cohort design including 2250 people beginning fertility treatment with a 12-month follow-up. Data were based on self-administered questionnaires measuring communication with partner and with other people, coping strategies: active-avoidance coping, active-confronting coping, passive-avoidance coping, meaning-based coping, and fertility problem stress. The study population included those participants (n = 816, men and women) who had not achieved pregnancy by assisted reproduction or delivery at follow-up. RESULTS Among both men and women, difficulties in partner communication predicted high fertility problem stress (odds ratio for women, 3.47, 95% confidence interval 2.09-5.76; odds ratio for men, 3.69, 95% confidence interval 2.09-6.43). Active-avoidance coping (e.g. avoiding being with pregnant women or children, turning to work to take their mind off things) was a significant predictor of high fertility problem stress. Among men, high use of active-confronting coping (e.g. letting feelings out, asking other people for advice, seeking social support) predicted low fertility problem stress in the marital domain (odds ratio 0.53, 95% confidence interval 0.28-1.00). Among women, medium or high use of meaning-based coping significantly predicted low fertility problem stress in the personal and marital domain. CONCLUSION The study provides information about where to intervene with fertility patients in order to reduce their stress after medically unsuccessful treatment.
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Affiliation(s)
- L Schmidt
- Institute of Public Health, University of Copenhagen, Panum Institute, 3 Blegdamsvej, DK-2200 Copenhagen N, Denmark.
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Choi SH, Shapiro H, Robinson GE, Irvine J, Neuman J, Rosen B, Murphy J, Stewart D. Psychological side-effects of clomiphene citrate and human menopausal gonadotrophin. J Psychosom Obstet Gynaecol 2005; 26:93-100. [PMID: 16050534 DOI: 10.1080/01443610400022983] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVE This study evaluated the psychological side-effects of clomiphene citrate (CC) and hMG in women undergoing fertility treatment. METHOD This study was a cross-sectional, self-report survey of 454 women at various stages of treatment for infertility. At the time of study, 139 women had not taken fertility drugs and 315 women had taken one or more cycles of CC or hMG. All subjects were asked to complete the State-Trait Anxiety Inventory (STAI). Women taking CC or hMG were also asked to complete a self-administered questionnaire on the side-effects of their medications. RESULT(S) In the CC group (n = 162) and hMG group (n = 153), 77.8% (126 of 162) and 94.8% (145 of 153) reported at least one side-effect, respectively. Irritability, mood swings, feeling down, and bloating had high frequencies in both CC and hMG groups, with a higher mean number of side effects reported in the hMG group (4.4 +/- 3.7 for the CC group and 6.8 +/- 3.7 for the hMG group, p < 0.001). There was no significant difference among the CC, hMG and no medication groups for mean state and trait anxiety scores. However, there were significant differences among the three side-effect groups (those who reported 1 to 4, 5 to 7, and more than 7 side-effects) for the mean scores of state (df = 2, F = 8.7, p < 0.001) and trait (df = 2, F = 11.9, p < 0.001) anxiety in women taking fertility drugs. CONCLUSION(S) Women taking CC or hMG reported high frequencies of psychological side-effects, and should be advised of these before treatment.
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Affiliation(s)
- So-Hyun Choi
- Women's Health Program, University Health Network, University of Toronto, Ontario, Canada.
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Baor L, Blickstein I. En Route to an “Instant Family”: Psychosocial Considerations. Obstet Gynecol Clin North Am 2005; 32:127-39, x. [PMID: 15644294 DOI: 10.1016/j.ogc.2004.10.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Societal and cultural norms require that a worthwhile person engage in reproduction and formation of a family. Young adults who postpone childbearing may presume that fertility is granted. When all other measures fail, the use of assisted reproductive technologies is considered the ultimate salvation for these couples. It is highly stressful and may lead to significant negative psychological consequences (loss of self-esteem, confidence, health, close relationships, security, and hope). Assisted reproductive technology may produce multiple pregnancy, which is frequently overlooked or underappreciated by infertile couples. Despite the real risks associated with a multiple pregnancy and birth, infertile patients often express a desperate wish to have twins or triplets, thereby accomplishing an instant family. It is necessary to provide these couples with detailed information on the risks of multiple pregnancy and birth.
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Affiliation(s)
- Liora Baor
- Faculty of Social Sciences, School of Social Work, Bar-Ilan University, Ramat-Gan 52900, Israel.
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45
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Abstract
The experience of 92 couples, who had unsuccessfully undergone one or more IVF cycles at a university clinic, was evaluated 3-8 years following their last failed attempt. One member of each couple completed a telephone questionnaire regarding life events during their last IVF cycle performed at the clinic and at the time of the interview. Some couples had continued further treatment and some had not. Multivariate correspondence analysis was used to analyse the data. Regarding the long-term experience of couples who had undergone further treatment, for men the main experiences were psychological problems and having adopted a child. For women, the main experiences were related to problems of self-image, psychological problems, loss of hope, and having adopted a child. These women also presented a strong association with problems in their marital relationship and with adoption. For the group that did not undergo further treatment, the women showed a strong association with considering adoption, and a less intense association with psychological problems and loss of hope. The men presented psychological problems and having adopted a child as associated variables. Comparison between men and women showed that recognizing the impossibility of conceiving a child and giving up treatment were strongly associated. Men and women who had not continued with further treatment were more affected in the long term than those who had undergone further treatment after IVF failure.
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Affiliation(s)
- Juliana N Filetto
- Centro de Pesquisas em Saúde Reprodutiva de Campinas (Cemicamp) and Department of Obstetrics and Gynaecology, School of Medicine, Universidade Estadual de Campinas (UNICAMP), Campinas, São Paulo, Brazil
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Heydecke G, Tedesco LA, Kowalski C, Inglehart MR. Complete dentures and oral health-related quality of life -- do coping styles matter? Community Dent Oral Epidemiol 2004; 32:297-306. [PMID: 15239781 DOI: 10.1111/j.1600-0528.2004.00169.x] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
UNLABELLED Oral health-related quality of life (OHRQOL) in edentulous patients with complete dentures is often impaired. This paper investigates the effect of different coping styles on OHRQOL. PURPOSE (a) To assess OHRQOL of edentulous patients with conventional complete dentures, and (b) to investigate if individual differences in these patients' styles of coping with stress affect their OHRQOL. MATERIALS AND METHODS Data were collected from 249 fully edentulous patients with complete dentures (mean age: 66.0 years) who responded to a mailed survey (adjusted response rate: 48.8%). OHRQOL was measured with the 14-item short form of the oral health impact profile (OHIP). Ratings of coping strategies were obtained using the 28-item Brief COPE, an instrument measuring various styles of coping with stress. Linear regression analyses were used to explore the relationships between coping styles, background variables such as age, gender, income, and age of prosthesis, and the patients' OHRQOL. RESULTS About 35% of the respondents reported impacts from their oral conditions on their overall OHRQOL (OHIP-14 total score) occasionally, fairly often, or often. Physical pain was even more prevalent, with 53.3% of the respondents reporting pain impacts. The linear regression model (P < 0.0001) explained 31.1% of the variation in the OHIP-14 total score. The coping variables instrumental support, behavioral disengagement, substance abuse, denial, and religion were significant negative predictors of OHRQOL. Only emotional support was a significant positive predictor of OHRQOL. CONCLUSION Wearing conventional complete dentures has a significant impact on OHRQOL. This impact is moderated by the styles a patient uses to cope with stress. Using emotional support has a positive effect on OHRQOL, while other coping styles, namely instrumental support, behavioral disengagement, substance abuse, denial, and religion are significant negative predictors of OHRQOL.
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Affiliation(s)
- Guido Heydecke
- Faculty of Dentistry, McGill University, Montréal, Canada.
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Franco JG, Silva PG, Achê RS, Baruffi RR, Mauri AL, Petersen CG, Felipe V, Vagnini L, Oliveira JBA. Comparison of the psychological evaluation test and classical psychoanalysis in infertile women. Reprod Biomed Online 2004; 8:8-13. [PMID: 14759280 DOI: 10.1016/s1472-6483(10)60492-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This study aims to compare a psychological evaluation test to classical psychoanalysis in infertile women. Two hundred women were submitted to the Psychological Evaluation Test (PET). The sum of the scores for the responses ranged from 15 to 60 points, with scores >/=30 points being defined as 'psycho-emotional maladjustment' (cut-off point: median + 25%). For comparison, the patients were simultaneously submitted to a psychological examination by a psychologist, who was unaware of the PET results. Of the 200 patients, 66 (33%) presented a test with >/=30 points ('psycho-emotional maladjustment') and 134 (67%) a test with <30 points (normal). Upon psychological examination, 105 (52.5%) presented an abnormal evaluation and 95 (47.5%) a normal evaluation. For the PET, statistical analysis showed 82% efficiency, 62% sensitivity, 98% positive predictive value, 99% specificity, 70% negative predictive value, likelihood ratio for a positive test result 62, and likelihood ratio for negative test result 0.38. The PET proved to be a useful clinical instrument, being of help in the selection of patients with psychological needs induced by infertility.
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Affiliation(s)
- J G Franco
- Centre for Human Reproduction, Sinhá Junqueira Maternity Foundation-Ribeirão Preto SP, Brazil.
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Mindes EJ, Ingram KM, Kliewer W, James CA. Longitudinal analyses of the relationship between unsupportive social interactions and psychological adjustment among women with fertility problems. Soc Sci Med 2003; 56:2165-80. [PMID: 12697205 DOI: 10.1016/s0277-9536(02)00221-6] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study examined the association of unsupportive social interactions and psychological adjustment among 123 women with fertility problems, and tested whether threat appraisals and avoidance coping mediate this association. Cross-sectional analyses suggested that infertility-specific unsupportive responses received from other people were associated positively with adjustment problems. Avoidance coping and threat appraisals mediated this association between unsupportive social interactions and adjustment. Longitudinal analyses with 67 of these women revealed that after controlling for Time 1 adjustment, Time 1 unsupportive social interactions were associated positively with depressive symptoms and overall psychological distress only for women who remained infertile at Time 2, compared with women who were pregnant or had given birth. Associations between Time 1 unsupportive social interactions and self-esteem at Time 2 were similar for both groups of women.
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Affiliation(s)
- Erica J Mindes
- Department of Psychology, Virginia Commonwealth University, P.O. Box 842018, Richmond, VA 23284-2018, USA
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50
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Abstract
Counselling was made a statutory requirement for clinics providing assisted reproduction services as a result of the concern raised that these treatments would raise uniquely challenging emotional and ethical problems for patients. Before the Human Fertilisation and Embryology Act 1990, few counsellors specialized in this field and there were no standards for their training or experience. In the intervening years considerable progress has been made in these areas. The research evidence, which informs their practice concerning the impact of infertility and its treatment, has also grown very substantially. There is now a reasonable consensus about the broad nature of the emotional and psychological sequelae, although many unexplored questions remain. In addition, the literature providing evidence for the efficacy and effectiveness of counselling in other areas has developed in both quantity and sophistication. Counsellors are often well-placed to work with patient groups and also with the multidisciplinary assisted conception team itself on the very difficult psychosocial and ethical issues faced in practice. The sophisticated research in these fields has not yet been done in the context of infertility; it is therefore necessary to extrapolate from other fields, especially in mental health practice. This article will argue that there is now ample evidence to support the decisions made by legislators in requiring counselling to be available to patients in assisted conception units. The infertility counselling profession is in a position to begin contributing to the generation of research relevant to this field.
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Affiliation(s)
- Jim Monach
- University of Sheffield, British Infertility Counselling Association-British Fertility Society National Accreditation Board for Infertility Counselling, Sheffield, UK
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