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Hu S, Su C, Zhou L, Dai L. Reliability and validity of the Chinese version of the COMPI Fertility Problem Stress Scale-Short Form for infertile women. Int J Gynaecol Obstet 2024; 165:1261-1267. [PMID: 38205844 DOI: 10.1002/ijgo.15342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 08/13/2023] [Accepted: 12/14/2023] [Indexed: 01/12/2024]
Abstract
OBJECTIVE To translate and culturally adapt the COMPI Fertility Problem Stress Scale-Short form (COMPI-FPSS-SF) and to test its reliability and validity in China. METHODS The cross-sectional study adopted Brislin's translation model to translate, synthesize, back-translate, and cross-culturally adapt the COMPI-FPSS-SF for the Chinese setting. A total of 279 infertile women were invited to participate in the study to test the reliability and validity of the scale between March and June 2021. RESULTS It was verified that the Chinese version of the COMPI-FPSS-SF has three domains with nine items. The Cronbach's α coefficient of the total scale was 0.907, and the coefficient for each dimension ranged from 0.760 to 0.855. The test-retest validity was 0.891. The exploratory factor analysis extracted three common factors with eigenvalues of 4.499, 1.124, and 1.011 and a cumulative variance contribution of 73.706. The validity factor analysis showed good results for the three-factor structure fit. The criterion-related validity with the Fertility Inventory Short-Form Scale was 0.649. The above analysis revealed statistically significant differences (P < 0.001). CONCLUSIONS The Chinese version of the COMPI-FPSS-SF can be used for the assessment of fertility-related stress in infertility patients in China with good reliability and validity.
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Affiliation(s)
- Shuang Hu
- Department of Obstetrics and Gynecology, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Department of Obstetrics and Gynecology, Chongqing Health Center for Women and Children, Chongqing, China
| | - Chengying Su
- Department of Obstetrics and Gynecology, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Department of Obstetrics and Gynecology, Chongqing Health Center for Women and Children, Chongqing, China
| | - Linlin Zhou
- Department of Obstetrics and Gynecology, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Department of Obstetrics and Gynecology, Chongqing Health Center for Women and Children, Chongqing, China
| | - Ling Dai
- Department of Obstetrics and Gynecology, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Department of Obstetrics and Gynecology, Chongqing Health Center for Women and Children, Chongqing, China
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Yadav A, Tiwari P, Dada R. Yoga and Lifestyle Changes: A Path to Improved Fertility - A Narrative Review. Int J Yoga 2024; 17:10-19. [PMID: 38899142 PMCID: PMC11185437 DOI: 10.4103/ijoy.ijoy_211_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 12/22/2023] [Accepted: 01/10/2024] [Indexed: 06/21/2024] Open
Abstract
Infertility, a widespread medical condition affecting numerous couples globally, persists as a challenge despite advances in assisted reproductive technologies (ARTs), often burdened by financial, physical, and emotional strains. Complementary and alternative approaches, notably yoga, have garnered attention for potentially enhancing fertility outcomes. Studies reveal yoga's influence on factors contributing to infertility, including reduced oxidative stress (OS) and oxidative DNA damage (ODD). OS, linked to mutagenic base formation, higher malondialdehyde levels, abnormal methylation, and altered gene expression, can impair sperm genome integrity. Yoga's efficacy is evident in lowering OS, positively affecting signal transmission, gene expression, and physiological systems. Furthermore, yoga has a positive impact on addressing the dysregulation of apoptosis, resulting in improved processes such as spermatogenesis, sperm maturation, and motility, while also reducing DNA fragmentation. OS correlates with genome-wide hypomethylation, telomere shortening, and mitochondrial dysfunction, contributing to genome instability. Yoga and meditation significantly reduce OS and ODD, ensuring proper reactive oxygen levels and preserving physiological systems. The review explores potential mechanisms underlying yoga's positive impact on infertility, including enhanced blood flow, reduced inflammation, relaxation response, and modulation of the hypothalamic-pituitary-adrenal axis. Furthermore, a comprehensive review of the literature reveals substantial evidence supporting the positive effects of yoga on infertility factors. These include oxidative stress (OS), oxidative DNA damage (ODD), epigenetic changes, hormonal balance, ovarian function, menstrual irregularities, and stress reduction. In summary, yoga emerges as a promising adjunctive therapy for infertility, demonstrating the potential to mitigate key factors influencing reproductive success. Although preliminary evidence indicates the positive effects of yoga on infertility, further clinical research is imperative to define specific benefits, molecular mechanisms associated, optimal protocols, and long-term effects in infertility treatment plans.
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Affiliation(s)
- Anjali Yadav
- Department of Anatomy, Lab for Molecular Reproduction and Genetics, All India Institute of Medical Sciences, New Delhi, India
| | - Prabhakar Tiwari
- Department of Anatomy, Lab for Molecular Reproduction and Genetics, All India Institute of Medical Sciences, New Delhi, India
| | - Rima Dada
- Department of Anatomy, Lab for Molecular Reproduction and Genetics, All India Institute of Medical Sciences, New Delhi, India
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Li QL, Wang C, Cao KX, Zhang L, Xu YS, Chang L, Liu ZH, Yang AJ, Xue YX. Sleep characteristics before assisted reproductive technology treatment predict reproductive outcomes: a prospective cohort study of Chinese infertile women. Front Endocrinol (Lausanne) 2023; 14:1178396. [PMID: 37908752 PMCID: PMC10614022 DOI: 10.3389/fendo.2023.1178396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 09/06/2023] [Indexed: 11/02/2023] Open
Abstract
Sleep disorders affect mental and physical health. Infertile women undergoing assisted reproductive technology (ART) treatment are prone to sleep disorders. Sleep condition, its influencing factors, and the association between sleep condition and ART treatment outcomes before treatment have not been explored within a population with a large sample size. Therefore, we investigated the sleep characteristics of 1002 Chinese infertile women before ovulation induction and investigated the influencing factors (negative and positive psychological factors, demographics, and fertility characteristics). We also examined whether sleep conditions before treatment predicted reproductive outcomes. We found that 24.1% of participants reported poor sleep quality. Women with primary infertility reported poorer sleep than women with secondary infertility. Negative psychological factors, including depression, anxiety, and perceived stress were associated with poor sleep, whereas positive affect was linked with good sleep. Adverse sleep characteristics, including poor subjective sleep quality, sleep disturbances, and poor sleep efficiency, decreased the quantity and quality of oocytes retrieved, fertilization rates, and clinical pregnancy rates. This study indicates that before ART treatment, a large number of females with infertility suffer from sleep problems, which are affected by psychological factors and infertility type, and unhealthy sleep characteristics may impair treatment outcomes. Our findings highlight the importance of screening and treatment for sleep disorders before the enrollment of ART treatment in infertile women.
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Affiliation(s)
- Qian-Ling Li
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
- Center for Reproductive Medicine, Affiliated Hospital of Jining Medical University, Jining, China
| | - Chao Wang
- Reproductive Medical Center, Department of Obstetrics and Gynecology, Peking University International Hospital, Beijing, China
| | - Ke-Xin Cao
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
- Department of Pharmacology, School of Basic Medical Sciences, Peking University, Beijing, China
| | - Lin Zhang
- Center for Reproductive Medicine, Affiliated Hospital of Jining Medical University, Jining, China
| | - Yun-Shuai Xu
- Department of Psychiatry, Shandong Daizhuang Hospital, Jining, China
| | - Liang Chang
- Henan Key Laboratory of Medical Tissue Regeneration, School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, China
| | - Zhen-Hui Liu
- Center for Reproductive Medicine, Affiliated Hospital of Jining Medical University, Jining, China
| | - Ai-Jun Yang
- Center for Reproductive Medicine, Affiliated Hospital of Jining Medical University, Jining, China
| | - Yan-Xue Xue
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
- Chinese Institute for Brain Research, Beijing, China
- Key Laboratory for Neuroscience, Ministry of Education/National Health Commission, Peking University, Beijing, China
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Kirca N, Özcan Ş. The effects of nursing care based on Levine's Conservation Model on fatigue, depression, perceived social support, and sleep quality in infertile women: A randomized controlled trial. Int J Nurs Knowl 2023; 34:284-296. [PMID: 36440648 DOI: 10.1111/2047-3095.12402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 10/02/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE The purpose of this study was to investigate the effects of nursing care based on the Levine's Conservation Model on depression caused by infertility, fatigue, perceived social support, and sleep quality levels. METHODS This study includes randomized controlled trial that was conducted from July 2019 to April 2020, with 65 Turkish women with infertility (experimental group: 34, control group: 31). We collected data using the Visual Similarity Scale for Fatigue, the Pittsburgh Sleep Quality Index, the Beck's Depression Inventory, and the Multidimensional Perceived Social Support Scale. The experimental group received nursing care based on the Levine's Conservation Model. Data were analyzed using t-tests and χ2 tests analyses. FINDINGS As a result of the measurements made, it was found that the experimental group had a lower fatigue level than the control group, with a statistically significant difference between the groups (p < 0.001). It was also found that the experimental group had higher energy and perceived social support scores than the control group after the practice, with a statistically significant difference between the groups (p < 0.001). As a result of the measurements made after the practice, it was found that the experimental group had a lower depression level than the control group, with a statistically significant difference between the groups (p < 0.001). CONCLUSIONS Nursing care based on the Levine's Conservation Model decreased fatigue and depression in women receiving infertility treatment and increased perceived social support and sleep. IMPLICATIONS FOR NURSING PRACTICE This research provides important findings about nursing care based on Levine's Conservation Model for women receiving infertility treatment. It decreased depression and fatigue and increased perceived social support and sleep quality.
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Affiliation(s)
- Nurcan Kirca
- Obstetrics and Gynecology Nursing Department, Nursing Faculty, Akdeniz University, Antalya, Turkey
| | - Şadiye Özcan
- Department of Nursing, Faculty of Health Sciences, Yalova University, Yalova, Turkey
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Ozcan S, Kirca N. Effects of care given in line with Levine's Conservation Model on the quality of life of women receiving infertility treatment: A single blind randomized controlled trial. Health Care Women Int 2023; 44:418-439. [PMID: 34846278 DOI: 10.1080/07399332.2021.2007927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Although infertility is not a life-threatening condition, it decreases the quality of life of people. This single blind randomized controlled trial was conducted with 80 women who received infertility treatment in an IVF Center located in a city center in the west of Turkey between May 2020 and February 2021. It was determined that thanks to the holistic care given in line with Levine's Conservation Model (LCM), fatigue levels of the women in the experimental group decreased, their energy levels increased, their structural, personal and social integrity was conserved and thus their quality of life improved compared to the women in the control group (all p < 0.001).
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Affiliation(s)
- Sadiye Ozcan
- Department of Obstetrics & Gynecological Nursing, Yalova University Faculty of Health Sciences, Yalova, Turkey
| | - Nurcan Kirca
- Department of Obstetrics & Gynecological Nursing, Akdeniz University Faculty of Nursing, Antalya, Turkey
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Zhou Y, Sun Z, Song J. Research progress on the impact of anxiety and depression on embryo transfer outcomes of in vitro fertilization. Zhejiang Da Xue Xue Bao Yi Xue Ban 2023; 52:61-67. [PMID: 37283119 DOI: 10.3724/zdxbyxb-2022-0473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Infertile women who receive in vitro fertilization-embryo transfer (IVF-ET) often present psychological distress such as anxiety, depression and perceived stress. This adverse psychological state can affect the immune homeostasis at the mother-fetus interface, the incubation of blastula and the receptivity of the maternal endometrium through the psycho-neuro-immuno-endocrine network, which in turns affect the proliferation, invasion and vascular remodeling of the embryo trophoblast, and reduces the success rate of embryo transfer. This adverse outcome of embryo transfer will further aggravate the psychological pain of patients, forming a vicious circle. The positive partner effect between husband and wife or the use of cognitive behavioral therapy, acupuncture, yoga and other measures for psychological intervention before and after IVF-ET, may break the vicious cycle and improve clinical pregnancy rate, continuous pregnancy rate and live birth rate after IVF-ET by alleviating anxiety and depression. This article reviews the research progress on anxiety and depression states in women receiving IVF-ET and the impact on outcome of IVF-ET and related mechanisms, as well as the application of psychological intervention for alleviating anxiety and depression, so as to provide insights in improving the outcome of IVF-ET.
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Affiliation(s)
- Yue Zhou
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan 250014, China.
| | - Zhen'gao Sun
- Reproductive & Genetic Center of Integrated Chinese & Western Medicine, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250014, China.
| | - Jingyan Song
- Reproductive & Genetic Center of Integrated Chinese & Western Medicine, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250014, China
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Yosri MM, Hamada HA, Abd El-Rahman Mohamed M, Yousef AM. Effect of different squatting exercises on menstrual aspects, pelvic mechanics and uterine circulation in primary dysmenorrhoea: a randomised controlled trial. J OBSTET GYNAECOL 2022; 42:3658-3665. [PMID: 36519235 DOI: 10.1080/01443615.2022.2153021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
This was a randomised trial aimed to determine squatting exercises' effects on menstruation, pelvic mechanics, and uterine circulation in primary dysmenorrhoea. A total of 120 females with primary dysmenorrhoea were assigned into group (A), receiving yoga protocol, or groups (B, C & D), receiving yoga protocol added to modified wall squat, sumo squat, or deep squat, respectively. Menstrual pain and distress, pelvic inclination, and uterine circulation were measured before and after interventions using a pain scale, a questionnaire, palpation metre, and Doppler ultrasonography, respectively. There was a significant reduction in pain intensity in groups B & C (effect size = 3.97 & 5.89, respectively), compared to group A (effect size = 3.68), and in group C (effect size = 5.89) compared to group D (effect size = 3.94), pain subscale in the groups B, C & D (effect size = 1.69, 3.3 & 3.41, respectively), compared to group A (effect size= 2.47), water retention subscale in group D effect size 0.90 compared to group A (effect size =0.41) and in the questionnaire total scores in the groups C &D (effect size = 2.3 & 2.46, respectively) when compared to group A (effect size =1.94). Adding squatting exercises to yoga is more effective than yoga alone in reducing menstrual pain and distress.IMPACT STATEMENTWhat is already known on this subject? Physical exercises positively affect primary dysmenorrhoea in terms of decreased pain and distress, possibly through altering faulty posture. Squatting exercises affect lumbopelvic mechanics.What do the results of this study add? This study explores the effect of squatting exercises on pelvic inclination, menstrual aspects, and circulation.What are the implications of these findings for clinical practice and/or further research? Squatting exercises can be utilised to affect pelvic mechanics leading to decreased menstrual pain and distress, because of decreased pelvic congestion.
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Affiliation(s)
- Mahitab Mohamed Yosri
- Department of Women’s Health, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Hamada Ahmed Hamada
- Department of Biomechanics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | | | - Amel Mohamed Yousef
- Department of Women’s Health, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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Demir Yıldırım A, Güngör Satılmış İ. The Effects of Yoga on Pregnancy, Stress, and Anxiety in Infertile Individuals: A Systematic Review. Holist Nurs Pract 2022; 36:275-283. [PMID: 35981112 DOI: 10.1097/hnp.0000000000000543] [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: 11/26/2022]
Abstract
It is believed that practicing yoga has a healing effect on reproductive organs and increases blood circulation. The aim of the present study was to systematically evaluate the results of previous studies on the effects of practicing yoga on infertility problems, depression caused by infertility, and pregnancy outcomes. This literature review was conducted from July through August 2020 from the following sources: Cochrane, Science Direct, Scopus, Medline, Complementary Index, and Google Scholar for the international data; Turkish Academic Network and Information Center, and the Council of Higher Education Thesis Search Database for the Turkish data. "Infertility" and "yoga" keywords were used, and the related publications were searched without date limitations. Twenty-four research articles that involved the practice of yoga were included in the study. The included studies were conducted in 9 different countries, the majority of which (n = 12) were conducted in India. In 3 of the studies, hatha yoga, and in 1 study, vinyasa yoga were performed; in the other studies, different yoga asanas that activated the pelvic regions were performed. In this systematic review, yoga practice was found to have a positive effect on stress, anxiety, and depression and emphasized that it should be applied as adjunctive therapy, especially during in vitro fertilization treatment. These studies have also shown that practicing yoga has a positive effect on pregnancy outcomes.
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Affiliation(s)
- Ayça Demir Yıldırım
- Midwifery Department, Faculty of Health Sciences, Uskudar University, Istanbul, Turkey (Dr Demir Yıldırım); and Department of Women's Health and Diseases, Florence Nightingale Faculty of Nursing, Istanbul University-Cerrahpaşa, Istanbul, Turkey (Dr Güngör Satılmış)
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Nayak H, Gerstl B, Sharma N, Appaneravanda LC, Gunasheela D. The Use of Integrative Medical Services to Address Psychological Concerns around Infertility in an Indian Academic Medical Centre. J Hum Reprod Sci 2022; 15:171-176. [PMID: 35928464 PMCID: PMC9345279 DOI: 10.4103/jhrs.jhrs_188_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 06/12/2022] [Accepted: 06/14/2022] [Indexed: 11/12/2022] Open
Abstract
Background Alternative and complementary therapies have been gaining popularity as ways to reduce anxiety in patients. Aim: This study aimed to assess whether yoga and meditation could decrease the severity of anxiety in Indian women diagnosed with infertility Study. Study Setting and Design: This was a retrospective data analysis of anxiety score of 354 women undergoing treatment at a tertiary infertility hospital between January 2016 and December 2018. Materials and Method: Women participated in group yoga, meditation and counselling therapy intervention during their treatment period. A self-reported questionnaire that used the Generalised Anxiety Disorder-7 criteria measured the participants’ severity of anxiety at the start of and again at the end of the intervention. Statistical Analysis: Demographic analysis and a two-tailed paired t-test were applied between groups. Results: The results indicated that there was a statistically significant mean reduction (7.3 ± 2.7) in the anxiety scores of the participants between entry (12.94 ± 2.65) and following exposure (5.39 ± 1.99) to the intervention (P < 0.0001). The mean reduction in scores remained similar between participants who received ≤6 sessions (7.50 ± 2.68) and participants who received >6 sessions (7.10 ± 2.64) (P > 0.05). Among the participants that experienced mild anxiety at baseline (n = 43), 72.1% (n = 31) reported experiencing minimal anxiety following the intervention (P < 0.0001). Among those that experienced moderate anxiety at baseline (n = 213), 32.4% (n = 69) reported experiencing minimal anxiety post-intervention (P < 0.0001). Participants who expressed severe anxiety at baseline (n = 94, 26.6%), reported experiencing minimal anxiety (13.8% [n = 13)], mild anxiety (81.9% [n = 77]) and moderate anxiety (4.3% [n = 4]) after exposure to the intervention (P < 0.0001). None of the participants reported experiencing severe anxiety post-intervention. Conclusion: The benefits of alternative anxiety-reduction therapies for women diagnosed with infertility have been demonstrated in this study. These therapies can be used to complement the routine treatment of such patients.
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Affiliation(s)
- Hita Nayak
- Department of Reproductive Medicine, Gunasheela Surgical and Maternity Hospital, Bengaluru, Karnataka, India
| | - Brigitte Gerstl
- Department of Reproductive Medicine, Gunasheela Surgical and Maternity Hospital, Bengaluru, Karnataka, India.,Department of Biostatistics, The Kirby Institute, University of New South Wales, Sydney, Australia.,Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia
| | - Neha Sharma
- Department of Reproductive Medicine, Gunasheela Surgical and Maternity Hospital, Bengaluru, Karnataka, India
| | | | - Devika Gunasheela
- Department of Reproductive Medicine, Gunasheela Surgical and Maternity Hospital, Bengaluru, Karnataka, India
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Abstract
This study was conducted to evaluate the effect of yoga on pain levels in female students with primary dysmenorrhea. This study is a randomized experimental study with control group and pretest post-test practice. This study included 60 volunteer female students (30 experimental and 30 control groups). The patients in the experimental group took part in the yoga program a total of 12 sessions, once per week for 12 weeks. "Personal Information Form", "Visual Analog Skala (VAS)" and "Dysmenorrhea Monitoring Form (DMF)" were used in data collection process. To measure dysmenorrhea pain, the students were requested to mark a number between 1 and 10 on the VAS scale according to the severity of their pain on the menstruation starting date. The yoga applications were used for three menstrual cycles. The mean age of the students in the experimental group was 20.30 ± 0.46, while the mean age of the students in the control group was 20.46 ± 0.50. The difference between the pain levels of the students in the experimental group in the first, second, third and fourth measurements was found to be statistically significant (p < 0.001). It was determined that the difference between the pain levels of the students in the control group in the first, second, third and fourth measurements was not statistically significant (p > 0.05). Yoga can be used as an effective intervention in reducing menstrual pain in women with primary dysmenorrhea.
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Affiliation(s)
- Nurcan Kirca
- Faculty of Nursing, Department of Obstetrics & Gynecological Nursing, Akdeniz University, Antalya, Turkey
| | - AslıSis Celik
- Faculty of Nursing, Department of Obstetrics & Gynecological Nursing, Ataturk University, Erzurum, Turkey
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Boedt T, Vanhove AC, Vercoe MA, Matthys C, Dancet E, Lie Fong S. Preconception lifestyle advice for people with infertility. Cochrane Database Syst Rev 2021; 4:CD008189. [PMID: 33914901 PMCID: PMC8092458 DOI: 10.1002/14651858.cd008189.pub3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Infertility is a prevalent problem that has significant consequences for individuals, families, and the community. Modifiable lifestyle factors may affect the chance of people with infertility having a baby. However, no guideline is available about what preconception advice should be offered. It is important to determine what preconception advice should be given to people with infertility and to evaluate whether this advice helps them make positive behavioural changes to improve their lifestyle and their chances of conceiving. OBJECTIVES To assess the safety and effectiveness of preconception lifestyle advice on fertility outcomes and lifestyle behavioural changes for people with infertility. SEARCH METHODS We searched the Cochrane Gynaecology and Fertility Group Specialised Register of controlled trials, CENTRAL, MEDLINE, Embase, PsycINFO, AMED, CINAHL, trial registers, Google Scholar, and Epistemonikos in January 2021; we checked references and contacted field experts to identify additional studies. SELECTION CRITERIA We included randomised controlled trials (RCTs), randomised cross-over studies, and cluster-randomised studies that compared at least one form of preconception lifestyle advice with routine care or attention control for people with infertility. DATA COLLECTION AND ANALYSIS We used standard methodological procedures recommended by Cochrane. Primary effectiveness outcomes were live birth and ongoing pregnancy. Primary safety outcomes were adverse events and miscarriage. Secondary outcomes included reported behavioural changes in lifestyle, birth weight, gestational age, clinical pregnancy, time to pregnancy, quality of life, and male factor infertility outcomes. We assessed the overall quality of evidence using GRADE criteria. MAIN RESULTS We included in the review seven RCTs involving 2130 participants. Only one RCT included male partners. Three studies compared preconception lifestyle advice on a combination of topics with routine care or attention control. Four studies compared preconception lifestyle advice on one topic (weight, alcohol intake, or smoking) with routine care for women with infertility and specific lifestyle characteristics. The evidence was of low to very low-quality. The main limitations of the included studies were serious risk of bias due to lack of blinding, serious imprecision, and poor reporting of outcome measures. Preconception lifestyle advice on a combination of topics versus routine care or attention control Preconception lifestyle advice on a combination of topics may result in little to no difference in the number of live births (risk ratio (RR) 0.93, 95% confidence interval (CI) 0.79 to 1.10; 1 RCT, 626 participants), but the quality of evidence was low. No studies reported on adverse events or miscarriage. Due to very low-quality evidence, we are uncertain whether preconception lifestyle advice on a combination of topics affects lifestyle behavioural changes: body mass index (BMI) (mean difference (MD) -1.06 kg/m², 95% CI -2.33 to 0.21; 1 RCT, 180 participants), vegetable intake (MD 12.50 grams/d, 95% CI -8.43 to 33.43; 1 RCT, 264 participants), alcohol abstinence in men (RR 1.08, 95% CI 0.74 to 1.58; 1 RCT, 210 participants), or smoking cessation in men (RR 1.01, 95% CI 0.91 to 1.12; 1 RCT, 212 participants). Preconception lifestyle advice on a combination of topics may result in little to no difference in the number of women with adequate folic acid supplement use (RR 0.98, 95% CI 0.95 to 1.01; 2 RCTs, 850 participants; I² = 4%), alcohol abstinence (RR 1.07, 95% CI 0.99 to 1.17; 1 RCT, 607 participants), and smoking cessation (RR 1.01, 95% CI 0.98 to 1.04; 1 RCT, 606 participants), on low quality evidence. No studies reported on other behavioural changes. Preconception lifestyle advice on weight versus routine care Studies on preconception lifestyle advice on weight were identified only in women with infertility and obesity. Compared to routine care, we are uncertain whether preconception lifestyle advice on weight affects the number of live births (RR 0.94, 95% CI 0.62 to 1.43; 2 RCTs, 707 participants; I² = 68%; very low-quality evidence), adverse events including gestational diabetes (RR 0.78, 95% CI 0.48 to 1.26; 1 RCT, 317 participants; very low-quality evidence), hypertension (RR 1.07, 95% CI 0.66 to 1.75; 1 RCT, 317 participants; very low-quality evidence), or miscarriage (RR 1.50, 95% CI 0.95 to 2.37; 1 RCT, 577 participants; very low-quality evidence). Regarding lifestyle behavioural changes for women with infertility and obesity, preconception lifestyle advice on weight may slightly reduce BMI (MD -1.30 kg/m², 95% CI -1.58 to -1.02; 1 RCT, 574 participants; low-quality evidence). Due to very low-quality evidence, we are uncertain whether preconception lifestyle advice affects the percentage of weight loss, vegetable and fruit intake, alcohol abstinence, or physical activity. No studies reported on other behavioural changes. Preconception lifestyle advice on alcohol intake versus routine care Studies on preconception lifestyle advice on alcohol intake were identified only in at-risk drinking women with infertility. We are uncertain whether preconception lifestyle advice on alcohol intake affects the number of live births (RR 1.15, 95% CI 0.53 to 2.50; 1 RCT, 37 participants; very low-quality evidence) or miscarriages (RR 1.31, 95% CI 0.21 to 8.34; 1 RCT, 37 participants; very low-quality evidence). One study reported on behavioural changes for alcohol consumption but not as defined in the review methods. No studies reported on adverse events or other behavioural changes. Preconception lifestyle advice on smoking versus routine care Studies on preconception lifestyle advice on smoking were identified only in smoking women with infertility. No studies reported on live birth, ongoing pregnancy, adverse events, or miscarriage. One study reported on behavioural changes for smoking but not as defined in the review methods. AUTHORS' CONCLUSIONS Low-quality evidence suggests that preconception lifestyle advice on a combination of topics may result in little to no difference in the number of live births. Evidence was insufficient to allow conclusions on the effects of preconception lifestyle advice on adverse events and miscarriage and on safety, as no studies were found that looked at these outcomes, or the studies were of very low quality. This review does not provide clear guidance for clinical practice in this area. However, it does highlight the need for high-quality RCTs to investigate preconception lifestyle advice on a combination of topics and to assess relevant effectiveness and safety outcomes in men and women with infertility.
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Affiliation(s)
- Tessy Boedt
- Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | - Anne-Catherine Vanhove
- Centre for Evidence-Based Practice, Belgian Red Cross, Mechelen, Belgium
- Belgian Centre for Evidence-Based Medicine - Cochrane Belgium, Leuven, Belgium
| | - Melissa A Vercoe
- Department of Obstetrics and Gynaecology, University of Auckland, Auckland, New Zealand
| | - Christophe Matthys
- Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | - Eline Dancet
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Sharon Lie Fong
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
- Department of Obstetrics and Gynaecology, Leuven University Fertility Center, University Hospitals Leuven, Leuven, Belgium
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Kirca N, Ongen M. Perceived stress and sleep quality before oocyte pick-up, embryo transfer, and pregnancy test in women receiving in vitro fertilization treatment. Sleep Breath 2021; 25:1977-1985. [PMID: 33624218 DOI: 10.1007/s11325-021-02328-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 02/05/2021] [Accepted: 02/12/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Infertility is a major health problem that affects both the family and the community. Women receiving infertility treatment may suffer from stress and even experience sleep disturbance. Sleep quality is an important factor of human health and well-being. Sleep disturbances tend to occur among infertile women during in vitro fertilization treatment. Many studies have focused on the stress and sleep quality associated with their treatment in infertile women. However, few studies have investigated factors linked to their sleep disturbances. OBJECTIVE This study investigated the relationship between perceived stress and sleep quality before oocyte pick-up, in vitro fertilization-embryo transfer, and pregnancy test in women receiving in vitro fertilization treatment. MATERIAL AND METHODS This prospective, longitudinal study was conducted between January and May 2020. One hundred fifty-seven women receiving infertility treatment were included in the study. A personal information form, the Perceived Stress Scale (PSS), and the Pittsburgh Sleep Quality Index (PSQI) were used to collect data. RESULTS The relationship between the Perceived Stress Scale scores and the Pittsburgh Sleep Quality Index scores in all stages of infertility treatment was found to be positively significant at the p < .001 significance level. CONCLUSION Perceived stress level was high in women throughout the infertility treatment. Our study suggested that sleep quality was impaired as stress increased. TRIAL REGISTRATION 70904504/38.
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Affiliation(s)
- Nurcan Kirca
- Department of Obstetrics & Gynecological Nursing, Faculty of Nursing, Akdeniz University, Dumlupinar Boulevard, Antalya, Turkey.
| | - Meryem Ongen
- Department of Obstetrics & Gynecological Nursing, Faculty of Nursing, Akdeniz University, Dumlupinar Boulevard, Antalya, Turkey
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