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Nadri P, Nadri T, Gholami D, Zahmatkesh A, Hosseini Ghaffari M, Savvulidi Vargova K, Georgijevic Savvulidi F, LaMarre J. Role of miRNAs in assisted reproductive technology. Gene 2024; 927:148703. [PMID: 38885817 DOI: 10.1016/j.gene.2024.148703] [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: 01/10/2024] [Revised: 06/11/2024] [Accepted: 06/14/2024] [Indexed: 06/20/2024]
Abstract
Cellular proteins and the mRNAs that encode them are key factors in oocyte and sperm development, and the mechanisms that regulate their translation and degradation play an important role during early embryogenesis. There is abundant evidence that expression of microRNAs (miRNAs) is crucial for embryo development and are highly involved in regulating translation during oocyte and early embryo development. MiRNAs are a group of short (18-24 nucleotides) non-coding RNA molecules that regulate post-transcriptional gene silencing. The miRNAs are secreted outside the cell by embryos during preimplantation embryo development. Understanding regulatory mechanisms involving miRNAs during gametogenesis and embryogenesis will provide insights into molecular pathways active during gamete formation and early embryo development. This review summarizes recent findings regarding multiple roles of miRNAs in molecular signaling, plus their transport during gametogenesis and embryo preimplantation.
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Affiliation(s)
- Parisa Nadri
- Department of Animal Science, College of Agriculture, Isfahan University of Technology, Isfahan, Iran
| | - Touba Nadri
- Department of Animal Science, College of Agriculture, Urmia University, Urmia, Iran; Department of Animal Science, College of Agriculture, Tehran University, Karaj, Iran.
| | - Dariush Gholami
- Department of Microbial Biotechniligy, Faculty of Biotechnology, Amol University of Special Modern Technologies, Amol, Iran
| | - Azadeh Zahmatkesh
- Department of Anaerobic Vaccine Research and Production, Razi Vaccine and Serum Research Institute (RVSRI), Agricultural Research, Education and Extension Organization (AREEO), Karaj, Iran
| | | | - Karin Savvulidi Vargova
- Institute of Pathological Physiology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Filipp Georgijevic Savvulidi
- Department of Animal Science, Faculty of Agrobiology, Food and Natural Resources, Czech University, Prague, Kamýcká, Czech Republic
| | - Jonathan LaMarre
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Canada
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Poulter MML, Balsom AA, Gordon JL. Pilot trial of a new self-directed psychological intervention for infertility-related distress. Pilot Feasibility Stud 2024; 10:111. [PMID: 39152484 PMCID: PMC11328509 DOI: 10.1186/s40814-024-01535-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 08/05/2024] [Indexed: 08/19/2024] Open
Abstract
BACKGROUND Now affecting one in six couples in Canada, infertility is defined as a lack of conception after 12 or more months of regular, unprotected heterosexual intercourse. Infertility is associated with immense psychological burden, particularly for individuals assigned female at birth. Yet existing psychological interventions are not specialized to this population and have been shown to be only marginally effective at relieving distress related to infertility. Thus, a new online self-directed psychological intervention was co-created with a panel of women experiencing infertility, and ultimately consisted of six 10-min video modules addressing the cognitive, emotional, and interpersonal aspects of infertility-related distress. METHODS In the current study, 21 women experiencing reduced quality of life related to infertility were recruited to participate in a one-arm pre-post pilot testing the feasibility, acceptability, and preliminary efficacy of the program. Participant adherence and retention were monitored, and participants rated the credibility of the program and the helpfulness of each module as well as provided feedback on the content and format of the program. Pre-to-post changes in fertility quality of life, anxious symptoms, depressive symptoms, and relationship satisfaction were examined. RESULTS The program modules were highly rated by participants, with average helpfulness ratings ranging from 7.5 to 8.2/10. Two participants became pregnant and therefore stopped prematurely, 79% of the remaining participants completed all six modules, and participants reported completing 52.8 (SD = 82.0) min of homework per week. Participants perceived the intervention as highly credible and generally approved of the format, length, and speed; however, 68% of participants had recommendations for additional content to be included in the intervention. While relationship satisfaction did not change significantly over time, large pre-to-post improvements in fertility quality of life, depression, and anxiety were observed (p < .001; Cohen's ds = 0.9-1.3). CONCLUSIONS This self-directed intervention was well received and has the potential to be highly effective in reducing infertility-related distress, informing future development and optimization. TRIAL REGISTRATION ClinicalTrials.gov, NCT05103982.
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Affiliation(s)
| | - Ashley A Balsom
- Department of Psychology, University of Regina, Regina, SK, Canada
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Clark CJ, Al-Hamdan Z, Bawadi H, Alsalem H, Hamadneh J, Abu Al-Haija A, Hadd AR, Spencer RA, Bergenfeld I, Hall-Clifford R. Preventing violence and enhancing mental health among clients of an invitro fertilization clinic in Jordan: results of a pre/post pilot test of the use of cognitive behavioral therapy. Reprod Health 2024; 21:117. [PMID: 39129010 PMCID: PMC11316984 DOI: 10.1186/s12978-024-01860-8] [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: 10/18/2023] [Accepted: 08/05/2024] [Indexed: 08/13/2024] Open
Abstract
INTRODUCTION Infertility increases women's risk of intimate partner violence (IPV). Cognitive behavioral therapy (CBT) is commonly used to treat mental health problems among fertility treatment seeking patients. CBT has not been tested for its potential to reduce IPV in this population. We pilot test the use of CBT to prevent IPV and improve patients' mental health in a fertility clinic in Jordan. METHODS Of 38 eligible fertility-treatment seeking couples, 16 consented and underwent up to 11 CBT sessions (average = 9) over 3 months. Interviews at baseline and 16 weeks post intervention (endline) assessed IPV, quality of life, social support, coping, and fear of spouse. Wilcoxon signed-rank and McNemar's tests were used to assess change in outcomes. RESULTS At baseline, women's rates of IPV, depression, and anxiety were 75%, 87.5%, and 75% respectively, whereas men's rates of depression and anxiety were each 80%. Average baseline post-traumatic stress disorder (PTSD) symptoms for men and women were 3.3 and 2.7 respectively out of 5. IPV decreased 25% after treatment, and women reported less spousal fear. For both men and women, depression, anxiety, and PTSD symptoms decreased and social support and fertility quality of life improved. CONCLUSION Psychosocial support should be standard of care for the treatment of infertility given the burden of mental health problems and IPV and the utility of CBT in this patient population. Co-design with couples is needed to identify strategies to bolster participation along with population-based interventions to combat the stigma of infertility and mental health service use and enhance women's status.
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Affiliation(s)
- Cari Jo Clark
- Rollins School of Public Health, Emory University, Atlanta, GA, USA.
| | - Zaid Al-Hamdan
- Faculty of Nursing/WHO Collaborating Center, Jordan University of Science and Technology, Irbid, Jordan
| | - Hala Bawadi
- Maternal and Child Health Nursing Department, the University of Jordan, Amman, Jordan
| | - Hussein Alsalem
- Psychosocial Department, Institute for Family Health, King Hussein Foundation, Amman, Jordan
| | - Jehan Hamadneh
- Consultant of Reproductive Endocrinology and IVFHead of Obstetrics and Gynecology DepartmentDirector of IVF Center/ KAUH, Jordan University of Science and Technology (JUST), King Abdullah University Hospital (KAUH), Irbid, Jordan
| | | | | | | | - Irina Bergenfeld
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Rachel Hall-Clifford
- Center for the Study of Human Health and Department of Sociology, Emory University, Atlanta, GA, USA
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Gameiro S, Leone D, Mertes H. Fertility clinics have a duty of care towards patients who do not have children with treatment. Hum Reprod 2024; 39:1591-1598. [PMID: 38890127 PMCID: PMC11291940 DOI: 10.1093/humrep/deae128] [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: 02/20/2024] [Revised: 04/06/2024] [Indexed: 06/20/2024] Open
Abstract
In medically assisted reproduction (MAR) success has mostly been measured in terms of achieving (healthy) livebirths. We argue this focus is too narrow and that success should be measured in terms of alleviating patient suffering caused by an unfulfilled child wish. The major implication is that clinics must better tailored care to effectively support patients who do not have child(ren) with treatment. First, we argue that clinics have a duty of care towards patients for whom MAR does not result in children because this is a common treatment outcome, because treatment is burdensome and creates new losses for patients, and because the field has the necessary expertise to provide support and it is part of patient-centred care. Then, we examine concerns about the adequacy of addressing the possibility that treatment may end without children, namely, that this may hinder patients' hope and put them off doing treatment, and that it may be perceived as a sign of clinical incompetence, as well as concerns about the required skill set. We end with a set of research-informed recommendations to promote healthy adjustment to ending fertility treatment without children. These focus on the need to reconceptualize 'success' and 'failure' in MAR, to promote open discussion about the possibility of treatment not resulting in children and encourage patients to develop 'plan(s) B', to support patients who end treatment without children, and to create the organizational structures needed to support clinics and healthcare professionals in this endeavour.
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Affiliation(s)
- S Gameiro
- School of Psychology, Cardiff University, Cardiff, UK
| | - D Leone
- Unit of Clinical Psychology, San Paolo University Hospital, Milan, Italy
| | - H Mertes
- Department of Philosophy and Moral Sciences, Ghent University, Gent, Belgium
- Department of Public Health and Primary Care, Ghent University, Gent, Belgium
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Szigeti F J, Kazinczi C, Szabó G, Sipos M, Ujma PP, Purebl G. The clinical effectiveness of the Mind/Body Program for Infertility on wellbeing and assisted reproduction outcomes: a randomized controlled trial in search for active ingredients. Hum Reprod 2024; 39:1735-1751. [PMID: 38852061 PMCID: PMC11291950 DOI: 10.1093/humrep/deae119] [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: 12/19/2023] [Revised: 04/20/2024] [Indexed: 06/10/2024] Open
Abstract
STUDY QUESTION Does the Mind/Body Program for Infertility (MBPI) perform better, due to certain distinctive elements, than a partly matched support group in improving the wellbeing and medically assisted reproduction (MAR) outcomes of women with elevated distress levels in a clinical setting? SUMMARY ANSWER While robust enhancements occurred in the wellbeing overall, the cognitive behavioural and formalized stress management elements of the MBPI allowed a significantly stronger improvement in trait anxiety, but not in other mental health and MAR outcomes, compared with a support group. WHAT IS KNOWN ALREADY Mind-body psychological programmes adjacent to MAR have been found to improve women's mental states and possibly increase chances of pregnancy. However, not enough is known about the programme's effectiveness among patients with elevated distress levels in routine clinical settings, nor is it clear which of its particular ingredients are specifically effective. STUDY DESIGN, SIZE, DURATION A pre-post design, single-centre, randomized controlled trial was performed between December 2019 and October 2022 (start and end of recruitment, respectively). The sample size (n = 168) was calculated to detect superiority of the MBPI in improving fertility-related quality of life. Randomization was computer-based, with random numbers concealing identities of patients until after allocation. PARTICIPANTS/MATERIALS, SETTING, METHODS The trial was conducted at a large university teaching hospital. A total of 168 patients were randomly assigned to the mind-body (MBPI) group (n = 84) and the fertility support (FS) control group (n = 84). Patients received a 10-week, 135-min/week group intervention, with the FS group following the same format as the MBPI group, but with a less restricted and systematic content, and without the presumed effective factors. The number of patients analysed was n = 74 (MBPI) and n = 68 (FS) for post-intervention psychological outcomes, and n = 54 (MBPI) and n = 56 (FS) for pregnancy outcomes at a 30-month follow-up. MAIN RESULTS AND THE ROLE OF CHANCE Significant improvements occurred in both groups in all psychological domains (adjusted P < 0.001), except for treatment-related quality of life. Linear mixed-model regression analysis did not reveal significantly greater pre-post improvements in the MBPI group than in the FS group in fertility-related quality of life (difference in differences (DD) = 4.11 [0.42, 7.80], d = 0.32, adjusted P = 0.124), treatment-related quality of life (DD = -3.08 [-7.72, 1.55], d = -0.20, adjusted P = 0.582), infertility-specific stress (DD = -2.54 [-4.68, 0.41], d = -0.36, adjusted P = 0.105), depression (DD = -1.16 [3.61, 1.29], d = -0.13, adjusted P = 0.708), and general stress (DD = -0.62 [-1.91, 0.68], d = -0.13, adjusted P = 0.708), but it did show a significantly larger improvement in trait anxiety (DD = -3.60 [-6.16, -1.04], d = -0.32, adjusted P = 0.042). Logistic regression showed no group effect on MAR pregnancies, spontaneous pregnancies, or live births. LIMITATIONS, REASONS FOR CAUTION The follow-up only covered MAR-related medical outcomes and no psychological variables, and their rates were not equal in the two groups. Biological factors other than age, aetiology, and duration of infertility may have confounded the study results. Loss to follow-up was between 5% and 10%, which may have led to some bias. WIDER IMPLICATIONS OF THE FINDINGS The psychologically and medically heterogeneous sample, the normal clinical setting and the low attrition rate all raise the external validity and generalizability of our study. The MBPI works not only in controlled conditions, but also in routine MAR practice, where it can be introduced as a cost-effective, low-intensity psychological intervention, within the framework of stepped care. More studies are needed to further identify its active ingredients. STUDY FUNDING/COMPETING INTEREST(S) The authors received no financial support for the research, authorship, and/or publication of this article. The authors have no conflict of interest to disclose. TRIAL REGISTRATION NUMBER ClinicalTrials.gov NCT04151485. TRIAL REGISTRATION DATE 5 November 2019. DATE OF FIRST PATIENT’S ENROLMENT 15 December 2019.
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Affiliation(s)
- Judit Szigeti F
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
- Department of Otorhinolaryngology, Head and Neck Surgery, Semmelweis University, Budapest, Hungary
| | - Csaba Kazinczi
- Department of Clinical Psychology, Semmelweis University, Budapest, Hungary
- Doctoral School of Clinical Medicine, University of Szeged, Szeged, Hungary
| | - Georgina Szabó
- Doctoral School of Mental Health Sciences, Semmelweis University, Budapest, Hungary
- Department of Psychiatry, North Buda Saint John’s Hospital Centre and Outpatient Clinic, Budapest, Hungary
| | - Miklós Sipos
- Department of Obstetrics and Gynecology, Assisted Reproduction Centre, Semmelweis University, Budapest, Hungary
| | | | - György Purebl
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
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Adhikary P, Mburu G, Kabra R, Habib NA, Kiarie J, Dhabhai N, Chowdhury R, Mazumder S. Intersectional analysis of the experiences of women who fail to conceive in low and middle income neighbourhoods of Delhi, India: Findings from a qualitative study. PLoS One 2024; 19:e0304029. [PMID: 38959201 PMCID: PMC11221677 DOI: 10.1371/journal.pone.0304029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 05/05/2024] [Indexed: 07/05/2024] Open
Abstract
BACKGROUND Experiences of delayed conception and infertility have been reported among women. However, the concept of intersectionality is rarely utilised in studies of infertility, and it is particularly uncommon in research from low- and middle- income countries. RESEARCH QUESTION What are the lived experiences of women with delayed conception in low to -middle income neighbourhoods of Delhi, India? METHODS This was a qualitative study (n = 35) that recruited women who had failed to conceive after 18 months of regular unprotected sexual intercourse. Data were collected between February and July 2021. Data were collected through focus group discussions in low income to middle income neighbourhoods of Delhi, India. Analysis identified themes related to intersecting axes of inequality. RESULTS The results showed that gender intersected with economics, masculinity, patriarchal norms and class to influence the experiences of women. The intersection of gender, economics and patriarchal norms compromised women's agency to be active generators of family income, and this dynamic was exacerbated by patrilocal residence. In addition, masculinity contributed to stigmatisation and blaming of women, due to the inaccurate perception that men did not contribute to a couple's infertility. The intersection of gender and social class in medical settings created barriers to women's access to medical information. CONCLUSION Findings from this study provide representative examples of the variety of axes of inequality that shape women's experiences in the study setting. Although these findings may not be generalisable to all women who are experiencing delayed conception, they highlight a need for improved awareness and education on infertility, as well as a need to ensure the availability and accessibility of fertility care for couples in need.
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Affiliation(s)
| | - Gitau Mburu
- UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Rita Kabra
- UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Ndema Abu Habib
- UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - James Kiarie
- UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
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Bardideh K, Jarareh J, Bardideh F, Bardideh A, Mofrad M. The effectiveness of cognitive-behavioural group therapy on infertile men, a randomised clinical trial. J Reprod Infant Psychol 2024; 42:581-594. [PMID: 36576275 DOI: 10.1080/02646838.2022.2162024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 12/19/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Infertility can result in the emergence of depression and anger, the loss of one's identity, and the feeling of guilt in the infertile person. Present study aimed to investigate the effects of cognitive behavioural group therapy (CBGT) on infertile men's anger and positive and negative affect. MATERIALS AND METHODS Forty-three men with infertility for at least five years were selected for the present randomised clinical study. Spielberger's State-Trait Anger Expression Inventory-II (STAXI-II) and the PANAS scale (positive and negative affect) were filled out by the participants, and they were randomly divided into the experimental (22) and control (21) groups. The experimental group received 18 ninety-minute sessions of hybrid group therapy held twice a week, while the control group received no intervention. When the intervention program was over, all participants performed the post-test. Moreover, the post-hoc stage was held two months later. RESULTS The effects of the intervention were significant in terms of state anger, trait anger, anger expression in, anger expression out, positive effects, and negative effects (p < 0.004), but they were not significant concerning the anger control out index (p = 0.241). The significant differences between the two groups were also observed in the post-hoc stage. CONCLUSIONS The CBGT therapy seems to be helpful for infertile men to reduce their anger and negative affect and increase their positive affect by implementing a set of techniques like cognitive regeneration, assertiveness, daily joyful activities, exercises to relax one's muscles, diaphragm respiration, the identification of various fillings, and emotional expression.
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Affiliation(s)
- Kosar Bardideh
- Department of counselling and Psychology, Islamic Azad university, Kish international, Kish, Iran
| | - Jamshid Jarareh
- Department of teacher training, Shahid Rajaee university, Tehran, Iran
| | - Fatemeh Bardideh
- Department of counselling and Psychology, Islamic Azad university, Kish international, Kish, Iran
| | | | - Mohammad Mofrad
- Department of Psychology, Khayyam University of Higher Education, Mashhad, Iran
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Erdemoğlu Ç, Aksoy Derya Y. The effect of hypnofertility on fertility preparedness, stress, and coping with stress in women having in vitro fertilization: A randomized controlled trial. J Reprod Infant Psychol 2024; 42:569-580. [PMID: 36513620 DOI: 10.1080/02646838.2022.2156488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 12/02/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND In vitro fertilisation is a stressful process for women. Hypnofertility is a method that can be used to relieve stress during in vitro fertilisation. It is based on an effective and strong body-mind interaction, as well as balancing the brain and body via positive words and thoughts. OBJECTIVE This study aimed to investigate the effects of hypnofertility on fertility preparedness, stress, and coping with stress in women undergoing in vitro fertilisation. METHODS This study was conducted with a randomised controlled trial design. Hypnofertility-based relaxation, visualisation, imagination, and affirmation techniques were applied to the intervention group at four stages, and no initiative was applied to the women in the control group. The Clinical Trial Registration number of the study is NCT04755270. RESULTS After the hypnofertility method, the mean score of the intervention group in the positive feelings and thoughts subscale of the Fertility Preparedness Scale was higher than that of the control group (p < 0.05). The hypnofertility method caused a significant decrease in the level of infertility stress in the intervention group, and the intervention group used the active-confronting and passive-avoidance methods more than control group did (p < 0.05). CONCLUSION The hypnofertility method increased the levels of preparedness for fertility, reduced stress levels and provided effective strategies to cope with stress.
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Affiliation(s)
- Çiğdem Erdemoğlu
- Department of Mıdwıfery, Health Scıences Faculty, Adıyaman University, Adıyaman, Turkey
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Szabo G, Szigeti F J, Sipos M, Varbiro S, Gonda X. Adherence to dietary recommendations mediates the effect of affective temperaments on infertility treatment outcomes. Sci Rep 2024; 14:12544. [PMID: 38822094 PMCID: PMC11143238 DOI: 10.1038/s41598-024-63343-x] [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: 11/21/2023] [Accepted: 05/28/2024] [Indexed: 06/02/2024] Open
Abstract
Affective temperaments have been shown to robustly affect infertility treatment success. However, identification of possible mediating factors through which they exert their influence is still lacking. A growing number of results suggest that adherence to recommended treatments may be such a mediator, on the one hand, because affective temperaments are known to influence adherence and, on the other hand, because non-adherence negatively influences the treatment outcome. Recommended treatment of infertility involves, beyond medications, dietary and lifestyle changes. The aim of this retrospective cohort study was to evaluate whether adherence to physician-prescribed diet and physical activity recommendations mediates the effect of affective temperaments on infertility treatment outcomes. Among 308 women who underwent infertility treatment in an Assisted Reproduction Center, affective temperaments, adherence to diet, adherence to physical exercise, and infertility treatment success (clinical pregnancy) were assessed besides detailed medical history and demographic parameters. Associations between affective temperaments, adherence to diet and recommended physical activity, and assisted reproduction outcomes were analyzed using generalized linear models and causal mediation analysis. Adherence to physical activity didn't have an effect, but diet adherence increased the odds of infertility treatment success by 130% suggesting its role as a potential mediator. Based on causal mediation analysis, higher depressive and anxious temperament scores were directly associated with 63% and 45% lower odds of achieving clinical pregnancy, respectively, with effects not mediated by diet adherence. Higher irritable temperament scores indirectly decreased the odds of achieving clinical pregnancy by 14%, mediated by diet adherence; while higher cyclothymic temperament scores decreased the odds of achieving clinical pregnancy both directly by 51% and indirectly, mediated by diet adherence by 11%. Our results suggest that diet adherence mediates the mechanism by which irritable and cyclothymic affective temperaments influence IVF treatment success. Since adherence is a modifiable risk factor of infertility treatment success, screening for affective temperaments may help to identify potentially high-risk non-adherent patient groups and offer patient-tailored treatment, which may help increase the chances of a successful pregnancy and live birth in women undergoing IVF treatment.
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Affiliation(s)
- Georgina Szabo
- Doctoral School of Mental Health Sciences, Semmelweis University, Budapest, Hungary
| | - Judit Szigeti F
- Institute of Behavioral Sciences, Semmelweis University, Budapest, Hungary
| | - Miklos Sipos
- Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
| | - Szabolcs Varbiro
- Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
| | - Xenia Gonda
- Department of Psychiatry and Psychotherapy, Semmelweis University, Gyulai Pal utca 2, Budapest, 1085, Hungary.
- NAP3.0-SE Neuropsychopharmacology Research Group, Hungarian Brain Research Program, Semmelweis University, Nagyvárad tér 4., Budapest, 1085, Hungary.
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Salari N, Babajani F, Hosseinian-Far A, Hasheminezhad R, Abdoli N, Haydarisharaf P, Mohammadi M. Global prevalence of major depressive disorder, generalized anxiety, stress, and depression among infertile women: a systematic review and meta-analysis. Arch Gynecol Obstet 2024; 309:1833-1846. [PMID: 38459997 DOI: 10.1007/s00404-024-07444-y] [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: 12/04/2023] [Accepted: 02/16/2024] [Indexed: 03/11/2024]
Abstract
BACKGROUND In recent years, the global prevalence of infertility has increased among women (Talmor and Dunphy, Best Pract Res Clin Obstet Gynaecol 29(4):498-506, 2015) and is considered as a public health concern. One of the impacts of infertility is mental health problems in the patients, which can lead to complications such as stress, anxiety, and depression. The aim of this study is to investigate the global prevalence of major depressive disorder, general anxiety, stress, and depression in infertile women through a systematic review and meta-analysis. METHODS To identify studies that have reported the prevalence of major depressive disorder, generalized anxiety, stress, and depression in infertile women, the PubMed, Scopus, Web of Science, Embase, ScienceDirect, and Google Scholar repositories were systematically searched. Articles published up until February 2023 were included, while no lower time limit was imposed in the search strategy. Heterogeneity of studies was examined using the I2 test and, thus, random-effects model was used to perform the analysis. Data analysis was conducted within the Comprehensive Meta-Analysis (v.2) software. RESULTS In the review of 44 studies with a sample size of 53,300 infertile female patients, the overall prevalence of major depressive disorder (clinical depression), generalized anxiety, stress, and depression was found to be 22.9%, 13.3%, 78.8%, and 31.6% respectively. It was also found that mental health complications are more prevalent among infertile women in Asia (continent). CONCLUSION Considering the prevalence of mental disorders among infertile women, health policymakers can use the results of the present meta-analysis to pay more attention to the mental health of infertile women and devise suitable interventions and programs to reduce and prevent the spread of psychological disorders among infertile women.
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Affiliation(s)
- Nader Salari
- Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Fateme Babajani
- Department of Clinical Psychology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Amin Hosseinian-Far
- Department of Business Systems and Operations, University of Northampton, Northampton, UK
| | - Razie Hasheminezhad
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nasrin Abdoli
- Department of Psychiatry, Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Parisa Haydarisharaf
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Masoud Mohammadi
- Cellular and Molecular Research Center, Gerash University of Medical Sciences, Gerash, Iran.
- Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.
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Shi H, Ge Q, Pan M, Sheng Y, Qi T, Zhou Y, Sun Y, Bai Y, Cai L. Agarose amplification based sequencing characterization cell-free RNA in preimplantation spent embryo medium. Anal Chim Acta 2024; 1296:342331. [PMID: 38401939 DOI: 10.1016/j.aca.2024.342331] [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: 09/15/2023] [Revised: 02/01/2024] [Accepted: 02/03/2024] [Indexed: 02/26/2024]
Abstract
BACKGROUND The cell-free RNA (cf-RNA) of spent embryo medium (SEM) has aroused a concern of academic and clinical researchers for its potential use in non-invasive embryo screening. However, comprehensive characterization of cf-RNA from SEM still presents significant technical challenges, primarily due to the limited volume of SEM. Hence, there is urgently need to a small input liquid volume and ultralow amount of cf-RNA library preparation method to unbiased cf-RNA sequencing from SEM. (75) RESULT: Here, we report a high sensitivity agarose amplification-based cf-RNA sequencing method (SEM-Acf) for human preimplantation SEM cf-RNA analysis. It is a cf-RNA sequencing library preparation method by adding agarose amplification. The agarose amplification sensitivity (0.005 pg) and efficiency (105.35 %) were increased than that of without agarose addition (0.45 pg and 96.06 %) by ∼ 90 fold and 9.29 %, respectively. Compared with SMART sequencing (SMART-seq), the correlation of gene expression was stronger in different SEM samples by using SEM-Acf. The cf-RNA number of detected and coverage uniformity of 3' end were significantly increased. The proportion of 5' end adenine, alternative splicing events and short fragments (<400 bp) were increased. It is also found that 4-mer end motifs of cf-RNA fragments was significantly differences between different embryonic stage by day3 spent cleavage medium and day5/6 spent blastocyst medium. (141) SIGNIFICANCE: This study established an efficient SEM amplification and library preparation method. Additionally, we successfully described the characterizations of SEM cf-RNA in preimplantation embryo using SEM-Acf, including expression features and fragment lengths. SEM-Acf facilitates the exploration of cf-RNA as a noninvasive embryo screening biomarker, and opens up potential clinical utilities of small input liquid volume and ultralow amount cf-RNA sequencing. (59).
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Affiliation(s)
- Huajuan Shi
- State Key Laboratory of Digital Medical Engineering, Southeast University, Nanjing, 210096, China
| | - Qinyu Ge
- State Key Laboratory of Digital Medical Engineering, Southeast University, Nanjing, 210096, China.
| | - Min Pan
- School of Medicine, Southeast University, Nanjing, 210097, China
| | - Yuqi Sheng
- State Key Laboratory of Digital Medical Engineering, Southeast University, Nanjing, 210096, China
| | - Ting Qi
- State Key Laboratory of Digital Medical Engineering, Southeast University, Nanjing, 210096, China
| | - Ying Zhou
- State Key Laboratory of Digital Medical Engineering, Southeast University, Nanjing, 210096, China
| | - Yuqing Sun
- State Key Laboratory of Digital Medical Engineering, Southeast University, Nanjing, 210096, China
| | - Yunfei Bai
- State Key Laboratory of Digital Medical Engineering, Southeast University, Nanjing, 210096, China
| | - Lingbo Cai
- Clinical Center of Reproductive Medicine, State Key Laboratory of Reproductive Medicine, First Affiliated Hospital, Nanjing Medical University, Nanjing, China.
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Urata Y, Harada M, Komiya S, Akiyama I, Tuchida C, Nakaoka Y, Fukuda A, Morimoto Y, Kawahara T, Ishikawa Y, Osuga Y. Lifestyle and fertility-specific quality of life affect reproductive outcomes in couples undergoing in vitro fertilization. Front Endocrinol (Lausanne) 2024; 15:1346084. [PMID: 38572478 PMCID: PMC10987689 DOI: 10.3389/fendo.2024.1346084] [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: 11/28/2023] [Accepted: 02/09/2024] [Indexed: 04/05/2024] Open
Abstract
Objective A Mediterranean dietary pattern, sleeping habits, physical activity, and lifestyle appear to affect reproductive health. There are few reports about whether fertility-specific quality of life (QOL) is linked to infertility treatment outcomes. The aim of this study is to investigate when lifestyle factors and fertility-specific QOL are comprehensively considered, which factors influence assisted reproductive technology (ART) outcomes. Methods This prospective cohort includes 291 women undergoing a first ART treatment at multiple centers in Japan and was designed to evaluate the influence of diet, physical activity, sleeping pattern, computer use duration, and fertility-specific quality of life tool (FertiQoL) score on ART treatment outcomes using a questionnaire. The primary endpoint was the good-quality blastocyst rate per oocyte retrieval and the secondary endpoints were a positive pregnancy test and gestational sac (GS) detection. Results The good-quality blastocyst rate per oocyte retrieval tended to be negatively associated with frequent fish consumption. After all embryo transfer (ET) cycles, a positive pregnancy test tended to be positively associated with longer sleep and longer computer use (OR = 1.6, 95% CI = 0.9-2.7 and OR = 1.7, CI = 1.0-2.8, respectively) and negatively associated with a smoking partner (OR = 0.6, CI = 0.3-1.0). GS detection was positively and significantly associated with frequent olive oil intake and longer computer use (OR = 1.7, CI = 1.0-3.0 and OR = 1.7, CI = 1.0-3.0, respectively). After ET cycles with a single blastocyst, a positive pregnancy test was positively and significantly associated with longer computer use (OR = 2.0, CI = 1.1-3.7), while GS detection was significantly more likely in women with longer computer use (OR = 2.1, CI = 1.1-3.8) and tended to be more likely in women with a higher FertiQoL Total scaled treatment score (OR = 1.8, CI = 1.0-3.3). p < 0.05 was considered statistically significant and 0.05 ≤ p <0.01 as tendency. Conclusions Olive oil may be an important factor in dietary habits. Fertility-specific QOL and smoking cessation guidance for partners are important for infertile couples.
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Affiliation(s)
- Yoko Urata
- Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Miyuki Harada
- Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shinnosuke Komiya
- HORAC Grand Front Osaka Clinic, Osaka, Japan
- Department of Obstetrics and Gynecology, Kansai Medical University Graduate School of Medicine, Osaka, Japan
| | - Ikumi Akiyama
- Department of Obstetrics and Gynecology, The Fraternity Memorial Hospital, Tokyo, Japan
| | - Chihiro Tuchida
- Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | | | | | - Yoshiharu Morimoto
- HORAC Grand Front Osaka Clinic, Osaka, Japan
- IVF Namba Clinic, Osaka, Japan
- IVF Osaka Clinic, Osaka, Japan
| | - Takuya Kawahara
- Clinical Research Promotion Center, The University of Tokyo Hospital, Tokyo, Japan
| | | | - Yutaka Osuga
- Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
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Kissiwaa AVM, Fouché N. Ghanaian women's experiences of unsuccessful in-vitro fertilisation treatment, unravelling their meanings: a Heideggerian hermeneutic phenomenological study. BMC Pregnancy Childbirth 2024; 24:212. [PMID: 38509466 PMCID: PMC10956244 DOI: 10.1186/s12884-024-06365-7] [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: 06/06/2023] [Accepted: 02/23/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Women having experienced infertility over a period usually decide on an option for an invitro fertilisation treatment (IVF). However, in the quest to seek help and to be part of motherhood, they sometimes become unsuccessful in their fertility journey. The researchers aimed to explore the meanings and emotions attached to infertility and unsuccessful invitro fertilisation (IVF) treatment among Ghanaian women, as this area of inquiry is less explored in Africa and specifically in the Ghanaian context. METHODS The study followed a qualitative approach and drew inspiration from the Heideggerian phenomenological philosophy and design. Six (6) women, aged between 29 and 40 years, who had experienced at least one unsuccessful IVF cycle, were purposefully selected from a private specialist fertility hospital in Kumasi, Ghana. One-on-one interviews were conducted with the participants, and the interviews were transcribed verbatim. The collected data was analyzed using Van Manen six-step framework, which helped to uncover the existential meanings and interpretations these women ascribed to their experiences. RESULTS The results of the study revealed four main themes that were deemed essential aspects of meaning for the participants. These themes were: (1) Experiencing an Existential Faith and Hope. The participants described their journey through infertility and invitro fertilisation (IVF) treatment as a profound test of their existential faith and hope finding strength in maintaining a positive outlook despite the challenges and setbacks they faced., (2) Facing up to the Angst: This theme highlights the participants' courage in confronting the emotional dimensions of their struggles. The women acknowledged and confronted their anxieties, fears, and emotional distress associated with their infertility and unsuccessful IVF treatment., (3). Non-disclosedness: This theme refers to the participants' experiences of keeping their struggles with IVF treatment private, often due to societal and cultural factors. (4). Endured feelings of inadequacy of being-in-the-world-of-motherless: Participants expressed feelings of inadequacy, self-doubt, and a sense of being incomplete due to their inability to conceive and fulfill the societal role of motherhood. Their narratives revealed the profound impact of societal expectations on their self-perception and identity. CONCLUSION The study's findings reveal insights into the experiences and interpretations of infertility and unsuccessful IVF treatment among Ghanaian women. Employing Heideggerian hermeneutics, the research elucidates the diverse existential, emotional, and societal aspects inherent in the struggles of infertility. The multifaceted nature of these women's journeys underscores the significance of a comprehensive approach to infertility care that recognizes the cultural, social, emotional, and existential dimensions of the IVF process. Additionally, the study emphasizes the necessity for culturally sensitive support systems and interventions to address the unique challenges faced by this population.
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Affiliation(s)
- Amoah Vida Maame Kissiwaa
- School of Nursing and Midwifery, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana.
| | - Nicola Fouché
- Department of Health and Rehabilitation Sciences, Division of Nursing and Midwifery, University of Cape Town, Cape Town, South Africa
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Sahraian K, Abdollahpour Ranjbar H, Namavar Jahromi B, Cheung HN, Ciarrochi J, Habibi Asgarabad M. Effectiveness of mindful self-compassion therapy on psychopathology symptoms, psychological distress and life expectancy in infertile women treated with in vitro fertilization: a two-arm double-blind parallel randomized controlled trial. BMC Psychiatry 2024; 24:174. [PMID: 38429659 PMCID: PMC10908010 DOI: 10.1186/s12888-023-05411-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 11/28/2023] [Indexed: 03/03/2024] Open
Abstract
OBJECTIVES Infertility is a prominent problem affecting millions of couples worldwide. Recently, there has been a hightened emphasis on elucidating the subtle linkages between infertility treatment leveraging assisted reproductive technology and the complex realm of psychological challenges, as well as efforts in implementation of psychological interventions.The Mindful Self-Compassion (MSC) program seeks to improve self-compassion, compassion for others, mindfulness, and life satisfaction while reducing depression, anxiety, and stress. In the current study, an MSC intervention was performed on infertile women (IW) undergoing in vitro fertilization (IVF) to assess the effectiveness of this intervention in reducing psychological distress and psychopathological symptoms and enhancing life expectancy. METHODS Fifty-seven IW undergoing IVF were randomly allocated to two groups: MSC (n = 29) or treatment as usual (TAU; n = 28). Participants in MSC met once a week for two hours for eight weeks and attended a half-day meditation retreat. The Synder's Hope questionnaire and the Revised 90-Symptom Checklist (SCL-90-R) were used as the primary outcome measures. Data were obtained before the intervention, immediately after the intervention, and two months post-intervention. Repeated measures of ANCOVA and paired t-tests in all assessment points were used to compare the MSC and the TAU groups in outcomes. RESULTS In the MSC group, hopelessness, anger-hostility, anxiety, interpersonal sensitivity difficulties, and depression were significantly reduced compared with the TAU group, and those improvements persisted at the two-month follow-up. Reliable change index revealed that the MSC group's gains were both clinically significant and durable. CONCLUSIONS MSC can facilitate higher life satisfaction and mental well-being for IW undergoing IVF by reducing psychological distress, psychopathological symptoms, and hopelessness. These encouraging findings call for more research into the effectiveness of mindfulness-based therapies in addressing psychological problems among IW undergoing IVF.
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Affiliation(s)
- Kimia Sahraian
- Department of Psychology, Higher Education Center of Eghlid, Eghlid, Iran
- Infertility Research Centre, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Bahia Namavar Jahromi
- Infertility Research Centre, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Obstetrics and Gynecology, School of Medical Science, Shiraz University of Medical Science, Shiraz, Iran
| | - Ho Nam Cheung
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
| | - Joseph Ciarrochi
- Institute for Positive Psychology and Education, Australian Catholic University, North Sydney, NSW, Australia
| | - Mojtaba Habibi Asgarabad
- Department of Psychology, Norwegian University of Science and Technology, 7491 Dragvoll, Trondheim, Norway.
- Health Promotion Research Center, Iran University of Medical Sciences, Tehran, Iran.
- Department of Health Psychology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran.
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15
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Bal Z, Uçar T. The effect of cognitive behavioural therapy and eye movement desensitization and reprocessing techniques on infertile women: a randomized controlled trial. Reprod Biomed Online 2024; 48:103612. [PMID: 38199076 DOI: 10.1016/j.rbmo.2023.103612] [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: 05/30/2023] [Revised: 09/09/2023] [Accepted: 10/09/2023] [Indexed: 01/12/2024]
Abstract
RESEARCH QUESTION What effects do training programmes based on cognitive behavioural therapy (CBT) and eye movement desensitization and reprocessing (EMDR) techniques applied to infertile women affected psychologically and emotionally by infertility have on post-traumatic stress disorder (PTSD) and psychological development? DESIGN This randomized controlled study was conducted between May 2021 and August 2022. The study population included 90 infertile women referred to the IVF unit of a hospital in a province in eastern Turkey: 30 in the CBT group, 30 in the EMDR group and 30 in the control group. Data were collected using a personal information form, the Subjective Units of Disturbance Scale (SUDS), the Validity of Cognition (VoC) scale, the Infertility Distress Scale (IDS), the Impact of Event Scale-Revised (IES-R) and the Post-traumatic Growth Inventory (PTGI). Women in the experimental groups (CBT and EMDR groups) received the intervention in six sessions over 3 weeks. Pre-tests were administered to both experimental groups and the control group, and post-tests were conducted 3 weeks after the intervention. RESULTS The mean scores on the SUDS, IDS and IES-R for women in the experimental groups were significantly lower compared with those for women in the control group following the interventions (P < 0.001). The mean scores on the VoC scale and PTGI for women in the experimental groups were significantly higher compared with those for women in the control group following the interventions (P < 0.001). CONCLUSION The use of CBT and EMDR techniques reduced the negative psychological and emotional effects of infertility among infertile women.
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Affiliation(s)
- Zeynep Bal
- Department of Midwifery, Faculty of Health Sciences, Gaziantep Islamic Science and Technology University, Gaziantep, Turkey.
| | - Tuba Uçar
- Department of Midwifery, Faculty of Health Sciences, Inonu University, Malatya, Turkey
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16
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Shon WJ, Seong H, Song JW, Shin DM. Taste receptor type 1 member 3 is required for the fertility of male mice. Heliyon 2024; 10:e24577. [PMID: 38312691 PMCID: PMC10835302 DOI: 10.1016/j.heliyon.2024.e24577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 12/28/2023] [Accepted: 01/10/2024] [Indexed: 02/06/2024] Open
Abstract
Male infertility is a global health concern. However, its underlying pathophysiology remains unclear. Taste receptor type 1 member 3 (TAS1R3) is highly expressed in the testes, indicating its potential involvement in male fertility. Using wild-type and Tas1r3 knockout (KO) mice, we investigated whether TAS1R3 modulates male reproductive function. Tas1r3 KO mice exhibited reduced male fertility compared to WT mice, with fewer live pups per litter and a delayed first litter. Testicular transcriptome analysis indicated suppressed PKA/CREB/StAR signaling-mediated testosterone synthesis in Tas1r3 KO mice. In silico single-cell RNA sequencing revealed considerably higher Tas1r3 expression in Leydig cells than in other testicular cell subtypes. An in vitro study validated that Tas1r3 knockdown downregulated the expression of Creb1 and steroidogenic genes in Leydig cells. Our results suggest that testicular TAS1R3 is intricately involved in male reproduction via the PKA/CREB/StAR signaling pathway, highlighting its potential as a promising target for addressing male infertility.
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Affiliation(s)
- Woo-Jeong Shon
- Research Institute of Human Ecology, Seoul National University, Gwanak-gu, Seoul 08826, Republic of Korea
- Department of Food and Nutrition, Seoul National University College of Human Ecology, Gwanak-gu, Seoul 08826, Republic of Korea
| | - Hobin Seong
- Department of Food and Nutrition, Seoul National University College of Human Ecology, Gwanak-gu, Seoul 08826, Republic of Korea
| | - Jae Won Song
- Department of Food and Nutrition, Seoul National University College of Human Ecology, Gwanak-gu, Seoul 08826, Republic of Korea
| | - Dong-Mi Shin
- Research Institute of Human Ecology, Seoul National University, Gwanak-gu, Seoul 08826, Republic of Korea
- Department of Food and Nutrition, Seoul National University College of Human Ecology, Gwanak-gu, Seoul 08826, Republic of Korea
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17
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Gordon JL, Poulter MML, Balsom AA, Campbell TS. Testing an Evidence-Based Self-Help Program for Infertility-Related Distress: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e52662. [PMID: 38236638 PMCID: PMC10835586 DOI: 10.2196/52662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 11/10/2023] [Accepted: 11/23/2023] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Infertility-the inability to achieve pregnancy despite ≥12 months of focused attempts to conceive-is experienced by 1 in 6 couples. Women typically carry a disproportionate share of the psychological burden associated with infertility, experiencing poor quality of life, and 30%-40% experiencing depressive mood or anxiety. Unfortunately, currently available psychological interventions targeting infertility-related distress are associated with modest effects. OBJECTIVE Our team, in collaboration with patient advisors, has designed a self-help intervention for infertility-related distress involving 7 weekly 10-minute videos addressing the cognitive, behavioral, and interpersonal challenges associated with infertility, delivered through a mobile app. A feasibility study suggests that it is well accepted and highly effective in reducing symptoms of anxiety and depressed mood among distressed individuals dealing with infertility. This study represents the next step in this line of research: a fully powered randomized controlled trial comparing the intervention to a waitlist control group. METHODS We will recruit 170 individuals struggling to become pregnant in Canada or the United States to be randomized to our 7-week self-help program or a treatment-as-usual condition. The primary outcome will be fertility quality of life, while secondary outcomes will include depressive symptoms, anxious symptoms, and relationship quality, assessed before and after the program as well as biweekly for 16 weeks following completion of the program. Self-reported health care use and the presence of diagnosed mood and anxiety disorders, assessed through a structured psychiatric interview, will also be assessed immediately following the intervention and at the 16-week follow-up assessment. Treatment adherence and retention will also be recorded throughout the intervention. Multilevel modeling will compare the intervention arm to the treatment-as-usual condition in terms of all continuous outcomes across the 9 measurement points. Logistic regression will be used to assess the occurrence of mood and anxiety disorders in the 2 treatment arms at the posttreatment assessment as well as at the 16-week follow-up. Sensitivity analyses will examine potential treatment moderators: membership in the LGBTQIA+ (lesbian, gay, bisexual, transgender, queer, intersex, and asexual) communities, baseline fertility quality of life, cultural background, disability status, and pursuit of conception through medical intervention. RESULTS We expect our intervention to be more effective than treatment-as-usual in improving all mental health parameters assessed and decreasing health care use related to both mental and reproductive health. Effects are expected to be larger with decreasing baseline quality of life and equally effective regardless of membership in the LGBTQIA+ communities, cultural background, or disability status. CONCLUSIONS If our intervention is successful, this would suggest that it should be scaled up and made publicly available. The availability of this program would fill an important gap in light of the high rates of psychopathology among those experiencing infertility and considering the current lack of effective psychotherapy approaches for infertility. TRIAL REGISTRATION Clinicaltrials.gov NCT06006936; https://classic.clinicaltrials.gov/ct2/show/NCT06006936. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/52662.
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Affiliation(s)
| | | | - Ashley A Balsom
- Department of Psychology, University of Regina, Regina, SK, Canada
| | - Tavis S Campbell
- Department of Psychology, University of Calgary, Calgary, SK, Canada
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Iranifard E, Yas A, Mansouri Ghezelhesari E, Taghipour A, Mahmoudinia M, Latifnejad Roudsari R. Treatment suspension due to the coronavirus pandemic and mental health of infertile patients: a systematic review and meta-analysis of observational studies. BMC Public Health 2024; 24:174. [PMID: 38218778 PMCID: PMC10787415 DOI: 10.1186/s12889-023-17628-x] [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: 06/29/2023] [Accepted: 12/31/2023] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND Access to fertility treatments is considered a reproductive right, but because of the quarantine due to the coronavirus pandemic most infertility treatments were suspended, which might affect the psychological and emotional health of infertile patients. Therefore, this study was conducted to review the mental health of infertile patients facing treatment suspension due to the coronavirus pandemic. METHODS This study was conducted based on the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guideline. The Web of Science, PubMed, Embase, Scopus, and Cochrane library databases were searched by two independent researchers, without time limitation until 31 December 2022. All observational studies regarding the mental health of infertile patients facing treatment suspension including anxiety, depression, and stress were included in the study. Qualitative studies, editorials, brief communications, commentaries, conference papers, guidelines, and studies with no full text were excluded. Quality assessment was carried out using Newcastle-Ottawa Scale by two researchers, independently. The random effects model was used to estimate the pooled prevalence of mental health problems. Meta-regression and subgroup analysis were used to confirm the sources of heterogeneity. RESULTS Out of 681 studies, 21 studies with 5901 infertile patients were systematically reviewed, from which 16 studies were included in the meta-analysis. The results of all pooled studies showed that the prevalence of anxiety, depression, and stress in female patients was 48.4% (95% CI 34.8-62.3), 42% (95% CI 26.7-59.4), and 55% (95% CI 45.4-65), respectively. Additionally, 64.4% (95% CI 50.7-76.1) of patients wished to resume their treatments despite the coronavirus pandemic. CONCLUSION Treatment suspension due to the coronavirus pandemic negatively affected the mental health of infertile patients. It is important to maintain the continuity of fertility care, with special attention paid to mental health of infertile patients, through all the possible measures even during a public health crisis.
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Affiliation(s)
- Elnaz Iranifard
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Atefeh Yas
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Ali Taghipour
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Epidemiology, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Malihe Mahmoudinia
- Maternal and Neonatal Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Obstetrics and Gynecology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Robab Latifnejad Roudsari
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
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Shafierizi S, Basirat Z, Nasiri-Amiri F, Kheirkhah F, Geraili Z, Pasha H, Faramarzi M. Predictors of nonresponse to treatment and low adherence to internet-based cognitive behavioral therapy in depressed/anxious women facing the couple's fertility problems: a secondary analysis of a randomized control trial. BMC Psychiatry 2024; 24:39. [PMID: 38200435 PMCID: PMC10782627 DOI: 10.1186/s12888-023-05484-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/28/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND The study aimed to examine the predictors of treatment nonresponse and low adherence to Internet-based cognitive behavioral therapy and face-to-face therapy for treating depression and anxiety in women facing the couple's fertility problems. METHODS This is a secondary analysis based on a previous randomized controlled trial including 152 depressed/anxious women facing the couple's fertility problems. The study defines low adherence as receiving less than 4 sessions (out of 8 sessions). Nonresponse to treatment refers to a < 50% reduction in the anxiety and depression total scores. RESULTS A high level of anxiety/depression score before psychotherapy increases the risk of nonresponse to both Internet-based and face-to-face psychotherapies by 1.4 to 2 times in women facing the couple's fertility problems after the treatment and in the 6-month follow-up. However, 4 factors, including diagnosis of mixed anxiety and depression, low education level, long marriage duration, and infertility caused by mixed female/male factors, reduced the risk of nonresponse to psychotherapies. CONCLUSION Women facing the couple's fertility problems with high depression and anxiety scores are at risk of poor prognosis in response to psychotherapy. Psychologists and healthcare providers of infertility centers should pay more attention to the timely identification and referral of depressed/anxious patients to psychologists.
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Affiliation(s)
- Shiva Shafierizi
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Zahra Basirat
- Department of Obstetrics and Gynecology, Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Fatemeh Nasiri-Amiri
- Department of Midwifery, Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Farzan Kheirkhah
- Department of Psychiatry, Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Zahra Geraili
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Hajar Pasha
- Department of Midwifery, Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mahbobeh Faramarzi
- Department of General Courses, Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
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Tetecher L, Cocchiaro T, Guarino A, Giannini T, Maucione S, Di Trani M, Rago R, Ciocca G. Sexological and traumatic aspects in reproductive difficulties: a psychometric study on couples seeking help for infertility. J Endocrinol Invest 2024; 47:179-189. [PMID: 37311972 DOI: 10.1007/s40618-023-02134-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 06/06/2023] [Indexed: 06/15/2023]
Abstract
PURPOSE To investigate the impact of infertility in gender differences on psycho-traumatological, sexological, relational and emotional aspects and gender differences in couples requiring assisted reproductive treatment. METHODS 151 couples were recruited with a mean age of 36.7 ± 4.8 years for women and 39.8 ± 6.6f or men. 43% of women and 34% of men had already received the diagnosis of infertility. To recruited subjects was administered the following psychometric tests: Sexological and Emotional in Infertility questionnaire (SEIq), Arizona Sexual Experience Scale (ASEX), the Orgasmomether and the International Trauma Questionnaire (ITQ). RESULTS There was a significant difference in traumatic symptoms between men and women (t = 5,859, p < 0.05). Gender differences were found in the sexological dimension of the SEIq (t = 7,858, p < .001) and in the total ASEX score (t = 3,979, p < .001). Specifically, significant correlations emerged between the ASEX domains and the emotional and sexological aspects related to infertility only in women. The reaction to the diagnosis was negatively correlated with the emotional area of the couple (r = -0.683, p < .001) and positively with the couple relationship (r = 0.815, p < .001). Multiple regression revealed that the overall functioning of the couple, rather than the single scales, is the main predictor of sexuality (R2 = 0.77). CONCLUSION A clear impact of infertility on the couple's psycho-traumatological, psycho-sexological and relational aspects emerged. It could be useful to promote targeted support interventions on the most compromised areas of couple functioning in assisted reproductive centers.
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Affiliation(s)
- L Tetecher
- Department of Dynamic and Clinical Psychology, and Health Studies, School of Health Psychology, Sapienza University of Rome, Rome, Italy
| | - T Cocchiaro
- Physiopathology of Reproduction and Andrology Unit, Sandro Pertini Hospital, Rome, Italy
| | - A Guarino
- Physiopathology of Reproduction and Andrology Unit, Sandro Pertini Hospital, Rome, Italy
| | - T Giannini
- Section of Sexual Psychopathology, Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Via Degli Apuli, 1, 00185, Rome, Italy
| | - S Maucione
- Section of Sexual Psychopathology, Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Via Degli Apuli, 1, 00185, Rome, Italy
| | - M Di Trani
- Department of Dynamic and Clinical Psychology, and Health Studies, School of Health Psychology, Sapienza University of Rome, Rome, Italy
| | - R Rago
- Physiopathology of Reproduction and Andrology Unit, Sandro Pertini Hospital, Rome, Italy
| | - G Ciocca
- Section of Sexual Psychopathology, Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Via Degli Apuli, 1, 00185, Rome, Italy.
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21
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Chen D, Wang A, Zhang W, Guo Y, Yao S, Chen X, Zhang J. Effectiveness of double ABCX-based psychotherapy for psychological distress among women undergoing in vitro fertilization-embryo transfer: a three-arm randomized controlled trial. J Psychosom Obstet Gynaecol 2023; 44:2278015. [PMID: 38056467 DOI: 10.1080/0167482x.2023.2278015] [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: 09/02/2023] [Accepted: 10/27/2023] [Indexed: 12/08/2023] Open
Abstract
OBJECTIVE This study aimed to evaluate the effectiveness of double ABCX-based psychotherapy for psychological distress during in vitro fertilization-embryo transfer (IVF-ET) among a female group (FG), couple group (CoG) and control group (CG). METHODS A total of 201 women undergoing their first IVF-ET cycle were randomized into three groups. The 6-session intervention was delivered at each visit to the IVF clinic. The primary outcomes were depression and anxiety, and the secondary outcomes included sleep quality, serum cortisol (nmol/L) levels and the clinical pregnancy rate, which were assessed before and after the intervention. RESULTS The group-by-time effects were significant for depression, anxiety, sleep quality and serum cortisol levels, with larger effect sizes in the FG than in the CoG. There was no significant difference in the pregnancy rate among the three groups. CONCLUSION Psychotherapy effectively mitigated psychological distress, suggesting greater effectiveness for couples undergoing IVF couples than for women only. It is structured and easy to use during the IVF treatment cycle. TRIAL REGISTRATION NUMBER https://register.clinicaltrials.gov (NCT03931187, retrospectively registered on April 23, 2019).
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Affiliation(s)
- Dan Chen
- Nursing Department, Medical College, Hunan Normal University, Changsha, China
| | - Anni Wang
- School of Nursing, Fudan University, Shanghai, China
| | - Wen Zhang
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, China
| | - Yufang Guo
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Shuyu Yao
- Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Xiaoxuan Chen
- School of Mathematics, Hunan Normal University, Changsha, China
| | - Jingping Zhang
- Xiangya School of Nursing, Central South University, Changsha, China
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22
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Swift A, Reis P, Swanson M. Comparing infertility-related stress, coping, and quality of life among assisted reproductive technology and non-assisted reproductive technology treatments. HUM FERTIL 2023; 26:1248-1255. [PMID: 36597775 DOI: 10.1080/14647273.2022.2163465] [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: 01/19/2022] [Accepted: 11/11/2022] [Indexed: 01/05/2023]
Abstract
Women who undergo assisted reproductive technology (ART) treatments experience infertility-related stress and have low quality of life (QOL). However, there is limited understanding of infertility-related stress, coping, or QOL among women who undergo non-ART treatments. The purpose of this study was to examine infertility-related stress, coping, and QOL among women who undergo ART and non-ART infertility treatments. Using a descriptive correlational cross-sectional design, we recruited 200 women who underwent infertility treatments. Participants completed the Copenhagen Multi-centre Psychosocial Infertility (COMPI) Fertility Problem Stress Scale, COMPI Coping Styles Scale, Fertility Quality of Life tool, and a demographic infertility survey. Data analysis included descriptive statistics, independent t-test, chi-square, and hierarchical multiple regression. Women who underwent non-ART had more personal stress, used more active-avoidance coping, and had lower emotional, social, and treatment environment QOL compared to those in ART treatment. Women who underwent ART treatments used more meaning-based coping but had lower treatment tolerability QOL. Stress and coping contribute to core QOL differently among infertility treatment groups. Both treatment groups report low satisfaction with emotional services. Regardless of the treatment type, women who undergo infertility treatments may need care to address their psychological health.
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Affiliation(s)
- Alison Swift
- Department of Advanced Nursing Practice and Education, East Carolina University College of Nursing, Greenville, NC, USA
| | - Pamela Reis
- Department of Nursing Science, East Carolina University College of Nursing, Greenville, NC, USA
| | - Melvin Swanson
- Department of Nursing Science, East Carolina University College of Nursing, Greenville, NC, USA
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23
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Khan NH, Shahnawaz MG, Patel A, Kashyap P, Singh CB. Resilience among involuntarily childless couples and individuals undergoing infertility treatment: a systematic review. HUM FERTIL 2023; 26:1562-1583. [PMID: 37439133 DOI: 10.1080/14647273.2023.2219400] [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: 04/18/2023] [Indexed: 07/14/2023]
Abstract
Infertility is regarded as a highly stressful and challenging experience. However, the response to this unexpected moment varies from one individual to the other. The review explores research that studies resilience in the context of infertility and its treatment. The purpose was to study the protective and risk factors associated with resilience and to identify psychosocial factors that could play a crucial role in resilience among infertile couples and individuals who are seeking infertility treatment. Four major databases (PubMed, Scopus, ScienceDirect, and Wiley Online Library) were searched with appropriate keywords. A total of 4101 articles were retrieved from the databases and after following various levels of screening 18 articles were finalized. These articles explored resilience and other psychosocial factors in couples/individuals seeking infertility treatment. The protective factors associated with resilience were quality of life, coping, social support, and posttraumatic growth. The risk factors associated with resilience were infertility-related stress, anxiety and depression. The unexpected diagnosis of infertility might be disturbing for many, still, it may not be extremely agonizing for some. Individuals who are encouraged to utilize their own resources and seek support are able to deal with stressors associated with infertility.
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Affiliation(s)
- Neda Haseeb Khan
- Department of Psychology, Jamia Millia Islamia, New Delhi, India
| | | | - Ansha Patel
- Department of Psychiatry & Psychology RNT Medical College, Paras & Shantiraj Hospitals, Psychological Clinic for Reproductive Health & Challenges, CMBS, Udaipur, FAIMER at MAHE, Karnataka, India
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24
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Ha JY, Park HJ, Ban SH. Efficacy of psychosocial interventions for pregnancy rates of infertile women undergoing in vitro fertilization: a systematic review and meta-analysis. J Psychosom Obstet Gynaecol 2023; 44:2142777. [PMID: 36480686 DOI: 10.1080/0167482x.2022.2142777] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
PURPOSE This study aimed to analyze the efficacy of psychosocial interventions for improving pregnancy rates in infertile women undergoing in vitro fertilization (IVF) treatment through a systematic review and meta-analysis. METHODS Twelve studies were included in the meta-analysis. To estimate the effect size, a meta-analysis of the studies was performed using RevMan 5.3. The possibility of publication bias was evaluated using funnel plots and Egger's method. RESULTS A statistically significant effect size (standardized mean difference [SMD] = 1.39; 95% confidence interval [CI] = 1.11-1.71; p = 0.004; I2 = 19%) was found for the 12 studies that investigated the effects of psychosocial interventions on clinical pregnancy rates. The psychosocial interventions that had a significant effect on pregnancy rates were mind-body interventions (SMD = 1.37; 95% CI = 1.01-1.85; p = 0.040; I2 = 0%) and cognitive behavioral therapy (SMD = 2.19; 95% CI = 1.17-4.13; p = 0.010). CONCLUSIONS The results suggest that psychosocial interventions affect pregnancy rates. Moreover, they indicate that mind-body interventions and cognitive behavioral therapy are beneficial for improving the pregnancy outcome in infertile women undergoing IVF.
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Affiliation(s)
- Ju-Young Ha
- College of Nursing, Pusan National University, Yangsan, Korea
| | - Hyo-Jin Park
- College of Nursing, Pusan National University, Yangsan, Korea
| | - Seon-Hwa Ban
- Korea Disease Control and Prevention Agency, Cheongju, Korea
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25
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Tabatabaei F, Tahernia H, Ghaedi A, Bazrgar A, Khanzadeh S. Diagnostic significance of neutrophil to lymphocyte ratio in endometriosis: a systematic review and meta-analysis. BMC Womens Health 2023; 23:576. [PMID: 37936116 PMCID: PMC10631181 DOI: 10.1186/s12905-023-02692-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 10/06/2023] [Indexed: 11/09/2023] Open
Abstract
BACKGROUND The purpose of this systematic review and meta-analysis was to compile existing evidence on the significance of the NLR in predicting endometriosis in order to aid clinical decision-making and outcomes. METHODS We searched ProQuest, Web of Science, and PubMed for related studies published before January 2, 2023. Standardized mean difference (SMD) with a 95% confidence interval (CI) was reported for each outcome. Because a significant level of heterogeneity was found, we used the random-effects model to calculate pooled effects. We used Newcastle-Ottawa Scale (NOS) for quality assessment. RESULTS Overall, 18 article with were included in the analysis. A random-effect model revealed that patients with endometriosis had elevated levels of NLR compared to healthy controls (SMD = 0.79, 95% CI = 0.33 to 1.25, P < 0.001). Patients with endometriosis had elevated levels of NLR compared to those with other benign tumors (SMD = 0.85, 95% CI = 0.17 to 1.53, P = 0.014). In addition, NLR level of patients with stage III and IV endometriosis was not different from that of patients with stage I and II endometrioma (SMD = 0.30, 95% CI = -0.14 to 0.74, P = 0.18). However, NLR level was not different between endometriosis patients with and without peritoneal lesions (SMD = -0.12, 95% CI = -0.34to 0.10, P = 0.28), between patients with and without endometrioma (SMD = 0.20, 95% CI = -0.15 to 0.55, P = 0.26) and between endometriosis patients with and without deep lesions (SMD = 0.04, 95% CI = -0.20 to 0.28, P = 0.72). The pooled sensitivity of NLR was 0.67 (95% CI = 0.60-0.73), and the pooled specificity was 0.68 (95% CI, 0.62-0.73). CONCLUSIONS NLR might be utilized in clinics as a possible predictor to help clinicians diagnose endometriosis in affected women.
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Affiliation(s)
- Fatemeh Tabatabaei
- Department of Obstetrics and Gynaecology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Gynaecologic Laparoscopic Surgeries, Al-Zahra Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Arshin Ghaedi
- Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Aida Bazrgar
- Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shokoufeh Khanzadeh
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.
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Huang J, Xiao X, Zhang L, Gao S, Wang X, Yang J. The effect of serum calcium on the association of depression with infertility among U.S. women. Heliyon 2023; 9:e22220. [PMID: 38045116 PMCID: PMC10692812 DOI: 10.1016/j.heliyon.2023.e22220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 11/06/2023] [Accepted: 11/07/2023] [Indexed: 12/05/2023] Open
Abstract
This study aimed to explored the association between depressive symptoms and infertility among U.S. women, and the effect of serum calcium on this association. We used data from the National Health and Nutrition Examination Survey (2013-2018), relating to women aged 20-45 years. Depressive symptoms were determined using the nine-item Patient Health Questionnaire (PHQ-9 scores ≥10), and interview data were used to identify self-reported infertility. Of 2708 women (mean age: 32.7 ± 7.5 years), 274 were depressed and 12.0 % self-reported being "ever-infertile." Depressive symptoms were associated with infertility in multivariable logistic regression (OR, 1.62; 95 % CI, 1.11-2.38). Depressive symptoms were associated with infertility among participants who were obese (OR, 1.68; 95 % CI, 1.03-2.74), had not received psychological counseling (OR, 1.60; 95 % CI, 1.03-2.50), were antidepressant users (OR 3.22; 95 % CI, 1.15-9.00), and had high serum calcium levels (OR, 2.05; 95 % CI, 1.25-3.35). A significant interaction between serum calcium and depression was observed for infertility (P = .038, interaction likelihood ratio test). In sensitivity analyses, the association between depressive symptoms and infertility remained after excluding women aged ≥35 years (OR, 1.87; 95 % CI, 1.08-3.23), lowering the cut-off for PHQ-9 scores (≥5) (OR, 1.48; 95 % CI, 1.12-1.96), excluding women with some gynecological diseases (OR, 1.63; 95 % CI, 1.07-2.49), and using inverse probability of treatment weighting (OR, 1.64; 95 % CI, 1.17-2.31). Conclusion Our findings indicate that depression is associated with infertility among U.S. women and serum calcium may have an effect on the association. Interventions such as serum calcium reduction, weight management and psychosocial counseling for infertility treatment in individuals with depression may be integrated into routine clinical practice. Additionally, more caution could be exercised when using antidepressants.
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Affiliation(s)
- Jungao Huang
- Key Laboratory of Environment and Disease-Related Gene, Ministry of Education, Department of Cell Biology and Genetics, School of Basic Medical sciences, Xi'an Jiaotong University, Health Science Center, Shaanxi, Xi'an 710061, China
- Ganzhou Maternal and Child Health Hospital, Ganzhou, Jiangxi Province, 341000, China
| | - Xuan Xiao
- Key Laboratory of Environment and Disease-Related Gene, Ministry of Education, Department of Cell Biology and Genetics, School of Basic Medical sciences, Xi'an Jiaotong University, Health Science Center, Shaanxi, Xi'an 710061, China
| | - Linyu Zhang
- Key Laboratory of Environment and Disease-Related Gene, Ministry of Education, Department of Cell Biology and Genetics, School of Basic Medical sciences, Xi'an Jiaotong University, Health Science Center, Shaanxi, Xi'an 710061, China
| | - Shanfeng Gao
- Key Laboratory of Environment and Disease-Related Gene, Ministry of Education, Department of Cell Biology and Genetics, School of Basic Medical sciences, Xi'an Jiaotong University, Health Science Center, Shaanxi, Xi'an 710061, China
| | - Xia Wang
- Key Laboratory of Environment and Disease-Related Gene, Ministry of Education, Department of Cell Biology and Genetics, School of Basic Medical sciences, Xi'an Jiaotong University, Health Science Center, Shaanxi, Xi'an 710061, China
| | - Juan Yang
- Key Laboratory of Environment and Disease-Related Gene, Ministry of Education, Department of Cell Biology and Genetics, School of Basic Medical sciences, Xi'an Jiaotong University, Health Science Center, Shaanxi, Xi'an 710061, China
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Obst KL, Oxlad M, Turnbull D, McPherson NO. "No One Asked Me If I'm Alright": A Mixed-Methods Study Exploring Information/Support Needs and Challenges Engaging Men Diagnosed With Male-Factor Infertility. Am J Mens Health 2023; 17:15579883231209210. [PMID: 38069523 PMCID: PMC10710112 DOI: 10.1177/15579883231209210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 09/12/2023] [Accepted: 10/04/2023] [Indexed: 12/18/2023] Open
Abstract
There is limited research exploring men's experiences of infertility, and fewer previous studies have examined what information and support men desire after being diagnosed specifically with male-factor infertility. We conducted a mixed-methods study utilizing a combined sequential, concurrent design (online survey/semi-structured interviews). Survey outcomes (N =12) were analyzed using quantitative data analysis, while qualitative survey data (N = 5) was analyzed by reflexive thematic analysis. Heterosexual men (>18 years), fluent in English, diagnosed solely with male-factor infertility/sub-fertility, who required assisted reproductive treatment within Australia in the past 5 years were recruited online and through fertility clinics Australia-wide. Most men reported that their information and support needs were only somewhat, slightly or not at all met. Preferred information sources on male infertility were a dedicated online resource, app, or fertility doctor/specialist, while support was preferred from fertility specialists and partners. Three themes were identified from the qualitative analysis about men's experiences and support needs when diagnosed with male infertility (a) Ultimate threat to masculinity; (b) Holistic care, and (c) the power of words. The information-rich data collected provided valuable insights into men's experiences of male-factor infertility and important considerations to improve recruitment for future research. A diagnosis of male-factor infertility has the potential to be deeply impactful and difficult to navigate for men. Adequate and holistic information, recognition of emotional impacts, proactive offers of support and sensitive language are needed to improve men's experiences when undergoing assisted reproductive technology.
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Affiliation(s)
- Kate L. Obst
- School of Psychology, Adelaide Health and Medical School, The University of Adelaide, Adelaide, South Australia, Australia
- Discipline of Reproduction and Development, School of Biomedicine, Adelaide Health and Medical School, The University of Adelaide, Adelaide, South Australia, Australia
- Freemasons Centre for Male Health and Wellbeing, The University of Adelaide, Adelaide, South Australia, Australia
| | - Melissa Oxlad
- School of Psychology, Adelaide Health and Medical School, The University of Adelaide, Adelaide, South Australia, Australia
- Freemasons Centre for Male Health and Wellbeing, The University of Adelaide, Adelaide, South Australia, Australia
| | - Deborah Turnbull
- School of Psychology, Adelaide Health and Medical School, The University of Adelaide, Adelaide, South Australia, Australia
- Freemasons Centre for Male Health and Wellbeing, The University of Adelaide, Adelaide, South Australia, Australia
| | - Nicole O. McPherson
- Discipline of Reproduction and Development, School of Biomedicine, Adelaide Health and Medical School, The University of Adelaide, Adelaide, South Australia, Australia
- Freemasons Centre for Male Health and Wellbeing, The University of Adelaide, Adelaide, South Australia, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia
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28
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Kiani Z, Fakari FR, Hakimzadeh A, Hajian S, Fakari FR, Nasiri M. Prevalence of depression in infertile men: a systematic review and meta-analysis. BMC Public Health 2023; 23:1972. [PMID: 37821902 PMCID: PMC10568846 DOI: 10.1186/s12889-023-16865-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 09/29/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Generally, infertile men hide their depression, which can threaten their health and lower their quality of life. Given the role of depression and its impact on people's health, this systematic review and meta-analysis aimed to investigate the prevalence of depression in infertile men. METHODS This research is a systematic review and meta-analysis based on preferred reporting items for systematic reviews and meta-analyses (PRISMA). Using the keywords of "Depression", "Emotional Depression", "Infertility", "Prevalence", and "Epidemiology", all English language articles were searched in international databases (PubMed, Cochran library, Web of sciences, Scopus, Embase, PsyINFO, and Google scholar) by two reviewers independently and without considering the time limit until September 2022. Title, abstract, full text and quality of each study were evaluated by two reviewers independently using the Newcastle-Ottawa Scale checklist. The results were analyzed using programming language and R software, and I2 test and Egger's Test were used to check heterogeneity and publication bias, respectively. RESULTS Twenty-two studies were included in the systematic part of this study; and 8 different measurement tools were used to identify depression. Then, based on the possibility of meta-analysis, 18 studies were included in 4 subgroups. Given the heterogeneity of the articles, random effect model was used. The overall prevalence of depression in infertile men was 18.30%. The lowest and highest overall prevalence of depression in men was reported to be 14.04% and 23.63% in the Zung Self-Rating Depression Scale (ZDS) and the Depression Anxiety Stress Scales (DASS) tools, respectively. The overall prevalence of depression among infertile men was reported to be 18.55% and 16.75% using the Beck Depression Inventory (BDI) and the Hospital Anxiety and Depression Scale (HADS) tools, respectively. CONCLUSION Based on the findings of this study, the significant prevalence of depression in infertile men requires a specific attention and planning. The study revealed varying degrees of depression among infertile men, emphasizing the importance of assessing their mental health, specifically in terms of depression, during infertility treatments as a hidden variable. It is strongly recommended to develop training programs for health service providers to effectively utilize diagnostic tools in this particular field.
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Affiliation(s)
- Zahra Kiani
- Midwifery and Reproductive Health Research Center, ShahidBeheshti University of Medical Sciences, Tehran, Iran
| | - Fahimeh Rashidi Fakari
- Department of Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Atena Hakimzadeh
- Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sepideh Hajian
- Department of Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzaneh Rashidi Fakari
- Department of Midwifery, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Malihe Nasiri
- Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Schuette SA, Andrade FC, Woodward JT, Smoski MJ. Identifying modifiable factors associated with psychological health in women experiencing infertility. J Health Psychol 2023; 28:1143-1156. [PMID: 37403402 DOI: 10.1177/13591053231185549] [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: 07/06/2023] Open
Abstract
This study assessed the relationship between modifiable psychological variables and depression, anxiety, and posttraumatic growth in women experiencing infertility. U.S. women (N = 457) who identified as experiencing infertility completed standardized self-report measures of mindfulness, self-compassion, positive affect, intolerance of uncertainty, relationship satisfaction, experiential avoidance, depression, anxiety, and posttraumatic growth. Clinical and demographic characteristics (age, duration trying to conceive, miscarriage, and childlessness) did not predict depression or anxiety. Lower positive affect and higher experiential avoidance were associated with depression and anxiety. Lower self-compassion was associated with depression; higher intolerance of uncertainty was associated with anxiety. There were indirect effects of mindfulness on anxiety and depression via these variables. Future research should explore whether intervening on these factors reduces depressive and anxiety symptoms. Promoting mindfulness may have beneficial effects on symptoms via its downstream effects on multiple coping variables. Counterintuitively, posttraumatic growth was associated with higher intolerance of uncertainty and experiential avoidance.
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Affiliation(s)
| | | | | | - Moria J Smoski
- Duke University, USA
- Duke University School of Medicine, USA
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30
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Warne E, Oxlad M, Best T. Evaluating group psychological interventions for mental health in women with infertility undertaking fertility treatment: A systematic review and meta-Analysis. Health Psychol Rev 2023; 17:377-401. [PMID: 35348050 DOI: 10.1080/17437199.2022.2058582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 03/22/2022] [Indexed: 11/04/2022]
Abstract
ABSTRACTWe conducted a systematic review and meta-analysis of the published literature concerning the effectiveness of group psychological interventions in improving anxiety, depression, marital dissatisfaction, fertility quality of life and stress, and pregnancy outcomes of women with infertility, participating in fertility treatment. A search of five databases yielded 1603 studies; 30 articles met inclusion criteria, and computations of effect sizes ensued (Hedges' g and Odds Ratios (OR)). The total sample comprised 2752 participants, with 1279 participants receiving group intervention and 1473 participants in the comparison group. Group psychological interventions reduced depression (Hgw = -1.277; 95% CI = [-1.739- -0.815]; p = 0.000), anxiety (Hgw = -1.136, 95% CI [-1.527- -0.744]; p = 0.000), fertility stress (Hgw = -0.250, 95% CI [-0.388- -0.122]; p = 0.000), and marital dissatisfaction (Hgw = -0.938; 95% [CI -1.455- -0.421]; p = 0.000), and pregnancy rates improved (OR = 2.422 95% CI [2.037-2.879]; p = 0.000). No improvement was observed regarding fertility quality of life (Hgw = 0. 144; 95% CI [-0.176- 0.463]; p = 0.379). Our findings highlight that participation in group psychological intervention improved the mental health, fertility stress and pregnancy rates of women with infertility.
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Affiliation(s)
- Emma Warne
- School of Psychology, The University of Adelaide, Adelaide, Australia
| | - Melissa Oxlad
- School of Psychology, The University of Adelaide, Adelaide, Australia
- CQU, School of Health, Medical and Applied Science, NeuroHealth Lab, Appleton Institute, Brisbane, Australia
| | - Talitha Best
- CQU, School of Health, Medical and Applied Science, NeuroHealth Lab, Appleton Institute, Brisbane, Australia
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Suleiman M, August F, Nanyaro MW, Wangwe P, Kikula A, Balandya B, Ngarina M, Muganyizi P. Quality of life and associated factors among infertile women attending infertility clinic at Mnazi Mmoja Hospital, Zanzibar. BMC Womens Health 2023; 23:400. [PMID: 37528393 PMCID: PMC10394830 DOI: 10.1186/s12905-023-02536-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 07/10/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND Worldwide, it is estimated at least 50 million couples are affected by infertility with the prevalence of infertility being 16% in Tanzania. Psychological impact of infertility in patients negatively affects women's Quality of Life (QoL) defined as a person`s perception of where they are in life in terms of culture and value in the emotional, mind-body, relational, social, environment and tolerability of treatment aspects. Poor Quality of Life is related to increased treatment discontinuation. The aim of this study was to determine the Quality of Life and associated factors among infertile women attending infertility clinic at Mnazi Mmoja Hospital, Zanzibar. METHODS A hospital based cross-sectional study was conducted among 340 infertile women attending infertility clinic at Mnazi Mmoja Hospital, Zanzibar. Data was collected using FertiQoL tool. The factors associated with Quality of Life using FertiQoL tool in infertile women were estimated in a multivariable linear regression model at 95% confidence interval and 5% level of significance. RESULTS Quality of life of infertile women at Mnazi Mmoja infertility clinic was 70.6 ± 10.0 on a scale of 0 to 100. It increased significantly with increase in educational level (p = 0.009). Women with female individual causes on average had 5.07 (B=- 5.07, 95%CI: -7.78, -2.35) and women with individual and respective male partner causes of infertility had on average 4.95 (B= -4.95, 95% CI: -7.77, -2.12) respective decrease in the FertiQoL scores compared to those who had their male partner with problems as reason for infertility. There was an average 4.50 (B=-4.50, 95% CI: 2.30, 6.70) decrease in quality of life in women with secondary infertility compared to women with primary infertility. Every month increase in duration of infertility led to an average of 0.04 (B=-2.57, 95%CI: -0.07, -0.01) decrease in FertiQoL scores. CONCLUSION The overall quality of life in this population was positively associated with level of education but negatively affected with reason for infertility, type of infertility and duration of infertility.
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Affiliation(s)
- Mubina Suleiman
- Department of Obstetrics and Gynecology, School of Medicine, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es salaam, Tanzania.
| | - Furaha August
- Department of Obstetrics and Gynecology, School of Medicine, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es salaam, Tanzania
| | - Mary Winnie Nanyaro
- Department of Research, National Institute of Medical Research, P. O. Box 3436, Dar es salaam, Tanzania
| | - Peter Wangwe
- Department of Obstetrics and Gynecology, School of Medicine, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es salaam, Tanzania
| | - Amani Kikula
- Department of Obstetrics and Gynecology, School of Medicine, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es salaam, Tanzania
| | - Belinda Balandya
- Department of Obstetrics and Gynecology, School of Medicine, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es salaam, Tanzania
| | - Matilda Ngarina
- Department of Obstetrics and Gynecology, Muhimbili National Hospital, Malik Road, Upanga West, P. O Box 65000, Dar es Salaam, Tanzania
| | - Projestine Muganyizi
- Department of Obstetrics and Gynaecology, University of Dar es Salaam, Mbeya College of Health and Allied Sciences, Mbeya, Tanzania
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Domar AD, Jasulaitis L, Matevossian K, Jasulaitis S, Grill EA, Uhler ML. The Impact of the FertiStrong Mobile Application on Anxiety and Depression in Men: A Randomised Control Pilot Study. J Hum Reprod Sci 2023; 16:195-203. [PMID: 38045496 PMCID: PMC10688279 DOI: 10.4103/jhrs.jhrs_75_23] [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: 06/23/2023] [Revised: 09/14/2023] [Accepted: 09/16/2023] [Indexed: 12/05/2023] Open
Abstract
Background Male factor accounts for up to half of all cases of infertility. Previously, research has focused on the psychological effects of infertility on female partners, but recent studies show negative consequences on male patients as well. Despite evidence that men are affected by infertility, there is limited studies focusing on coping methods for them. Aims Determine if a cognitive-behavioral and relaxation mobile application, targeted at men experiencing infertility, could lead to decreases in psychological distress. Settings and Design Randomized controlled. Materials and Methods Thirty-nine men participated in a randomized pilot study of the FertiStrong application. Participants completed a demographic form, the Hospital Anxiety and Depression Scale (HADS) and Fertility Problem Inventory (FPI) at baseline and one month follow-up. The intervention group downloaded the FertiStrong application and used it when needed. Control participants received routine infertility care. Statistical Analysis Used Normally distributed data is presented as mean+/- SD; Differences in proportions were tested using Chi-square test and within group comparison were performed using paired t-test. Results One participant was excluded, resulting in 38 participants, 19 in each group. There were no baseline differences in demographic characteristics (P>0.31). For the HADS anxiety domain, the control group had a small increase between baseline and follow up, while the intervention group had a small decrease. For the HADS depression domain, there was a slight increase in the controls. For the FPI, the control group had a two-point increase, from moderately stressed to extremely high while the intervention group had a five-point decrease, from extremely high to moderately high, but was not significant. Each FPI domain-specific score in the intervention group decreased and one, Rejection of Childfree lifestyle, was significant (P=0.03). The increase in stress level was significantly greater in the control group (P<0.02). Conclusion Recruitment was challenging due to the short recruitment phase and the sample size was smaller than planned. However, there were several significant improvements noted in the intervention group and on all testing, the intervention group trended to less distress. More research is needed on convenient interventions for men experiencing infertility.
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Affiliation(s)
- Alice D. Domar
- Inception Fertility, Houston TX, Harvard Medical School, Boston MA
| | | | - Karine Matevossian
- Women and Infants Hospital, Warren Alpert Medical School of Brown University, Wakefield, Rhode Island
| | | | - Elizabeth A. Grill
- Center for Reproductive Medicine, Weill Cornell Medicine, New York, NY, USA
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Bian C, Cao J, Chen K, Xia X, Yu X. Effectiveness of psychological interventions on pregnancy rates in infertile women undergoing assisted reproductive technologies: a meta-analysis of randomised controlled trials. Biotechnol Genet Eng Rev 2023:1-20. [PMID: 37200381 DOI: 10.1080/02648725.2023.2213080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/08/2023] [Indexed: 05/20/2023]
Abstract
The purpose of this study was to assess the effects of psychological interventions on the pregnancy rates of infertile women undergoing assisted reproductive technology (ART). Using the electronic databases PubMed, EM Base, Cochrane Library, WOS, CNKI, WanFang Data, CSTJ, and CBM, a systematic literature search was conducted in the second week of August 2019. Randomized controlled trials (RCTs) on the effect of psychological interventions on the pregnancy rate of infertile women undergoing assisted reproductive technology were collected. There is no time limit for this search setting. The language is limited to Chinese or English. Two investigators independently screened the literature, extracted data, and assessed the risk of bias of the included studies, and then used Revman5.3 and STATA16.0 software for meta-analysis. A total of 25 randomized controlled trials were included in this meta-analysis, including 2098 patients in the experimental group and 2075 patients in the control group. There was a significant difference in the pregnancy rate between the two groups [RR=1.31, 95%CI(1.22,1.40)]. Subgroup analysis showed that this is also true of infertile women of different nationalities, different intervention timing and format. However, different psychological interventions may indeed have different effects. Current evidence suggests that psychological interventions may improve pregnancy rates in infertile women undergoing assisted reproductive technology. Limited by the quantity and quality of included studies, the above conclusions need to be verified by more high-quality studies. Our PROSPERO registration number is: CRD42019140666.
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Affiliation(s)
- Chaorong Bian
- Medical Service Division, Changzhou Children's Hospital Affiliated to Nantong University, Changzhou, Jiangsu, China
| | - Jie Cao
- Department of Intensive Care Rehabilitation, Yixing JORU Rehabilitation Hospital, Wuxi, Jiangsu, China
| | - Kejin Chen
- Changzhou maternal and Child Health Care Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, Jiangsu, China
| | - Xiyang Xia
- Changzhou maternal and Child Health Care Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, Jiangsu, China
| | - Xuexia Yu
- Changzhou maternal and Child Health Care Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, Jiangsu, China
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Li W, Honggui W, Hong P, Hong L. Factors that affect career success of nurses who practice in assisted reproductive technology. Rev Lat Am Enfermagem 2023; 31:e3926. [PMID: 37194896 PMCID: PMC10202227 DOI: 10.1590/1518-8345.6388.3927] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 02/10/2023] [Indexed: 07/27/2024] Open
Abstract
to examine the relationship between career success and work environment of nurses who practice in assisted reproductive technology and to identify factors that affect career success. a cross-sectional study conducted in 53 fertility centres in 26 provinces in mainland China. Data were collected using a demographic data questionnaire, a specialised nursing competence questionnaire, the Career-Success Scale, and the Nursing Work Environment Scale. Descriptive and inferential statistics were applied. 597 assisted reproductive technology nurses participated in our survey, and 555 valid questionnaires were collected. Theoverall mean scores for career success and work environment were 3.75 [standard deviation (SD) = 1.01] and 3.42 (SD = 0.77) respectively. There was a strong positive correlation between career success and work environment (r = 0.742, p < 0.01). Multiple regression showed that attending academic conferences, psychological care, professional development, support and care, salary, and welfare were significant factors that influence career success. attending academic conferences, psychological care, and work environment are positively related to career success. Administrators should consider ways to address these factors.
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Affiliation(s)
- Wang Li
- Women and Children's Hospital of Chongqing Medical University, Center for Reproductive Medicine, Chongqing, Chongqing, China
- Chongqing Health Center for Women and Children, Center for Reproductive Medicine, Chongqing, Chongqing, China
| | - Wen Honggui
- Women and Children's Hospital of Chongqing Medical University, Center for Reproductive Medicine, Chongqing, Chongqing, China
- Chongqing Health Center for Women and Children, Center for Reproductive Medicine, Chongqing, Chongqing, China
| | - Peng Hong
- Women and Children's Hospital of Chongqing Medical University, Center for Reproductive Medicine, Chongqing, Chongqing, China
- Chongqing Health Center for Women and Children, Center for Reproductive Medicine, Chongqing, Chongqing, China
| | - Luo Hong
- Women and Children's Hospital of Chongqing Medical University, Center for Reproductive Medicine, Chongqing, Chongqing, China
- Chongqing Health Center for Women and Children, Center for Reproductive Medicine, Chongqing, Chongqing, China
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Li W, Honggui W, Hong P, Hong L. Factors that affect career success of nurses who practice in assisted reproductive technology. Rev Lat Am Enfermagem 2023; 31:e3926. [PMID: 37194896 PMCID: PMC10202227 DOI: 10.1590/1518-8345.6388.3926] [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: 07/10/2022] [Accepted: 02/10/2023] [Indexed: 05/18/2023] Open
Abstract
to examine the relationship between career success and work environment of nurses who practice in assisted reproductive technology and to identify factors that affect career success. a cross-sectional study conducted in 53 fertility centres in 26 provinces in mainland China. Data were collected using a demographic data questionnaire, a specialised nursing competence questionnaire, the Career-Success Scale, and the Nursing Work Environment Scale. Descriptive and inferential statistics were applied. 597 assisted reproductive technology nurses participated in our survey, and 555 valid questionnaires were collected. Theoverall mean scores for career success and work environment were 3.75 [standard deviation (SD) = 1.01] and 3.42 (SD = 0.77) respectively. There was a strong positive correlation between career success and work environment (r = 0.742, p < 0.01). Multiple regression showed that attending academic conferences, psychological care, professional development, support and care, salary, and welfare were significant factors that influence career success. attending academic conferences, psychological care, and work environment are positively related to career success. Administrators should consider ways to address these factors.
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Affiliation(s)
- Wang Li
- Women and Children's Hospital of Chongqing Medical University, Center for Reproductive Medicine, Chongqing, Chongqing, China
- Chongqing Health Center for Women and Children, Center for Reproductive Medicine, Chongqing, Chongqing, China
| | - Wen Honggui
- Women and Children's Hospital of Chongqing Medical University, Center for Reproductive Medicine, Chongqing, Chongqing, China
- Chongqing Health Center for Women and Children, Center for Reproductive Medicine, Chongqing, Chongqing, China
| | - Peng Hong
- Women and Children's Hospital of Chongqing Medical University, Center for Reproductive Medicine, Chongqing, Chongqing, China
- Chongqing Health Center for Women and Children, Center for Reproductive Medicine, Chongqing, Chongqing, China
| | - Luo Hong
- Women and Children's Hospital of Chongqing Medical University, Center for Reproductive Medicine, Chongqing, Chongqing, China
- Chongqing Health Center for Women and Children, Center for Reproductive Medicine, Chongqing, Chongqing, China
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Willis MD, Wesselink AK, Hystad P, Pescador Jimenez M, Coleman CM, Kirwa K, Hatch EE, Wise LA. Associations between Residential Greenspace and Fecundability in a North American Preconception Cohort Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:47012. [PMID: 37098782 PMCID: PMC10132140 DOI: 10.1289/ehp10648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/16/2022] [Accepted: 03/13/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Residential green space can have positive physiological effects on human health through various mechanisms, including reducing stress and/or depression or facilitating physical activity. Although green space has been consistently associated with improved birth outcomes in several studies, there has been limited study of its effect on other reproductive outcomes, including fertility. OBJECTIVE We examined associations between residential green space and fecundability, the per-cycle probability of conception. METHODS We analyzed data from 8,563 female participants enrolled between 2013 and 2019 in Pregnancy Study Online (PRESTO), a prospective preconception cohort study of North American couples attempting conception. Participants completed a baseline questionnaire on sociodemographic, behavioral, and reproductive factors, and bimonthly follow-up questionnaires for up to 12 months to ascertain pregnancies. Using geocoded addresses, we calculated residential green space exposure using the Normalized Difference Vegetation Index (NDVI) within 50-, 100-, 250-, and 500 -m buffers across multiple temporal scales: annual maximum, seasonal maximum, and seasonal mean. We used proportional probabilities regression models to estimate fecundability ratios (FRs), adjusting for sociodemographic, behavioral, and neighborhood characteristics. We also evaluated the extent to which associations were mediated by reductions in perceived stress or depressive symptoms and increased physical activity. RESULTS When comparing the highest (≥ 0.8 ) with the lowest (< 0.2 ) NDVI exposures within 50 m , we observed positive associations in the annual maximum NDVI [FR: 1.33; 95% confidence interval (CI): 1.06, 1.67] and seasonal maximum NDVI (FR: 1.19; 95% CI: 1.00, 1.41) models, but little association in the seasonal mean NDVI models (FR: 0.98; 95% CI: 0.73, 1.30). Restricted cubic splines showed evidence of nonlinearity in this association. Results were similar across buffer distances. Perceived stress, depressive symptoms, and physical activity explained ≤ 5 : 0 % of mediation across all NDVI metrics. DISCUSSION In this cohort, greater residential green space was associated with a modest increase in fecundability. https://doi.org/10.1289/EHP10648.
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Affiliation(s)
- Mary D. Willis
- Department of Epidemiology, School of Public Health, Boston University, Boston, Massachusetts, USA
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, USA
| | - Amelia K. Wesselink
- Department of Epidemiology, School of Public Health, Boston University, Boston, Massachusetts, USA
| | - Perry Hystad
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, USA
| | - Marcia Pescador Jimenez
- Department of Epidemiology, School of Public Health, Boston University, Boston, Massachusetts, USA
| | - Chad M. Coleman
- Department of Epidemiology, School of Public Health, Boston University, Boston, Massachusetts, USA
| | - Kipruto Kirwa
- Department of Public Health and Community Medicine, School of Medicine, Tufts University, Boston, Massachusetts, USA
| | - Elizabeth E. Hatch
- Department of Epidemiology, School of Public Health, Boston University, Boston, Massachusetts, USA
| | - Lauren A. Wise
- Department of Epidemiology, School of Public Health, Boston University, Boston, Massachusetts, USA
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Njogu A, Kaburu F, Njogu J, Barasa E, Mutisya A, Luo Y. The effect of self-compassion-based programs for infertility (SCPI) on anxiety and depression among women pursuing fertility treatment: a three-armed, randomised controlled trial. J Assist Reprod Genet 2023; 40:911-927. [PMID: 36930358 PMCID: PMC10224906 DOI: 10.1007/s10815-023-02771-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 03/06/2023] [Indexed: 03/18/2023] Open
Abstract
PURPOSE To examine the effects of self-compassion training using videos (SCV) versus self-compassion training using digital stories (SC-DS) as compared to a control group (CG) on reducing anxiety and depression symptoms among women pursuing fertility treatment. METHODS A three-armed, randomised controlled trial randomly assigned 200 eligible women to SCV(n = 65), SC-DS (n = 67), and CG (n = 68). All three randomised groups completed questionnaires immediately after randomisation (T1), after completing the interventions (T2), and 10 weeks after the interventions (T3). A generalised estimation equation was used with the intention-to-treat analysis. The primary outcomes were anxiety and depression, and secondary outcomes were self-compassion, infertility self-efficacy, and pregnancy rates. RESULTS SCV and SC-DS participants experienced a significant reduction in anxiety and depression from T1 to T2 and from T1 to T3 (p < 0.001; d > 0.8). SCV and SC-DS participants experienced a significant increase in self-compassion and infertility self-efficacy from T1 to T2 and from T1 to T3 (p < 0.001; d > 0.8). SC-DS seemed to be superior to SCV and CG. No significant differences were found among the three groups in pregnancy rates. SCV and SC-DS participants rated self-compassion training programs positively and said they would highly recommend them to others. CONCLUSION These findings suggest that SCV and SC-DS were effective in reducing anxiety and depression and increasing self-compassion and infertility self-efficacy. Online flexible self-compassion interventions could make psychological support more accessible for women undergoing fertility treatment in resource-poor settings. TRIAL REGISTRATION (ChiCTR2100046065) [12/04/2021].
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Affiliation(s)
- Anne Njogu
- Xiangya School of Nursing, Central South University, Changsha, 410013, Hunan, China
| | - Francis Kaburu
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Julius Njogu
- Jomo Kenyatta University of Agriculture and Technology (JKUAT)/Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Emmanuel Barasa
- Masinde Muliro University of Science and Technology (MMUST), Kakamega, Kenya
| | - Albanus Mutisya
- Jomo Kenyatta University of Agriculture and Technology (JKUAT), Juja, Kenya
| | - Yang Luo
- Xiangya School of Nursing, Central South University, Changsha, 410013, Hunan, China.
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Lehto S, Sevón E, Laakso ML, Rönkä A. Infertility as a lonely struggle? Coping stories of previously infertile women. Health Care Women Int 2023; 44:397-417. [PMID: 34936858 DOI: 10.1080/07399332.2021.2007246] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
In this narrative study, we explored the meaning infertile women attribute to social support in coping with their infertility-related challenges. Written accounts and episodic interviews with 26 previously infertile Finnish women were used as data. Two different coping story types emerged: coping alone and coping with support. In the coping alone type women neither sought nor received support. Their coping appeared as a lonely struggle. In the coping with stories, women turned to their spouses, peers, or professionals, but still emphasized that they would have needed more support. Based on our findings, we underline the need for individually tailored support.
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Affiliation(s)
- Siru Lehto
- School of Professional Teacher Education, JAMK University of Applied Sciences, Jyväskylä, Finland
| | - E Sevón
- Department of Education, University of Jyväskylä, Jyväskylä, Finland
| | - M-L Laakso
- Department of Education, University of Jyväskylä, Jyväskylä, Finland
| | - A Rönkä
- Department of Education, University of Jyväskylä, Jyväskylä, Finland
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Aker MN, Özdemir F. The effect of the approach based on the Neuman Systems Model on stress and coping in women receiving intrauterine insemination treatment: A randomized controlled trial. Health Care Women Int 2023; 44:457-472. [PMID: 35767837 DOI: 10.1080/07399332.2022.2087075] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
This randomized controlled study was conducted to determine the effect of the approach based on the Neuman Systems Model (NSM) on stress and coping in women receiving intrauterine insemination (IUI) treatment. The study participants consisted of 62 women. Data was collected using a personal information form, the COMPI Fertility Problem Stress Scale, and the COMPI Coping Strategy Scale. Women in the intervention group had lower stress levels in their personal and marital domain post-test median scores than those in the control group. Women in the intervention group also had lower active-avoidance coping method and higher meaning-based coping method post-test mean scores. The NSM-based approach is beneficial in decreasing stress and positively affects women to cope with stress. Both infertility and its treatments are stressful. Health care professionals have important responsibilities for reducing the stress of infertile women and strengthening infertile women's ability to cope. The NSM-based approach is considered to have positive effects on stress and the ability of women to cope who receive IUI treatments. In addition, IUI is a widely applied method which is used before switching to assisted reproductive techniques. If this treatment fails, the stress coping techniques learned during this treatment can be used in later treatment processes. We conducted this study to investigate the effects of the NSM-based approach on stress and coping strategies in women receiving IUI treatment.
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Whynott RM, Summers KM, Mejia RB, Segre LS, Ryan G, Pawlak SA. Creating affiliations, learning, and mindfulness for in vitro fertilization patients (CALM IVF): a clinical trial. F S Rep 2023; 4:61-71. [PMID: 36959953 PMCID: PMC10028477 DOI: 10.1016/j.xfre.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 01/04/2023] [Accepted: 01/04/2023] [Indexed: 01/09/2023] Open
Abstract
Objective Determine if group psychoeducational support can improve in vitro fertilization (IVF) patients' quality of life (QoL). Design Randomized controlled trial (NCT04048772). Setting University-affiliated IVF clinic. Patients Women (n = 76) and male partners undergoing initial autologous IVF cycle from August 2019, to December 2020. Interventions Couples were assigned to groups based on projected oocyte retrieval date. Groups were randomly assigned to the control or intervention arm. Clinic closures because of the COVID-19 pandemic delayed treatment for a portion of participants. Groups were conducted in person before and virtually during the pandemic. Main Outcome Measures The primary outcome was a change in fertility quality of life (FertiQoL) from baseline to 3 days after retrieval. Secondary outcomes were changes in depression (Patient Health Questionnaire 9), anxiety (Generalized Anxiety Disorder 7), resilience (Connor-Davidson Resilience scale), IVF knowledge scores, and the likelihood of return to treatment. Results Knowledge scores among women in Creating Affiliations, Learning, and Mindfulness (CALM) for IVF groups significantly increased compared with control (mean difference 13.19 [3.53 - 22.84]) before the pandemic. During the pandemic, women in CALM IVF had significant improvement in the social FertiQoL score compared with controls (10.42 [1.79 - 19.04]). Compared with controls, male CALM IVF participants had significantly greater improvement in total FertiQoL (mean difference 6.68 [0.39 - 12.98]), treatment FertiQoL (8.26 [0.69 - 15.82]), and resilience (Connor-Davidson 1.13 [0.54 - 1.72]). Immediate return to care did not significantly differ between arms. Conclusions For women undergoing IVF, group psychoeducational programs can improve IVF knowledge and social QoL during a pandemic. Participation in a group psychoeducational program can improve QoL and resilience in IVF dyad male partners. Clinical Trial Registration Number Trial registration NCT04048772.
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Affiliation(s)
- Rachel M. Whynott
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Washington, Seattle, Washington
- Reprint requests: Rachel Whynott, M.D., Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Washington, 4245 Roosevelt Way NE, 3rd Floor, Seattle, Washington 98105.
| | - Karen M. Summers
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Rachel B. Mejia
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Lisa S. Segre
- College of Nursing, University of Iowa, Iowa City, Iowa
| | - Ginny Ryan
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Washington, Seattle, Washington
| | - Stacey A. Pawlak
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa
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Kremer F, Ditzen B, Wischmann T. Effectiveness of psychosocial interventions for infertile women: A systematic review and meta-analysis with a focus on a method-critical evaluation. PLoS One 2023; 18:e0282065. [PMID: 36854039 PMCID: PMC9974119 DOI: 10.1371/journal.pone.0282065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 02/07/2023] [Indexed: 03/02/2023] Open
Abstract
BACKGROUND Approximately seven to nine percent of couples of reproductive age do not get pregnant despite regular and unprotected sexual intercourse. Various psychosocial interventions for women and men with fertility disorders are repeatedly found in the literature. The effects of these interventions on outcomes such as anxiety and depression, as well as on the probability of pregnancy, do not currently allow for reliable generalisable statements. This review includes studies published since 2015 performing a method-critical evaluation of the studies. Furthermore, we suggest how interventions could be implemented in the future to improve anxiety, depression, and pregnancy rates. METHOD The project was registered with Prospero (CRD42021242683 13 April 2021). The literature search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Six databases were searched and 479 potential studies were discovered. After reviewing the full texts, ten studies were included for the synthesis. Not all studies reported the three outcomes: four studies each for depression, three for anxiety and nine studies for pregnancy rates were included in the meta-analysis, which was conducted using the Comprehensive meta-analysis (CMA) software. RESULTS Psychosocial interventions do not significantly change women's anxiety (Hedges' g -0,006; CI: -0,667 to 0,655; p = 0,985), but they have a significant impact on depression in infertile women (Hedges' g -0,893; CI: -1,644 to -0,145; p = 0,026). Implementations of psychosocial interventions during assisted reproductive technology (ART) treatment do not increase pregnancy rates (odds ratio 1,337; 95% CI 0,983 to 1,820; p = 0,064). The methodological critical evaluation indicates heterogeneous study design and samples. The results of the studies were determined with different methods and make comparability difficult. All these factors do not allow for a uniform conclusion. METHODOLOGICAL CRITICAL EVALUATION Study design (duration and timing of intervention, type of intervention, type of data collection) and samples (age of women, reason for infertility, duration of infertility) are very heterogeneous. The results of the studies were determined with different methods and make comparability difficult. All these factors do not allow for a uniform conclusion. CONCLUSION In order to be able to better compare psychosocial interventions and their influence on ART treatment and thus also to achieve valid results, a standardised procedure to the mentioned factors is necessary.
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Affiliation(s)
- Franziska Kremer
- Institute of Medical Psychology, Centre for Psychosocial Medicine, University Hospital, Heidelberg, Germany
- * E-mail:
| | - Beate Ditzen
- Institute of Medical Psychology, Centre for Psychosocial Medicine, University Hospital, Heidelberg, Germany
| | - Tewes Wischmann
- Institute of Medical Psychology, Centre for Psychosocial Medicine, University Hospital, Heidelberg, Germany
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Lin JW, Shorey S. Online peer support communities in the infertility journey: A systematic mixed-studies review. Int J Nurs Stud 2023; 140:104454. [PMID: 36841192 DOI: 10.1016/j.ijnurstu.2023.104454] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 02/01/2023] [Accepted: 02/03/2023] [Indexed: 02/12/2023]
Abstract
BACKGROUND Infertile individuals desire support, as they are highly vulnerable to multi-dimensional distress. However, support from family, friends and professionals has been found to be inadequate for their needs. Online peer support communities are avenues where infertile individuals come together virtually to share experiences and provide peer support. Though they are known to fulfil the major need of understanding and sharing experiences, little is known about their actual role in supporting individuals struggling with infertility. OBJECTIVE To systematically consolidate and explore the role of online peer support communities for infertile individuals. DESIGN This is a systematic mixed-studies review. METHODS Eight published and unpublished databases were screened for English studies from inception to October 2022: PubMed, EMBASE, Cochrane, PsycINFO, CINAHL, Scopus and ProQuest. Forty-nine studies were included, and quality was appraised using the Mixed Methods Appraisal Tool. Data-based convergent qualitative (narrative and thematic) synthesis was conducted. RESULTS An overarching theme titled: Online peer support, a 'double-edged sword' and four themes were identified: 1) Receiving varied types of support with mutual benefits; 2) convenient and "safe haven" with diverse options for struggling couples; 3) herd mentality and negative collective emotions; and 4) credibility, confidentiality, and misinformation. The online communities were mainly utilised by couples in their late 20s to early 30s and the users were predominantly females. Online communities were mostly on forums and popular social media sites, public and unmoderated. Findings revealed that there were two-way benefits for both providers and receivers of peer support. Online communities were also found to be convenient and "safe haven" with diverse options for struggling couples. Conversely for some couples, online communities led to negative collective emotions and feelings of "unrelatedness" despite being among "similar others". Lastly, some couples raised concerns around the credibility, confidentiality, and misinformation from the online communities. CONCLUSIONS Whilst online communities are crucial in the individuals' journey through infertility, they can act as a 'double-edged' sword if not managed by professionals. Healthcare professionals can monitor online communities to improve fertility care for individuals; advice individuals to use online communities with caution, rain peer volunteers and develop expert-moderated peer support online communities. REGISTRATION NUMBER PROSPERO [CRD42022291461]. TWEETABLE ABSTRACT Online peer-to-peer support communities may be a double-edged sword for infertile individuals.
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Affiliation(s)
- Jing Wen Lin
- Nursing Division, National University Hospital, 5 Lower Kent Ridge Rd, 119074, Singapore
| | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive, 117597, Singapore.
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Shi H, Pan M, Jia E, Lu W, Zhou Y, Sheng Y, Zhao X, Cai L, Ge Q. A comprehensive characterization of cell-free RNA in spent blastocyst medium and quality prediction for blastocyst. Clin Sci (Lond) 2023; 137:129-0. [PMID: 36597876 DOI: 10.1042/cs20220495] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 12/16/2022] [Accepted: 01/03/2023] [Indexed: 01/05/2023]
Abstract
The rate of pregnancy can be affected by many factors in assisted reproductive technology (ART), and one of which is the quality of embryos. Therefore, selecting the embryos with high potential is crucial for the outcome. Fifteen spent blastocyst medium (SBM) samples were collected from 14 patients who received in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI), seven from high-grade embryos and eight from low-grade embryos. Cell-free RNA (cf-RNA) profile of SBM samples were analyzed by RNA sequencing in the present study. It was found that a large amount of cf-RNA were released into SBM, including protein-coding genes (68.9%) and long noncoding RNAs (lncRNAs) (17.26%). Furthermore, a high correlation was observed between blastocyst genes and SBM genes. And the cf-mRNAs of SBM were highly fragmented, and coding sequence (CDS) and untranslated (UTR) regions were released equally. Two hundred and thirty-two differentially expressed genes were identified in high-grade SBM (hSBM) and low-grade SBM (lSBM), which could be potential biomarker in distinguishing the embryos with different quality as an alternative or supplementary approach for subjective morphology criteria. Hence, cf-RNAs sequencing revealed the characterization of circulating transcriptomes of embryos with different quality. Based on the results, the genes related to blastocyst quality were screened, including the genes closely related to translation, immune-signaling pathway, and amino acid metabolism. Overall, the present study showed the types of SBM cf-RNAs, and the integrated analysis of cf-RNAs profiling with morphology grading displayed its potential in predicting blastocyst quality. The present study provided valuable scientific basis for noninvasive embryo selection in ART by RNA-profiling analysis.
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Affiliation(s)
- Huajuan Shi
- State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, Nanjing 210096, People's Republic of China
| | - Min Pan
- School of Medicine, Southeast University, Nanjing 210097, China
| | - Erteng Jia
- State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, Nanjing 210096, People's Republic of China
| | - Wenxiang Lu
- State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, Nanjing 210096, People's Republic of China
| | - Ying Zhou
- State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, Nanjing 210096, People's Republic of China
| | - Yuqi Sheng
- State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, Nanjing 210096, People's Republic of China
| | - Xiangwei Zhao
- State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, Nanjing 210096, People's Republic of China
| | - Lingbo Cai
- Clinical Center of Reproductive Medicine, State Key Laboratory of Reproductive Medicine, First Affiliated Hospital, Nanjing Medical University, Nanjing, China
| | - Qinyu Ge
- State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, Nanjing 210096, People's Republic of China
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Guo Y, Fang Z, Yu L, Sun X, Li F, Jin L. Which endometrial preparation protocol provides better pregnancy and perinatal outcomes for endometriosis patients in frozen-thawed embryo transfer cycles? A retrospective study on 1413 patients. J Ovarian Res 2023; 16:7. [PMID: 36624470 PMCID: PMC9830850 DOI: 10.1186/s13048-023-01095-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 01/03/2023] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE To determine the optimal endometrial preparation protocol for a frozen embryo transfer in patients with endometriosis. DESIGN Retrospective cohort study. SETTING Tertiary care academic medical center. PATIENT(S) One thousand four hundred thirteen patients with endometriosis who underwent oocyte aspiration from 2015 to 2020 and frozen embryo transfer from 2016 to 2020 and received natural cycle, hormone replacement treatment with or without GnRHa pretreatment endometrial preparation. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Clinical pregnancy rate, live birth rate, miscarriage rate, multiple pregnancy rate, biochemical pregnancy rate and ectopic pregnancy rate. Singleton live births were assessed for perinatal outcomes and obstetric complications. RESULT(S) There were no differences in clinical pregnancy outcomes or prenatal outcomes among the three commonly used endometrial preparation protocols for frozen embryo transfer cycles in patients with endometriosis. Results remained after screening variables using univariate logistic regression into multivariate logistic regression. No advantages or disadvantages were found among the three endometrial preparation protocols in patients with endometriosis. CONCLUSION(S) Natural cycle, hormone replacement cycle, or hormone replacement treatment with GnRHa pretreatment showed no superiority or inferiority in pregnancy and perinatal outcomes in patients with endometriosis.
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Affiliation(s)
- Yaxin Guo
- grid.412793.a0000 0004 1799 5032Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 JieFang Avenue, Wuhan, 430030 People’s Republic of China
| | - Zishui Fang
- grid.412793.a0000 0004 1799 5032Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 JieFang Avenue, Wuhan, 430030 People’s Republic of China
| | - Lin Yu
- Department of Artificial Intelligence, NanPeng Artificial Intelligence Research Institute Ltd, Chongqing, People’s Republic of China
| | - Xin Sun
- Department of Artificial Intelligence, NanPeng Artificial Intelligence Research Institute Ltd, Chongqing, People’s Republic of China
| | - Fei Li
- grid.412793.a0000 0004 1799 5032Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 JieFang Avenue, Wuhan, 430030 People’s Republic of China
| | - Lei Jin
- grid.412793.a0000 0004 1799 5032Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 JieFang Avenue, Wuhan, 430030 People’s Republic of China
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Dube L, Bright K, Hayden KA, Gordon JL. Efficacy of psychological interventions for mental health and pregnancy rates among individuals with infertility: a systematic review and meta-analysis. Hum Reprod Update 2023; 29:71-94. [PMID: 36191078 DOI: 10.1093/humupd/dmac034] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/29/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Depression and anxiety are highly prevalent among individuals struggling with infertility. Thus, numerous psychological interventions have been adapted to infertility, with the aim of relieving distress as well as increasing pregnancy rates. OBJECTIVE AND RATIONALE This systematic review and meta-analysis aimed to identify all randomized controlled trials (RCTs) evaluating the effect of psychological interventions on infertility-related distress and pregnancy rates among individuals and/or couples with infertility and to analyse their overall effect. It also sought to examine potential treatment moderators, including intervention length, format and therapeutic approach. SEARCH METHODS An electronic search of 11 databases, including MEDLINE, EMBASE, PsycINFO and Cochrane Central Register of Controlled Trials, was performed for studies published until January 2022. The inclusion criteria were RCTs conducted on humans and published in English. Psychological outcomes of interest included anxiety, depression, infertility-related distress, wellbeing and marital satisfaction. The Cochrane Risk of Bias tool was used to assess study quality, and the Grading of Recommendations Assessment, Development and Evaluation was used to assess the overall quality of the research evidence. OUTCOMES There were 58 RCTs in total, including 54 which included psychological outcomes and 21 which assessed pregnancy rates. Studies originated from all regions of the world, but nearly half of the studies were from the Middle East. Although a beneficial effect on combined psychological outcomes was found (Hedge's g = 0.82, P < 0.0001), it was moderated by region (P < 0.00001) such that studies from the Middle East exhibited large effects (g = 1.40, P < 0.0001), while the effects were small among studies conducted elsewhere (g = 0.23, P < 0.0001). Statistically adjusting for study region in a meta-regression, neither intervention length, therapeutic approach, therapy format, nor participant gender (P > 0.05) moderated the effect of treatment. A beneficial treatment effect on pregnancy (RR (95% CI) = 1.25 (1.07-1.47), P = 0.005) was not moderated by region, treatment length, approach or format (P > 0.05). Largely due to the lack of high quality RCTs, the quality of the available evidence was rated as low to moderate. WIDER IMPLICATIONS This is the first meta-analysis of RCTs testing the effect of psychological interventions on infertility-related distress and pregnancy rates. These findings suggest that in most regions of the world, psychological interventions are associated with small reductions in distress and modest effects on conception, suggesting the need for more effective interventions. These findings must be considered in light of the fact that the majority of the included RCTs were deemed to be at high risk of bias. Rigorously conducted trials are needed.
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Affiliation(s)
- Loveness Dube
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
| | - Katherine Bright
- Department of Outpatient Psychiatry, Alberta Health Services, Calgary, Alberta, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - K Alix Hayden
- Department of Libraries and Cultural Resources, University of Calgary, Calgary, Alberta, Canada
| | - Jennifer L Gordon
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
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Ma J, Gao W, Li D. Recurrent implantation failure: A comprehensive summary from etiology to treatment. Front Endocrinol (Lausanne) 2023; 13:1061766. [PMID: 36686483 PMCID: PMC9849692 DOI: 10.3389/fendo.2022.1061766] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 12/13/2022] [Indexed: 01/06/2023] Open
Abstract
Implantation is the first step in human reproduction. Successful implantation depends on the crosstalk between embryo and endometrium. Recurrent implantation failure (RIF) is a clinical phenomenon characterized by a lack of implantation after the transfer of several embryos and disturbs approximately 10% couples undergoing in vitro fertilization and embryo transfer. Despite increasing literature on RIF, there is still no widely accepted definition or standard protocol for the diagnosis and treatment of RIF. Progress in predicting and preventing RIF has been hampered by a lack of widely accepted definitions. Most couples with RIF can become pregnant after clinical intervention. The prognosis for couples with RIF is related to maternal age. RIF can be caused by immunology, thrombophilias, endometrial receptivity, microbiome, anatomical abnormalities, male factors, and embryo aneuploidy. It is important to determine the most possible etiologies, and individualized treatment aimed at the primary cause seems to be an effective method for increasing the implantation rate. Couples with RIF require psychological support and appropriate clinical intervention. Further studies are required to evaluate diagnostic method and he effectiveness of each therapy, and guide clinical treatment.
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Affiliation(s)
- Junying Ma
- Center of Reproductive Medicine, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Reproductive and Genetic Medicine, China Medical University, National Health Commission, Shenyang, China
- Shengjing Hospital of China Medical University, Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang, China
| | - Wenyan Gao
- Department of Obstetrics, the First Affiliated Hospital of China Medical University, Shenyang, China
| | - Da Li
- Center of Reproductive Medicine, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Reproductive and Genetic Medicine, China Medical University, National Health Commission, Shenyang, China
- Shengjing Hospital of China Medical University, Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang, China
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Péloquin K, Boucher S, Benoit Z, Jean M, Beauvilliers L, Carranza-Mamane B, Brassard A. "We're in this together": Attachment insecurities, dyadic coping strategies, and relationship satisfaction in couples involved in medically assisted reproduction. JOURNAL OF MARITAL AND FAMILY THERAPY 2023; 49:92-110. [PMID: 36047353 DOI: 10.1111/jmft.12608] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 08/11/2022] [Accepted: 08/16/2022] [Indexed: 06/15/2023]
Abstract
Attachment is an important predictor of relationship satisfaction and attachment insecurities are a risk factor for couples under stress. Drawing from the Vulnerability-Stress-Adaptation model, we investigated whether dyadic coping strategies (DCS) would explain the links between attachment insecurities and relationship satisfaction in 97 couples involved in medically assisted reproduction (MAR). Path analyses revealed that for women and men, attachment insecurities (anxiety, avoidance) were associated with their own lower relationship satisfaction through their lower use of positive DCS. Attachment avoidance was also associated with participants' own lower relationship satisfaction through their own lower use of negative DCS. Men's attachment avoidance was also related to their partner's lower relationship satisfaction via their own and their partner's lower use of positive DCS. The findings suggest that promoting the use of positive DCS may be important to preserve relationship satisfaction in couples involved in MAR.
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Affiliation(s)
| | - Stéphanie Boucher
- Psychology Department, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Zoé Benoit
- Psychology Department, Université de Montréal, Montreal, Quebec, Canada
| | - Mireille Jean
- Psychology Department, Université de Montréal, Montreal, Quebec, Canada
| | | | - Belina Carranza-Mamane
- Department of Obstetrics and Gynecology, GREI Division, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Audrey Brassard
- Psychology Department, Université de Sherbrooke, Sherbrooke, Quebec, Canada
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Scaravelli G, Fedele F, Spoletini R, Monaco S, Renzi A, Di Trani M. Toward a Personalized Psychological Counseling Service in Assisted Reproductive Technology Centers: A Qualitative Analysis of Couples' Needs. J Pers Med 2022; 13:jpm13010073. [PMID: 36675734 PMCID: PMC9867277 DOI: 10.3390/jpm13010073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/22/2022] [Accepted: 12/26/2022] [Indexed: 12/30/2022] Open
Abstract
Infertility may have a very strong emotional impact on individuals, requiring adequate support, but few studies on patients' demands toward psychological support have been conducted. This study aims to explore the emotions related to the infertility and to the Assisted Reproductive Technology (ART) procedure for which patients consider useful a psychological support. A total of 324 women completed a sociodemographic and clinical questionnaire and an open-ended questionnaire on emotional needs for psychological support. The written texts were explored by the Linguistic Inquiry and Word Count (LIWC) programme and linguistic characteristics were related to sociodemographic and anamnestic variables. Specific linguistic features were connected to several individual characteristics. More specifically, differences in linguistic processes emerged comparing women with an age over or under 40 years, women undergoing their first attempts versus more attempts, women undergoing ART with or without gamete donation, and women undergoing ART for male or unknown causes, as well as those undergoing ART for female or both partners' problems. These differences seem to confirm that older age, more attempts, gamete donation, and ART for unknown or male causes are risk factors that may worsen women's psychological well-being. This study contributes to increase the knowledge about the emotional needs of patients undergoing an ART procedure to develop specific psychological intervention programs.
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Affiliation(s)
- Giulia Scaravelli
- ART Italian National Register, National Centre for Diseases Prevention and Health Promotion, Italian National Health Institute, Viale Regina Elena 299, 00161 Rome, Italy
| | - Fabiola Fedele
- ART Italian National Register, National Centre for Diseases Prevention and Health Promotion, Italian National Health Institute, Viale Regina Elena 299, 00161 Rome, Italy
| | - Roberta Spoletini
- ART Italian National Register, National Centre for Diseases Prevention and Health Promotion, Italian National Health Institute, Viale Regina Elena 299, 00161 Rome, Italy
| | - Silvia Monaco
- Department of Dynamic and Clinical Psychology and Health Studies, “Sapienza” University of Rome, Via degli Apuli 1, 00185 Rome, Italy
- Correspondence:
| | - Alessia Renzi
- Department of Dynamic and Clinical Psychology and Health Studies, “Sapienza” University of Rome, Via degli Apuli 1, 00185 Rome, Italy
| | - Michela Di Trani
- Department of Dynamic and Clinical Psychology and Health Studies, “Sapienza” University of Rome, Via degli Apuli 1, 00185 Rome, Italy
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Payne N, van den Akker O. Mental health and coping with fertility treatment cessation during the COVID-19 pandemic in the UK. J Psychosom Obstet Gynaecol 2022; 43:550-556. [PMID: 35833417 DOI: 10.1080/0167482x.2022.2097475] [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: 10/17/2022] Open
Abstract
PURPOSE This study examined experiences during the cessation of fertility treatment due to the COVID-19 pandemic, including levels of mental health, coping strategies used to manage uncertainty about treatment due to the pandemic, sources of support, and predictors of mental health. METHODS One hundred and seventy-five participants in the UK completed an online survey. RESULTS Half of the participants experienced clinical levels of anxiety and/or depression, and 20% reported suicidal feelings as a result of the uncertainty about treatment due to the pandemic. Support from friends, family and online forums were reported by more than half of participants, but support from fertility clinics or counsellors were reported by less than one quarter. The strategy used most frequently to cope with the uncertainty about treatment due to the pandemic was self-distraction, and this predicted reduced depression. However, self-blame, behavioral disengagement and venting predicted increased depression and self-blame, behavioral disengagement, and denial predicted increased anxiety. CONCLUSIONS Fertility clinic communication and psychological support, such as counselling, which had substantially reduced during treatment cessation, could include some focus on personal coping, including what to avoid. Psychological support is likely to be more important now than ever. Despite resumption of treatment, the impacts of the period of cessation and of COVID-19 are likely to continue to reverberate.
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Affiliation(s)
- Nicola Payne
- Department of Psychology, Middlesex University, London, UK
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Tavousi SA, Behjati M, Milajerdi A, Mohammadi AH. Psychological assessment in infertility: A systematic review and meta-analysis. Front Psychol 2022; 13:961722. [PMID: 36389481 PMCID: PMC9650266 DOI: 10.3389/fpsyg.2022.961722] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 10/03/2022] [Indexed: 11/23/2022] Open
Abstract
Infertility is a prevalent worldwide health issue and is defined by the World Health Organization (WHO) as a global health problem. Considering the importance of the psychological dimensions of infertility, various measurement tools have been used to measure the variables involved in infertility, of which the most widely used are the following: the Symptom Checklist 90 (SCL90), the Brief Symptom Inventory (BSI), the State-Trait Anxiety Inventory Form (STAI), and the Depression Anxiety Stress Scale (DASS). Therefore, given the problems of infertile people in terms of psychological dimensions, the aim of this meta-analysis was to assess the psychological assessment score in infertility. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol, we applied an online database with no time restriction. Data were gathered using a random-effect model to estimate the standard mean difference (SMD) for the evaluation of the strength of association analyses. Our data demonstrated a significant higher SCL90 score (CISCL90: 0.96, 0.34–1.57, heterogeneity: 94%, pheterogeneity < 0.001), and a non-significant higher DASS score (CIAnxiety: 0.82, -0.14 to 1.79; CIDepression: 0.8, -0.28 to 1.87; and CIStress: 0.82, -0.24 to 1.88). It is essential to seek for strategies to help infertile patients overcome their infertility-related psychological problems.
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Affiliation(s)
| | - Mohaddeseh Behjati
- Cellular, Molecular and Genetics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Milajerdi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran
| | - Amir Hossein Mohammadi
- Student Research Committee, Kashan University of Medical Sciences, Kashan, Iran
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran
- *Correspondence: Amir Hossein Mohammadi,
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