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Pakpahan C, Agustinus A, Sa'adi A, Nguyen TTA, Liamputtong P, Effendy C, Hinting A. Lay understanding and experience of sexual intercourse among couples with infertility undergoing an assisted reproduction technology program: A qualitative study. Heliyon 2024; 10:e26879. [PMID: 38434274 PMCID: PMC10907792 DOI: 10.1016/j.heliyon.2024.e26879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 02/09/2024] [Accepted: 02/21/2024] [Indexed: 03/05/2024] Open
Abstract
Aim To explore the perception and lay understanding of sexual intercourse and sexual life experiences among infertile couples before, during, and after undergoing an assisted reproduction technology (ART) program. Method The participants of this descriptive qualitative study were Indonesian couples with infertility who underwent an ART program. Semi-structured interviews were conducted between September and December 2022, and the participants' responses were recorded. Data were analyzed using a step-by-step analysis based on Braun's qualitative analysis. The study was reported based on the Consolidated Criteria for Reporting a Qualitative Research (COREQ) Checklist. Results Fifty participants were included, and five themes were developed before and two themes during or after the ART program. The couples' knowledge varied as they experienced sexual intercourse at different periods, such as before, during, and after the ART program. Many participants reported that ART affected their emotions and mood, leading to decreased desire to engage in sexual intercourse. However, some used sexual intercourse as a basis for creating optimism and confidence in having offspring. Furthermore, couples perceived that the purpose of sexual intercourse is not only to have offspring but also to improve communication, promote intimacy, and express affection. In contrast, some perceived the ART program as time consuming, preventing them from engaging in sexual activities. However, not all couples considered sexual activity solely as a means of procreation. They concluded that sexual behavior is not only determined by genetics. Conclusion Couples who underwent the ART program regardless of its effectiveness were aware that sexual interaction is not only for having children but also for preserving harmony and familial connection.
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Affiliation(s)
- Cennikon Pakpahan
- Andrology Study Program, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Department of Biomedical Sciences, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Ferina Mother and Child Hospital, Surabaya, Indonesia
| | - Agustinus Agustinus
- Andrology Study Program, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Department of Biomedical Sciences, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Ferina Mother and Child Hospital, Surabaya, Indonesia
| | - Ashon Sa'adi
- Ferina Mother and Child Hospital, Surabaya, Indonesia
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | | | - Pranee Liamputtong
- College of Health Sciences, VinUniversity, Gia Lam District, Hanoi, Viet Nam
- Center for Global Health, Perelman School of Medicine, University of Pennsylvania, USA
| | - Christantie Effendy
- Medical Surgical Nursing Department, Faculty of Medicine, Public Health and Nursing. Universitas Gadjah Mada, Indonesia
| | - Aucky Hinting
- Andrology Study Program, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Department of Biomedical Sciences, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Ferina Mother and Child Hospital, Surabaya, Indonesia
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Saadedine M, Faubion SS, Kling JM, Kuhle C, Shufelt CL, Mara K, Enders F, Kapoor E. History of infertility and sexual dysfunction in midlife women: Is there a link? J Sex Med 2023; 20:1188-1194. [PMID: 37537692 PMCID: PMC10472170 DOI: 10.1093/jsxmed/qdad097] [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: 01/26/2023] [Revised: 05/16/2023] [Accepted: 06/26/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND Infertility has been linked with an increased risk of sexual dysfunction in reproductive-aged women, with longer periods of infertility associated with a greater risk. AIM The study's aim was to examine whether a history of infertility treatment in women is linked to sexual dysfunction during midlife. METHODS The cross-sectional study was conducted among sexually active women, between the ages of 45 and 65 years, who sought consultation at the women's health clinics at a US tertiary care center. History of infertility treatment was assessed with a single question that asked participants if they were treated for infertility in the past. The association between a history of infertility treatment and sexual dysfunction-which was diagnosed by a combination of Female Sexual Function Index score ≤26.55 and Female Sexual Distress Scale-Revised score ≥11-was assessed in a multivariable logistic regression model that adjusted for multiple confounders. OUTCOMES The primary outcome was sexual dysfunction in midlife women. RESULTS The analysis included 5912 women, with a mean age of 54.1 years. Nearly 16% of women reported receiving treatment for infertility. More than half the women (55%) had sexual dysfunction: 56.3% of those with previous fertility treatments and 54.4% of those without any fertility treatment (P = .3). Receiving treatment for infertility in the younger years did not significantly increase the odds of sexual dysfunction in midlife in univariate (odds ratio, 1.08; 95% CI, 0.94-1.24; P = .3) and multivariable analyses (odds ratio, 1.11; 95% CI, 0.96-1.29; P = .17). CLINICAL IMPLICATIONS While infertility is known to be predictive of sexual dysfunction in women during their reproductive years, there was no association between a history of infertility treatment and sexual dysfunction in midlife women in the current study. STRENGTHS AND LIMITATIONS The study used validated questionnaires accounting for sexual complaints and distress and adjusted for multiple confounding factors. Limitations include the selection bias introduced by the study of women presenting for evaluation of sexual dysfunction, which may have been a result of factors stronger than the influence of infertility. Other limitations include the study's cross-sectional nature with suboptimal racial and ethnic representation. CONCLUSION Although infertility is commonly associated with female sexual dysfunction in women of reproductive age, the association was not present in midlife women in the current study.
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Affiliation(s)
- Mariam Saadedine
- Division of General Internal Medicine, Mayo Clinic, Jacksonville, FL, 32224, United States
- Center for Women’s Health, Mayo Clinic, Rochester, MN, 55905, United States
| | - Stephanie S Faubion
- Division of General Internal Medicine, Mayo Clinic, Jacksonville, FL, 32224, United States
- Center for Women’s Health, Mayo Clinic, Rochester, MN, 55905, United States
| | - Juliana M Kling
- Center for Women’s Health, Mayo Clinic, Rochester, MN, 55905, United States
- Division of Women’s Health Internal Medicine, Mayo Clinic, Scottsdale, AZ, 85259, United States
| | - Carol Kuhle
- Center for Women’s Health, Mayo Clinic, Rochester, MN, 55905, United States
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, 55905, United States
| | - Chrisandra L Shufelt
- Division of General Internal Medicine, Mayo Clinic, Jacksonville, FL, 32224, United States
- Center for Women’s Health, Mayo Clinic, Rochester, MN, 55905, United States
| | - Kristin Mara
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, 55905, United States
| | - Felicity Enders
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, 55905, United States
| | - Ekta Kapoor
- Center for Women’s Health, Mayo Clinic, Rochester, MN, 55905, United States
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, 55905, United States
- Women’s Health Research Center, Mayo Clinic, Rochester, MN, 55905, United States
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN, 55905, United States
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Santona A, Vismara L, Gorla L, Tognasso G, Ambrosini C, Luli A, Rollè L. The Relationship between Attachment, Dyadic Adjustment, and Sexuality: A Comparison between Infertile Men and Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3020. [PMID: 36833722 PMCID: PMC9962621 DOI: 10.3390/ijerph20043020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/23/2023] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Abstract
Infertility impacts several life dimensions. Among them, sexuality is particularly affected; yet studies have mainly focused on infertile women. We aimed to explore infertile men's and women's experiences in sexual satisfaction, internal control, and anxiety, and the relationship between attachment, dyadic adjustment, and sexuality. The sample consisted of 129 infertile people (47.3% females, 52.7% males, Mage = 39 years) who fulfilled an ad hoc questionnaire, the Multidimensional Sexuality Questionnaire (MSQ), the Experiences in Close Relationship-Revised (ECR-R), and the Dyadic Adjustment Scale (DAS). We found a significant effect of type of infertility and infertility factors on sexual anxiety only in infertile men. As regards infertile women, dyadic adjustment predicted sexual satisfaction, anxious attachment decreased sexual internal control, and avoidant attachment reduced sexual anxiety. As regards infertile men, high dyadic adjustment increased sexual satisfaction and a high avoidant attachment predicted high levels of sexual internal control. There was no relationship between attachment, dyadic adjustment, and sexual anxiety for infertile men. From the results, it emerges how important is to consider both dyadic adjustment and attachment in studying how infertility impacts women's and men's lives.
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Affiliation(s)
- Alessandra Santona
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy
| | - Laura Vismara
- Department of Pedagogy, Psychology, Philosophy, University of Cagliari, 09123 Cagliari, Italy
| | - Laura Gorla
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy
| | - Giacomo Tognasso
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy
| | - Carolina Ambrosini
- Department of Developmental Psychology and Socialisation, University of Padua, 35131 Padova, Italy
| | - Anisa Luli
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy
| | - Luca Rollè
- Department of Psychology, University of Torino, 10124 Torino, Italy
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Lo SST, Wong GCY, Ng EHY, Chan CHY, Li RHW. Longitudinal study on sexual function and quality of life in infertile couples undergoing intrauterine insemination. J Sex Med 2023; 20:30-37. [PMID: 36897240 DOI: 10.1093/jsxmed/qdac013] [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: 07/01/2022] [Revised: 10/03/2022] [Accepted: 10/14/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND Cross-sectional studies have shown that sexual dysfunction and poor quality of life were prevalent among couples undergoing assisted reproduction at specific time points, but nothing is known about how these outcomes change over the course of their intrauterine insemination (IUI) journey. AIM We investigated the longitudinal changes in sexual function and quality of life of infertile couples undergoing IUI. METHODS Sixty-six infertile couples completed an anonymous questionnaire at 3 time points: after IUI counseling (T1), 1 day before IUI (T2), and 2 weeks after IUI (T3). The questionnaire consisted of demographic data, Female Sexual Function Index (FSFI) or International Index of Erectile Function-5, and Fertility Quality of Life (FertiQoL). OUTCOMES Descriptive statistics, significance testing with the Friedman test, and post hoc analysis with the Wilcoxon signed rank test were used to compare changes in sexual function and quality of life at different time points. RESULTS Overall, 18 (26.1%), 16 (23.2%), and 12 (17.4%) women and 29 (42.0%), 37 (53.6%), and 31 (44.9%) men were at risk for sexual dysfunction at T1, T2, and T3, respectively. There were significant differences in mean FSFI scores in arousal (3.87, 4.06, 4.10) and orgasm (4.15, 4.24, 4.39) domains at T1, T2, and T3. After post hoc analysis, only the increase in mean orgasm FSFI scores between T1 and T3 was statistically significant. Men's FertiQoL scores remained high during IUI (74.33-75.63 out of 100). Men also scored significantly higher than women on all FertiQoL domains except environment at the 3 time points. Post hoc analysis showed significant improvement in women's FertiQoL domain scores between T1 and T2: mind-body, environment, treatment, and total. Women's FertiQoL score at T2 for the treatment domain was also significantly higher than that at T3. CLINICAL IMPLICATIONS Men should not be neglected during IUI as their erectile function got worse in the process, with half of the men being affected. Although women's quality of life showed some improvement during IUI, most of their scores were lower than men's. STRENGTHS AND LIMITATIONS The use of psychometrically validated questionnaires and a longitudinal approach are the major strengths; a small sample size and the lack of a dyadic approach are the major limitations. CONCLUSION During IUI, women's sexual performance and quality of life improved. The proportion of men having erectile problems was high for this age group, but men's FertiQoL scores remained good and were better than their partners' throughout IUI.
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Affiliation(s)
- Sue Seen-Tsing Lo
- Health Services Division, The Family Planning Association of Hong Kong, Hong Kong SAR, China
| | - Grace Ching-Yin Wong
- Health Services Division, The Family Planning Association of Hong Kong, Hong Kong SAR, China
| | - Ernest Hung-Yu Ng
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Hong Kong SAR, China
| | - Celia Hoi-Yan Chan
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
| | - Raymond Hang-Wun Li
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Hong Kong SAR, China
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Leeners B, Tschudin S, Wischmann T, Kalaitzopoulos DR. Sexual dysfunction and disorders as a consequence of infertility: a systematic review and meta-analysis. Hum Reprod Update 2023; 29:95-125. [PMID: 35900268 DOI: 10.1093/humupd/dmac030] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 04/06/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Sexuality has a key impact on quality of life and on reproductive health. Infertility often results in sexual dysfunction. Despite this close association, addressing sexuality is not a standard component of infertility counselling, especially since in most countries sexual medicine is not a core element of specialist training. Even today, many doctors and patients consider discussing sexuality to be more challenging than other aspects of reproductive medicine. The present review addresses the complex consequences of infertility on sexuality. OBJECTIVE AND RATIONALE Our goals were: (i) to identify the prevalence of sexual problems resulting from infertility, (ii) to evaluate characteristics of sexual difficulties and disorders resulting from infertility and (iii) to analyse factors involved in the complex association between sexual problems and infertility. SEARCH METHODS A systematic search for publications containing keywords related to sexual disorders and infertility was performed via PubMed, Web of Science and Psyndex. A total of 170 manuscripts published between January 1966 and April 2021 were identified after verification of inclusion and exclusion criteria. The reference lists in these manuscripts were searched for further relevant literature. Studies were reviewed for quality-related methodological details. OUTCOMES Couples diagnosed with infertility have an increased risk of sexual disorders. Loss of sexual desire and erectile dysfunction are among the most frequent sexual disorders resulting from infertility. Currently available literature reflects only fragmentarily the complexity of the diverse interactions. Sexuality plays out against the backdrop of interactions among personal, cultural, infertility-related and sexuality-related factors. Considering this complexity, it is crucial to evaluate individual profiles as well as partnership interactions to avoid a negative impact of infertility on a couple's sexual life. WIDER IMPLICATIONS Identifying sexual disorders as relevant considerations in the context of infertility and exploring their impact during the entire course of diagnosis and treatment constitute an important contribution to comprehensively care for the couples concerned. Counselling should focus on preventing the onset and aggravation of sexual disorders. As sexuality represents a major component of quality of life and of partnership, such support may improve not only the current overall wellbeing but also the chances of a satisfactory long-term partnership and family life.
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Affiliation(s)
- Brigitte Leeners
- Department of Reproductive Endocrinology, University Hospital Zurich, Zurich, Switzerland
| | - Sibil Tschudin
- Division of Social Medicine and Psychosomatics, University Hospital Basel, Basel, Switzerland
| | - Tewes Wischmann
- Institute for Medical Psychology, University Hospital Heidelberg, Heidelberg, Germany
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Fernandes J, Pedro J, Costa ME, Martins MV. Effect of depression and anxiety on sexual functioning in couples trying to conceive with and without an infertility diagnosis. Psychol Health 2023; 38:37-54. [PMID: 34279131 DOI: 10.1080/08870446.2021.1955115] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE This study examined the effects of anxiety and depression on sexual functioning in couples trying to conceive, and tested the moderating role of infertility diagnosis on this association. DESIGN An online questionnaire was completed by 1453 individuals in a heterosexual relationship for more than one year. The final sample had 107 couples who were actively attempting a pregnancy (63 had an infertility diagnosis; 44 were presumably fertile). Data was analyzed with the Actor-Partner Interdependence Model (APIM). MAIN OUTCOME MEASURES Depression and anxiety symptoms were assessed by the Hospital Anxiety and Depression Scale (HADS), and male and female sexual functioning were assessed through the International Index of Erectile Function (IIEF) and the Female Sexual Function Index (FSFI), respectively. RESULTS Actor effects were found between depression and sexual functioning in both men (β= -.28, p= .003) and women (β= -.43, p < .001), with no significant partner effects. The moderation analysis showed that the relationship between depression and sexual functioning is stronger in infertile men than in presumably fertile men (β= -.29; p= .002). CONCLUSION Psychological interventions with couples trying to conceive should address the role of depression in sexual functioning, particularly in infertile men.
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Affiliation(s)
- Joana Fernandes
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | - Juliana Pedro
- Centre for Psychology, University of Porto, Porto, Portugal
| | - Maria Emília Costa
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal.,Centre for Psychology, University of Porto, Porto, Portugal
| | - Mariana Veloso Martins
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal.,Centre for Psychology, University of Porto, Porto, Portugal
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Le Goff J, Reignier A, Mirallie S, Dubourdieu S, Barrière P, Fréour T, Lefebvre T. Sexual function in heterosexual couples undergoing assisted reproductive technology (ART) cycles with donor sperm. Arch Gynecol Obstet 2023; 307:625-632. [PMID: 36480033 PMCID: PMC9734951 DOI: 10.1007/s00404-022-06877-7] [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: 08/09/2022] [Accepted: 11/29/2022] [Indexed: 12/13/2022]
Abstract
PURPOSE Sexuality and the desire for children are closely linked, and infertility can increase the risk of sexual dysfunction (SD). Among heterosexual infertile couples undergoing assisted reproductive technology (ART) cycles, those referred for donor sperm cycles constitute a specific subgroup, potentially different than those undergoing ART with partner's sperm, as giving up on biological parenthood can be difficult to overcome. However, the impact of donor sperm ART on infertile couples' sexuality has been hardly explored in the literature. This study aimed to describe the sexual function in couples undergoing ART with donor sperm. METHODS This monocentric prospective observational study was conducted in heterosexual couples undergoing ART cycle with sperm donor, using the FSFI and the IIEF15 questionnaires. Seventy-nine couples were solicited to participate in the study. RESULTS In our sample, 39.3% (n = 24) of women had sexual dysfunction (SD). Among men, 26.5% (n = 13) had erectile dysfunction (ED). No statistically significant difference was found between both groups (with or without SD) in men and women in univariate analysis. Therefore, multivariate analysis was not performed and no specific predictor of SD could be identified. CONCLUSION Although this should be confirmed in a larger number of participants, our study demonstrates that a significant proportion of infertile patients undergoing ART with donor semen suffer from SD. No significant predictor could, however, be identified. Further research should focus on the evaluation of psychological interventions to treat or improve these disorders.
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Affiliation(s)
- Juliette Le Goff
- Service de Médecine et Biologie de la Reproduction, Hôpital Mère et Enfant, CHU de Nantes, 38 Boulevard Jean Monnet, Nantes, France
| | - Arnaud Reignier
- Service de Médecine et Biologie de la Reproduction, Hôpital Mère et Enfant, CHU de Nantes, 38 Boulevard Jean Monnet, Nantes, France ,Center for Research in Transplantation and Translational Immunology, UMR 1064, Nantes Université, CHU Nantes, INSERM, 44000 Nantes, France
| | - Sophie Mirallie
- Service de Médecine et Biologie de la Reproduction, Hôpital Mère et Enfant, CHU de Nantes, 38 Boulevard Jean Monnet, Nantes, France
| | - Sophie Dubourdieu
- Service de Médecine et Biologie de la Reproduction, Hôpital Mère et Enfant, CHU de Nantes, 38 Boulevard Jean Monnet, Nantes, France
| | - Paul Barrière
- Service de Médecine et Biologie de la Reproduction, Hôpital Mère et Enfant, CHU de Nantes, 38 Boulevard Jean Monnet, Nantes, France ,Center for Research in Transplantation and Translational Immunology, UMR 1064, Nantes Université, CHU Nantes, INSERM, 44000 Nantes, France
| | - Thomas Fréour
- Service de Médecine et Biologie de la Reproduction, Hôpital Mère et Enfant, CHU de Nantes, 38 Boulevard Jean Monnet, Nantes, France. .,Center for Research in Transplantation and Translational Immunology, UMR 1064, Nantes Université, CHU Nantes, INSERM, 44000, Nantes, France. .,Department of Obstetrics, Gynecology and Reproductive Medicine, Dexeus University Hospital, Barcelona, Spain.
| | - Tiphaine Lefebvre
- Service de Médecine et Biologie de la Reproduction, Hôpital Mère et Enfant, CHU de Nantes, 38 Boulevard Jean Monnet, Nantes, France
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Liu Y, Wang Y, Pu Z, Wang Y, Zhang Y, Dong C, Zeng Y, Zhou S. Sexual Dysfunction in Infertile Men: A Systematic Review and Meta-Analysis. Sex Med 2022; 10:100528. [PMID: 35636279 PMCID: PMC9386642 DOI: 10.1016/j.esxm.2022.100528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 04/11/2022] [Accepted: 04/14/2022] [Indexed: 11/28/2022] Open
Abstract
Background According to previous studies of male infertility, we found that the association between sexual dysfunction and male infertility was reported rarely and controversially. Aim We carried out this 1meta-analysis to evaluate the prevalence of sexual dysfunction and the International Index of Erectile Function (IIEF) score in infertile men. Methods A systematic search of the target literature was conducted using PubMed, EMBASE, and Cochrane Library. Data were analyzed using Review Manager 5.4 software. Standardized mean differences (SMD) with the corresponding 95% confidence intervals (95% CIs) were implemented in 6 controlled studies as a measure of effect size to assess the relationship between sexual dysfunction and male infertility and Odds Ratio (OR) were performed for the morbidity between infertility group and fertility group. Outcomes Men in infertile group were found with higher prevalence of sexual dysfunction and lower IIEF values than in controls. Results A meta-analysis of morbidity was performed in 8 of 10 controlled studies. Meta-analysis of the 8 studies found remarkable higher prevalence of sexual dysfunction in men with infertility than in controls (OR = 2.66, 95% confidence interval = 1.69–4.19, P < .0001; I² = 67%, P for heterogeneity = 0.004). Another meta-analysis of evidence suggested that IIEF in infertile men was lower than controls (SMD = −0.47, 95% confidence interval = −0.63 to −0.31, P < .00001; I² = 64%, p for heterogeneity = 0.02). Clinical Implications We recommend further research based on the relevant criteria of region, sample size, rigorous statistical analysis, and research design. Strengths & limitations This systematic review is the first to evaluate the prevalence of sexual dysfunction and the score of sexual dysfunction in male infertility. Investigation on the topic is scarce, and only few studies used appropriate measures. Conclusions Male infertility was associated with an increase in the prevalence of sexual dysfunction. The areas most affected by sexual function were erectile function, orgasm and sexual desire. Liu Y, Wang Y, Dong C, et al. Sexual Dysfunction in Infertile Men: A Systematic Review and Meta-Analysis. Sex Med 2022;10:100528.
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Szatmári A, Helembai K, Zádori J, Kovács I. Paramedical counselling in infertility treatment: its effects on anxio-depressive symptom severity, perceived stress and self-esteem. Heliyon 2022; 8:e09827. [PMID: 35800247 PMCID: PMC9254525 DOI: 10.1016/j.heliyon.2022.e09827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 04/05/2022] [Accepted: 06/24/2022] [Indexed: 11/24/2022] Open
Abstract
Aims The importance of contributing psychological factors and stress-control in female infertility is well documented, but research on their role in male infertility is scarce. The present study aimed to evaluate the effects of a novel paramedical counselling on anxio-depressive symptom severity, perceived stress and self-esteem in infertile men participating in an infertility treatment programme. Methods Patients were recruited from clinics of University of Szeged, Hungary between 2019 May and 2020 December, and were sorted into control (n = 51) and experimental (n = 57) groups, where patients in the experimental group received a 5-session paramedical counselling in extension to their medical treatment. The levels of anxio-depressive symptom severity, perceived stress and self-esteem were measured prior to and after receiving paramedical counselling. The control group scored lower in regards of the severity of depressive symptom, and showed an increase of self-esteem, while the experimental group resulted in a significant decrease of anxio-depressive scores with the elevation of the level of self-esteem. Results Our results indicate that joining an infertility treatment programme alone had a positive role in reducing depressive symptoms and in the increase of self-esteem among infertile men, but receiving additional paramedical counselling throughout the treatment programme resulted in the decrease of anxio-depressive symptoms, besides the elevation of the level of self-esteem, with a significantly higher decrease in the state anxiety compared to not receiving this additional paramedical counselling. Conclusions Thus, it would be advisable for infertility treatment programmes to incorporate screening for psychological vulnerability and implement additional paramedical counselling to alleviate these confounding symptoms detrimental to conceiving.
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10
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Impact of assisted reproduction treatment on sexual function of patients diagnosed with infertility. Arch Gynecol Obstet 2022; 305:1595-1604. [DOI: 10.1007/s00404-021-06367-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 12/09/2021] [Indexed: 11/26/2022]
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Patel A, Sharma PSVN, Kumar P. "When Love Does not bear a Fruit": Patterns and Prevalence of Sexual Difficulties in Infertile Men and Women as Predictors of Emotional Distress. J Hum Reprod Sci 2021; 14:307-312. [PMID: 34759622 PMCID: PMC8527079 DOI: 10.4103/jhrs.jhrs_70_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 07/28/2021] [Accepted: 08/08/2021] [Indexed: 11/04/2022] Open
Abstract
Background Self-identity, sexuality, and subfertility have multidirectional effects on each other. Subfertility is known to alter sexual esteem, threaten identity, body image, sexual attractivness, coital pleasure, and sexual satisfaction. Objective This study aimed to evaluate sexual difficulties as predictors of infertility-specific stress in patients undergoing fertility treatments and to assess the profile of sexual dysfunctions in participants. Study Setting and Design This cross-sectional study was conducted in a tertiary hospital setup of a medical college. Methods Three hundred married men and women diagnosed with infertility participated. The psychological evaluation test, international classification of diseases (10th, CDDG), female sexual functioning index, and international index of erectile functioning were used as measures. Statistical Analysis Data were analyzed using SPSS (version 15, Chicago, USA). Chi-square test was used for univariate analysis between stress and presence of sexual dysfunctions in men and women. Medians, quartile, and cutoff scores were used to profile the sexual issues in participants. Results Prevalence of sexual dysfunctions since marriage was higher in women (75%) than men (60%). Ninety-two percent of women and 86% of men experienced emergence of sexual difficulties after the couple started treatments. Conclusions Sexual dysfunctions appear to be a consistent psychosocial concern for those awaiting conception. These appear to worsen during the treatments. Our findings suggest the need to sensitively approach and explore sexual anamnesis with the couple before recourse to medically assisted reproductive treatments. Psychological interventions for sexual issues in distressed patients before, during, and after treatments such as controlled ovarian hyperstimulation, intrauterine insemination, in vitro fertilization, and intracytoplasmic sperm injection are most needed.
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Affiliation(s)
- Ansha Patel
- Department of Psychiatry & Psychology, MB Hospital, RNT Government Medical College, Shantiraj Hospitals and Paras JK Hospital, Udaipur and Post Doc Fellow at Mahe Faimer Manipal, India.,Department of Psychiatry and Surgery, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
| | - P S V N Sharma
- Department of Psychiatry, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
| | - Pratap Kumar
- Reproductive Medicine and Surgery, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
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Amiri SE, Brassard A, Rosen NO, Rossi MA, Beaulieu N, Bergeron S, Péloquin K. Sexual Function and Satisfaction in Couples with Infertility: A Closer Look at the Role of Personal and Relational Characteristics. J Sex Med 2021; 18:1984-1997. [PMID: 34702685 DOI: 10.1016/j.jsxm.2021.09.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 08/11/2021] [Accepted: 09/14/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Research to date suggests that couples undergoing assisted reproductive technology (ART) are at a high risk of experiencing sexual difficulties. AIM This dyadic cross-sectional study aimed to provide a better understanding of the infertility-specific personal (ie, emotional, mind-body) and relational stressors associated with the sexual desire, orgasm, arousal, and sexual satisfaction of infertile couples seeking ART. METHODS The sample included 185 mixed-sex infertile couples seeking ART. Participants completed online the Fertility Quality of Life tool and either the Female Sexual Function Index or the International Index of Erectile Function. Data were analyzed using path analyses based on the Actor-Partner Interdependence Model. OUTCOMES Individuals' own and their partners' sexual function (desire, orgasm, arousal domains) and sexual satisfaction. RESULTS For men and women, infertility-related emotional stressors were associated with their own and their partner's lower sexual desire. For women, experiencing greater infertility-related emotional stressors was also associated with their partner's lower sexual satisfaction. While experiencing greater infertility-related mind-body stressors was not associated with men and women's own sexual desire, arousal, orgasm, and satisfaction, for women, it was associated with their partner's lower sexual arousal. Lastly, for men and women, infertility-related relational stressors were associated with their own lower sexual arousal, as well as with their own and their partner's lower sexual satisfaction. For women, experiencing greater relational stressors was also associated with their own lower sexual desire and orgasm. CLINICAL IMPLICATIONS Interventions addressing the emotional, mind-body, and relational spheres of infertile couples seeking ART may help facilitate improvements in sexual function and satisfaction and better serve their needs. STRENGTHS & LIMITATIONS This study included a large sample of couples. Our sample was heterogeneous with regards to couples' cause of infertility and treatment stage. The use of an infertility-related measure allowed us to better capture personal and relational stressors specific to couples seeking ART. Given the cross-sectional design of our study, causality between infertility-related stressors and sexual function and satisfaction cannot be inferred. Our sample included predominantly White, mixed-sex individuals with a high level of education, which may reduce the generalizability of our findings. CONCLUSION Couples' subjective experience of infertility and treatment (personal and relational stressors) seems to be strongly associated with their sexual health, allowing us to identify potential targets of intervention with couples seeking ART. S.E. Amiri, A Brassard, N.O. Rosen, et al. Sexual Function and Satisfaction in Couples with Infertility: A Closer Look at the Role of Personal and Relational Characteristics. J Sex Med 2021;18:1984-1997.
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Affiliation(s)
- Sawsane El Amiri
- Departement of Psychology, Université de Montréal, Montréal, Québec, Canada
| | - Audrey Brassard
- Departement of Psychology, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Natalie O Rosen
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Meghan A Rossi
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Noémie Beaulieu
- Departement of Psychology, Université de Montréal, Montréal, Québec, Canada
| | - Sophie Bergeron
- Departement of Psychology, Université de Montréal, Montréal, Québec, Canada
| | - Katherine Péloquin
- Departement of Psychology, Université de Montréal, Montréal, Québec, Canada.
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13
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Luca G, Parrettini S, Sansone A, Calafiore R, Jannini EA. The Inferto-Sex Syndrome (ISS): sexual dysfunction in fertility care setting and assisted reproduction. J Endocrinol Invest 2021; 44:2071-2102. [PMID: 33956331 PMCID: PMC8421318 DOI: 10.1007/s40618-021-01581-w] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 04/19/2021] [Indexed: 12/20/2022]
Abstract
PURPOSE Infertility represents a peculiar social burden affecting more than 15% of couples, provoking it a real threat to the general quality of life and to the sexual health. The medicalization (diagnosis, therapy and follow up) of the lack of fertility is frequently a challenge in term of personal and couple's involvement. In particular, while the Assisted Reproductive Technology (ART) has allowed many infertile couples to achieve pregnancy, the therapeutic process faced by the couple bears a strong psychological stress that can affect the couple's quality of life, relationship and sexuality. Despite infertility affects both female and male sexual health, only recently the interest in the effects of ART on the couple's sexuality has grown, especially for women. METHODS A literature research on the sexual dysfunction in fertility care and particularly in ART setting was performed. RESULTS Literature largely found that intimacy and sexuality appear specifically impaired by intrusiveness of treatments and medical prescriptions. Moreover, there is a close relationship between emotional, psychological and sexual aspects, which can be integrated in the new concept of Inferto-Sex Syndrome (ISS) that can impair the ART treatment outcomes. Evidence demonstrates that the assessment of sexual function is necessary in couples undergoing diagnosis of infertility and ART. CONCLUSION A close relationship between infertility and sexuality, both in the female and male partners, was detected. ART treatments may heavily impact on the couple's psychosexual health. A couple-centred program for the integrated management of psychological and sexual dysfunction should be considered in the context of ART programs.
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Affiliation(s)
- G Luca
- Unit of Andrology and Endocrinology of Reproduction, Department of Experimental Medicine, University Medical School, 06129, Perugia, Italy
| | - S Parrettini
- Section of Endocrinology and Metabolism, Department of Medicine, Perugia, University Medical School, 06129, Perugia, Italy
| | - A Sansone
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier, 1, E Tower South. Floor 4, Room E413, 00133, Rome, Italy
| | - R Calafiore
- Section of Endocrinology and Metabolism, Department of Medicine, Perugia, University Medical School, 06129, Perugia, Italy
| | - E A Jannini
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier, 1, E Tower South. Floor 4, Room E413, 00133, Rome, Italy.
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14
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Okobi OE. A Systemic Review on the Association Between Infertility and Sexual Dysfunction Among Women Utilizing Female Sexual Function Index as a Measuring Tool. Cureus 2021; 13:e16006. [PMID: 34336497 PMCID: PMC8319583 DOI: 10.7759/cureus.16006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2021] [Indexed: 01/23/2023] Open
Abstract
The Center for Disease Control and Prevention describes infertility as the inability to conceive after one year or longer with adequate unprotected sex. Infertility affects both females and males, interfering with their everyday lives and significantly impacting their mental health. Sexual dysfunction is defined as an alteration of the sexual response cycle phases, preventing satisfaction during sexual activity. The prevalence of sexual dysfunction in the United States is high, with about 10%-52% among men and 25%-63% among women. Different scales can measure sexual satisfaction and double as a tool to diagnose sexual dysfunction. The Female Sexual Function Index (FSFI) is the gold standard for diagnosing sexual dysfunction in women. Overall, fertile women had a higher score on the FSFI than infertile women; however, both groups showed sexual dysfunctions even if the fertile group was classified as a mild disorder. The most common disorders were disorders of desire and lubrication. Desire and arousal dysfunction appeared more common in participants with secondary infertility, while lubrication dysfunctions were more common in older participants. In the future, it will be important to evaluate other factors that affect sexual function and fertility including mental health, male health, and couple factors.
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Affiliation(s)
- Okelue E Okobi
- Family Medicine, Lakeside Medical Center, Belle Glade, USA
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15
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Capogrosso P, Jensen CFS, Rastrelli G, Torremade J, Russo GI, Raheem AA, Frey A, Fode M, Maggi M, Reisman Y, Bettocchi C, Corona G. Male Sexual Dysfunctions in the Infertile Couple-Recommendations From the European Society of Sexual Medicine (ESSM). Sex Med 2021; 9:100377. [PMID: 34090242 PMCID: PMC8240351 DOI: 10.1016/j.esxm.2021.100377] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 03/31/2021] [Accepted: 04/03/2021] [Indexed: 02/09/2023] Open
Abstract
INTRODUCTION Sexual dysfunctions (SDs) have been frequently reported among male partners of infertile couples due to psychogenic, relational and/or organic issues related with the inability to conceive. Likewise, male infertility (MI) could be a consequence of sexual dysfunctions. AIM To review the evidence on the prevalence and treatment of male SDs in men of infertile couples and provide clinical recommendations on behalf of the European Society of Sexual Medicine (ESSM). METHODS The MEDLINE database was searched in September 2019 for randomized clinical trials (RCTs), meta-analyses and open-label prospective or retrospective studies investigating the presence of erectile dysfunction (ED) and/or ejaculatory dysfunctions (EjDs) and/or low sexual desire (LSD) in conjunction with infertility. MAIN OUTCOME MEASURE The panel provided statements on: (i) Prevalence and association between SDs and MI; (ii) Treatment of male SDs in men of infertile couples. RESULTS ED has been reported in 9% to 62% of male partners of infertile couples, with severe impairment observed in only 1% to 3% of ED cases. Moreover, worse semen parameters have been associated with greater ED severity. Phosphodiesterase type 5 inhibitors (PDE5is) can be safely used to treat ED among patients seeking fatherhood. Male partners of infertile couples are at higher risk of premature ejaculation (PE). Retrograde ejaculation (RE) and anejaculation are a cause of MI and can be managed with electroejaculation (EEJ) or penile vibratory stimulation (PVS) or, alternatively, with oral treatments, however the latter with limited documented success. Low sexual desire has been reported by one third of men of infertile couples. CONCLUSION ED could significantly affect male partners of infertile couple; PDE5is should be suggested to ensure an effective and satisfactory sexual relationship of the couple. Anejaculation and RE should be considered as a possible cause of MI and treated accordingly. Low sexual desire is frequently reported among men of infertile couple and could be a symptom of other systemic conditions or psychological distress. Capogrosso P, Jensen CFS, Rastrelli G, et al. Male Sexual Dysfunctions in the Infertile Couple-Recommendations From the European Society of Sexual Medicine (ESSM). J Sex Med 2021;9:100377.
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Affiliation(s)
- Paolo Capogrosso
- Department of Urology, Circolo & Fondazione Macchi Hospital, University of Insubria, Varese, Italy.
| | | | - Giulia Rastrelli
- Andrology, Female Endocrinology and Gender Incongruence Unit, Department of Experimental, Clinical and Biomedical Sciences, University of Florence, Florence, Italy
| | | | | | - Amr Abdel Raheem
- Department of Andrology, The Institute of Urology, University College London Hospitals, London, UK
| | - Anders Frey
- Department of Urology, University of Southern Denmark, Esbjerg, Odense
| | - Mikkel Fode
- Department of Urology, Zealand University Hospital, Roskilde; Department of Clinical Medicine, University of Copenhagen
| | - Mario Maggi
- Endocrinology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence
| | - Yacov Reisman
- Men's Health Clinic, Amstelland Hospital, Amsterdam, The Netherlands
| | - Carlo Bettocchi
- Division of Urology, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Giovanni Corona
- Endocrinology Unit, Medical Department, Azienda USL, Maggiore-Bellaria Hospital, Bologna, Italy
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16
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Oehler L, Freeman L, Hughes AA. Sex therapy with couples experiencing infertility: an intersystem approach. SEXUAL AND RELATIONSHIP THERAPY 2021. [DOI: 10.1080/14681994.2021.1915472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Lexi Oehler
- Marriage and Family Therapy Program, School of Family Life, Brigham Young University, Provo, UT, USA
| | - Liz Freeman
- Marriage and Family Therapy Program, School of Family Life, Brigham Young University, Provo, UT, USA
| | - Anthony A. Hughes
- Marriage and Family Therapy Program, School of Family Life, Brigham Young University, Provo, UT, USA
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17
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Dreischor F, Laan ETM, Apers S, Repping S, van Lunsen RHW, Lambalk CB, D' Hooghe TM, Goddijn M, Custers IM, Dancet EAF. The stepwise development of an interactive web-based sex education programme for subfertile couples: the Pleasure & Pregnancy programme. Hum Reprod 2021; 35:1839-1854. [PMID: 32649754 DOI: 10.1093/humrep/deaa106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 02/27/2020] [Indexed: 11/12/2022] Open
Abstract
STUDY QUESTION Can we develop a web-based sex education programme (programme running in a web browser) that addresses the needs of subfertile couples who are advised expectant management for at least 6 months? SUMMARY ANSWER The 'Pleasure & Pregnancy' programme addresses couples' needs, is likely to improve couples' sexual functioning, and is subsequently hypothesised to improve the chance of natural pregnancy. WHAT IS KNOWN ALREADY According to professional guidelines (e.g. the Netherlands and UK) couples with unexplained subfertility and a good chance of natural pregnancy, should be advised at least 6 months of expectant management. Adherence to expectant management is challenging as couples and gynaecologist prefer a more active approach. Targeting sexuality may be useful as subfertility is a risk factor for decreased sexual functioning. STUDY DESIGN, SIZE, DURATION A novel programme was developed according to the three steps of the Medical Research Councils' (MRC) framework. First, relevant literature was explored. Second, an interdisciplinary expert panel developed a theory (based on a systematic literature review and patient interviews) on how the chance of natural conception can be improved. Third, the expected process and outcomes were modelled. PARTICIPANTS/MATERIALS, SETTING, METHODS Two licenced clinical sexologists, two gynaecologists, a clinical embryologist and two midwife-researchers, all from Belgium and the Netherlands, proposed components for the sex education programme. PubMed was searched systematically for randomised controlled trials (RCTs) evaluating the proposed components in different patient populations. The needs of 12 heterosexual Dutch or Belgian couples who were advised expectant management were explored with in-depth interviews. The content and delivery characteristics of the novel programme were described in detail with the aid of 'Intervention Taxonomy'. To model the outcomes, a protocol for an RCT was designed, registered and submitted for publication. MAIN RESULTS AND THE ROLE OF CHANCE To help maintain or improve sexual functioning, mainly pleasure, and hence increase pregnancy rates, the web-based Pleasure & Pregnancy programme contains a combination of psychosexual education and couple communication, mindfulness and sensate focus exercises. Information on the biology of conception and interaction with fertility clinic staff and peers were added based on couples' needs to increase potential acceptability. LIMITATIONS AND REASON FOR CAUTION This paper outlines the development phase of a sex education programme according to the MRC-framework. Whether the Pleasure & Pregnancy programme actually is acceptable, improves sexual functioning, increases pregnancy rates and is cost-effective remains to be determined. WIDER IMPLICATIONS OF THE FINDINGS No previous interactive web-based sex education programme has aimed to increase the natural pregnancy rate of subfertile couples by targeting their sexual pleasure. The Pleasure & Pregnancy programme addresses couples' needs and its effect on sexual functioning and pregnancy rate is plausible but remains to be demonstrated by an RCT which is currently ongoing. STUDY FUNDING/COMPETING INTEREST(S) Funding was provided by The Netherlands Organisation for Health Research and Development (ZonMw), Flanders Research Foundation and the University of Amsterdam. C.B.L. is editor-in-chief of Human Reproductionbut was blinded to all parts of the peer review process. The remaining authors have no conflict of interest to report. TRIAL REGISTRATION NUMBER Not applicable.
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Affiliation(s)
- F Dreischor
- Department of Obstetrics and Gynaecology, Center for Reproductive Medicine, Amsterdam University Medical Center (UMC), University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
| | - E T M Laan
- Department of Sexology and Psychosomatic Obstetrics and Gynaecology, Amsterdam University Medical Center (UMC), 1105 AZ Amsterdam, The Netherlands
| | - S Apers
- Department of Development and Regeneration, University of Leuven (KU Leuven), 3000 Leuven, Belgium
| | - S Repping
- Department of Obstetrics and Gynaecology, Center for Reproductive Medicine, Amsterdam University Medical Center (UMC), University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
| | - R H W van Lunsen
- Department of Sexology and Psychosomatic Obstetrics and Gynaecology, Amsterdam University Medical Center (UMC), 1105 AZ Amsterdam, The Netherlands
| | - C B Lambalk
- Division of Reproductive Medicine, Department of Obstetrics and Gynaecology, Amsterdam University Medical Center (UMC), Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - T M D' Hooghe
- Department of Development and Regeneration, University of Leuven (KU Leuven), 3000 Leuven, Belgium
| | - M Goddijn
- Department of Obstetrics and Gynaecology, Center for Reproductive Medicine, Amsterdam University Medical Center (UMC), University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.,Division of Reproductive Medicine, Department of Obstetrics and Gynaecology, Amsterdam University Medical Center (UMC), Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - I M Custers
- Department of Obstetrics and Gynaecology, Center for Reproductive Medicine, Amsterdam University Medical Center (UMC), University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
| | - E A F Dancet
- Department of Obstetrics and Gynaecology, Center for Reproductive Medicine, Amsterdam University Medical Center (UMC), University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.,Department of Development and Regeneration, University of Leuven (KU Leuven), 3000 Leuven, Belgium.,Research Foundation of Flanders, Belgium
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18
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Lo SST, Li RHW, Kok WM, Wong GCY, Ng EHY, Chan CHY. Sexual function and quality of life in Chinese couples undergoing assisted reproductive treatment: a prospective cohort study. HUM FERTIL 2021; 25:593-599. [PMID: 33432863 DOI: 10.1080/14647273.2020.1871518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Couples undergoing assisted reproductive technologies (ART) are prone to sexual dysfunction and lower quality of life (QoL), but whether the incidence of these problems differs with the type of ART is unknown. As such, we conducted this cross-sectional survey to compare the sexual function and QoL of 75 couples undergoing intrauterine insemination (IUI), and 160 couples undergoing in vitro fertilization (IVF). They completed an anonymous questionnaire which included: (i) demographic characteristics; (ii) female sexual function index (FSFI) or (iii) international index of erectile function-5 (IIEF-5); and (iv) fertility QoL questionnaire (FertiQoL). Overall, 22.6% of wives and 39.1% of husbands were at risk for sexual dysfunction, and the risk was similar in IUI and IVF groups. Mean core/treatment/total FertiQoL scores of husbands were higher than wives: 74.98 vs. 68.24/70.02 vs. 65.87/73.52 vs. 67.54 (all p < 0.001). FertiQoL scores were similar in IUI and IVF groups except wives' treatment FertiQoL score was significantly higher in the IUI group (68.93 vs. 64.44; p = 0.009). This study confirms that risks for sexual dysfunction were similar in IUI and IVF couples. Wives undergoing IVF had significantly lower treatment FertiQoL score. In both IUI and IVF groups, husbands' QoL was better than wives' QoL.
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Affiliation(s)
| | - Raymond Hang-Wun Li
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, The University of Hong Kong, Po Fu Lam, ROC
| | - Wai-Ming Kok
- The Family Planning Association of Hong Kong, Wan Chai, ROC
| | | | - Ernest Hung-Yu Ng
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, The University of Hong Kong, Po Fu Lam, ROC
| | - Celia Hoi-Yan Chan
- Department of Social Work and Social Administration, The University of Hong Kong, Pok Fu Lam, ROC
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19
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Warchol-Biedermann K. The Risk of Psychiatric Morbidity and Course of Distress in Males Undergoing Infertility Evaluation Is Affected by Their Factor of Infertility. Am J Mens Health 2020; 13:1557988318823904. [PMID: 30819064 PMCID: PMC6440055 DOI: 10.1177/1557988318823904] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
This panel study aimed to explore the effects of male, female, mixed or idiopathic factor of infertility on the course of clinical distress and possible psychiatric morbidity in involuntarily childless males undergoing fertility evaluation for the first time. A sample of 255 males completed the General Health Questionnaire-28 (GHQ-28) (a) at the baseline, before their initial fertility evaluation (T1); (b) before their second andrological appointment 2-3 months after diagnostic disclosure (T2); and (c) before subsequent treatment-related/follow-up appointments (T3, T4) to be screened for clinically significant distress and risk for psychiatric morbidity. Then they were dichotomized as non-cases and cases. The timing of psychological testing was strictly related to andrological appointments and medical procedures. The research demonstrated that the baseline prevalence of clinical distress and psychiatric morbidity in all the subgroups was similar to reference values, but then significantly surged after the diagnostic disclosure, particularly in male and mixed factor respondents. However, the percentage of clinically distressed mixed or idiopathic factor of infertility respondents remained stable after diagnostic disclosure and during the entire follow-up. The prevalence of clinically significant distress and risk for psychiatric morbidity in the male factor of infertility, female factor of infertility, and mixed factor subgroups decreased during the follow-up but remained higher than at the baseline. The study identifies that the course of distress and risk of psychiatric morbidity of males is significantly affected by their factor of infertility and changes across the pathway of treatment-related/follow-up appointments.
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20
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Bagheri M, Jafarabadi M, Vasegh Rahimparvar SF, Nourbala AA, Behboodi Moghadam Z. Concerns of Infertile Women Candidates for Egg Donation: A Qualitative Study. J Family Reprod Health 2020; 14:21-31. [PMID: 32863835 PMCID: PMC7428411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Objective: Women with premature ovarian insufficiency, menopause, gonadal dysgenesis, and genetic disorders as well as those with a history of recurrent in vitro fertilization failure may benefit from the assisted fertility techniques. These women experience concerns that directly affect their married life especially in egg donation treatment. This study was conducted to investigate the reproductive health concerns of infertile women who were candidates for egg donation. Materials and methods: This qualitative content analysis was conducted in 17 infertile women who were referred to Imam Khomeini Hospital Infertility Clinic from July 2018 to March 2019. The participants were selected through purposeful sampling. Data were collected through individual in-depth semi-structured interviews. A conventional qualitative content analysis approach was adopted for data analysis using the MAXQDA12 software. Results: The results of data analysis showed five themes, including threatened married life, lack of supportive situation, religious beliefs, psychosocial damage, and damaged feminine identity. Conclusion: Infertility is usually accompanied by a great psychological sadness referred to as "stress of infertility". Assisted reproductive techniques (ART) are also a source of stress for patients; therefore, it has a significant impact on the marital relationship and mental health of infertile women. Hence, there is a need for psychological support from the treatment team to reduce woman reproductive health concerns.
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Affiliation(s)
- Maryam Bagheri
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Mina Jafarabadi
- Vali-e-Asr Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Ahmad Ali Nourbala
- Department of Psychology, School of Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Behboodi Moghadam
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
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21
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La Rosa VL, De Franciscis P, Barra F, Schiattarella A, Tropea A, Tesarik J, Shah M, Kahramanoglu I, Marques Cerentini T, Ponta M, Ferrero S. Sexuality in women with endometriosis: a critical narrative review. Minerva Med 2019; 111:79-89. [PMID: 31726815 DOI: 10.23736/s0026-4806.19.06299-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Endometriosis is a chronic gynecological disease that generally affects young and sexually active women in different stages of their development and sexual life. Because endometriosis affects about 5-10% of women in reproductive age, it is possible to estimate that about 2-4% of those who are sexually active may suffer from sexual dysfunction caused by this disease. Surgical and pharmacological treatments of endometriosis can improve the patient's sexual function in the medium and long term, but not necessarily lead to a definitive resolution of the sexual issue. For this reason, the ideal treatment should be conducted by a multidisciplinary team, with the aim to improve overall sexual functioning and not only to reduce the painful symptoms during intercourse. In light of these considerations, the aim of this narrative review was to provide a general overview about the impact of endometriosis on sexuality of women affected and the effectiveness of surgical and pharmacological treatments in improving sexual function.
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Affiliation(s)
- Valentina L La Rosa
- Unit of Psychodiagnostics and Clinical Psychology, University of Catania, Catania, Italy -
| | - Pasquale De Franciscis
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Fabio Barra
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy.,Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Antonio Schiattarella
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Alessandro Tropea
- Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), University of Pittsburgh Medical Center, Palermo, Italy
| | | | - Mohsin Shah
- Department of Physiology, Institute of Basic Medical Sciences, Khyber Medical University, Peshawar, Pakistan
| | - Ilker Kahramanoglu
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, İstanbul University Cerrahpaşa Faculty of Medicine, İstanbul, Turkey
| | | | - Marco Ponta
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
| | - Simone Ferrero
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy.,Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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22
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Starc A, Trampuš M, Pavan Jukić D, Rotim C, Jukić T, Polona Mivšek A. INFERTILITY AND SEXUAL DYSFUNCTIONS: A SYSTEMATIC LITERATURE REVIEW. Acta Clin Croat 2019; 58:508-515. [PMID: 31969764 PMCID: PMC6971809 DOI: 10.20471/acc.2019.58.03.15] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
This study aimed to investigate whether infertility and its treatment affect couple sexuality. A systematic literature review was performed, focusing on female and male sexual dysfunctions due to infertility. The method was descriptive, using a meta-synthesis of scientific research published between 2012 and 2017 in the English language. The search for suitable studies was carried out with the research databases Medline, CINAHL, PubMed and ScienceDirect using the following keywords: infertility, sexual dysfunctions, couple. It can be concluded that infertility negatively affects the sexuality of an infertile couple, which is further proven by a high percentage of sexual dysfunctions (43%-90% among women and 48%-58% among men). Couples report less satisfaction with sexuality. Since lower satisfaction and dysfunctions are closely connected with infertility and its treatment, couples might benefit from sexual therapy and support during the process of infertility treatment. Further research should focus on the evaluation of different psychological interventions that would address sexuality in couples when diagnosed and treated for infertility.
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Affiliation(s)
| | - Manca Trampuš
- 1Department of Public Health, Faculty of Health Sciences, University of Ljubljana, Ljubljana, Slovenia; 2Jesenice General Hospital, Department of Pediatrics, Jesenice, Slovenia; 3Department of Gynecology and Obstetrics, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 4Dr Andrija Štampar Teaching Institute of Public Health, Zagreb, Croatia; 5Department of Internal Medicine, Family Medicine and History of Medicine, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 6Department of Midwifery, Faculty of Health Sciences, University of Ljubljana, Ljubljana, Slovenia
| | - Doroteja Pavan Jukić
- 1Department of Public Health, Faculty of Health Sciences, University of Ljubljana, Ljubljana, Slovenia; 2Jesenice General Hospital, Department of Pediatrics, Jesenice, Slovenia; 3Department of Gynecology and Obstetrics, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 4Dr Andrija Štampar Teaching Institute of Public Health, Zagreb, Croatia; 5Department of Internal Medicine, Family Medicine and History of Medicine, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 6Department of Midwifery, Faculty of Health Sciences, University of Ljubljana, Ljubljana, Slovenia
| | - Cecilija Rotim
- 1Department of Public Health, Faculty of Health Sciences, University of Ljubljana, Ljubljana, Slovenia; 2Jesenice General Hospital, Department of Pediatrics, Jesenice, Slovenia; 3Department of Gynecology and Obstetrics, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 4Dr Andrija Štampar Teaching Institute of Public Health, Zagreb, Croatia; 5Department of Internal Medicine, Family Medicine and History of Medicine, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 6Department of Midwifery, Faculty of Health Sciences, University of Ljubljana, Ljubljana, Slovenia
| | - Tomislav Jukić
- 1Department of Public Health, Faculty of Health Sciences, University of Ljubljana, Ljubljana, Slovenia; 2Jesenice General Hospital, Department of Pediatrics, Jesenice, Slovenia; 3Department of Gynecology and Obstetrics, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 4Dr Andrija Štampar Teaching Institute of Public Health, Zagreb, Croatia; 5Department of Internal Medicine, Family Medicine and History of Medicine, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 6Department of Midwifery, Faculty of Health Sciences, University of Ljubljana, Ljubljana, Slovenia
| | - Ana Polona Mivšek
- 1Department of Public Health, Faculty of Health Sciences, University of Ljubljana, Ljubljana, Slovenia; 2Jesenice General Hospital, Department of Pediatrics, Jesenice, Slovenia; 3Department of Gynecology and Obstetrics, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 4Dr Andrija Štampar Teaching Institute of Public Health, Zagreb, Croatia; 5Department of Internal Medicine, Family Medicine and History of Medicine, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 6Department of Midwifery, Faculty of Health Sciences, University of Ljubljana, Ljubljana, Slovenia
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Kruljac M, Finnbogadóttir H, Bobjer J, Giraldi A, Fugl-Meyer K, Giwercman A. Symptoms of sexual dysfunction among men from infertile couples: prevalence and association with testosterone deficiency. Andrology 2019; 8:160-165. [PMID: 31325248 DOI: 10.1111/andr.12678] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 05/30/2019] [Accepted: 06/14/2019] [Indexed: 01/10/2023]
Abstract
BACKGROUND This case control study aimed to investigate whether symptoms of sexual dysfunction are more common in males from infertile couples than in the general population and to explore whether symptoms of sexual dysfunction are associated to hypogonadism. OBJECTIVES Participants were 165 subfertile men in infertile heterosexual relationships, 18-50 years of age, with sperm concentrations < 15 × 106 /mL. The controls were 199 men from a population-based group, matched for age. MATERIAL AND METHODS Logistic regression was applied in order to calculate odds ratios (ORs) for seven different symptoms of sexual dysfunction. In a multivariate model, we tested independent effects of infertility and primary as well as secondary hypogonadism. RESULTS Statistically significant association between subfertility and symptoms of sexual dysfunction was found for lack of ability to control ejaculation (OR 2.2, 95% CI: 1.2-4.2). For hypogonadism, statistical significance was seen both in relation to low sexual interest/desire for sex (OR 2.3, 95% CI: 1.0-5.5) and for being worried about the size or shape of the penis (OR 3.6, 95% CI: 1.3-9.5). These associations remained statistically significant in males with primary but not those with secondary hypogonadism. DISCUSSION Our study showed that men from infertile couples have an increased risk of symptoms of sexual dysfunction and this risk is linked to androgen deficiency. CONCLUSION Assessment of reproductive hormone levels and sexual function should routinely be done in this group of males.
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Affiliation(s)
- M Kruljac
- Reproductive Medicine Center, Skåne University Hospital, Malmoe, Sweden
| | - H Finnbogadóttir
- Faculty of Health and Society, Department of Care Science, Malmoe University, Malmoe, Sweden
| | - J Bobjer
- Reproductive Medicine Center, Skåne University Hospital, Malmoe, Sweden
| | - A Giraldi
- Psychiatric Center Copenhagen, Sexologic Clinic & Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - K Fugl-Meyer
- Department of Neurobiology, Care Science and Society, Karolinska Institute and Function area Social Work in Health Care, Karolinska University Hospital, Stockholm, Sweden
| | - A Giwercman
- Reproductive Medicine Center, Skåne University Hospital, Malmoe, Sweden.,Molecular Reproductive Medicine, Department of Translational Medicine, Lund University, Malmoe, Sweden
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Tavakol Z, Nasrabadi AN, Moghadam ZB, Salehiniya H. The presence of the child, the opportunity or a threat to marital satisfaction: A qualitative study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2019; 8:67. [PMID: 31008134 PMCID: PMC6442331 DOI: 10.4103/jehp.jehp_250_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 11/20/2018] [Indexed: 05/27/2023]
Abstract
BACKGROUND The aim of this qualitative study was to explore if the presence of a child in the family was an opportunity or threat to the marital life. METHODS In this common qualitative content analysis, semi-structured interviews with 20 participants were conducted. All of the interviews were recorded and then transcribed. The data were categorized, and the main themes and sub-themes were extracted. RESULTS Twenty transcription were analysed. The data analysis led to the development of the first theme of "feeling evolution" with the category of "flourishing the motherhood sense," and the second theme of "strengthening the marital life" with the two categories of "the marital life stabilization" and "efforts for a common goal." CONCLUSIONS The presence of the child can lead to the feeling of development and stabilizing the marital life. Furthermore, the presence of the child can facilitate or hinder marital satisfaction. Given the challenges due to a lack of preparation of parents for childbirth, consultation and support by family members or the society can help with adaptation with this life period and increasing the positive effects of the presence of the child on parents' relationships and marital satisfaction.
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Affiliation(s)
- Zeinab Tavakol
- Department of Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
- Department of Midwifery, School of Nursing and Midwifery, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Alireza Nikbakht Nasrabadi
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Behboodi Moghadam
- Department of Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Salehiniya
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
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Luk BHK, Loke AY. Sexual satisfaction, intimacy and relationship of couples undergoing infertility treatment. J Reprod Infant Psychol 2018; 37:108-122. [PMID: 30317866 DOI: 10.1080/02646838.2018.1529407] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To explore the infertility-related sexual and relationship concerns, sexual satisfaction and perceived intimacy of infertile couples. BACKGROUND Infertility is known to affect the psychosocial well-being of couples. Fertility treatment and the scheduled regime of sexual activities places further pressure on infertile couples. METHODS This was a cross-sectional study. Infertile couples who attended fertility clinics for treatment between November 2015 and March 2016 were invited. A total of 113 pairs of infertile women and men participated in the study as couples. RESULTS A significantly higher proportion of women than men reported that their partner did not understand how the problem of fertility affected them and had worries that they were drifting apart in their relationship. Significantly more men than women considered their sex life to be lacking in quality. In terms of perceived intimacy, more women than men reported that they had disclosed their feelings and negative emotions to their partner. The correlation analysis revealed significant positive correlations between sexual (dis)satisfaction and infertility-related sexual and relationship concerns in couples. CONCLUSIONS The results show that infertile couples suffer from infertility-related sexual and relationship concerns. An intervention study should be conducted to help these couples overcome such concerns.
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Affiliation(s)
- Bronya H K Luk
- a School of Nursing , Tung Wah College , Homantin, Kowloon, Hong Kong , China
| | - Alice Yuen Loke
- b School of Nursing , The Hong Kong Polytechnic University , Hung Hom, Kowloon, Hong Kong , China
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26
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Abstract
Infertility affects up to 12% of all men, and sexual dysfunction occurs frequently in men of reproductive age, causing infertility in some instances. In infertile men, hypoactive sexual desire and lack of sexual satisfaction are the most prevalent types of sexual dysfunction, ranging from 8.9% to 68.7%. Erectile dysfunction and/or premature ejaculation, evaluated with validated tools, have a prevalence of one in six infertile men, and orgasmic dysfunction has a prevalence of one in ten infertile men. In addition, infertile men can experience a heavy psychological burden. Infertility and its associated psychological concerns can underlie sexual dysfunction. Furthermore, general health perturbations can lead to male infertility and/or sexual dysfunction. Erectile dysfunction and male infertility are considered proxies for general health, the former underlying cardiovascular disorders and the latter cancerous and noncancerous conditions. The concept that erectile dysfunction in infertile men might be an early marker of poor general health is emerging. Finally, medications used for general health problems can cause sperm abnormalities and sexual dysfunction. The treatment of some causes of male infertility might improve semen quality and reverse infertility-related sexual dysfunction. In infertile men, an investigation of sexual, general, and psychological health status is advisable to improve reproductive problems and general health.
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Affiliation(s)
- Francesco Lotti
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Mario Maggi
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
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27
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Peterson ZD, Buday SK. Sexual coercion in couples with infertility: prevalence, gender differences, and associations with psychological outcomes. SEXUAL AND RELATIONSHIP THERAPY 2018. [DOI: 10.1080/14681994.2018.1435863] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Zoë D. Peterson
- Department of Psychological Sciences, University of Missouri-St. Louis, St. Louis, MO, USA
| | - Sarah K. Buday
- Community Psychological Service, University of Missouri-St. Louis, St. Louis, MO, USA
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Zare Z, Golmakani N, Amirian M. Comparison of Sexual Problems in Fertile and Infertile Couples. J Caring Sci 2017; 6:269-279. [PMID: 28971077 PMCID: PMC5618951 DOI: 10.15171/jcs.2017.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Accepted: 06/25/2017] [Indexed: 12/18/2022] Open
Abstract
Introduction: Infertility is known to have a negative effect on couple's life and in most cases it has a profound impact on sexual relations. Sexual problems may be the cause of infertility or may arise as a result of infertility. The aim of this study was to compare the sexual problems in fertile and infertile couples. Methods: This cross-sectional study was performed on 110 infertile and 110 fertile couples referring to Montaserieh infertility center and five health centers in Mashhad which were selected as class clustering method and easy method. Data collection tools included demographic questionnaires and Golombok-Rust Inventory. The collected information was analyzed by SPSS software and descriptive and inferential statistics. Results: No significant difference was found between fertile 26 (17, 37) and infertile 26(18, 37) women in terms of total score of sexual problems and other aspects of sexual problems (except infrequency). The women in the fertile group had higher infrequency than infertile women. Total score of sexual problems in fertile men was 18.5 (13, 27) and in infertile men 25 (19, 31) and the difference was statistically significant. Infertile men reported more problems in no relation, impotency and premature ejaculation compared to fertile men. Men in both fertile and infertile group reported more sexual problems than women. Conclusion: In view of the more frequent sexual problems in infertile men than infertile women, it seems that it is necessary to pay more attention to sexual aspects of infertility in men and design the training programs for sexual and marital skills in infertility centers.
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Affiliation(s)
- Zahra Zare
- Departement of Midwifery, Faculty of Nursing and Midwifery, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Nahid Golmakani
- Departement of Midwifery, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Malihe Amirian
- Departement of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Mendonça CRD, Arruda JT, Noll M, Campoli PMDO, Amaral WND. Sexual dysfunction in infertile women: A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol 2017. [PMID: 28628848 DOI: 10.1016/j.ejogrb.2017.06.013] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE This study aimed to assess the prevalence of sexual dysfunction and Female Sexual Function Index (FSFI) score in women with infertility. STUDY DESIGN A systematic search of the literature was conducted using PubMed, EMBASE, IBECS, and LILACS. The search was limited to articles published from January 2000 to September 2016, without language restriction. Data were analyzed using Stata 12.0. Random effects meta-analyses in weighted mean difference (WMD) were performed for six comparative studies (infertility versus fertility). Heterogeneity was estimated using I2. Moreover, to explore the heterogeneity sources among the studies, meta-regression analyses were also performed. Quality of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation guidelines, and risk of bias, with a graphic funnel. RESULTS Meta-analysis was performed in 11 of 13 comparative studies. The result indicated a significant association between an increase in sexual dysfunction and infertility in women (WMD=-0.16, 95% confidence interval=-0.254 to -0.084, p<0.001), and high heterogeneity between studies was noted (I2=98.6%, p<0.000). Meta-regression analysis did not indicate heterogeneity (I2=0.00%). We also performed a meta-analysis of individual FSFI domains in 10 studies. Infertile women had problems with lubrication, orgasm, and satisfaction. Meta-regression analysis also showed that heterogeneity had no influence on the final results of all the analyses. CONCLUSIONS Infertility was associated with an increase in female sexual dysfunction. The most affected areas of sexual function were lubrication, orgasm, and satisfaction.
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Affiliation(s)
| | | | - Matias Noll
- Federal Institute Goiano, Campus Ceres, Goiás, Ceres, Brazil
| | | | - Waldemar N do Amaral
- Department of Gynaecology and Obstetrics, School of Medicine, Federal University of Goiás, Goiânia, Brazil
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Pastor Z, Froněk J, Nováčková M, Chmel R. Sexual Life of Women With Mayer-Rokitansky-Küster-Hauser Syndrome After Laparoscopic Vecchietti Vaginoplasty. Sex Med 2017; 5:e106-e113. [PMID: 28274598 PMCID: PMC5440630 DOI: 10.1016/j.esxm.2016.12.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 12/12/2016] [Accepted: 12/20/2016] [Indexed: 02/07/2023] Open
Abstract
Introduction Adequate anatomic and physiologic functions of the genitalia are fundamental prerequisites for sexual well-being and reproduction. Mayer-Rokitansky-Küster-Hauser syndrome (MRKHS) compromises female sexual life and makes reproduction impossible. Aim To assess the psychosexual effect of vaginal reconstruction using the laparoscopic Vecchietti technique in patients with MRKHS. Methods Forty-two patients with MRKHS who underwent laparoscopic Vecchietti vaginoplasty were included. Their partners also were interviewed. A control group of 45 age-matched, childless, sexually active women were examined during the same period. Main Outcome Measures A gynecologic examination was performed to determine the anatomic outcome. Psychosexual function was evaluated with the Female Sexual Distress Scale–Revised (FSDS-R), the Female Sexual Function Index (FSFI), and a semistructured interview. Genital self-image was evaluated using the Female Genital Self-Image Scale (FGSIS). Results Average neovagina length (7.0 ± 9.6 cm) in the MRKHS group was significantly shorter than the vaginal length in the control group (9.3 ± 2.5 cm). Women with a neovagina reported satisfactory sexual function (FSFI score = 29 ± 2.7) that was not significantly different from the control group (P < .05); however, they also had significantly higher levels of distress (FSDS-R score = 14.5 ± 6.5) and were not satisfied with their genitals (FGSIS score = 22.0 ± 2.4) compared with the control group. Conclusion Sexual function in women with MRKHS can be restored successfully by vaginoplasty; however, they have higher rates of distress and are less satisfied with their genitals. Pastor Z, Fronĕk J, Nováčková M, Chmel R. Sexual Life of Women With Mayer-Rokitansky-Küster-Hauser Syndrome After Laparoscopic Vecchietti Vaginoplasty. Sex Med 2017;5:e106–e113.
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Affiliation(s)
- Zlatko Pastor
- Department of Obstetrics and Gynecology, Second Faculty of Medicine, Charles University of Prague and Motol University Hospital, Prague, Czech Republic; National Institute of Mental Health, Klecany, Czech Republic.
| | - Jiří Froněk
- Transplant Surgery Department, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Marta Nováčková
- Department of Obstetrics and Gynecology, Second Faculty of Medicine, Charles University of Prague and Motol University Hospital, Prague, Czech Republic
| | - Roman Chmel
- Department of Obstetrics and Gynecology, Second Faculty of Medicine, Charles University of Prague and Motol University Hospital, Prague, Czech Republic
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31
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Lotti F, Corona G, Castellini G, Maseroli E, Fino M, Cozzolino M, Maggi M. Semen quality impairment is associated with sexual dysfunction according to its severity. Hum Reprod 2016; 31:2668-2680. [DOI: 10.1093/humrep/dew246] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 07/07/2016] [Accepted: 09/01/2016] [Indexed: 01/23/2023] Open
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Lo SST, Kok WM. Sexual functioning and quality of life of Hong Kong Chinese women with infertility problem. HUM FERTIL 2016; 19:268-274. [PMID: 27706954 DOI: 10.1080/14647273.2016.1238516] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Infertility is estimated to affect 10-15% of couples in industrialized countries and many of them are under tremendous stress. Stress can lead to poor quality of life and sexual dysfunction in general, but little is known about their prevalence in infertile women. We, therefore, conducted this cross-sectional survey in two primary care subfertility clinics between August 2012 and April 2013. A total of 159 women completed two validated Chinese questionnaires: Female Sexual Function Index and core Fertility Quality of Life. The overall Female Sexual Function Index score (mean ± SD) of the whole group was 24.99 ± 4.22. Using the urban Chinese cut-off, the prevalence of female sexual dysfunction, low desire, arousal disorder, lubrication disorder, orgasmic disorder and sexual pain were 32.5%, 15.7%, 19.3%, 22.3%, 33.1% and 15.1%. The core Fertility Quality of Life score of the whole group was 59.76 ± 13.59 and the subgroup of infertile women with sexual dysfunction (n = 50) had significantly lower mean core Fertility Quality of Life score than those without sexual dysfunction (n = 109) (55.03 versus 61.88) (p = 0.005). Among the subscales, the relational score had the strongest correlation with sexual dysfunction. Infertile women with sexual dysfunction had significantly worse quality of life especially in the relational aspect.
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Affiliation(s)
- Sue Seen-Tsing Lo
- a Health Services Division, The Family Planning Association of Hong Kong , Wanchai, Hong Kong SAR
| | - Wai-Ming Kok
- a Health Services Division, The Family Planning Association of Hong Kong , Wanchai, Hong Kong SAR
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Masoumi SZ, Garousian M, Khani S, Oliaei SR, Shayan A. Comparison of Quality of Life, Sexual Satisfaction and Marital Satisfaction between Fertile and Infertile Couples. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2016; 10:290-296. [PMID: 27695611 PMCID: PMC5023039 DOI: 10.22074/ijfs.2016.5045] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Accepted: 08/03/2015] [Indexed: 11/22/2022]
Abstract
Background: Fertility plays an important role in sexual and psychological function in
families. Infertility can result in major emotional, social, and mental disorders, including
a reduction in satisfaction with marital life and quality of life. The present study aimed to
compare the quality of life and marital satisfaction and sexual satisfaction between fertile
and infertile couples. Materials and Methods: This analytical cross-sectional study was conducted on 250
couples at the Fatemiyeh Educational Research Center affiliated to Hamadan University of Medical Sciences, Hamadan, Iran, from May to August in 2014. The subjects
were randomly selected from the patients referred to this center using a table of random
numbers. They were then allocated into two groups of infertile group (n=125) and fertile
group (n=125). The study participants completed World Health Organization Quality of
Life-BREF (WHOQOL-BREF) questionnaire, Linda Berg’s Sexual Satisfaction Scale,
and Enrich Marital Satisfaction Scale. Then, the data were entered into the SPSS version16 for statistical analysis. The Chi-square and Mann-Whitney tests were also applied
to compare the data between the groups. Results: The results revealed no significant difference between the two groups regarding
demographic and general health variables. The mean scores of sexual satisfaction were
63.67 ± 13.13 and 46.37 ± 7.72 in the fertile and infertile couples, respectively. Furthermore, the mean scores of marital satisfaction were also 44.03 ± 9.36 and 36.20 ± 4.03
in the fertile and infertile groups, respectively. Our finding demonstrated that the fertile
couples obtained significantly higher mean scores of quality of life as well as lower mean
scores of sexual satisfaction and marital satisfaction as compared to the infertile ones
(P<0.001). Conclusion: According to the results, the fertile couples obtained significantly higher
quality of life and lower sexual satisfaction and marital satisfaction as compared to the
infertile ones. Therefore, holding consultation programs and conducting more studies are
necessary for improving the quality of life and promoting sexual and marital satisfaction
in infertile couples.
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Affiliation(s)
- Seyedeh Zahra Masoumi
- Students Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Maryam Garousian
- Fatemieh Hospital, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Somayeh Khani
- Students Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | | | - Arezoo Shayan
- Department of Midwifery, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
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Amiri M, Sadeqi Z, Hoseinpoor MH, Khosravi A. Marital Satisfaction and Its Influencing Factors in Fertile and Infertile Women. J Family Reprod Health 2016; 10:139-145. [PMID: 28101115 PMCID: PMC5241358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objective: To determine marital satisfaction and its influencing factors among fertile and infertile women in Shahroud. Materials and methods: In this comparative study, 1528 participants (511 infertile and1017 fertile women) were evaluated using Enrich Marital Satisfaction Scale. Data were analyzed using chi-square and t-test. Results: A total of 1402 participants (78.7%) had high marital satisfaction. The results show that no significant differences exist between marital satisfaction, marital communication, conflict resolution and idealistic distortion in fertile and infertile women. However, a significant difference was observed between marital satisfaction, and job, spouse's job and income in fertile and infertile groups, but the place of residence, education, spouse's education and fertility status showed no significant difference. Conclusion: Results showed that infertility does not reduce marital satisfaction. Since marital satisfaction is moderate in both groups, sex education for people bound to marry and sexual counseling for couples can lead to improved sexual satisfaction.
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Affiliation(s)
- Mohammad Amiri
- Department of Public Health, School of Public Health, Shahroud University of Medical Sciences. Shahroud, Iran
| | - Zakieh Sadeqi
- Department of Chemistry, Analytical Chemistry, Shahroud, Iran
| | | | - Ahmad Khosravi
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
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Datta J, Palmer MJ, Tanton C, Gibson LJ, Jones KG, Macdowall W, Glasier A, Sonnenberg P, Field N, Mercer CH, Johnson AM, Wellings K. Prevalence of infertility and help seeking among 15 000 women and men. Hum Reprod 2016; 31:2108-18. [PMID: 27365525 PMCID: PMC4991655 DOI: 10.1093/humrep/dew123] [Citation(s) in RCA: 237] [Impact Index Per Article: 29.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 04/29/2016] [Indexed: 12/03/2022] Open
Abstract
STUDY QUESTION What is the prevalence of infertility and of help seeking among women and men in Britain? SUMMARY ANSWER One in eight women and one in ten men aged 16–74 years had experienced infertility, defined by unsuccessfully attempting pregnancy for a year or longer, and little more than half of these people sought medical or professional help. WHAT IS KNOWN ALREADY Estimates of infertility and help seeking in Britain vary widely and are not easily comparable because of different definitions and study populations. STUDY DESIGN, SIZE, DURATION A cross-sectional population survey was conducted between 2010 and 2012 with a sample of 15 162 women and men aged 16–74 years. PARTICIPANTS/MATERIALS, SETTING, METHODS Participants completed the Natsal-3 questionnaire, using computer-assisted personal interviewing (CAPI) and computer-assisted self-interview (CASI). MAIN RESULTS AND THE ROLE OF CHANCE The reported prevalence of infertility was 12.5% (CI 95% 11.7–13.3) among women and 10.1% (CI 95% 9.2–11.1) among men. Increased prevalence was associated with later cohabitation with a partner, higher socio-economic status and, for those who had a child, becoming parents at older ages. The reported prevalence of help seeking was 57.3% (CI 95% 53.6–61.0) among women and 53.2% (CI 95% 48.1–58.1) among men. Help seekers were more likely to be better educated and in higher status occupations and, among those who had a child, to have become parents later in life. LIMITATIONS, REASONS FOR CAUTION These data are cross-sectional so it is not possible to establish temporality or infer causality. Self-reported data may be subject to recall bias. WIDER IMPLICATIONS OF THE FINDINGS The study provides estimates of infertility and help seeking in Britain and the results indicate that the prevalence of infertility is higher among those delaying parenthood. Those with higher educational qualifications and occupational status are more likely to consult with medical professionals for fertility problems than others and these inequalities in help seeking should be considered by clinical practice and public health. STUDY FUNDING/COMPETING INTEREST(S) Funding was provided by grants from the Medical Research Council and the Wellcome Trust, with support from the Economic and Social Research Council and the Department of Health. AMJ is a Governor of the Wellcome Trust. Other authors have no competing interests.
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Affiliation(s)
- J Datta
- Centre for Sexual and Reproductive Health Research, Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK
| | - M J Palmer
- Centre for Sexual and Reproductive Health Research, Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK
| | - C Tanton
- Research Department of Infection and Population Health, University College London, Mortimer Market Centre, London WC1E 6JB, UK
| | - L J Gibson
- Centre for Sexual and Reproductive Health Research, Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK
| | - K G Jones
- Research Department of Infection and Population Health, University College London, Mortimer Market Centre, London WC1E 6JB, UK
| | - W Macdowall
- Centre for Sexual and Reproductive Health Research, Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK
| | - A Glasier
- MRC Centre for Reproductive Health, Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TY, UK Centre for Sexual and Reproductive Health Research, Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK
| | - P Sonnenberg
- Research Department of Infection and Population Health, University College London, Mortimer Market Centre, London WC1E 6JB, UK
| | - N Field
- Research Department of Infection and Population Health, University College London, Mortimer Market Centre, London WC1E 6JB, UK
| | - C H Mercer
- Research Department of Infection and Population Health, University College London, Mortimer Market Centre, London WC1E 6JB, UK
| | - A M Johnson
- Research Department of Infection and Population Health, University College London, Mortimer Market Centre, London WC1E 6JB, UK
| | - K Wellings
- Centre for Sexual and Reproductive Health Research, Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK
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Winkelman WD, Katz PP, Smith JF, Rowen TS. The Sexual Impact of Infertility Among Women Seeking Fertility Care. Sex Med 2016; 4:e190-7. [PMID: 27165191 PMCID: PMC5005306 DOI: 10.1016/j.esxm.2016.04.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 03/30/2016] [Accepted: 04/03/2016] [Indexed: 01/23/2023] Open
Abstract
Introduction Infertility affects approximately 6.7 million women in the United States. Couples with infertility have significantly more anxiety, depression, and stress. This is compounded by the fact that almost 40% of couples undergoing assisted reproduction technology still cannot conceive, which can have an ongoing effect on quality of life, marital adjustment, and sexual impact. Aim To assess the sexual impact of infertility in women undergoing fertility treatment. Methods This study is a cross-sectional analysis of women in infertile couples seeking treatment at academic or private infertility clinics. Basic demographic information was collected. Respondents were surveyed regarding sexual impact and perception of their infertility etiology. Multivariate regression analyses were used to identify factors independently associated with increased sexual impact. Main Outcome Measure Sexual impact of perceived fertility diagnosis. Results In total, 809 women met the inclusion criteria, of whom 437 (54%) agreed to participate and 382 completed the sexual impact items. Most of the infertility was female factor only (58.8%), whereas 30.4% of infertility was a combination of male and female factors, 7.3% was male factor only, and 3.5% was unexplained infertility. In bivariate and multivariate analyses, women who perceived they had female factor only infertility reported greater sexual impact compared with woman with male factor infertility (P = .01). Respondents who were younger than 40 years experienced a significantly higher sexual impact than respondents older than 40 years (P < .01). When stratified by primary and secondary infertility, respondents with primary infertility overall reported higher sexual impact scores. Conclusion In women seeking fertility treatment, younger age and female factor infertility were associated with increased sexual impact and thus these women are potentially at higher risk of sexual dysfunction. Providers should consider the role young age and an infertility diagnosis plays in a women’s sexual well-being.
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Affiliation(s)
- William D Winkelman
- Department of Obstetrics, Gynecology and Reproductive Medicine, University of California-San Francisco, Irene Betty Moore Women's Hospital, San Francisco, CA, USA
| | - Patricia P Katz
- Department of Medicine, University of California-San Francisco, San Francisco, CA, USA; Philip R. Lee Institute for Health Policy Studies, University of California-San Francisco, San Francisco, CA, USA
| | - James F Smith
- Department of Obstetrics, Gynecology and Reproductive Medicine, University of California-San Francisco, Irene Betty Moore Women's Hospital, San Francisco, CA, USA; Department of Urology, University of California-San Francisco, San Francisco, CA, USA; Philip R. Lee Institute for Health Policy Studies, University of California-San Francisco, San Francisco, CA, USA
| | - Tami S Rowen
- Department of Obstetrics, Gynecology and Reproductive Medicine, University of California-San Francisco, Irene Betty Moore Women's Hospital, San Francisco, CA, USA.
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Bechoua S, Hamamah S, Scalici E. Male infertility: an obstacle to sexuality? Andrology 2016; 4:395-403. [PMID: 27061770 DOI: 10.1111/andr.12160] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 11/26/2015] [Accepted: 12/18/2015] [Indexed: 11/28/2022]
Abstract
Interactions between infertility and sexuality are numerous and complex. Infertile men may suffer from sexual dysfunction (SD) when undergoing an assisted reproductive technology programme. We undertook a review both in French and English of the available data on male SD when being diagnosed with a fertility problem with a specific focus on azoospermic men. The review was performed over a 30-year time period using PubMed/Medline. The sexual concerns and needs of infertile/sterile men for whom potential parenting can be compromised were evaluated. When diagnosed with infertility, men usually go through a crisis that can have a deleterious effect on their sexuality with sometimes a feeling of sexual inadequacy. Infertile men will feel stigmatized because they are perceived as being deficient in a specific component of their masculinity. Hence, subsequent SD may occur that can impact the couple sexuality and the infertility management. However, little is known on how the announcement of azoospermia may affect male on a sexual and psychological point of view. The present review suggests that a global management through a healthcare network (biologist, andrologist, sexologist and psychologist) is required which will allow to consider infertility and its subsequent sexual disorders as a whole and not as dichotomized issues.
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Affiliation(s)
- S Bechoua
- UFR Sciences de Santé de Dijon, Université de Bourgogne, Dijon, France.,Centre Hospitalier Universitaire de Dijon, Dijon, France
| | - S Hamamah
- ART-PGD Department, INSERM U1203, Arnaud de Villeneuve Hospital, CHU Montpellier, Montpellier, France
| | - E Scalici
- ART-PGD Department, INSERM U1203, Arnaud de Villeneuve Hospital, CHU Montpellier, Montpellier, France
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Abstract
Infertility and perinatal loss are common, and associated with lower quality of life, marital discord, complicated grief, major depressive disorder, anxiety disorders, and post-traumatic stress disorder. Young women, who lack social supports, have experienced recurrent pregnancy loss or a history of trauma and / or preexisting psychiatric illness are at a higher risk of experiencing psychiatric illnesses or symptoms after a perinatal loss or during infertility. It is especially important to detect, assess, and treat depression, anxiety, or other psychiatric symptoms because infertility or perinatal loss may be caused or perpetuated by such symptoms. Screening, psychoeducation, provision of resources and referrals, and an opportunity to discuss their loss and plan for future pregnancies can facilitate addressing mental health concerns that arise. Women at risk of or who are currently experiencing psychiatric symptoms should receive a comprehensive treatment plan that includes the following: (1) proactive clinical monitoring, (2) evidence-based approaches to psychotherapy, and (3) discussion of risks, benefits, and alternatives of medication treatment during preconception and pregnancy.
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Affiliation(s)
- Amritha Bhat
- Department of Psychiatry, University of Washington, Box 35650, Seattle, WA, 98195, USA.
| | - Nancy Byatt
- Departments of Psychiatry and Obstetrics and Gynecology, UMass Medical School, Worcester, MA, USA
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Soleimani AA, Najafi M, Ahmadi K, Javidi N, Hoseini Kamkar E, Mahboubi M. The Effectiveness of Emotionally Focused Couples Therapy on Sexual Satisfaction and Marital Adjustment of Infertile Couples with Marital Conflicts. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2015. [PMID: 26644864 DOI: 10.22074/ijfs.2015.4556.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND The purpose of this investigation is to determine the efficacy of emotionally focused couples therapy (EFT-C) on enhancement of marital adjustment in infertile couples. MATERIALS AND METHODS This was a semi-experimental study with a pre- and post-test design. We selected 30 infertile couples (60 subjects) by purposive sampling. Couples were randomly assigned to two groups, sample and control. Each group consisted of 15 couples who had marital maladjustment and low sexual satisfaction. Couples answered the marital adjustment and sexual satisfaction questionnaires at baseline after which the sample group received 10 sessions of EFT-C. RESULTS Results of pre-test and post-test showed that EFT-C significantly impacted marital adjustment and sexual satisfaction. CONCLUSION EFT-C had a significant effect on enhancement of satisfaction, cohesion and affectional expression. This approach impacted physical and emotional sexual satisfaction of infertile couples.
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Affiliation(s)
| | - Maryam Najafi
- Department of Psychology, University of Science and Culture, Tehran, Iran
| | - Khodabakhsh Ahmadi
- Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Nasirudin Javidi
- Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | | | - Mohamad Mahboubi
- Abadan College of Medical Sciences and Health Services, Abadan, Iran
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Soleimani AA, Najafi M, Ahmadi K, Javidi N, Hoseini Kamkar E, Mahboubi M. The Effectiveness of Emotionally Focused Couples Therapy on Sexual Satisfaction and Marital Adjustment of Infertile Couples with Marital Conflicts. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2015; 9:393-402. [PMID: 26644864 PMCID: PMC4671378 DOI: 10.22074/ijfs.2015.4556] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Accepted: 05/20/2014] [Indexed: 11/25/2022]
Abstract
Background The purpose of this investigation is to determine the efficacy of emotionally
focused couples therapy (EFT-C) on enhancement of marital adjustment in infertile couples. Materials and Methods This was a semi-experimental study with a pre- and post-test
design. We selected 30 infertile couples (60 subjects) by purposive sampling. Couples
were randomly assigned to two groups, sample and control. Each group consisted of 15
couples who had marital maladjustment and low sexual satisfaction. Couples answered
the marital adjustment and sexual satisfaction questionnaires at baseline after which the
sample group received 10 sessions of EFT-C. Results Results of pre-test and post-test showed that EFT-C significantly impacted marital adjustment and sexual satisfaction. Conclusion EFT-C had a significant effect on enhancement of satisfaction, cohesion and
affectional expression. This approach impacted physical and emotional sexual satisfaction
of infertile couples.
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Affiliation(s)
| | - Maryam Najafi
- Department of Psychology, University of Science and Culture, Tehran, Iran
| | - Khodabakhsh Ahmadi
- Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Nasirudin Javidi
- Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | | | - Mohamad Mahboubi
- Abadan College of Medical Sciences and Health Services, Abadan, Iran
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Samadaee-Gelehkolaee K, McCarthy BW, Khalilian A, Hamzehgardeshi Z, Peyvandi S, Elyasi F, Shahidi M. Factors Associated With Marital Satisfaction in Infertile Couple: A Comprehensive Literature Review. Glob J Health Sci 2015; 8:96-109. [PMID: 26652079 PMCID: PMC4877237 DOI: 10.5539/gjhs.v8n5p96] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 08/31/2015] [Accepted: 07/23/2015] [Indexed: 11/25/2022] Open
Abstract
Background: Many factors impact on marital satisfaction. Related factors include demographic factors, assisted reproductive techniques, psychological health, quality of life, psychological, socioeconomic and family support, and sexual function. Methods: This study is a literature review of research studies conducted on factors associated with marital satisfaction in infertile couples. The current literature review search was undertaken using multiple databases selected from articles pertinent to the study. The selection of subjects was undertaken from1990 through 2015. The methodological quality was analyzed based on a checklist adopted from a systematic review. Quality assessment of full text studies was finally carried out by two reviewers. Results: The initial search yielded a list of 445 papers, and then reviewers studied titles and abstracts. Thereafter, 69 papers were incorporated, and researchers reviewed summaries of all of the searched articles. Finally, the researchers utilized the data gained from 64 full articles so as to compile this review paper. Reviewing the studies conducted on marital satisfaction, they classified related findings into 6 categories: demographic factors, using fertility assisting methods, psychological health, life quality, economic, social, and family support, and sexual function. Conclusion: The results of this review article depicted that various factors play role in creating marriage life satisfaction in an infertile couple, so that paying attention to them can play an important role in continuing their treatment. Thus, to identify such factors is considered essential in their treatment protocol highly based on culture. Of the drawbacks of this research is that it has tried at best to employ the studies belonging to diverse countries with different cultures. Also, the number of the papers was considerably limited.
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Affiliation(s)
- Keshvar Samadaee-Gelehkolaee
- 1 Department of Reproductive Health and Midwifery, Nasibeh Nursing and Midwifery Faculty, Mazandaran University of Medical Sciences, Sari, Iran 2 Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran.
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Amiri M, Khosravi A, Chaman R, Sadeghi Z, Raei M, Jahanitiji M, Mehrabian F. Social Consequences of Infertility on Families in Iran. Glob J Health Sci 2015; 8:89-95. [PMID: 26652089 PMCID: PMC4877219 DOI: 10.5539/gjhs.v8n5p89] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Accepted: 07/20/2015] [Indexed: 11/29/2022] Open
Abstract
Background and Objective: Social reactions to infertility are one of the concerns infertile people. This study aimed to investigate the social consequences of infertility among urban and rural population of Shahroud in northeast of Iran. Method: This study is a comparative study that was conducted in 2013. In this study, 1,528 women (511 infertile and 1017 fertile ones) were randomly selected. The 36-item questionnaire included 18 items about women’s attitude towards infertility and 18 questions about the consequences of infertility was used. Data were analyzed using chi-square test, one-way analysis of variance and t test. Findings: The prevalence of infertility in rural areas was estimated to be 2.23 percent. 42.2% of the participants were living the city (n= 645) and 57.8 % were living in the village (n=883). 49.2% of the participants had education below high school diploma (n=751), 31.7% had high school diploma (n=484) and 19.2% had university degrees (n=293). 51.9% of the people referred to the infertility problem among distant relatives, 24.9% referred to infertility among the close relatives and 9% reported the infertility among their family members. The mean score of attitude of the fertile was 56.6±7.0 and that of the infertile was 56.8± 6.6 and there was no statistically significant difference between the two groups (P>0.05). There was a significant association between fertility status and encouraging divorce, encouraging remarriage and encouraging adoption (P=0.001). Conclusion: Infertility causes a negative attitude toward infertile people. But the interference of others leads to further encouragement of divorce and remarriage among the infertile people.
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Affiliation(s)
- Mohammad Amiri
- Department of Public Health, School of Public Health, Shahroud University of Medical Sciences. Shahroud, Iran..
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Muin DA, Wolzt M, Rezaei SS, Tremmel-Scheinost M, Salama M, Fuchs C, Luger A, Müller M, Bayerle-Eder M. Effect of sexual diary keeping and self-evaluation on female sexual function and depression: A pilot study. EUR J CONTRACEP REPR 2015; 21:141-9. [PMID: 26290038 DOI: 10.3109/13625187.2015.1074676] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES The aim of the trial was to assess the effect of self-evaluation and sexual diary keeping on female sexual function and depressive symptoms in women diagnosed with sexual dysfunction. METHODS A single-arm non-randomised trial included 30 women (53 ± 7 years of age) with female sexual dysfunction (Female Sexual Function Index [FSFI] < 27) and a stable partnership duration of 5-40 years. Female sexual function was assessed by sexual, psychological and gynaecological history taking and validated questionnaires including the FSFI, Female Sexual Distress Scale (FSDS) and Hamilton Depression Scale (HDS), before and after 4 weeks of sexual diary keeping. RESULTS A subjective improvement in communication of sexual problems was reported by 60% of participants; no participants reported any worsening of communication. FSFI and FSDS scores were, respectively, 18.0 ± 7.7 and 22.0 ± 10.0 at baseline and 20.2 ± 7.2 and 20.6 ± 11.5 after 4 weeks. HDS score decreased from 6.0 ± 4.0 at baseline to 4.4 ± 2.7 after 4 weeks (p = 0.042). CONCLUSIONS Self-evaluation and sexual diary keeping may improve aspects of sexual life, such as couple communication, without a direct effect on variables measured with validated questionnaires on different domains of sexual function.
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Affiliation(s)
- Dana Anaïs Muin
- a * Department of Gynecologic Endocrinology and Reproductive Medicine , Medical University of Vienna , Vienna , Austria
| | - Michael Wolzt
- b Department of Clinical Pharmacology , Medical University of Vienna , Vienna , Austria
| | - Safoura Sheikh Rezaei
- b Department of Clinical Pharmacology , Medical University of Vienna , Vienna , Austria
| | - Max Tremmel-Scheinost
- b Department of Clinical Pharmacology , Medical University of Vienna , Vienna , Austria
| | - Mohamed Salama
- d Department of Thoracic Surgery , Otto-Wagner-Spital , Vienna , Austria
| | - Carola Fuchs
- b Department of Clinical Pharmacology , Medical University of Vienna , Vienna , Austria
| | - Anton Luger
- c Department of Internal Medicine III , Medical University of Vienna , Vienna , Austria
| | - Markus Müller
- b Department of Clinical Pharmacology , Medical University of Vienna , Vienna , Austria
| | - Michaela Bayerle-Eder
- c Department of Internal Medicine III , Medical University of Vienna , Vienna , Austria
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Ghavi F, Jamale S, Mosalanejad L, Mosallanezhad Z. A Study of Couple Burnout in Infertile Couples. Glob J Health Sci 2015; 8:158-65. [PMID: 26573033 PMCID: PMC4873592 DOI: 10.5539/gjhs.v8n4p158] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 06/09/2015] [Indexed: 11/18/2022] Open
Abstract
Introduction: Infertility is a major crisis that can cause psychological problems and emotionally distressing experiences, and eventually affect a couples’ relationship. The objective of this study is to investigate couple burnout in infertile couples who were undergoing treatmentat the Infertility Clinic of Yazd, Iran. Method: The present study is a cross-sectional descriptive one on 98 infertile couples referringto the Infertility Centerof Yazd, Iran, who were chosen on a simple random sampling basis. The measuring tools consisted of the Couple Burnout Measure (CBM) and a demographic questionnaire. The collected data were analyzed using SPSS 16 and the statistical tests of ANOVA and t-test. P-values less than 0.05 were considered as significant. Results: The results show that infertile women experience higher levels of couple burnout than their husbands (p<0.001). Also, a comparison of the scales of couple burnout—psychological burnout (p<0.01), somatic burnout (p<0.01), and emotional burnout (p<0.001)—between wives and husbands show that women are at greater risk. Conclusion: Infertile couples’ emotional, mental, and sexual problems need to be addressed as part of the infertility treatment programs, and psychotherapists should be included in the medical team.
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Affiliation(s)
- Fatemeh Ghavi
- Faculty of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
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Wilkinson J, Roberts C, Mort M. Ovulation monitoring and reproductive heterosex: living the conceptive imperative? CULTURE, HEALTH & SEXUALITY 2015; 17:454-469. [PMID: 25732331 DOI: 10.1080/13691058.2015.1005671] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Using biosensors, or devices that provide biological information to users about their own bodies, to map ovulation and time intercourse is a practice of rising significance in economically privileged countries. Based on an ethnographic study of ovulation biosensing, this paper explores the contradictions between device manufacturers' figurations of reproductive heterosex as a natural and pleasurable experience facilitated by fertility monitoring technology, and heterosexual women users' accounts of the pleasures and difficulties of ovulation monitoring and associated sexual encounters. Drawing on Science and Technology Studies and the concept of 'script', we examine the frameworks of action defined by makers of ovulation biosensors and how these are accepted, refused or remade by users. Within the scientific romance configured by manufacturers, reproductive heterosex emerges as exciting and fun, whilst the hard, 'technical' work of conception is done by ovulation technologies. Yet ovulation monitoring is described by many heterosexual women users as an exciting and yet anxiety-producing practice through which they come to know their bodies differently, often through online discussions with other women. Living a 'conceptive imperative', women engaging with ovulation sensing reconfigure their reproductive embodiment and shift their relationship to male partners in ways that reveal heterosexual 'baby-making' as a complex and nuanced practice worthy of critical engagement.
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Affiliation(s)
- Joann Wilkinson
- a Department of Sociology , Lancaster University , Lancaster , UK
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Piva I, Lo Monte G, Graziano A, Marci R. A literature review on the relationship between infertility and sexual dysfunction: Does fun end with baby making? EUR J CONTRACEP REPR 2014; 19:231-7. [DOI: 10.3109/13625187.2014.919379] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Lo Monte G, Piva I, Marci R. Should the desire for a child always be fulfilled? Taiwan J Obstet Gynecol 2014; 53:136-7. [PMID: 24767670 DOI: 10.1016/j.tjog.2013.04.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2013] [Indexed: 11/15/2022] Open
Affiliation(s)
- Giuseppe Lo Monte
- Department of Morphology, Surgery and Experimental Medicine, Section of Obstetrics and Gynaecology, Infertility Unit, University Hospital of Ferrara, Ferrara, Italy
| | - Isabella Piva
- Department of Morphology, Surgery and Experimental Medicine, Section of Obstetrics and Gynaecology, Infertility Unit, University Hospital of Ferrara, Ferrara, Italy
| | - Roberto Marci
- Department of Morphology, Surgery and Experimental Medicine, Section of Obstetrics and Gynaecology, Infertility Unit, University Hospital of Ferrara, Ferrara, Italy.
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McQuillan SK, Grover SR. Systematic review of sexual function and satisfaction following the management of vaginal agenesis. Int Urogynecol J 2014; 25:1313-20. [DOI: 10.1007/s00192-013-2316-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2013] [Accepted: 12/21/2013] [Indexed: 01/08/2023]
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Gadarowski A. Procreative sex in infertile couples: the decay of pleasure? A letter to the editor. Health Qual Life Outcomes 2013; 11:52. [PMID: 23577920 PMCID: PMC3644235 DOI: 10.1186/1477-7525-11-52] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Accepted: 03/26/2013] [Indexed: 11/25/2022] Open
Abstract
A response to Marci et al. ‘Procreative sex in infertile couples: the decay of pleasure?’ This is a reply to http://www.hqlo.com/content/pdf/1477-7525-11-52.pdf.
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