Effect of cognitive behavioral therapy-based counseling on perceived stress in pregnant women with history of primary infertility: a controlled randomized clinical trial

The effectiveness of cognitive-behavioural group therapy on infertile men, a randomised clinical trial

BACKGROUND

Infertility can result in the emergence of depression and anger, the loss of one's identity, and the feeling of guilt in the infertile person. Present study aimed to investigate the effects of cognitive behavioural group therapy (CBGT) on infertile men's anger and positive and negative affect.

MATERIALS AND METHODS

Forty-three men with infertility for at least five years were selected for the present randomised clinical study. Spielberger's State-Trait Anger Expression Inventory-II (STAXI-II) and the PANAS scale (positive and negative affect) were filled out by the participants, and they were randomly divided into the experimental (22) and control (21) groups. The experimental group received 18 ninety-minute sessions of hybrid group therapy held twice a week, while the control group received no intervention. When the intervention program was over, all participants performed the post-test. Moreover, the post-hoc stage was held two months later.

RESULTS

The effects of the intervention were significant in terms of state anger, trait anger, anger expression in, anger expression out, positive effects, and negative effects (p < 0.004), but they were not significant concerning the anger control out index (p = 0.241). The significant differences between the two groups were also observed in the post-hoc stage.

CONCLUSIONS

The CBGT therapy seems to be helpful for infertile men to reduce their anger and negative affect and increase their positive affect by implementing a set of techniques like cognitive regeneration, assertiveness, daily joyful activities, exercises to relax one's muscles, diaphragm respiration, the identification of various fillings, and emotional expression.

Reliability and validity of the Chinese version of the COMPI Fertility Problem Stress Scale-Short Form for infertile women

OBJECTIVE

To translate and culturally adapt the COMPI Fertility Problem Stress Scale-Short form (COMPI-FPSS-SF) and to test its reliability and validity in China.

METHODS

The cross-sectional study adopted Brislin's translation model to translate, synthesize, back-translate, and cross-culturally adapt the COMPI-FPSS-SF for the Chinese setting. A total of 279 infertile women were invited to participate in the study to test the reliability and validity of the scale between March and June 2021.

RESULTS

It was verified that the Chinese version of the COMPI-FPSS-SF has three domains with nine items. The Cronbach's α coefficient of the total scale was 0.907, and the coefficient for each dimension ranged from 0.760 to 0.855. The test-retest validity was 0.891. The exploratory factor analysis extracted three common factors with eigenvalues of 4.499, 1.124, and 1.011 and a cumulative variance contribution of 73.706. The validity factor analysis showed good results for the three-factor structure fit. The criterion-related validity with the Fertility Inventory Short-Form Scale was 0.649. The above analysis revealed statistically significant differences (P < 0.001).

CONCLUSIONS

The Chinese version of the COMPI-FPSS-SF can be used for the assessment of fertility-related stress in infertility patients in China with good reliability and validity.

Exploring the therapeutic effect of Pen Yan Kang Fu Decoction on SPID rats based on LIF/JAK2/STAT3 signaling pathway

Tubal inflammation, endometritis, and uterine adhesions due to post-pelvic inflammatory disease (SPID) are important causes of infertility. Chronic endometritis (CE) belongs to SPID, which seriously affects women's reproductive health, quality of life, and family harmony, and is a hot and difficult problem in clinical research. The efficacy of Pen Yan Kang Fu Decoction (PYKFD) has been verified in long-term clinical practice for chronic endometritis infertility caused by the SPID. Numerous studies have confirmed that the LIF/JAK2/STAT3 signaling pathway is important in embryo implantation and development, and endometritis infertility is close to LIF/JAK2/STAT3. In vivo results showed that PYKFD increased endometrial receptivity, repaired uterine tissue damage, and regulates the expression of endometrial receptivity-related factors ER (estrogen receptor), PR (progesterone receptor), CD31, and integrin αvβ3, and induced the transduction of LIF/JAK2/STAT3 signaling pathway. PYKFD can also regulate the expression of IL-6. The results of in vitro experiments showed that PYKFD regulates the behavior of rat endometrial epithelial cells (REECs) involving LIF. In conclusion, PYKFD can improve endometrial receptivity and promote endometrial repair by LIF/JAK2/STAT3 signaling pathway.

Supplementary Information

The online version contains supplementary material available at 10.1007/s13205-024-03981-0.

Cognitive behavioural therapy for women with infertility: A systematic review and meta-analysis

Cognitive behavioural therapy (CBT) has been used for women with infertility. However, the efficacy of CBT among the infertile female population remains inconclusive. We performed a systematic literature search using the Cochrane Library, MEDLINE (OVID), EMBASE (OVID), CINAHL, PsycINFO (OVID), Web of Science, and ProQuest databases from the inception to May 2022. The Cochrane risk of bias tool for randomized trials was used to assess the methodological quality of the included studies. Revman 5.4 was conducted for statistical analysis, and meta-analyses were performed to calculate the pooled effects of CBT. Sixteen articles were finally included in the meta-analysis. The results of the meta-analysis revealed large, significant effects of cognitive-behavioural interventions that can effectively reduce depression, anxiety symptoms, psychological distress, perceived stress, infertility-specific stress, and improve the quality of life in women with infertility. However, the pooled MD using a fixed-effects model was 0.25, 95% CI [-0.33, 0.84], P = 0.40, and no significant differences in BMI were observed among those who received CBT therapy compared with those who did not. CBT effectively alleviates depression, anxiety, psychological distress, and infertility-specific stress levels and improves the quality of life among women with infertility. Future studies should explore the sustainability and long-term effect of cognitive-behavioural interventions in women with infertility.

Efficacy of nondrug interventions in perinatal depression: A meta-analysis

Perinatal depression causes significant harm to mothers and unborn infants. Nondrug intervention is a common and acceptable method for reducing perinatal depression in pregnant women; however, it lacks an evidence-based basis. This study aimed to evaluate the effectiveness of nondrug interventions, such as cognitive behavioral therapy (CBT), interpersonal psychotherapy (IPT), and yoga, in reducing perinatal depression. Randomized controlled trials (RCTs) of CBT, IPT, and yoga for improving perinatal depression were searched in the Cochrane Library, PubMed, Web of Science, Embase, ProQuest, ScienceDirect, ClinicalKey, Wanfang Data (Chinese database), and China Knowledge Resource Integrated Database. The retrieval time limit was set from the establishment of the database to December 2021. Twenty-one studies involving a total of 1981 participants were included.The present meta-analysis showed that CBT and IPT could effectively alleviate depressive symptoms in perinatal women, and the curative effect of IPT was better than that of CBT. There was no significant difference in the improvement effect of yoga on participants with depressive symptoms compared with that in the controls.This study was registered with the International Prospective Register of Systematic Reviews (PROSPERO, CRD42022307675).

The effect of individual counseling based on the GATHER principles on perceived stress and empowerment of the mothers with high-risk pregnancies: an experimental study

BACKGROUND

High-risk pregnancy causes different responses, including negative emotions, feelings of vulnerability and psychological stress in the mother. The aim of this study was to investigate the effect of individual counseling on the empowerment and the perceived stress of high-risk pregnant mothers.

METHODS

This study was a two-group experimental study. The study was performed on 82 high-risk pregnant women hospitalized in Fatemieh Hospital in Hamadan, Iran. Inclusion criteria were high-risk pregnancy, being literate, gestational age 24 to 36 weeks. The samples were divided into experimental and control groups using randomized block design. Data were collected using Cohen's perceived stress scale and Kameda empowerment questionnaires. For the experimental group, four sessions of individual counseling according to GATHER principles (Greet, Ask, Tell, Help, Explain, and Return) were performed for 45-60 minutes for two consecutive weeks. SPSS 25 software was used for data analysis.

RESULTS

The mean score of the perceived stress after the intervention in the control and experimental groups were 27.07(5.80) and 25.30(4.95), respectively (P = 0.097). There was a substantial difference in the mean score of empowerment 84.76)9.14) and 88.75 (6.17) (P < 0.001) and different dimensions of empowerment (self-efficacy, Future image, self-esteem, Support and assurance from others) between the control and intervention groups after the intervention.

CONCLUSIONS

The findings of this study indicate individual counseling is effective in empowering the mothers with high-risk pregnancy but has no significant effect on their perceived stress.

The effectiveness of telemedicine interventions on women with postpartum depression: A systematic review and meta-analysis

BACKGROUND

Postpartum depression (PPD) is a public health problem that has significant adverse effects on mothers, couple's relationships, newborn neurodevelopment, and child emotional and cognitive development. This study reviewed the effectiveness of telemedicine interventions in postparturient women with postpartum depression.

AIMS

To evaluate the effectiveness of telemedicine intervention in women with postpartum depression.

METHODS

Cochrane Library, PubMed, EMBASE, Web of Science, CINAHL, and PsycINFO were searched for relevant articles published between 2003 and March 2021. We also manually reviewed the reference lists of the retrieved articles. The present study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The risk of bias for individual studies was evaluated according to the Cochrane Handbook. RevMan 5.4 software was used to carry out the meta-analysis.

RESULTS

The meta-analysis included 20 randomized controlled trials with a total of 3252 patients. The results demonstrated that telemedicine was an effective intervention for treating PPD and anxiety and for improving functional impairment in women during their postpartum period.

LINKING EVIDENCE TO ACTION

This meta-analysis provided evidence that telemedicine was an effective intervention for treating PPD in women. Telemedicine also has significant effects on anxiety and improved functional impairment in women during their postpartum period. Our findings may provide accurate evidence-based guidance for postpartum women's mental health management. In the future, more high-quality studies are required for verifying these results.

Early Spontaneous Abortion in Fresh- and Frozen-Embryo Transfers: An Analysis of Over 35,000 Transfer Cycles

BACKGROUND

The aim of this study was to explore the risk factors for early spontaneous abortion (ESA) in fresh- and frozen-embryo transfers.

METHODS

This retrospective cohort study comprised a total of 35,076 patients, including 15,557 women in the fresh-embryo transfer group and 19,519 women in the frozen-embryo transfer group from January 2016 to December 2020. The primary outcome of this study was ESA, which we defined as the termination of embryonic development before 12 weeks of pregnancy (i.e., an early abortion after artificial multi-fetal pregnancy reduction was excluded).

RESULTS

In the 35,076 ART transfer cycles, the incidence of ESA was 5.77% (2023/35,076), and the incidence rates for ESA in fresh and frozen cycles were 4.93% (767 of 15,557) and 6.43% (1,256 of 19,519), respectively. Using a multivariate logistic regression analysis model, maternal age, body mass index (BMI), and number of embryos transferred were independent predictors for ESA. In addition, frozen-thawed transfer was a risk factor for ESA as compared with fresh transfer (OR = 1.207; 95% CI, 1.094-1.331; P = 0.000), blastocyst transfer was risk factor for ESA as compared with cleavage transfer (OR =1.373; 95% CI, 1.186-1.591; P = 0.000 in the total group; OR = 1.291; 95% CI, 1.111-1.499; P = 0.001 in the frozen-transfer group), and unexplained infertility was a protective factor for ESA only in the frozen group (OR = 0.746; 95% CI, 0.565-0.984; P = 0.038).

CONCLUSIONS

Maternal age, BMI, number of embryos transferred, and frozen-thawed transfer were independent risk factors for ESA in assisted reproductive technology treatment cycles.