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Wan L, He S. Association between depression and infertility based on the PHQ-9 score: Analyses of NHANES 2013-2018. PLoS One 2024; 19:e0305176. [PMID: 39037991 PMCID: PMC11262654 DOI: 10.1371/journal.pone.0305176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 05/26/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND Over the past decade, nationally representative research elucidating the association between depression and infertility has been notably lacking. Our study aimed to investigate the association between depression and infertility among women of childbearing age. METHODS Our study encompassed 3,654 women aged 18 to 45 years from the National Health and Nutrition Examination Survey (NHANES) 2013-2018. Infertility was defined as a positive response to the query: "Have you attempted to conceive for a minimum of one year without achieving pregnancy?" Depression was evaluated by the Patient Health Questionnaire (PHQ-9) score (range, 0-27). Multiple logistic regression analyses and subgroup analyses stratified by age and race/ethnicity were conducted to investigate the association between depression and infertility. Furthermore, fitted smoothing curves and threshold effect analysis were utilized to depict the nonlinear relationship. RESULTS Total PHQ-9 score was associated with infertility in the fully adjusted model (OR 1.04, 95% CI 1.01-1.07, P = 0.010), and this relationship exhibited a non-linear pattern, reaching a saturation point at 13, as substantiated by the fitting of smoothed curves. Additionally, the association remained robust when stratified by age but not by race/ethnicity. LIMITATIONS Cross-sectional design and recall biases. CONCLUSIONS In this cross-sectional study, depression was associated with infertility among women of childbearing age in the fully adjusted models. This observed association holds potential relevance for clinicians tasked with enhancing psychological well-being during infertility management strategies.
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Affiliation(s)
- Li Wan
- Department of Pharmacy, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Sijie He
- Department of Pharmacy, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Liu Y, Su Y, Li X. Psychological impact of the COVID-19 pandemic on infertile patients: A systematic review and meta-analysis. Psych J 2024. [PMID: 38894564 DOI: 10.1002/pchj.782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 05/06/2024] [Indexed: 06/21/2024]
Abstract
The present study aimed to examine the psychological impact of the COVID-19 pandemic on infertile patients. We adopted a comparison design and searched articles published from 1 September 2016 to 31 December 2019 as the control group, while articles published from 1 January 2020 to 31 April 2023 were treated as the pandemic group. Specifically, Web of Science, PubMed, Medline, PsycArticle, CNKI and PsycINFO were searched to identify potential eligible records. Risk of bias was assessed, and random-effects meta-analyses were conducted to estimate the prevalence of specific mental health problems. Forty studies with a total of 19,480 participants were included in the analysis. The pooled prevalence of anxiety in the pandemic group was significantly higher than that in the control group. The depression and stress prevalence in the pandemic group was higher than that in the control group, yet did not reach statistical significance. A subgroup analysis revealed region differences with developed countries exhibiting higher rates of anxiety and depression in the pandemic group, but the result was the opposite in the control group. Physiological factors, psychological factors and social factors correlated with infertile patients' mental health were identified. The COVID-19 pandemic had a significant negative impact on infertile patients' mental health, emphasizing the importance of ways to mitigate the risks during the pandemic.
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Affiliation(s)
- Yu Liu
- School of Psychology, Jiangxi Normal University, Nanchang, China
| | - Yiyao Su
- School of Psychology, Jiangxi Normal University, Nanchang, China
| | - Xiaoshan Li
- Center of Mental Health Education and Research, Jiangxi Normal University, Nanchang, China
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Salari N, Babajani F, Hosseinian-Far A, Hasheminezhad R, Abdoli N, Haydarisharaf P, Mohammadi M. Global prevalence of major depressive disorder, generalized anxiety, stress, and depression among infertile women: a systematic review and meta-analysis. Arch Gynecol Obstet 2024; 309:1833-1846. [PMID: 38459997 DOI: 10.1007/s00404-024-07444-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 02/16/2024] [Indexed: 03/11/2024]
Abstract
BACKGROUND In recent years, the global prevalence of infertility has increased among women (Talmor and Dunphy, Best Pract Res Clin Obstet Gynaecol 29(4):498-506, 2015) and is considered as a public health concern. One of the impacts of infertility is mental health problems in the patients, which can lead to complications such as stress, anxiety, and depression. The aim of this study is to investigate the global prevalence of major depressive disorder, general anxiety, stress, and depression in infertile women through a systematic review and meta-analysis. METHODS To identify studies that have reported the prevalence of major depressive disorder, generalized anxiety, stress, and depression in infertile women, the PubMed, Scopus, Web of Science, Embase, ScienceDirect, and Google Scholar repositories were systematically searched. Articles published up until February 2023 were included, while no lower time limit was imposed in the search strategy. Heterogeneity of studies was examined using the I2 test and, thus, random-effects model was used to perform the analysis. Data analysis was conducted within the Comprehensive Meta-Analysis (v.2) software. RESULTS In the review of 44 studies with a sample size of 53,300 infertile female patients, the overall prevalence of major depressive disorder (clinical depression), generalized anxiety, stress, and depression was found to be 22.9%, 13.3%, 78.8%, and 31.6% respectively. It was also found that mental health complications are more prevalent among infertile women in Asia (continent). CONCLUSION Considering the prevalence of mental disorders among infertile women, health policymakers can use the results of the present meta-analysis to pay more attention to the mental health of infertile women and devise suitable interventions and programs to reduce and prevent the spread of psychological disorders among infertile women.
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Affiliation(s)
- Nader Salari
- Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Fateme Babajani
- Department of Clinical Psychology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Amin Hosseinian-Far
- Department of Business Systems and Operations, University of Northampton, Northampton, UK
| | - Razie Hasheminezhad
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nasrin Abdoli
- Department of Psychiatry, Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Parisa Haydarisharaf
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Masoud Mohammadi
- Cellular and Molecular Research Center, Gerash University of Medical Sciences, Gerash, Iran.
- Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.
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Braverman AM, Davoudian T, Levin IK, Bocage A, Wodoslawsky S. Depression, anxiety, quality of life, and infertility: a global lens on the last decade of research. Fertil Steril 2024; 121:379-383. [PMID: 38224730 DOI: 10.1016/j.fertnstert.2024.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/05/2024] [Accepted: 01/08/2024] [Indexed: 01/17/2024]
Abstract
We aimed to review the global literature in the past 10 years regarding the impact of infertility on depression, anxiety, stress, and quality of life while exploring the potential clinical utility of psychosocial fertility questionnaires. PubMed, Scopus, and CINAHL were searched for English-published articles since 2013 on key search terms related to infertility, assisted reproductive technologies, and psychological terms such as depression, anxiety, mood disorders, and quality of life. The search yielded 7,947 articles, of which 366 articles were independently deemed relevant by the 3 reviewers. Anxiety, depression, and diminished quality of life are prevalent in the infertility experience of both men and women. Studies from around the world show similar experiences independent of culture.
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Affiliation(s)
- Andrea Mechanick Braverman
- Department of Obstetrics and Gynecology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Philadelphia.
| | - Teni Davoudian
- Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, Oregon
| | - Isabelle K Levin
- Department of Obstetrics and Gynecology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Philadelphia
| | - Anne Bocage
- Department of Obstetrics and Gynecology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Philadelphia
| | - Sascha Wodoslawsky
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Philadelphia
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Bahadur A, Kumari S, Mundhra R, Khoiwal K, Das A, Heda A, Pathak A, Heda S. Anxiety, Depression, and Quality of Life Among Infertile Women: A Case-Control Study. Cureus 2024; 16:e55837. [PMID: 38590470 PMCID: PMC10999894 DOI: 10.7759/cureus.55837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2024] [Indexed: 04/10/2024] Open
Abstract
Introduction Pregnancy holds significant cultural and social value for women. However, women facing challenges in conceiving often grapple with emotional distress, including depression and anxiety. The connection between psychological elements (stress, anxiety, and depression) and infertility is complex, influenced by multiple factors, and bidirectional. Infertile women are more likely to develop mental illnesses, marital dissatisfaction, and impaired quality of life compared to the individuals of the fertile group. Thus, the study aimed to assess levels of anxiety, depression, and quality of life among infertile women compared to fertile women. Methods This case-control study conducted at a tertiary care center recruited 100 nulliparous women between the age group of 20 and 38 years with primary or secondary infertility, while those with male factor infertility were excluded. The control group (N=100) comprised normal parous women who had at least one child. The primary objective of the study was to assess the impact of infertility on the mental health and quality of life of women seeking infertility treatment. Outcome measures included standardized tools such as the WHOQOL-BREF questionnaire to assess the quality of life across multiple domains (e.g., physical, psychological, social, and environmental) as well as the Depression Anxiety and Stress Scale (DASS-21) to measure levels of anxiety, depression, and stress. Cronbach's alpha was used to measure the tool's reliability. A P value of <0.05 was considered statistically significant. Results Baseline sociodemographic parameters were comparable between the two groups. The mean age of infertile women was 30.6±3.9 years compared to 31.5±3.2 years in fertile women (P=0.076). Using the WHOQOL-BREF scale, we found that the quality of life was better in the fertile group compared to the infertile group through all the physical, psychological, social, and environmental domains (P<0.001). The infertile group had a significantly higher number of women with anxiety, depression, and stress. The questionnaires showed high internal reliability. Conclusion Infertile women experienced a lower quality of life in various domains, higher levels of anxiety, and increased rates of depression compared to fertile counterparts. The study findings underscore the multidimensional impact of infertility, emphasizing the need for comprehensive healthcare approaches to address the psychosocial challenges faced by women undergoing infertility treatment.
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Affiliation(s)
- Anupama Bahadur
- Obstetrics and Gynaecology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Sukriti Kumari
- Obstetrics and Gynaecology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Rajlaxmi Mundhra
- Obstetrics and Gynaecology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Kavita Khoiwal
- Obstetrics and Gynaecology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Anindya Das
- Psychiatry, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Ayush Heda
- Obstetrics and Gynaecology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Anjali Pathak
- Obstetrics and Gynaecology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Sakshi Heda
- Obstetrics and Gynaecology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
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Tetecher L, Cocchiaro T, Guarino A, Giannini T, Maucione S, Di Trani M, Rago R, Ciocca G. Sexological and traumatic aspects in reproductive difficulties: a psychometric study on couples seeking help for infertility. J Endocrinol Invest 2024; 47:179-189. [PMID: 37311972 DOI: 10.1007/s40618-023-02134-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 06/06/2023] [Indexed: 06/15/2023]
Abstract
PURPOSE To investigate the impact of infertility in gender differences on psycho-traumatological, sexological, relational and emotional aspects and gender differences in couples requiring assisted reproductive treatment. METHODS 151 couples were recruited with a mean age of 36.7 ± 4.8 years for women and 39.8 ± 6.6f or men. 43% of women and 34% of men had already received the diagnosis of infertility. To recruited subjects was administered the following psychometric tests: Sexological and Emotional in Infertility questionnaire (SEIq), Arizona Sexual Experience Scale (ASEX), the Orgasmomether and the International Trauma Questionnaire (ITQ). RESULTS There was a significant difference in traumatic symptoms between men and women (t = 5,859, p < 0.05). Gender differences were found in the sexological dimension of the SEIq (t = 7,858, p < .001) and in the total ASEX score (t = 3,979, p < .001). Specifically, significant correlations emerged between the ASEX domains and the emotional and sexological aspects related to infertility only in women. The reaction to the diagnosis was negatively correlated with the emotional area of the couple (r = -0.683, p < .001) and positively with the couple relationship (r = 0.815, p < .001). Multiple regression revealed that the overall functioning of the couple, rather than the single scales, is the main predictor of sexuality (R2 = 0.77). CONCLUSION A clear impact of infertility on the couple's psycho-traumatological, psycho-sexological and relational aspects emerged. It could be useful to promote targeted support interventions on the most compromised areas of couple functioning in assisted reproductive centers.
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Affiliation(s)
- L Tetecher
- Department of Dynamic and Clinical Psychology, and Health Studies, School of Health Psychology, Sapienza University of Rome, Rome, Italy
| | - T Cocchiaro
- Physiopathology of Reproduction and Andrology Unit, Sandro Pertini Hospital, Rome, Italy
| | - A Guarino
- Physiopathology of Reproduction and Andrology Unit, Sandro Pertini Hospital, Rome, Italy
| | - T Giannini
- Section of Sexual Psychopathology, Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Via Degli Apuli, 1, 00185, Rome, Italy
| | - S Maucione
- Section of Sexual Psychopathology, Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Via Degli Apuli, 1, 00185, Rome, Italy
| | - M Di Trani
- Department of Dynamic and Clinical Psychology, and Health Studies, School of Health Psychology, Sapienza University of Rome, Rome, Italy
| | - R Rago
- Physiopathology of Reproduction and Andrology Unit, Sandro Pertini Hospital, Rome, Italy
| | - G Ciocca
- Section of Sexual Psychopathology, Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Via Degli Apuli, 1, 00185, Rome, Italy.
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Warne E, Oxlad M, Best T. Consulting patients and providers of assisted reproductive technologies to inform the development of a group psychological intervention for women with infertility. PEC INNOVATION 2023; 3:100206. [PMID: 37711398 PMCID: PMC10497790 DOI: 10.1016/j.pecinn.2023.100206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 07/27/2023] [Accepted: 08/29/2023] [Indexed: 09/16/2023]
Abstract
Objective To consult providers and women patients of Assisted Reproductive Technologies regarding their preferences for the format, duration and content in the development of a group psychological intervention. Methods Providers and current and past women patients of Assisted Reproductive Technologies completed an online cross-sectional survey comprising items about session content, number, frequency, timing, format, delivery mode and inclusion of experiential practice of psychological strategies to promote well-being. Results Eight providers, 51 current women patients and 51 women who previously underwent Assisted Reproductive Technologies participated. Sixty-two percent of participants indicated a group psychological program would be helpful; and 34% thought it may be helpful. Face-to-face was the preferred delivery mode (42%). Seventy-one percent preferred 60-min sessions held fortnightly (64%), with six sessions most acceptable (24%). Most respondents (74%) felt group participants would likely complete at-home practice. Detailed thematic content from participants highlighted a complex range of consumer challenges. Relevant behaviour change techniques were verified, with those to be included identified as: feedback and monitoring, regulation, self belief, reward and threat, natural consequences, identity, support, shaping knowledge, and comparison of outcomes. Conclusion Providers and patients were supportive of the development of a group psychological intervention to provide support for women undergoing Assisted Reproductive Technologies. Innovation The results of this study provide insight informing the co-design of a group psychological program for women with infertility.
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Affiliation(s)
- Emma Warne
- School of Psychology, University of Adelaide, Adelaide 5000, Australia
| | - Melissa Oxlad
- School of Psychology, University of Adelaide, Adelaide 5000, Australia
| | - Talitha Best
- Central Queensland University, School of Health, Medical and Applied Science, NeuroHealth Lab, Appleton Institute, Brisbane, Australia
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Khan NH, Shahnawaz MG, Patel A, Kashyap P, Singh CB. Resilience among involuntarily childless couples and individuals undergoing infertility treatment: a systematic review. HUM FERTIL 2023; 26:1562-1583. [PMID: 37439133 DOI: 10.1080/14647273.2023.2219400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 04/18/2023] [Indexed: 07/14/2023]
Abstract
Infertility is regarded as a highly stressful and challenging experience. However, the response to this unexpected moment varies from one individual to the other. The review explores research that studies resilience in the context of infertility and its treatment. The purpose was to study the protective and risk factors associated with resilience and to identify psychosocial factors that could play a crucial role in resilience among infertile couples and individuals who are seeking infertility treatment. Four major databases (PubMed, Scopus, ScienceDirect, and Wiley Online Library) were searched with appropriate keywords. A total of 4101 articles were retrieved from the databases and after following various levels of screening 18 articles were finalized. These articles explored resilience and other psychosocial factors in couples/individuals seeking infertility treatment. The protective factors associated with resilience were quality of life, coping, social support, and posttraumatic growth. The risk factors associated with resilience were infertility-related stress, anxiety and depression. The unexpected diagnosis of infertility might be disturbing for many, still, it may not be extremely agonizing for some. Individuals who are encouraged to utilize their own resources and seek support are able to deal with stressors associated with infertility.
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Affiliation(s)
- Neda Haseeb Khan
- Department of Psychology, Jamia Millia Islamia, New Delhi, India
| | | | - Ansha Patel
- Department of Psychiatry & Psychology RNT Medical College, Paras & Shantiraj Hospitals, Psychological Clinic for Reproductive Health & Challenges, CMBS, Udaipur, FAIMER at MAHE, Karnataka, India
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Fitz VW, Soria-Contreras DC, Rifas-Shiman SL, Shifren JL, Oken E, Chavarro JE. Exploring the relationship between history of infertility and the experience of menopausal symptoms. Menopause 2023; 30:913-919. [PMID: 37527458 PMCID: PMC10527707 DOI: 10.1097/gme.0000000000002229] [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] [Indexed: 08/03/2023]
Abstract
OBJECTIVE The aim of the study is to examine longitudinal associations of history of infertility with menopausal symptoms in midlife. METHODS Six hundred ninety-five midlife women (≥45 y old or reporting ≥12 mo of amenorrhea at the midlife visit) in Project Viva, a prospective cohort enrolled 1999-2002 during pregnancy and followed for 18 years after enrollment ("midlife visit"). Exposure was history of infertility defined as time to pregnancy ≥12 months (≥6 mo if ≥35 y), use of medical treatment to conceive, or infertility consultation or treatment in the 6-month preceding enrollment. The primary outcome was score below or above the median on the Menopause Rating Scale (MRS). Secondary outcomes included individual symptom score on the MRS and self-reported age of menopause. RESULTS A total of 36.6% had a history of infertility in their lifetime. At the time of MRS completion, the women with prior infertility were older (53.4 [SD, 3.8] vs 51.2 [SD, 3.7] y) than those without infertility and a larger proportion had reached menopause (62% vs 40%). Women with prior infertility were more likely to score above the median on the MRS (Adjusted Odds Ratio [aOR], 1.45; 95% confidence interval [CI], 1.04-2.01) and had higher odds for reporting any depressive mood (aOR, 1.56; 95% CI, 1.12-2.16) and irritability (aOR, 1.57; 95% CI, 1.13-2.19). There was a trend toward greater severity of sleep problems among women with prior infertility. There was no association of prior infertility with report of other menopausal symptoms or age of menopause. CONCLUSIONS Our findings suggest that women with prior infertility are more likely to have an MRS score above the median and experience depressive mood, irritability, and sleep problems during midlife than women without infertility. These findings have implications for mental health screening among midlife women.
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Affiliation(s)
| | | | - Sheryl L Rifas-Shiman
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston MA
| | | | - Emily Oken
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston MA
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Warne E, Oxlad M, Best T. Evaluating group psychological interventions for mental health in women with infertility undertaking fertility treatment: A systematic review and meta-Analysis. Health Psychol Rev 2023; 17:377-401. [PMID: 35348050 DOI: 10.1080/17437199.2022.2058582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 03/22/2022] [Indexed: 11/04/2022]
Abstract
ABSTRACTWe conducted a systematic review and meta-analysis of the published literature concerning the effectiveness of group psychological interventions in improving anxiety, depression, marital dissatisfaction, fertility quality of life and stress, and pregnancy outcomes of women with infertility, participating in fertility treatment. A search of five databases yielded 1603 studies; 30 articles met inclusion criteria, and computations of effect sizes ensued (Hedges' g and Odds Ratios (OR)). The total sample comprised 2752 participants, with 1279 participants receiving group intervention and 1473 participants in the comparison group. Group psychological interventions reduced depression (Hgw = -1.277; 95% CI = [-1.739- -0.815]; p = 0.000), anxiety (Hgw = -1.136, 95% CI [-1.527- -0.744]; p = 0.000), fertility stress (Hgw = -0.250, 95% CI [-0.388- -0.122]; p = 0.000), and marital dissatisfaction (Hgw = -0.938; 95% [CI -1.455- -0.421]; p = 0.000), and pregnancy rates improved (OR = 2.422 95% CI [2.037-2.879]; p = 0.000). No improvement was observed regarding fertility quality of life (Hgw = 0. 144; 95% CI [-0.176- 0.463]; p = 0.379). Our findings highlight that participation in group psychological intervention improved the mental health, fertility stress and pregnancy rates of women with infertility.
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Affiliation(s)
- Emma Warne
- School of Psychology, The University of Adelaide, Adelaide, Australia
| | - Melissa Oxlad
- School of Psychology, The University of Adelaide, Adelaide, Australia
- CQU, School of Health, Medical and Applied Science, NeuroHealth Lab, Appleton Institute, Brisbane, Australia
| | - Talitha Best
- CQU, School of Health, Medical and Applied Science, NeuroHealth Lab, Appleton Institute, Brisbane, Australia
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11
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Matsushima M, Yamada H, Kondo N, Arakawa Y, Tabuchi T. Married women's decision to delay childbearing, and loneliness, severe psychological distress, and suicidal ideation under crisis: online survey data analysis from 2020 to 2021. BMC Public Health 2023; 23:1642. [PMID: 37641039 PMCID: PMC10464056 DOI: 10.1186/s12889-023-16476-z] [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: 09/16/2022] [Accepted: 08/08/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has affected every aspect of our lives, including the decision to become pregnant. Existing literature suggests that infertility and the decision to delay childbearing at a younger age are associated with a lower level of well-being and regrets when women start to desire a baby. Thus, the decision to delay childbearing due to the pandemic could negatively affect the well-being of women. This study focuses on how pregnancy decisions affect the well-being of women during the COVID-19 pandemic. METHODS From the Japan COVID-19 and Society Internet Survey, a nationally representative web-based survey, 768 observations of married women aged 18 to 50 years who had the intention of getting pregnant during the pre-pandemic period (conducted in 2020 and 2021) were used. Loneliness, severe psychological distress, and suicidal ideation were used as well-being indicators. For pooled data, a generalised estimated equation (GEE) model was used to estimate how pregnancy decision related to well-being indicators. For a sub-analysis, the sample was divided by the survey year and a Poisson regression model was used. RESULTS The GEE analysis showed an association between delaying childbearing and severe psychological distress, with the prevalence ratio (PR) being 2.06 [95% CI (1.40-3.03)]. Furthermore, loneliness and suicidal ideation that occurred after the beginning of the pandemic were significantly related to the decision to delay childbearing-1.55 [95% CI (1.03,2.34)] and 2.55 [95% CI (1.45-4.51)], respectively. Moreover, these PRs were larger for 2021 compared to 2020. CONCLUSION During the COVID-19 pandemic, approximately one-fifth of married women who had childbearing intentions before the pandemic decided to postpone pregnancy. They exhibited a deteriorated mental health state. Furthermore, the negative associations were larger in 2021 compared to 2020. Loneliness has negative consequences for both mental and physical health, as well as elevated severe psychological distress and suicidal ideation among those who decided to postpone pregnancy. Therefore, the current results should not be overlooked by society.
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Affiliation(s)
- Midori Matsushima
- Faculty of Humanities and Social Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba Ibaraki, 305-8577, Japan.
| | | | - Naoki Kondo
- Department of Social Epidemiology, Graduate School of Medicine, University of Kyoto, Kyoto, Japan
| | - Yuki Arakawa
- Departments of Health and Social Behavior, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
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Zargar M, Sayyah M, Nikbakht R, Abdipour Z. Comparison of psychological disorders during and after pregnancies caused by assisted reproductive treatments and spontaneous pregnancies. Cent Nerv Syst Agents Med Chem 2023; 23:CNSAMC-EPUB-133742. [PMID: 37592788 DOI: 10.2174/1871524923666230817102216] [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: 05/10/2023] [Revised: 06/24/2023] [Accepted: 07/17/2023] [Indexed: 08/19/2023]
Abstract
INTRODUCTION Mental disorders during pregnancy are one of the major public health problems because of its effect on both mother and child, but the prevalence of psychiatric disorders in infertile women is largely unknown to compare psychiatric disorders during and after pregnancies with assisted reproductive therapies (ART) and spontaneous pregnancies. METHODS This cross-sectional study was conducted on pregnant women referring to midwifery centers in Ahvaz City in 2022. Pregnant women were included in two groups of either pregnancy caused by ART (n= 84) or spontaneous pregnancy (n= 256). The Symptom Checklist-90-R (SCL90-R) was used to assess psychiatric disorders during and after pregnancies. RESULTS A high percentage of women with spontaneous pregnancy (74.6%) and ART (91.7%) had some degree of psychological disorders. The severity of psychological disorders in both groups was higher during pregnancy than after pregnancy (P<0.001). The intensity of various psychological disorders during and after pregnancy in the ART pregnancy group was significantly higher than the control group (P<0.001). An increased risk of psychiatric disorders during pregnancy was associated with the history of psychiatric disorders [odd ratio (OR): 12.393; P= 0.022], family history of psychiatric disorders (OR:26.168; P<0.001), history of infertility (OR: 19.00; P<0.001), primary infertility (OR: 12.714; P=0.004), infertility duration more than three years (OR: 43.424; P<0.001), and frequency of embryo transfer (OR: 18.939; P=0.045). CONCLUSION Psychiatric disorders were prevalent among pregnant women in the study area especially in pregnant women with ART. Regular screening programs for mental health problem should be included in an antenatal care service especially in this high-risk group.
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Affiliation(s)
- Mahvash Zargar
- Department of Obstetrics and Gynecology, School of Medicine, Fertility Infertility and Perinatology Research Center,
Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mehdi Sayyah
- Educational Development Center, Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Roshan Nikbakht
- Department of Obstetrics and Gynecology, School of Medicine, Fertility Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Zahra Abdipour
- Department of Obstetrics and Gynecology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Hassan S, Bhatti MI, Habib S, Fatima S, Bhader S, Khan NH, Jiang E. How fear of intimacy affects infertile men's neuropsychological functioning through mental toughness. Front Psychiatry 2023; 14:1049008. [PMID: 37555007 PMCID: PMC10406444 DOI: 10.3389/fpsyt.2023.1049008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 05/03/2023] [Indexed: 08/10/2023] Open
Abstract
OBJECTIVE There is a significant need in Pakistan to investigate the psychological effects of infertility on the mental health of infertile men. The current study examined how fear of intimacy affects neuropsychological impairment and evaluated its relationship to other variables including quality of life and mental toughness. METHOD An analytical cross-sectional study was carried out on infertile male patients in various healthcare settings in Punjab, Pakistan. The participants were recruited using a non-probability (purposive) sampling strategy. The sample size was 120 infertile. SPSS 26 was used to analyze the data. RESULTS Fear of intimacy was found significant impact on neuropsychological impairment (r = 0.40; ***p < 0.001), as well as fear of intimacy, significantly associated with emotional problems (r = 0.48; **p < 0.01), learning problems (r = 0.33; **p < 0.01), sensory and motor problem (r = 0.55; **p < 0.01), concentration problem (r = 0.21; **p < 0.01), mental & physical in coordination (r = 0.37; **p < 0.01) and depression (r = 0.22; **p < 0.01). Fear of intimacy has negative impact on QoL (r = -0.25; *p > 0.05). Similarly, neuropsychological impairment was found to be negatively associated with QoL (r = -0.52; **p > 0.01). The relationship between fear of intimacy and neuropsychological impairment was found to be significantly mediated by QoL. Furthermore, the findings revealed that mental toughness significantly moderated the relationship between fear of intimacy and neuropsychological impairment. CONCLUSION Overall, infertile men in Pakistan had relatively high levels of fear of intimacy, which largely caused neuropsychological impairment. This study can help neuropsychological researchers, mental health professionals, as well as policymakers in improving clinical mental health practices for infertile patients.
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Affiliation(s)
- Sajid Hassan
- Institute of Nursing and Health, Henan University, Kaifeng, China
| | - Mazhar Iqbal Bhatti
- Department of Psychology, International Islamic University, Islamabad, Pakistan
| | - Shazia Habib
- Department of Applied Psychology, Government College University Faisalabad, Faisalabad, Pakistan
| | - Sidra Fatima
- University Gillani Law College, Bahauddin Zakariya University, Multan, Pakistan
| | - Sher Bhader
- Department of Psychology, International Islamic University, Islamabad, Pakistan
| | - Nazeer Hussain Khan
- Institute of Nursing and Health, Henan University, Kaifeng, China
- Department of Animal Sciences, Quaid I Azam University, Islamabad, Pakistan
| | - Enshe Jiang
- Institute of Nursing and Health, Henan University, Kaifeng, China
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14
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Li CC, Hwang JL, Ko YL, Chen HH, Chien LY. Factors associated with postpartum depressive symptoms among women who conceived with infertility treatment. Acta Psychol (Amst) 2023; 238:103987. [PMID: 37467654 DOI: 10.1016/j.actpsy.2023.103987] [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: 06/19/2023] [Revised: 07/11/2023] [Accepted: 07/11/2023] [Indexed: 07/21/2023] Open
Abstract
Infertility treatment experiences may accumulate and influence postpartum psychological well-being among women with infertility. However, the association between infertility treatment experiences and postpartum depressive symptoms remained unclear. This cross-sectional survey aimed to describe depressive symptom scores of 180 women, who conceived while undergoing infertility treatment, at 2-6 months after childbirth, and to explore factors, including infertility history and treatment experiences, associated with postpartum depressive symptoms. Data were collected via telephone interviews and patient record reviews. Postpartum depressive symptoms were measured using the Edinburgh Postnatal Depression Scale, with a cutoff score of 10. The prevalence of postpartum depressive symptoms was 34.4 %. Higher perceived stress levels after childbirth than before undergoing infertility treatment, a duration of infertility diagnosis longer than three years, maternal age >35 years, pregnancy conceived through in vitro fertilization (IVF), and experiencing all three lines of infertility treatment, namely ovarian stimulation, intrauterine insemination, and IVF, were associated with a higher risk of postpartum depressive symptoms. Breastfeeding, social support, and baby sex in line with stated preference were negatively associated with postpartum depressive symptoms. There were no significant interactions between the variables. The women's infertility history and treatment experiences were found to have influenced their postpartum depressive symptoms, especially among women who had a long duration of infertility, conceived through IVF, and had received all lines of infertility treatment.
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Affiliation(s)
- Chuan-Chen Li
- Department of Nursing, Fu Jen Catholic University Hospital, New Taipei City, Taiwan; Department of Nursing, Fu Jen Catholic Univeristy, New Taipei City, Taiwan
| | - Jiann-Loung Hwang
- Department of Obstetrics and Gynecology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan; Taipei IVF Center for Reproduction and Genetics, Taipei, Taiwan; Department of Obstetrics and Gynecology, Taipei Medical University, Taipei, Taiwan
| | - Yi-Li Ko
- Department of Nursing, Fu Jen Catholic University, New Taipei City, Taiwan.
| | - Hung-Hui Chen
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Nursing, National Taiwan Univeristy Hospital, Taipei, Taiwan.
| | - Li-Yin Chien
- Institute of Community Health Care, College of Nursing, National Yang Ming Chiao Tung University, Yang-Ming Campus, Taipei, Taiwan.
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Yifei Huang E, Hansen AV, Tidemandsen C, la Cour Freiesleben N, Nielsen HS, Backer V, Ulrik CS. Anxiety and depression in women with asthma prior to fertility treatment. Eur Clin Respir J 2023; 10:2221376. [PMID: 37313367 PMCID: PMC10259298 DOI: 10.1080/20018525.2023.2221376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 05/31/2023] [Indexed: 06/15/2023] Open
Abstract
Objective We investigate symptoms of anxiety and depression among women with asthma prior to fertility treatment. Methods This is a cross-sectional study of women screened for eligibility to the PRO-ART study (RCT of omalizumab versus placebo in asthmatic women undergoing fertility treatment (NCT03727971)). All participants were scheduled for in vitro fertilization (IVF) treatment at four public fertility clinics in Denmark. Data on demographics and asthma control (ACQ-5) were obtained. Symptoms of anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS-A and D, respectively) and defined as being present on both subscales if a score >7 was obtained. Spirometry, diagnostic asthma test, and measurement of fractional exhaled nitric oxide (FeNO) were conducted. Results A total of 109 women with asthma were included (mean age 31.8 ± 4.6 and BMI 25.5 ± 4.6). Most women had male factor infertility (36.4%) or unexplained infertility (35.5%). Twenty-two percent of the patients reported uncontrolled asthma (ACQ-5 score > 1.5). The mean HADS-A and HADS-D scores were 6.0 ± 3.8 (95% CI 5.3-6.7) and 2.5 ± 2.2 (95% CI 2.1-3.0), respectively. Thirty (28.0%) women reported anxiety symptoms, and four (3.7%) had concomitant depressive symptoms. Uncontrolled asthma was significantly associated with both depressive (p = 0.04) and anxiety symptoms (p = 0.03). Conclusions More than 25% of women with asthma prior to fertility treatment had self-reported symptoms of anxiety, and just below 5% had self-reported depressive symptoms, possibly related to uncontrolled asthma.
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Affiliation(s)
- Emilia Yifei Huang
- Department of Respiratory Medicine, Copenhagen University Hospital – Hvidovre, Copenhagen, Denmark
| | - Anne Vejen Hansen
- Department of Respiratory Medicine, Copenhagen University Hospital – Hvidovre, Copenhagen, Denmark
| | - Casper Tidemandsen
- Department of Respiratory Medicine, Copenhagen University Hospital – Hvidovre, Copenhagen, Denmark
| | - Nina la Cour Freiesleben
- Department of Obstetrics and Gynaecology, the Fertility Clinic, Copenhagen University Hospital, Hvidovre, Copenhagen, Denmark
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Henriette Svarre Nielsen
- Department of Obstetrics and Gynaecology, the Fertility Clinic, Copenhagen University Hospital, Hvidovre, Copenhagen, Denmark
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Vibeke Backer
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Otorhinolaryngology and Head & Neck Surgery, Rigshospitalet, Copenhagen, Denmark
| | - Charlotte Suppli Ulrik
- Department of Respiratory Medicine, Copenhagen University Hospital – Hvidovre, Copenhagen, Denmark
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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16
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Zurlo MC, Cattaneo Della Volta MF, Vallone F. Paths towards parenthood after repeated treatment failures: a comparative study on predictors of psychological health outcomes in infertile couples persisting in treatments or opting for adoption. Front Psychol 2023; 14:1147926. [PMID: 37342643 PMCID: PMC10277654 DOI: 10.3389/fpsyg.2023.1147926] [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: 01/19/2023] [Accepted: 05/10/2023] [Indexed: 06/23/2023] Open
Abstract
Introduction Infertility literature suggests widespread recourse to long-term medical treatments despite evidence of high stress, costs, and adverse effects of repeated treatment failures. However, there is a lack of research comparing predictors of stress and psychological health outcomes between members of infertile couples who - after repeated failures - persist in pursuing medical treatments (PT) with those who opted for quitting treatments and adopting (QTA). Basing on a transactional and multidimensional approach to infertility-related stress and health, the present study aims at exploring individual (socio-demographics; coping strategies) and situational (infertility-related parameters; infertility-related stressors; couple's dyadic adjustment dimensions) predictors of state-anxiety and depression in male and female partners of PT-infertile couples and of QTA-infertile couples. Methods Participants were both members of 176 couples with duration of infertility and a history of medical treatments for at least 3 years (76 PT-infertile couples, 100 QTA-infertile couples). The study variables were compared by study group across genders. Structural equation models (SEM) were used to test main and moderating effects of study variables on state-anxiety and depression by study group and across genders. Results Members of infertile couples quitting treatments and adopting (QTA) reported significantly lower levels of state-anxiety and depression, higher stress related to need for parenthood and rejection of childfree-lifestyle and lower stress related to social and couple's relationship concerns than those who persist in pursuing medical treatments (PT). Members of infertile couples quitting treatments and adopting (QTA) recurred to a greater extent to active coping strategies (problem-solving/social-support) and to a lower extent to passive coping strategies (avoiding/turning-to-religion), and they reported higher levels of dyadic adjustment. Specificities in main and moderating factors related to state-anxiety and depression by study group and across genders were found. Conclusion Findings should be addressed to provide a comprehensive assessment of both members of infertile couples facing repeated treatment failures to identify risks and resources and develop tailored evidence-based interventions.
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Affiliation(s)
- Maria Clelia Zurlo
- Dynamic Psychology Laboratory, Department of Political Sciences, University of Naples Federico II, Naples, Italy
- Department of Humanities, University of Naples Federico II, Naples, Italy
| | | | - Federica Vallone
- Dynamic Psychology Laboratory, Department of Political Sciences, University of Naples Federico II, Naples, Italy
- Department of Humanities, University of Naples Federico II, Naples, Italy
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Ni Y, Shen H, Yao H, Zhang E, Tong C, Qian W, Huang L, Wu X, Feng Q. Differences in Fertility-Related Quality of Life and Emotional Status Among Women Undergoing Different IVF Treatment Cycles. Psychol Res Behav Manag 2023; 16:1873-1882. [PMID: 37250753 PMCID: PMC10216870 DOI: 10.2147/prbm.s411740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 05/18/2023] [Indexed: 05/31/2023] Open
Abstract
Objective The present study aimed to provide more insight into the possible differences in the fertility-related quality of life (FertiQoL) and emotional status of women undergoing different cycles of in vitro fertilization (IVF) treatments. Methods A prospective cohort study was performed, and a total of 432 women undergoing IVF treatment were recruited. FertiQoL scale, self-rating anxiety scale (SAS), self-rating depression scale (SDS), and perceived social support scale (PSSS) were used to analyze fertility-related QoL and emotional status. Data were analyzed comparing women undergoing different cycles of IVF treatments. Results A significant decrease in FertiQoL scores occurred in women with increased cycles of IVF treatment. Both anxiety and depression scores significantly increased with increased cycles of attempting IVF treatment. There was no significant difference detected in perceived social support among groups. Conclusion With the increase in the number of IVF treatment cycles, women's FertiQoL gradually decreased, while the risk of anxiety and depression gradually increased.
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Affiliation(s)
- Ying Ni
- Department of Gynecology and Obstetrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
- Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Hao Shen
- Department of Gynecology and Obstetrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
- Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Haihui Yao
- Xianda College of Economics and Humanities, Shanghai International Studies University, Shanghai, People’s Republic of China
| | - Enming Zhang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
| | - Chenye Tong
- Department of Gynecology and Obstetrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Wen Qian
- Department of Gynecology and Obstetrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Limin Huang
- Department of Gynecology and Obstetrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Xian Wu
- Department of Gynecology and Obstetrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Qing Feng
- Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
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18
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Rodriguez-Wallberg KA, Jiang Y, Lekberg T, Nilsson HP. The Late Effects of Cancer Treatment on Female Fertility and the Current Status of Fertility Preservation-A Narrative Review. Life (Basel) 2023; 13:1195. [PMID: 37240840 PMCID: PMC10224240 DOI: 10.3390/life13051195] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/08/2023] [Accepted: 05/15/2023] [Indexed: 05/28/2023] Open
Abstract
Fertility counseling should be offered to all individuals of young reproductive age early in the patient's trajectory following a cancer diagnosis. Systemic cancer treatment and radiotherapy often have an inherent gonadotoxic effect with the potential to induce permanent infertility and premature ovarian failure. For the best chances to preserve a patient's fertility potential and to improve future quality of life, fertility preservation methods should be applied before cancer treatment initiation, thus multidisciplinary team-work and timely referral to reproductive medicine centers specialized in fertility preservation is recommended. We aim to review the current clinical possibilities for fertility preservation and summarize how infertility, as a late effect of gonadotoxic treatment, affects the growing population of young female cancer survivors.
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Affiliation(s)
- Kenny A. Rodriguez-Wallberg
- Department of Oncology-Pathology, Laboratory of translational Fertility Preservation, Karolinska Institutet, SE-17177 Stockholm, Sweden; (Y.J.); (T.L.); (H.P.N.)
- Department of Reproductive Medicine, Division of Gynecology and Reproduction, Karolinska University Hospital, SE-17177 Stockholm, Sweden
| | - Yanyu Jiang
- Department of Oncology-Pathology, Laboratory of translational Fertility Preservation, Karolinska Institutet, SE-17177 Stockholm, Sweden; (Y.J.); (T.L.); (H.P.N.)
| | - Tobias Lekberg
- Department of Oncology-Pathology, Laboratory of translational Fertility Preservation, Karolinska Institutet, SE-17177 Stockholm, Sweden; (Y.J.); (T.L.); (H.P.N.)
- Breast, Endocrine tumors and Sarcoma Cancer Theme, Karolinska University Hospital, SE-17177 Stockholm, Sweden
| | - Hanna P. Nilsson
- Department of Oncology-Pathology, Laboratory of translational Fertility Preservation, Karolinska Institutet, SE-17177 Stockholm, Sweden; (Y.J.); (T.L.); (H.P.N.)
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Ozcan S, Kirca N. Effects of care given in line with Levine's Conservation Model on the quality of life of women receiving infertility treatment: A single blind randomized controlled trial. Health Care Women Int 2023; 44:418-439. [PMID: 34846278 DOI: 10.1080/07399332.2021.2007927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Although infertility is not a life-threatening condition, it decreases the quality of life of people. This single blind randomized controlled trial was conducted with 80 women who received infertility treatment in an IVF Center located in a city center in the west of Turkey between May 2020 and February 2021. It was determined that thanks to the holistic care given in line with Levine's Conservation Model (LCM), fatigue levels of the women in the experimental group decreased, their energy levels increased, their structural, personal and social integrity was conserved and thus their quality of life improved compared to the women in the control group (all p < 0.001).
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Affiliation(s)
- Sadiye Ozcan
- Department of Obstetrics & Gynecological Nursing, Yalova University Faculty of Health Sciences, Yalova, Turkey
| | - Nurcan Kirca
- Department of Obstetrics & Gynecological Nursing, Akdeniz University Faculty of Nursing, Antalya, Turkey
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20
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Mirzaasgari H, Momeni F, Pourshahbaz A, Keshavarzi F, Hatami M. The Role of Psychological Distress in the Relationship between Personality Dimensions and Pregnancy Outcome of Women Undergoing Assisted Reproductive Treatment (IVF/ICSI). IRANIAN JOURNAL OF PSYCHIATRY 2023; 18:153-164. [PMID: 37383963 PMCID: PMC10293695 DOI: 10.18502/ijps.v18i2.12366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 01/12/2022] [Accepted: 08/03/2022] [Indexed: 06/30/2023]
Abstract
Objective: The aim of this study was to determine the role played by psychological distress in the relation between personality dimensions and pregnancy outcome of women undergoing in vitro fertilization/Intra-Cytoplasmic Injections (IVF/ICSI) treatment. Method : This prospective cohort study was conducted for 12 months on 154 infertile women who were receiving IVF/ICSI assisted reproductive treatment for the first time. Research instruments for measuring psychological distress included the Fertility Problem Inventory (FPI) and the Depression, Anxiety, and Stress Scale (DASS-21). One of these was completed prior to ovarian stimulation and the other during the embryo transfer stage. The temperament and Character Inventory-Revised (TCI-R 125) was employed once to assess personality dimensions prior to the ovarian stimulation stage. Independent t-test, Mann Whitney test, Repeated Measures and path analysis were performed for statistical analysis of data. Results: The results of this study showed no significant difference between the pregnant and non-pregnant groups in personality traits (Harm avoidance and self-directness) and psychological distress (FPI and DASS scores). Repeated measures showed a significant difference in stress, anxiety, and depression levels between the two stages of ovarian stimulation and embryo transfer (P < 0.01). Path analysis showed no significant direct and indirect effect for harm avoidance on the pregnancy outcome when psychological distress was mediated. Conclusion: The effect of psychological factors on IVF outcomes is more complicated than is generally assumed and more studies are mandatory to clarify the relationship between personality traits and infertility treatments.
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Affiliation(s)
- Hosna Mirzaasgari
- Department of Clinical Psychology, Faculty of Behavioral Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Fereshte Momeni
- Department of Clinical Psychology, Faculty of Behavioral Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Abbas Pourshahbaz
- Department of Clinical Psychology, Faculty of Behavioral Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Farahnaz Keshavarzi
- Department of Obstetrics and Gynecology, School of Medicine, Motazedi Infertility Research and treatment Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Masoud Hatami
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Wang G, Liu X, Lei J. Effects of mindfulness-based intervention for women with infertility: a systematic review and meta-analysis. Arch Womens Ment Health 2023; 26:245-258. [PMID: 36952004 DOI: 10.1007/s00737-023-01307-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 03/13/2023] [Indexed: 03/24/2023]
Abstract
This review aimed to examine the effects of mindfulness-based interventions on physical and psychological outcomes in women with infertility. Studies were included if participants were women diagnosed with infertility, were over the age of 18, and the design was a randomized controlled trial of a mindfulness-based intervention program. Two independent reviewers undertook eligibility screening, data extraction, and methodological quality assessment. We used RevMan software version 5.4 (The Cochrane Collaboration) to conduct the meta-analyses. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) was followed. Ten articles were finally included in the current meta-analysis. The results of the meta-analysis revealed large, significant effects of mindfulness-based interventions that can effectively reduce depression[SMD = -1.28, 95% CI (-1.95, -0.60), P < 0.0001], anxiety [SMD = -0.89, 95% CI (-1.26, -0.51), P < 0.00001] symptoms, and improve five domains of health-related quality of life (physical function [MD = 9.47, 95% CI (4.33, 14.61), P = 0.0003], general health [MD = 15.77, 95% CI (7.62, 23.92), P = 0.0002], vitality [MD = 14.85, 95% CI (4.95, 24.74), P = 0.003], role-physical [MD = 22.44, 95% CI (14.97, 29.91), P < 0.00001] and social function [MD = 8.27, 95% CI (3.56, 12.97), P = 0.0006)] in women with infertility. The current meta-analysis results revealed that mindfulness-based interventions could effectively reduce depression and anxiety symptoms and improve health-related quality of life in women with infertility. Future rigorously designed, high-quality research is required to demonstrate whether mindfulness-based intervention programs can effectively reduce perceived stress and BMI.
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Affiliation(s)
- Guangpeng Wang
- Xiangya School of Nursing, Central South University, Changsha, Hunan Province, China
- The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha, Hunan Province, China
| | - Xueyan Liu
- School of Nursing, Shandong University, 44 Wenhuaxi Road, Lixia District, Jinan, Shandong Province, China
| | - Jun Lei
- The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha, Hunan Province, China.
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Foti FL, Karner-Huţuleac A, Maftei A. The value of motherhood and psychological distress among infertile women: The mediating role of coping strategies. Front Public Health 2023; 11:1024438. [PMID: 36817897 PMCID: PMC9931740 DOI: 10.3389/fpubh.2023.1024438] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 01/06/2023] [Indexed: 02/05/2023] Open
Abstract
Introduction The present study investigated psychological distress and coping strategies among infertile women during the COVID-19 pandemic using a multi-dimensional model of infertility-related stress. We explored the associations between individual (i.e., age) and situational characteristics related to infertility (i.e., duration of infertility, cause of infertility, number of lost pregnancies, and assisted reproductive techniques [ART] status), and perceived-infertility-related factors (i.e., the perceived importance of motherhood). Methods Our total sample consisted of 193 women aged 20 to 46 (M= 33.23, SD = 4.58), out of which 102 were undergoing ART procedures (M = 33.60, SD = 4.23), and 91 were not (M= 32.81, SD = 4.94). Participants filled in questionnaires measuring psychological distress, coping strategies, and the importance of motherhood. Results Correlation analyses suggested that the importance of motherhood was positively associated with psychological distress and negative coping strategies. Mediation analysis results indicated that both in the overall sample and in the sample of women undergoing ART procedures, the negative self-perception fully mediated the link between the importance of motherhood on psychological distress. In the non-ART sample, we found a significant mediation effect of denial on the link between the importance of motherhood and psychological distress. Discussion We discuss the theoretical and practical implications of the present findings, focusing on the mental health-related consequences of the social stigma of infertility heightened by the pressure of parenthood.
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Affiliation(s)
- Florentina Larisa Foti
- Faculty of Psychology and Education Sciences, Alexandru Ioan Cuza University, Iaşi, Romania
| | - Adina Karner-Huţuleac
- Faculty of Psychology and Education Sciences, Alexandru Ioan Cuza University, Iaşi, Romania
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Boivin J, Oguz M, Duong M, Cooper O, Filipenko D, Markert M, Samuelsen C, Lenderking WR. Emotional reactions to infertility diagnosis: thematic and natural language processing analyses of the 1000 Dreams survey. Reprod Biomed Online 2023; 46:399-409. [PMID: 36463078 DOI: 10.1016/j.rbmo.2022.08.107] [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: 04/19/2022] [Revised: 08/24/2022] [Accepted: 08/25/2022] [Indexed: 02/07/2023]
Abstract
RESEARCH QUESTION What are the emotional effects of infertility on patients, partners, or both, and how can qualitative thematic analyses and natural language processing (NLP) help evaluate textual data? DESIGN A cross-sectional, multi-country survey conducted between March 2019 and May 2019. A total of 1944 patients, partners, or both, from nine countries responded to the open-ended question asking about their initial feelings related to an infertility diagnosis. A mixed-method approach that integrated NLP topic modelling and thematic analyses was used to analyse responses. Sentiment polarity was quantified for each response. Linear regression evaluated the association between patient characteristics and sentiment negativity. RESULTS Common emotional reactions to infertility diagnoses were sadness, depression, stress, disappointment, anxiety, frustration, confusion and loss of self-confidence. NLP topic modelling found additional reactions, i.e. shared feelings with partners, recollections about causes of infertility and treatment experience. Responses to the open-ended question were brief (median: three words) with 71.8% conveying negative sentiments. Some respondent characteristics showed small but significant associations with sentiment negativity, i.e. country (Spain, China and France were more negative than the USA, P < 0.001, P < 0.003 and P < 0.009 respectively), treatment engagement (no treatment was more negative than one or more treatment, P = 0.027) and marital status (missing/other was more negative than divorced, P = 0.003). CONCLUSION Infertility diagnoses create an emotional burden for patients and partners. The mixed-method approach provides a compelling synergy in support of the validity of these findings and shows potential for these techniques in future research.
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Affiliation(s)
- Jacky Boivin
- Cardiff Fertility Studies Research Group, School of Psychology, Cardiff University, 70 Park Place, CF10 3AT, Cardiff Wales, UK.
| | - Mustafa Oguz
- Evidera, The Ark, 201 Talgarth Road, 2nd Floor, London, W6 8BJ, UK
| | - Mai Duong
- Evidera, The Ark, 201 Talgarth Road, 2nd Floor, London, W6 8BJ, UK
| | - Owen Cooper
- Evidera, The Ark, 201 Talgarth Road, 2nd Floor, London, W6 8BJ, UK
| | - Dina Filipenko
- Evidera, The Ark, 201 Talgarth Road, 2nd Floor, London, W6 8BJ, UK
| | - Marie Markert
- Ferring Pharmaceuticals A/S, Amager Strandvej 405, DK - 2770 Kastrup, Denmark
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ŞAHİN M, KARAASLAN MF, ŞAHİN H. İnfertil kadınlarda kişilik özelliklerinin anksiyete ve depresyon gelişimi üzerine olan etkileri. KAHRAMANMARAŞ SÜTÇÜ İMAM ÜNIVERSITESI TIP FAKÜLTESI DERGISI 2023. [DOI: 10.17517/ksutfd.1186968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Amaç: Bu çalışmada infertil kadınların kişilik özelliklerinin anksiyete ve depresyon gelişimi üzerine olan etkilerinin araştırılması amaçlandı.
Gereç ve yöntemler: Çalışmaya, Ocak 2015-Agustos 2016 tarihleri arasında tüp bebek merkezine ve kadın doğum polikliniğine başvurmuş olan sırası ile 67 infertil ve 61 fertil kadın olmak üzere toplam 128 kişi dahil edildi. İnfertil grubu primer veya sekonder infertilitesi olup infertilite tedavisi planlanan veya başlanan kadınlar oluşturdu. Kontrol grubunu ise birden fazla sayıda çocuğu olan fertil kadınlar oluşturdu. Her iki gruba Beck Anksiyete Ölçeği (BAÖ), Beck Depresyon Ölçeği (BDÖ), Eysenck Kişilik Anketi (EKA) ve Çift Uyum Ölçeği (ÇUÖ) uygulandı.
Bulgular: İnfertil ve fertil gruplar arasında yaş gruplarının dağılımı açısından anlamlı bir fark tespit edilmedi. Bununla birlikte BAÖ, BDÖ ve ÇUÖ toplam ortalama puanları infertil grupta anlamlı olarak daha yüksek tespit edildi. Kişilik ve çift uyum ölçeklerinde nörotizm, yalan, çift doyumu, çift uyumu ve sevgi alt ölçekleri ortalama puanları infertil grupta anlamlı olarak daha yüksek bulunurken; dışa-dönüklük, psikotizm ve çiftlerin bağlılığı alt ölçekleri ortalama puanları açısından iki grup arasında anlamlı bir fark izlenmedi. Korelasyon analizinde nörotizm ile anksiyete ve depresyon arasında pozitif yönde; dışa-dönüklük ile anksiyete ve depresyon arasında negatif yönde zayıf bir ilişki bulundu.
Sonuç: Bu çalışmaya göre infertil kadınlarda nörotizm kişilik özelliğine sahip olanların anksiyete ve depresyon gelişimine daha yatkın olabileceği düşünülebilir.
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Affiliation(s)
- Merve ŞAHİN
- Kahramanmaraş Necip Fazıl Şehir Hastanesi, Ruh Sağlığı ve Hastalıkları Kliniği, Kahramanmaraş, Türkiye
| | - Mehmet Fatih KARAASLAN
- Prof.Dr. M. Fatih Karaaslan Özel Kliniği, Ruh Sağlığı ve Hastalıkları Kliniği, Kahramanmaraş, Türkiye
| | - Hamza ŞAHİN
- Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi, Nöroloji Anabilim Dalı, Kahramanmaraş, Türkiye
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Wu L, Sun L, Wang J, Sun Y, Zhang X, Huang Y, Lu Y, Cao F. Psychological distress among women undergoing in vitro fertilization-embryo transfer: A cross-sectional and longitudinal network analysis. Front Psychol 2023; 13:1095365. [PMID: 36687877 PMCID: PMC9849569 DOI: 10.3389/fpsyg.2022.1095365] [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: 11/11/2022] [Accepted: 12/12/2022] [Indexed: 01/07/2023] Open
Abstract
Background Women undergoing in vitro fertilization-embryo transfer (IVF-ET) treatment were generally found to experience varying degrees of psychological distress across the treatment. Existing studies focused on total scores and diagnostic thresholds to characterize the symptoms' severity, which might hinder scientific progress in understanding and treating psychological distress. Aims We aimed to investigate (a) how depression and anxiety symptoms are interconnected within a network, and (b) the changes of the network (symptom connections and network centralities) over time, in women undergoing in vitro fertilization-embryo transfer. Methods A 4-wave longitudinal study was designed with 343 eligible women recruited from the Reproductive Medicine Center of a tertiary hospital in China. The network models were created to explore the relationship and changes between psychopathology symptoms both within and across anxiety and depression, with anxiety measured by the Generalized Anxiety Disorder-7 and depression measured by the Patient Health Questionnaire-9. Symptom network analysis was conducted to evaluate network and network properties, network centrality, and bridge centrality, as well as change trajectory network. Results For the strength centrality, "inability to control worry" and "worrying too much" were the most central symptoms at T1; however, these symptoms decreased. The centrality of "sadness" and "guilt" tended to increase steadily and became dominant symptoms. For bridge centrality indices, several bridge symptoms were identified separately from T1 to T4: "irritability," "concentration difficulties," "nervousness," and "restlessness;" "guilt" exhibited increased bridge symptoms. Furthermore, the change trajectory network indicated that "suicide ideation" became more closely related to guilt but not to worrying too much over time. Conclusion This study provides novel insights into the changes in central features, connections, and bridge symptoms during IVF-ET treatment and identified several bridge symptoms separately at different stages, which could activate the connection between psychopathology symptoms. The results revealed that sense of guilt was associated with worsening psychopathology symptoms, indicating that future psychological interventions should target guilt-related symptoms as a priority.
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Affiliation(s)
- Liuliu Wu
- Department of Health Psychology, School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Lijing Sun
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Juan Wang
- Department of Health Psychology, School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Yaoyao Sun
- Institute of Mental Health, Peking University Sixth Hospital, Beijing, China
| | - Xuan Zhang
- Department of Health Psychology, School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Yongqi Huang
- Department of Health Psychology, School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Yan’e Lu
- Department of Health Psychology, School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Fenglin Cao
- Department of Health Psychology, School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China,*Correspondence: Fenglin Cao, ✉
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Women infertility and common mental disorders: A cross-sectional study from North India. PLoS One 2023; 18:e0280054. [PMID: 36603005 PMCID: PMC9815660 DOI: 10.1371/journal.pone.0280054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 12/20/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Infertility is a very distressing condition. It is often associated with long-term stress, which can emerge as anxiety and depression. AIM To understand the effect of socio-demographic variables, reproductive trajectories, and lifestyle variables on stress, depression, and anxiety independently and to understand the relationship of psychological variables with each other among infertile and fertile women. METHODS This cross-sectional study recruited 500 women which included 250 primary infertile cases and 250 age-matched fertile controls of the age group 22-35 years. A pretested modified interview schedule was administered which included demographic variables, lifestyle variables, and reproductive trajectories. In addition, psychological tools like PSS, GAD-7, and PHQ-9 were used to collect the data pertaining to Stress, anxiety, and depression, respectively. Data analysis was performed with the statistical software version SPSS, IBM version 24. RESULTS Infertile women are more prone to various psychological disorder (stress, anxiety and depression). None of the demographic and lifestyle variables were associated with stress, anxiety, and depression among infertile women. Only reproductive trajectories were found to be causing stress, anxiety, and depression respectively among infertile women. In addition, stress is leading to both anxiety and depression among infertile women but only to depression in fertile women. CONCLUSION Infertile women should be counselled by medical experts regarding reproductive trajectories. Infertile couples should be guided and counselled to incorporate mental health screening and treatment in their routine check-up.
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Afshari P, Abedi P, Sarizadeh R, Maniati M. Evaluation of depression, stress, and anxiety among women with subfertility during the COVID‐19 pandemic: A cross‐sectional study in Ahvaz, Iran. Health Sci Rep 2023; 6:e967. [DOI: 10.1002/hsr2.967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 11/16/2022] [Accepted: 11/17/2022] [Indexed: 12/02/2022] Open
Affiliation(s)
- Poorandokht Afshari
- Midwifery Department, Reproductive Health Promotion Research Center Ahvaz Jundishapur University of Medical Sciences Ahvaz Iran
| | - Parvin Abedi
- Midwifery Department, Menopause Andropause Research Center Ahvaz Jundishapur University of Medical Sciences Ahvaz Iran
| | - Reihaneh Sarizadeh
- Midwifery Department, Reproductive Health Promotion Research Center Ahvaz Jundishapur University of Medical Sciences Ahvaz Iran
| | - Mahmoud Maniati
- Department of General Course, Reproductive Health Promotion Research Center Ahvaz Jundishapur University of Medical Sciences Ahvaz Iran
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Kiani Z, Simbar M, Hajian S, Zayeri F, RashidiFakari F, Chimeh FJ. Investigating different dimensions of infertile women's quality of life: a descriptive cross-sectional study. BMC Public Health 2022; 22:2436. [PMID: 36575427 PMCID: PMC9793385 DOI: 10.1186/s12889-022-14924-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 12/21/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Infertility is a major challenge in the life of women which affects their quality of life. Infertile women's quality of life is a relatively new field of research that has recently been considered by health researchers. However, there has been no standard tool for measuring different aspects of infertile women's quality of life with female factors, and general and specific tools of infertile couples have been used to assess their quality of life. This study, thus, aimed to analyze different aspects of the quality of life of infertile women. METHODS This descriptive cross-sectional study was conducted on 320 infertile women referred to a teaching hospital affiliated with Mazandaran University of Medical Sciences and private infertility treatment centers in Sari, Iran. Demographic and fertility characteristics and the quality of life questionnaire for infertile women questionnaire (a 25-item tool was designed which measured 7 factors of psychological effects, sexual life with infertility family and social effects, infertility-related concerns, physical effects, adaptive approaches and factors preventing infertility adaptation), were recruited for data gathering. Data were analyzed using SPSS version 22. Descriptive statistics (percentage, mean, standard deviation), correlation coefficient, independent sample t-test, and multiple linear regression were used. P-values less than 0.05 were considered statistically significant. RESULTS The total mean score of infertile women's quality of life was 65.68 ± 8.91%. Findings were indicative of infertile women's quality of life in the dimensions of adaptive approach (70.48 ± 15.02%), psychological (67.88 ± 12.06%), family and social (64.63 ± 10.76%), physical, 63.42 ± 11.36%), inhibitory factors/ factors preventing adaptation (60.98 ± 8.24%), related concerns (51.52 ± 10.21%) and sexual life (40.12 ± 14.28%). According to the final multiple linear regression model, women's education (B = 2.57, p < 0.001), spouse's education (B = 1.56, p = 0.046), economic status (B = 1.64, p < 0.001), age of women (B = -0.62, p < 0.001), age of spouse (B = -0.65, p < 0.001), duration of infertility (B = -0.36, p = 0.024) and duration of marriage (B = -0.39, p = 0.022) were the final predictors of the quality of life score in infertile women of the study. CONCLUSION Given that infertility causes extensive changes in individuals, families, and social dimensions of infertile women, it can affect their quality of life. We can take steps to improve the health of infertile women by promoting various dimensions of their quality of life.
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Affiliation(s)
- Zahra Kiani
- grid.411600.2Midwifery and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoumeh Simbar
- grid.411600.2Midwifery and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran ,grid.411600.2Midwifery and Reproductive Health Research Center, Department of Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sepideh Hajian
- grid.411600.2Department of Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farid Zayeri
- grid.411600.2Proteomics Research Center and Department of Biostatistics, Faculty of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzaneh RashidiFakari
- grid.464653.60000 0004 0459 3173Department of Midwifery, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Fatemeh Jalali Chimeh
- grid.411600.2Midwifery and Reproductive Health Research Center, Department of Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Bai J, Zheng J, Dong Y, Wang K, Cheng C, Jiang H. Psychological Distress, Dyadic Coping, and Quality of Life in Infertile Clients Undergoing Assisted Reproductive Technology in China: A Single-Center, Cross-Sectional Study. J Multidiscip Healthc 2022; 15:2715-2723. [DOI: 10.2147/jmdh.s393438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 11/22/2022] [Indexed: 11/30/2022] Open
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Associations between Stigma, Cognitive Appraisals, Coping Strategies and Stress Responses among Japanese Women Undergoing Infertility Treatment. Healthcare (Basel) 2022; 10:healthcare10101907. [PMID: 36292354 PMCID: PMC9601508 DOI: 10.3390/healthcare10101907] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/22/2022] [Accepted: 09/27/2022] [Indexed: 11/20/2022] Open
Abstract
The number of infertility treatment cycles in Japan is the highest worldwide. Studies have shown that stigma is a predictor of stress-related symptoms including anxiety and depression in women undergoing infertility treatment. Stress management to prevent stress-related symptoms may be crucial; however, few studies have examined the model of stigma and stress responses. Based on the stress-coping model, we hypothesized that stigma threatens the identity of such women and that coping failure increases stress responses. We aimed to explore the role of cognitive appraisals and coping strategies as mediators of the association between the stigma of infertility and stress responses. In December 2021, we conducted a cross-sectional study in Japan, in which 254 women undergoing infertility treatment completed a web-based survey. Hierarchical multiple regression analysis was conducted to analyze the associations between stigma, cognitive appraisals, coping strategies, and stress responses. The results showed that explanatory power increased with each additional variable in the following order: stigma, cognitive appraisals, and coping. Participants with a high level of stigma evaluated it as threatening, and used self-blame and venting coping strategies, and showed higher stress responses. Conversely, participants who used positive reframing coping strategies exhibited lower stress responses. Based on this, effective strategies to address stigma and stress responses are necessitated.
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Bahadori F, Jahanian Sadatmahalleh S, Montazeri A, Nasiri M. Sexuality and psychological well-being in different polycystic ovary syndrome phenotypes compared with healthy controls: a cross-sectional study. BMC Womens Health 2022; 22:390. [PMID: 36155624 PMCID: PMC9509607 DOI: 10.1186/s12905-022-01983-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 09/21/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Introduction
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. The present study aimed to compare the women with different PCOS phenotypes with the healty group in terms of sexual function, depression, anxiety and quality of life scale.
Materials and methods
The present cross-sectional study was carried out on 192 women with PCOS (classified on the basis of Rotterdam criteria into four categories) and 50 healthy controls. All participants were asked to fill out the valid and reliable questionnaires of FSFI (Female Sexual Function Index), HADS (Hospital Depression and Anxiety Scale) and SF-12.
Results
In the HADS questionnaire, phenotype B achieved the highest mean score in anxiety and depression domains, whereas, phenotype B had the lowest mean score in the FSFI and SF-12 quassionnaires. Furthermore, there was a significant difference between the women with PCOS phenotypes and the control grroup in arousal, lubrication, pain, and mean total score of FSFI (P < 0.05). In regression logistic analysis, age, infertility and depression were predictors of sexual dysfunction (P < 0.05).
Conclusion
The results indicated significant differences in terms of sexual dysfunction, depression, anxiety and quality of life in the women suffering from different phenotypes of PCOS compared with the healthy group. These results provide evidence that care and recommendations for improving women’s QoL and sexual function should be considered according to the relevant PCOS phenotypes.
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Performance of Marmoset Monkeys as Embryo Donors Is Reflected by Different Stress-Related Parameters. Animals (Basel) 2022; 12:ani12182414. [PMID: 36139275 PMCID: PMC9494952 DOI: 10.3390/ani12182414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/28/2022] [Accepted: 09/05/2022] [Indexed: 11/29/2022] Open
Abstract
Non-human primates (NHPs) serve as embryo donors for embryo collection in order to mimic genetic diseases in humans by genetic modification. Reproductive health of the embryo donors is crucial, and chronic distress needs to be avoided. Embryo retrieval rates (ERR), anti-Müllerian hormone (AMH) concentrations, cortisol levels, and body weight fluctuations were assessed as markers for fertility and distress. With regard to successful embryo retrievals (total n = 667), the animals were either used for extended periods (long-term group; LTG) or only for short periods (short-term group; STG). Retrospective evaluation expectedly showed that animals in the LTG had a higher ERR than animals in the STG (p < 0.0001). Importantly, ERR in the LTG remained stable throughout the experimental period, and high embryo rates were already encountered during the first year of experimental use (p = 0.0002). High ERR were associated with high AMH and low cortisol levels, and minimal body weight fluctuations following anesthesia, indicating a superior ability of the LTG animals to handle distress. We conclude that the long-term experimental use of marmosets does not impair their fertility or health status per se, supporting the view that animal reuse can be in accordance with the 3R-principle, implying reduction, replacement, and refinement in animal experimentation.
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Sun S, Lu J, Wang Y, Wang Y, Wu L, Zhu S, Zheng X, Lu X, Xu H. Gender differences in factors associated with the health literacy of hospitalized older patients with chronic diseases: A cross-sectional study. Front Public Health 2022; 10:944103. [PMID: 36033792 PMCID: PMC9399651 DOI: 10.3389/fpubh.2022.944103] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 07/27/2022] [Indexed: 01/21/2023] Open
Abstract
Background To identify gender differences in factors associated with the health literacy of hospitalized older patients with chronic diseases. Methods A total of 471 hospitalized older patients with chronic diseases in four hospitals were investigated from May 2019 to June 2020. The self-developed demographic information questionnaire, the "Health Literacy Scale for Patients with Chronic Diseases" and the "Self-Efficacy for Managing Chronic Diseases 6-item Scale" were applied in this study. Multiple linear regression was used to assess the factors influencing health literacy among older patients with chronic diseases by gender. Results The factors influencing health literacy differed by gender. Male health literacy was related to education background, number of children, monthly income, duration of chronic disease and chronic disease self-efficacy. For females, health literacy was associated with age, education background, monthly income, duration of chronic disease and chronic disease treatment. Conclusion Healthcare providers should focus on the above-mentioned factors that could help identify those with low health literacy differ base on gender. Gender-specific strategies should be developed to improve the health literacy of older patients with chronic diseases and strengthen their chronic disease management.
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Affiliation(s)
- Shuting Sun
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Jinjin Lu
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Yawen Wang
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Ya Wang
- Intensive Care Unit, The First Affiliated Hospital of Zhejiang University, Hangzhou, China
| | - Lihao Wu
- School of Foreign Language Studies, Wenzhou Medical University, Wenzhou, China
| | - Saiqiong Zhu
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Xiuyun Zheng
- Respiratory Department, The Affiliated Hospital of Wenzhou Medical University, Wenzhou, China,*Correspondence: Xiuyun Zheng
| | - Xueqin Lu
- Respiratory Department, The Affiliated Hospital of Wenzhou Medical University, Wenzhou, China,Endocrinology Department, The Affiliated Hospital of Wenzhou Medical University, Wenzhou, China,Xueqin Lu
| | - Hongbo Xu
- School of Nursing, Wenzhou Medical University, Wenzhou, China,Hongbo Xu
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Zhang S, Tang HH, Zhou ML. Impact of prolonged one or more natural menstrual cycles on the outcomes of ovulation induction intrauterine artificial insemination pregnancy: a single-centre, retrospective study in China. BMJ Open 2022; 12:e061043. [PMID: 35725260 PMCID: PMC9214352 DOI: 10.1136/bmjopen-2022-061043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES We determined if the time interval between two ovulation induction intrauterine artificial insemination (IUI) treatment cycles should be extended by one or more natural menstrual cycles in patients undergoing successive cycles of ovulation stimulation, and whether this affects clinical pregnancy rate (CPR). DESIGN This study was conducted on infertility patients treated under the ovulation induction programme IUI in a large reproductive centre in China. Study participants were assigned into continuous and discontinuous groups. Differences in baseline clinical pregnancy and abortion rates were compared between the groups. A multivariate logistic model was used to evaluate the effects of time interval on clinical pregnancy outcomes. SETTING Reproductive Centre of Maternal and Child Health Hospital of Lianyungang city. INTERVENTIONS None. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome measure was CPR, the secondary outcome measure was the abortion rate. RESULTS A total of 550 IUI treatment cycles involving 275 couples were included in this study. Differences in CPR and abortion rate between the groups were not significant (20.5% vs 21.9% and 27.8% vs 22.0%, p≥0.05). Stratified analyses based on infertility factors did not reveal any significant differences in pregnancy and abortion rates between the groups (p≥0.05). Multivariate analysis showed that increased endometrial thickness correlates with CPR (OR 1.205, 95% CI 1.05 to 1.384, p=0.008). Compared with primary infertility, secondary infertility significantly correlated with improved CPR (OR 2.637, 95% CI 1.313 to 5.298, p=0.006). The effects of time interval between the first two ovulation induction IUI treatment cycles on clinical pregnancy were not significant (OR 1.007, 95% CI 0.513 to 1.974, p=0.985). CONCLUSIONS Longer time intervals between the first two ovulation induction IUI treatment cycles did not significantly improve CPR. Therefore, in the absence of clear clinical indications, it may not be necessary to deliberately prolong the interval between two ovulation induction IUI treatment cycles.
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Affiliation(s)
- Shuai Zhang
- Clinical Center of Reproductive Medicine, Lianyungang Maternal and Child Health Hospital, Lianyungang, Jiangsu, China
| | - Han-Han Tang
- Graduate School of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Ming-Lian Zhou
- Clinical Center of Reproductive Medicine, Lianyungang Maternal and Child Health Hospital, Lianyungang, Jiangsu, China
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Tokgoz VY, Kaya Y, Tekin AB. The level of anxiety in infertile women whose ART cycles are postponed due to the COVID-19 outbreak. J Psychosom Obstet Gynaecol 2022; 43:114-121. [PMID: 32812477 DOI: 10.1080/0167482x.2020.1806819] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
AIM This study evaluated the level of fear and anxiety related to the COVID-19 outbreak, in infertile women whose ART cycles were delayed due to the pandemic. MATERIALS AND METHODS An online survey was sent to women whose ART cycles were postponed due to the COVID-19 outbreak between April and May 2020. The study population were 101 participants. The main outcome measure is to determine the levels of fear and anxiety in infertile women by using the Spielberger State-Trait Anxiety Inventory (STAI-T and STAI-S) and Fear of COVID-19 scale (FCV-19S). The relationship of the COVID-19 outbreak with the willingness to go ahead with the desire for pregnancy was also assessed. RESULTS The state-anxiety levels were significantly higher in women above 35 years (45.0 ± 5.2 vs. 42.2 ± 4.5, p = 0.006). Women with diminished ovarian reserve had a higher state-anxiety compared to other causes, but were not found to be significant (44.7 ± 5.2 vs. 42.5 ± 5.0, p = 0.173). Women who thought that the possibility of not being able to get pregnant was more important than being infected with the COVID-19 had higher anxiety levels than women who thought just the opposite. The diminished ovarian reserve and high duration of infertility were found to be significantly associated with higher anxiety levels (OR = 2.5, p < 0.05). The diminished ovarian reserve and previous ART failure significantly predicted the presence of clinical state-anxiety. CONCLUSION The state-anxiety was found to be higher in women whose cycles were postponed due to the outbreak and the presence of diminished ovarian reserve also significantly affected anxiety levels. Further research is needed to assess whether COVID-19 will have any impact on ART treatments in the next few years.
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Affiliation(s)
- Vehbi Yavuz Tokgoz
- Department of Obstetrics and Gynecology, Eskisehir Osmangazi University, Faculty of Medicine, Eskisehir, Turkey
| | - Yeliz Kaya
- Department Obstetric And Women's Disease Nursing, Eskisehir Osmangazi University, Faculty of Health Sciences, Eskisehir, Turkey
| | - Ahmet Basar Tekin
- Department of Obstetrics and Gynecology, Eskisehir Osmangazi University, Faculty of Medicine, Eskisehir, Turkey
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Impact of Stress and Financials on Romanian Infertile Women Accessing Assisted Reproductive Treatment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063256. [PMID: 35328944 PMCID: PMC8948966 DOI: 10.3390/ijerph19063256] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 02/25/2022] [Accepted: 03/08/2022] [Indexed: 11/17/2022]
Abstract
Around 20% of couples worldwide are affected by infertility issues, with numbers in the European Union reaching as high as 25%, while access to reproductive care varies significantly by geopolitical and country-specific variables. The purpose of this research is to shed light on the unique social, psychological, and financial difficulties faced by Romanian couples seeking access to assisted reproductive therapy (ART). A cross-sectional study was conducted between 2017 and 2019 to involve women who accessed ART at fertility clinics in Romania by completing two infertility surveys. We analyzed the data in terms of all facets of infertility and ART, including the effect of personal background and stress levels on succeeding to conceive, the impact of treatment costs, and household income. A total of 829 participants completed the survey. We observed that high stress exposure leads to a substantially higher duration to conceive using ART, although the proportions of successful pregnancies did not differ between low-stress and high-stress groups. A significantly higher number of couples achieved pregnancy when their monthly household income was higher than EUR 1000 and if the ART method was more expensive. Additionally, we observed that advanced age, high stress levels, and the high cost of ART had a negative association with achieving pregnancy using ART. The findings indicated that Romanian couples experiencing infertility must contend with significant expenses for specialist infertility treatments, as well as treatment-related stress, both of which have a detrimental effect on their odds of attaining conception.
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Mokhtari F, Torabi F, Pirhadi M. Relationship between fertility characteristics with spiritual intelligence and resilience in infertile couples. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:44. [PMID: 35372623 PMCID: PMC8975001 DOI: 10.4103/jehp.jehp_97_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 05/29/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Infertility and the use of assisted reproductive therapies affect infertile couples quality of life. Infertile couples face many physical, psychological, and financial challenges due to having a higher level of spiritual intelligence and resilience will help the infertile couple to adapt to infertility conditions and achieve their therapeutic goals. This study was aimed to determine the relationship between fertility characteristics and spiritual intelligence and resilience in infertile couples. MATERIALS AND METHODS This was a cross-sectional study that was conducted in 2020 on 162 infertile couples referring to infertility centers in Isfahan who met the inclusion criteria. Samples were selected by convenience sampling method. Information was gathered using a questionnaire consists of three parts: demographic and fertility characteristics, spiritual intelligence, and resilience. Data were analyzed using descriptive and inferential statistical methods (t-test, Pearson's correlation coefficient, and Chi-square). P < 0.05 was considered statistically significant. RESULTS Pearson's correlation coefficient showed that there was no significant relationship between resilience score and spiritual intelligence score with age, duration of marriage, and duration of treatment (P > 0.05). There was no significant relationship between resilience score and spiritual intelligence score and its dimensions with the level of education and economic status of the family (P > 0.05). CONCLUSIONS There was no significant relationship between demographic and fertility factors with spiritual intelligence and resilience.
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Affiliation(s)
- Fatemeh Mokhtari
- Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Torabi
- Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoume Pirhadi
- Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Casu G, Zaia V, Montagna E, de Padua Serafim A, Bianco B, Barbosa CP, Gremigni P. The Infertility-Related Stress Scale: Validation of a Brazilian-Portuguese Version and Measurement Invariance Across Brazil and Italy. Front Psychol 2022; 12:784222. [PMID: 35095671 PMCID: PMC8792459 DOI: 10.3389/fpsyg.2021.784222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 12/24/2021] [Indexed: 12/28/2022] Open
Abstract
Infertility constitutes an essential source of stress in the individual and couple’s life. The Infertility-Related Stress Scale (IRSS) is of clinical interest for exploring infertility-related stress affecting the intrapersonal and interpersonal domains of infertile individuals’ lives. In the present study, the IRSS was translated into Brazilian–Portuguese, and its factor structure, reliability, and relations to sociodemographic and infertility-related characteristics and depression were examined. A sample of 553 Brazilian infertile individuals (54.2% female, mean aged 36 ± 6 years) completed the Brazilian–Portuguese IRSS (IRSS-BP), and a subsample of 222 participants also completed the BDI-II. A sample of 526 Italian infertile individuals (54.2% female, mean aged 38 ± 6 years) was used to test for the IRSS measurement invariance across Brazil and Italy. Results of exploratory structural equation modeling (ESEM) indicated that a bifactor solution best represented the structure underlying the IRSS-BP. Both the general and the two specific intrapersonal and interpersonal IRSS-BP factors showed satisfactory levels of composite reliability. The bifactor ESEM solution replicated well across countries. As evidence of relations to other variables, female gender, a longer duration of infertility, and higher depression were associated with higher scores in global and domain-specific infertility-related stress. The findings offer initial evidence of validity and reliability of the IRSS-BP, which could be used by fertility clinic staff to rapidly identify patients who need support to deal with the stressful impact of infertility in the intrapersonal and interpersonal life domains, as recommended by international guidelines for routine psychosocial care in infertility settings.
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Affiliation(s)
- Giulia Casu
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Victor Zaia
- Postgraduate Program in Health Sciences, Centro Universitário FMABC, Santo André, Brazil.,Ideia Fértil Institute of Reproductive Health, Centro Universitário FMABC, Santo André, Brazil
| | - Erik Montagna
- Postgraduate Program in Health Sciences, Centro Universitário FMABC, Santo André, Brazil
| | - Antonio de Padua Serafim
- Neuropsychology Unit, Department and Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil.,Department of Psychology, Methodist University of São Paulo, São Bernardo do Campo, Brazil
| | - Bianca Bianco
- Postgraduate Program in Health Sciences, Centro Universitário FMABC, Santo André, Brazil.,Ideia Fértil Institute of Reproductive Health, Centro Universitário FMABC, Santo André, Brazil
| | - Caio Parente Barbosa
- Postgraduate Program in Health Sciences, Centro Universitário FMABC, Santo André, Brazil.,Ideia Fértil Institute of Reproductive Health, Centro Universitário FMABC, Santo André, Brazil
| | - Paola Gremigni
- Department of Psychology, University of Bologna, Bologna, Italy
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Di Guardo F, Palumbo M. Immersive virtual reality as tool to reduce anxiety during embryo transfer. J OBSTET GYNAECOL 2022; 42:802-808. [PMID: 34985372 DOI: 10.1080/01443615.2021.1995855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The use of Virtual Reality (VR) has gained wide acceptance in several scientific fields. It represents an innovative technological tool providing the experience to be immersed in a non-physical world putting on head-mounted displays that surround the users with images and sounds. To date, VR has been mainly employed in the healthcare sector for educational aims, in order to provide the learners with a new method of delivering simulations. However, its application to real clinical practice has recently generated beneficial effects for patients, especially for those who experience symptoms of psychological burden. Infertile couples often struggle with anxiety and depression which have a strong impact on life quality. Furthermore, the perspective to undergo long treatments with uncertain results and an history of failed attempts may contribute to enhance patients' negative feelings during In Vitro Fertilization (IVF) cycles until Embryo Transfer (ET). The role of VR in reducing pain and anxiety during outpatient hysteroscopy, hysterosalpingography and oocytes retrieval, has been recently investigated with satisfactory results in terms of reducing pain and anxiety levels. However, to date, inconclusive outcomes have been reported on pregnancy rate. Our study would discuss the existent literature on VR applied to current medical practice and infertility, proposing its beneficial impact on women anxiety during IVF cycle with ET.
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Affiliation(s)
- Federica Di Guardo
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - Marco Palumbo
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
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Ni Y, Huang L, Zhang E, Xu L, Tong C, Qian W, Zhang A, Fang Q. Psychosocial correlates of fertility-related quality of life among infertile women with repeated implantation failure: The mediating role of resilience. Front Psychiatry 2022; 13:1019922. [PMID: 36440419 PMCID: PMC9691643 DOI: 10.3389/fpsyt.2022.1019922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 10/31/2022] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE This study aimed to examine associations between psychosocial factors and fertility-related quality of life (FertiQoL) among infertile women with repeated implantation failure (RIF), and to identify the possible role of resilience in mediating the effect of social support on FertiQoL. MATERIALS AND METHODS A cross-sectional study was conducted with 234 infertile women with RIF in total. Fertility quality of life scale (FertiQoL), perceived social support scale (PSSS), and Connor-Davidson Resilience Scale (CD-RISC) were used to evaluate the patients. Data were described by univariate and multivariate analyses. Stepwise regression method was performed to analyse the mediating effect of resilience. RESULTS Social support had a positive predictive effect on FertiQoL (β = 0.757, P < 0.001), also positive on resilience (β = 0.847, P < 0.001). After both variables were added to the regression equation, resilience was found to have a significant positive predictive effect on FertiQoL (β = 0.798, P < 0.001), while the predictive effect of social support on FertiQoL was no longer significant (β = 0.081, P > 0.05). The results indicated that resilience played a complete mediating role between social support and FertiQoL. CONCLUSION This study preliminarily verified the mediating role of resilience between social support and FertiQoL among infertile women with RIF. Interventions that consider enhancing resilience and building social support will likely improve their FertiQoL.
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Affiliation(s)
- Ying Ni
- Department of Gynecology and Obstetrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Reproductive Medical Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Limin Huang
- Department of Gynecology and Obstetrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Reproductive Medical Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Enming Zhang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Lianying Xu
- Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chenye Tong
- Reproductive Medical Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wen Qian
- Reproductive Medical Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Aijun Zhang
- Department of Gynecology and Obstetrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Reproductive Medical Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiong Fang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
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Mahoney DE, Russell CL. Women's Reports of Barriers to and Facilitators of Oral Medication Adherence During Ovarian Stimulation: A Mixed Methods Pilot Study. J Reprod Infertil 2021; 22:184-200. [PMID: 34900639 PMCID: PMC8607872 DOI: 10.18502/jri.v22i3.6719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 08/03/2020] [Indexed: 11/24/2022] Open
Abstract
Background: Adherence to lifestyle modification recommendations remains problematic for women undergoing fertility treatment, raising concerns about the extent to which women adhere to prescribed medication regimens. Limited data have shown suboptimal oral medication adherence rates of 19% to 74%. The objective of this study was to explore what women perceive as barriers to and facilitators of oral medication adherence during fertility treatment cycles. Methods: An exploratory mixed methods pilot study was conducted among a sample of 30 women who were actively taking one to two cycles of letrozole or clomiphene citrate for ovarian stimulation in conjunction with intrauterine insemination cycles. Medication adherence barriers were measured using a 20-item survey. Medication adherence facilitators and personal experiences with fertility treatment were assessed with structured interviews. Medication adherence was assessed with electronic event monitoring. Results: The overall medication adherence median was 0.97 with a range of 0.75 to 1.00, and nine women (50%) demonstrated perfect adherence. The most commonly reported barriers were recently feeling sad, down, or blue (53%), and taking medication more than once per day (40%). Women with higher barrier scores had significantly lower medication adherence scores (p=0.02) compared to women with lower total barrier scores. Facilitators included using physical aides as reminders (60%) and establishing a daily routine (50%). No significant correlation was found between medication adherence scores and facilitators. Conclusion: The dynamic interplay between perceived barriers and facilitators and women’s medication-taking patterns could influence whether or not medication regimens are followed correctly.
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Affiliation(s)
- Diane E Mahoney
- School of Nursing, University of Kansas Medical Center, Kansas, US
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Yüksekol ÖD, Baltaci N, Yilmaz AN, Ulucan M. Perception of genital self-image, sexual quality of life and marital adjustment in infertile women. SEXUAL AND RELATIONSHIP THERAPY 2021. [DOI: 10.1080/14681994.2021.1998422] [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: 10/19/2022]
Affiliation(s)
- Özlem Doğan Yüksekol
- Department of Midwifery, Faculty of Health Sciences, Firat University, Elazig, Turkey
| | - Nazli Baltaci
- Department of Nursing, Faculty of Health Sciences, Ondokuz Mayis University, Samsun, Turkey
| | - Ayşe Nur Yilmaz
- Department of Midwifery, Faculty of Health Sciences, Firat University, Elazig, Turkey
| | - Mihriban Ulucan
- Department of Midwifery, Faculty of Health Sciences, Firat University, Elazig, Turkey
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Zaami S, Driul L, Sansone M, Scatena E, Andersson KL, Marinelli E. ART Innovations: Fostering Women's Psychophysical Health between Bioethics Precepts and Human Rights. Healthcare (Basel) 2021; 9:healthcare9111486. [PMID: 34828532 PMCID: PMC8623993 DOI: 10.3390/healthcare9111486] [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: 09/25/2021] [Revised: 10/28/2021] [Accepted: 10/29/2021] [Indexed: 12/02/2022] Open
Abstract
Infertility is a highly relevant global issue affecting the reproductive health of at least 15% of reproductive-aged couples worldwide. The scope and severity of the infertility problem is even more prevalent in developing countries, mostly due to untreated reproductive tract infections (RTIs). Infertility, however, goes beyond the mere inability to procreate, but brings about profound psychological, social, and ethical implications of enormous magnitude. In vitro fertilization (IVF) and other assisted reproduction technologies (ARTs) have gradually become widespread therapeutic options. After all, the implementation of medically assisted reproductive procedures in order to overcome infertility is in keeping with the tenets of the reproductive rights agenda laid out at the International Conference on Population and Development (ICPD) in Cairo in 1994. Nonetheless, concerns still linger about how to implement and regulate such interventions in an ethically tenable fashion. The unremitting pace at which such techniques develop have upset the very notion of sexuality relating to reproduction as well as the concept of family itself. That rift risks causing a crisis in terms of bioethics sustainability and enforcement, which is bound to happen when science and innovation outpace the bioethical precepts on which we rely for essential guidance in medical practice. The authors argue in favor of an approach to regulation and policy-making that puts on the forefront a thorough assessment as to potential risks that such interventions might entail for foundational bioethics principles and inalienable human rights.
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Affiliation(s)
- Simona Zaami
- Department of Anatomical, Histological, Medicolegal and Orthopedic Sciences, Sapienza University of Rome, 00161 Rome, Italy;
- Correspondence:
| | - Lorenza Driul
- Clinic of Obstetrics and Gynecology, Hospital of Udine, DAME, University of Udine, 33100 Udine, Italy;
| | - Milena Sansone
- Department of Obstetrics and Gynecology, Sant’Eugenio Hospital, 00144 Rome, Italy;
| | - Elisa Scatena
- Department of Gynecology and Obstetrics, Santo Stefano Hospital, 59100 Prato, Italy;
| | - Karin Louise Andersson
- Department of Territory Health, Azienda Sanitaria Toscana Centro, 50012 Florence, Italy;
| | - Enrico Marinelli
- Department of Anatomical, Histological, Medicolegal and Orthopedic Sciences, Sapienza University of Rome, 00161 Rome, Italy;
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Mitrović M, Kostić JO, Ristić M. Intolerance of uncertainty and distress in women with delayed IVF treatment due to the COVID-19 pandemic: The mediating role of situation appraisal and coping strategies. J Health Psychol 2021; 27:2515-2528. [PMID: 34670414 DOI: 10.1177/13591053211049950] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The COVID-19 pandemic has caused delays of numerous medical procedures, including IVF. This study investigates the relationship between Intolerance of Uncertainty (IU), situation appraisal-the perceived threat that COVID-19 poses for infertility treatment, coping strategies, and general distress among women with a delayed IVF procedure. SEM showed that situation appraisal is a partial mediator of the relationship between IU and avoidance, as well as the relationship between IU and general distress. The connection between situation appraisal and general distress is partially mediated by avoidance. In this challenging context for mental health, situation appraisal and coping strategies determine the level of distress, where IU, as a dispositional variable, represents the main determinant of the entire reaction.
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Affiliation(s)
| | | | - Milica Ristić
- Pedagogical Faculty in Vranje, University of Nis, Serbia
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45
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Ozturk A, Aba YA, Sik BA. The relationship between stigma, perceived social support and depression in infertile Turkish women undergoing in vitro fertilization-embryo transfer. Arch Psychiatr Nurs 2021; 35:434-440. [PMID: 34561056 DOI: 10.1016/j.apnu.2021.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 06/03/2020] [Accepted: 05/02/2021] [Indexed: 10/21/2022]
Abstract
This study was conducted to determine the relationship between the perceived social support, stigmatization and depression in infertile women and the influencing factors. The study was conducted on 298 infertile women at a private hospital between March and September 2019 using a Personal Information Questionnaire, Infertility Stigma Scale (ISS), Beck Depression Inventory (BDI), and Multidimensional Scale of Perceived Social Support (MSPSS). BDI had a significantly positive correlation with ISS and negative correlation with MSPSS. And MSPSS had a significantly negative correlation with ISS. Infertility leads women to suffer various psychosocial problems. Nurses should be aware of these problems during diagnostic procedures for infertility treatment, which should also include psychiatric counseling.
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Affiliation(s)
- Ayfer Ozturk
- Department of Psychiatric Mental Health Nursing, Faculty of Health Science, Bartın University, Turkey
| | - Yılda Arzu Aba
- Bandırma Onyedi Eylül University, Faculty of Health Sciences, Department of Nursing, Turkey.
| | - Bulat Aytek Sik
- Istanbul Aydin University, Faculty of Medicine, Department of Obstetrics and Gynecology, Turkey
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Gui W, Yang X, Jiang H, Wu H, Zeng M, Wen Y, Qiu T, Zhang Y, Ma Z, Tong C, Luo L, Zhao Y, Wang L. Prevalence of anxiety and its associated factors among infertile patients after 'two-child' policy in Chongqing, China: a cross-sectional study. Reprod Health 2021; 18:193. [PMID: 34593017 PMCID: PMC8482576 DOI: 10.1186/s12978-021-01140-9] [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: 01/07/2020] [Accepted: 04/14/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND With the prevalence of infertility increasing every year around the world, it has seriously impacted the individual quality of family and social life. Anxiety is one of the most prevalent anxiety disorders among infertile patients. After the two-child policy, whether it affected the prevalence of anxiety is controversial. This study aimed to determine the prevalence of anxiety and its potential risk factors among Chinese infertile women after the enforcement of 'two-child policy'. METHODS This cross-sectional study included 693 infertile patients in a reproductive medical center in Chongqing, China, between February 2016 and December 2018. Data was collected by Self-filling questionnaires including basic demographic information and the Generalized Anxiety Disorder-7 (GAD-7). SPSS statistical software (IBM SPSS version 25) was used to analyse the obtained data. Descriptive analysis was used to describe basic information and anxiety scores, the chi-square test and binary logistic regression were used to analyse the relationship between anxiety and other variables. RESULTS The prevalence of anxiety among total infertile patients was 21.8%, and its 23.5% among first-child infertile patients (FI), and 18.4% among second-child infertile patients (SI) respectively (P > 0.05). Binary logistic regression showed that patients with lower education levels were more likely to have anxiety (P < 0.01). Patients with middle salary incomes were more likely to have anxiety (OR = 1.860, 95% CI: 1.068-3.238). Oral contraception taking history (OR = 1.778, 95% CI: 1.186-2.667), and history of allergy (OR = 2.098, 95% CI: 1.219-3.612) were associated with anxiety. CONCLUSIONS Under the full liberalization of the "two-child policy", the total prevalence of anxiety among Chinese infertile female is comparatively high. Low education levels, middle incomes, oral contraception taking and allergy history can be the related risk factors of anxiety. We promote that all infertile patients should be evaluated for the prevalence of anxiety, especially those with potential risks, and receive consultant or targeted treatment when needed.
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Affiliation(s)
- Wenwu Gui
- Department of Reproductive Center, The First Affiliated Hospital of Chongqing Medical University, Youyi Road, Yuzhong, Chongqing, China
| | - Xi Yang
- Department of Reproductive Center, The First Affiliated Hospital of Chongqing Medical University, Youyi Road, Yuzhong, Chongqing, China
| | - Huimin Jiang
- Department of Reproductive Center, The First Affiliated Hospital of Chongqing Medical University, Youyi Road, Yuzhong, Chongqing, China
| | - Hongwen Wu
- Department of Reproductive Center, The First Affiliated Hospital of Chongqing Medical University, Youyi Road, Yuzhong, Chongqing, China
| | - Mao Zeng
- School of Public Health and Management, Chongqing Medical University, Yixueyuan Road, Yuzhong, Chongqing, 400016, China.,Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, 400016, China.,The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, 400016, China
| | - Yidi Wen
- Department of Reproductive Center, The First Affiliated Hospital of Chongqing Medical University, Youyi Road, Yuzhong, Chongqing, China
| | - Tian Qiu
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Yong Zhang
- School of Public Health and Management, Chongqing Medical University, Yixueyuan Road, Yuzhong, Chongqing, 400016, China.,Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, 400016, China.,The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, 400016, China
| | - Zhi Ma
- Department of Reproductive Center, The First Affiliated Hospital of Chongqing Medical University, Youyi Road, Yuzhong, Chongqing, China
| | - Chao Tong
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.,Canada-China-New Zealand Joint Laboratory of Maternal and Fetal Medicine, Chongqing Medical University, Chongqing, 400016, China
| | - Li Luo
- School of Public Health and Management, Chongqing Medical University, Yixueyuan Road, Yuzhong, Chongqing, 400016, China.,Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, 400016, China.,The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, 400016, China
| | - Yong Zhao
- School of Public Health and Management, Chongqing Medical University, Yixueyuan Road, Yuzhong, Chongqing, 400016, China. .,Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, 400016, China. .,The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, 400016, China.
| | - Lianlian Wang
- Department of Reproductive Center, The First Affiliated Hospital of Chongqing Medical University, Youyi Road, Yuzhong, Chongqing, China. .,Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
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Comparison of various aspects of women's lives between infertile and women with and without tubal ligation: a comparative cross-sectional study. BMC WOMENS HEALTH 2021; 21:318. [PMID: 34454492 PMCID: PMC8403402 DOI: 10.1186/s12905-021-01454-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 08/19/2021] [Indexed: 11/23/2022]
Abstract
Background The aim of this study is to compare anxiety, depression, body image, self-esteem, sexual function, and quality of life (QoL) between infertile women and control fertile women undergoing tubal ligation (TL) and using condom. Methods This cross-sectional study was conducted on 600 women in three groups of infertile and control fertile women with or without TL (200 women in each group), who met the inclusion criteria. They were selected from Royan Institute and a number of health care centers in Tehran (Iran) from May 2017 to February 2019. The subjects were asked to fill out the Short Form Health Survey (SF-12), Female Sexual Function Index (FSFI), Hospital Anxiety and Depression Scale (HADS), Body Image Concern Inventory (BICI), and Rosenberg’ Self-Esteem Scale (RSES). One-way ANOVA was used to identify the possible statistical differences between the three groups of participants. Results The mean scores of all FSFI domains were lower in the control TL women, and the differences between the three groups in all dimensions were statistically significant. In addition, the TL group had more female sexual dysfunction (FSD) comparing to the infertile and condom group (22.43 ± 5.30, 24.79 ± 4.74, and 28.03 ± 3.29, respectively P < 0.001). There was a significant difference between the three groups in SF-12 scores (76.59 ± 13.14, 68.49 ± 14.47, and 78.87 ± 12.62, respectively P < 0.001). Also there was a significant difference between the three groups in anxiety, depression, and total scores of HADS (P < 0.001). Furthermore, infertile women had lower body image (P < 0.05) and the TL group had lower self-esteem comparing to the two other groups (P < 0.05). Conclusions The findings revealed the adverse effects of using TL on the anxiety, depression, sexual life, body image, and QoL of women. It is recommended that health-care professionals should increase their awareness and knowledge regarding the side-effects of using TL on women’s lives and share this information with the patients.
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Zurlo MC, Cattaneo Della Volta MF, Vallone F. Infertility-Related Stress and Psychological Health Outcomes in Infertile Couples Undergoing Medical Treatments: Testing a Multi-dimensional Model. J Clin Psychol Med Settings 2021; 27:662-676. [PMID: 31471847 DOI: 10.1007/s10880-019-09653-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The study aims to propose and test a multi-dimensional infertility-related stress model including socio-demographic and fertility-related characteristics, infertility-related stress dimensions, coping strategies and couple's dyadic adjustment dimensions as predictors of anxiety and depression among partners of couples undergoing infertility treatments. Both members of 250 infertile couples filled out a questionnaire consisting of Socio-demographics (Age; Educational level; Employment status), Fertility-related characteristics (Type of diagnosis; Duration of infertility), Fertility Problem Inventory-Short Form, Coping Orientations to Problem Experienced-New Italian Version, Dyadic Adjustment Scale, State-Trait Anxiety Inventory-Y and Edinburgh Depression Scale. Hierarchical Multiple Linear Regressions indicated that the proposed predictive models for anxiety and depression were significant and had good levels of fit with the data. Gender differences emerged in predictor variables. Findings provide valid predictive models that could be adopted to assess psychological health in infertile patients and to develop evidence-based and tailored counselling interventions at centres for assisted reproduction.
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Affiliation(s)
- Maria Clelia Zurlo
- Department of Political Sciences, University of Naples Federico II, Via L. Rodinò 22, 80138, Naples, Italy.
| | | | - Federica Vallone
- Department of Humanities, University of Naples Federico II, Naples, Italy
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Petre LM, Gemescu M, Bulgari D. Using artistic activities within experiential psychotherapy to alleviate the psychological consequences of female infertility. ARTS IN PSYCHOTHERAPY 2021. [DOI: 10.1016/j.aip.2021.101758] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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The prevalence of depression symptoms among infertile women: a systematic review and meta-analysis. FERTILITY RESEARCH AND PRACTICE 2021; 7:6. [PMID: 33663615 PMCID: PMC7931512 DOI: 10.1186/s40738-021-00098-3] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 02/21/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Infertile women's mental health problems, including depression, are key fertility health issues that affect infertile women more severely than infertile men. Depression may threaten the health of individuals and reduce the quality of their lives. Considering the role and impact of depression on responses to infertility treatments, a systematic review and meta-analysis were conducted to investigate the prevalence of depression symptoms among infertile women. METHODS International databases (PubMed, Cochrane Library, Web of Sciences, Scopus, Embase, and PsycINFO), national databases (SID and Magiran), and Google Scholar were searched by two independent reviewers for articles published from 2000 to April 5, 2020. The search procedure was performed in both Persian and English using keywords such as "depression," "disorders," "infertility," "prevalence," and "epidemiology." The articles were evaluated in terms of their titles, abstracts, and full texts. The reviewers evaluated the quality of the articles using the Newcastle-Ottawa Scale, after which they analyzed the findings using STATA version 14. The I2 and Egger's tests were performed to examine heterogeneity and publication bias, respectively. RESULTS Thirty-two articles were subjected to the meta-analysis, and a random effects model was used in the examination given the heterogeneity of the articles. The samples in the reviewed studies encompassed a total of 9679 infertile women. The lowest and highest pooled prevalence rates were 21.01% (95% confidence interval [CI]: 15.61-34.42), as determined using the Hospital Anxiety and Depression Scale, and 52.21% (95% CI: 43.51-60.91), as ascertained using the Beck Depression Inventory, respectively. The pooled prevalence values of depression among infertile women were 44.32% (95% CI: 35.65-52.99) in low- and middle-income countries and 28.03% (95% CI: 19.61-36.44) in high-income countries. CONCLUSION The prevalence of depression among infertile women was higher than that among the general population of a given country. Especially in low- and middle-income countries, appropriate measures, planning, and policy that target the negative effects of depression on infertile women's lives should be established to reduce related problems.
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