A review of the psychometric properties and implications for the use of the fertility quality of life tool

Dysmenorrhea and Its Impact on Patients' Quality of Life-A Cross-Sectional Study

Background: Dysmenorrhea is a common condition that may have negative effects on social life, couples' relationships and professional activities. The objectives of this study were to evaluate the prevalence, risk factors and characteristics of dysmenorrhea and its impact on patients' quality of life using a specific self-questionnaire named "DysmenQoL questionnaire". We also checked the validity and reliability of this questionnaire in our population. Methods: We conducted a cross-sectional study that included 504 participants of reproductive age between 18 and 45 years of age. The data were collected with an original form divided into three sections. The last section (DysmenQoL questionnaire) included 20 statements scored from 1 ("never") to 5 ("every time") that evaluates the effects of menstrual pain on health and feelings, daily activities, relationships and professional activity. We calculated the sum of the scores for each statement and we called it the "DysmenQoL score". Results: The prevalence of dysmenorrhea was 83.7%. The presence of dysmenorrhea was statistically significant associated with the degree of menstrual bleeding (p = 0.017), the presence of infertility (p = 0.034) and dyspareunia (p = 0.002), but also with the presence of premenstrual syndrome and a family history of dysmenorrhea (p < 0.001). Among the participants with dysmenorrhea, 73.9% considered that this symptom affected their quality of life, and this was correlated with pain intensity and the DysmenQoL score (p < 0.001). A significant difference regarding the DysmenQoL score depending on the pain intensity, frequency and duration of dysmenorrhea and the methods used to reduce the pain was observed. Conclusions: Dysmenorrhea had a high prevalence among the participants included in the study, and its presence was associated with a series of risk factors. Most women considered that dysmenorrhea affected their quality of life. The DysmenQoL questionnaire proved to be a reliable and valid method for evaluating the impact of dysmenorrhea on quality of life.

Enhancing cultural sensitivity in the implementation of the Fertility Quality of Life Tool in Sudan: a science diplomacy perspective

Background

Infertility is a global health challenge impacting quality of life, particularly in low and middle-income countries such as Sudan. The Fertility Quality of Life (FertiQoL) tool, a standardized questionnaire, is pivotal in assessing fertility-related quality of life. However, existing research on its utility has primarily been conducted in Global North and High-Income Countries, highlighting the need to shift away from neocolonialism to promote truly inclusive research and effective healthcare practices. Science diplomacy, through the adaptation and culturally sensitive implementation of research tools, can serve as a catalyst for addressing health disparities on a global scale. This study aims to assess methodological and cultural considerations that impact the implementation of the FertiQoL tool in Sudan, framed within the context of science diplomacy and neocolonialism. By investigating the challenges and opportunities of utilizing this tool in a non-Western cultural setting, we seek to contribute to the broader discussion on decolonizing global health research.

Methods

Utilizing an explanatory sequential design involving surveys and interviews, we conducted a study in a Sudanese fertility clinic from November 2017 to May 2018. A total of 102 participants were recruited using convenience sampling, providing socio-demographic, medical, and reproductive history data. The Arabic version of FertiQoL was administered, with 20 participants interviewed and 82 surveyed (40 self-administered and 42 provider-administered). We applied descriptive statistics, one-way ANOVA, thematic analysis, and triangulation to explore methodological and cultural nuances.

Results

Most participants were educated women who lived in urban areas. While the ANOVA results revealed no statistically significant differences in FertiQoL scores based on the mode of administration [core score (F(2,99) = 1.58, p = 0.21, η 2 = 0.03) and domain scores: emotional (F(2,99) = 1.85, p = 0.16, η 2 = 0.04); mind/body (F(2,99) = 1.95, p = 0.15, η 2 = 0.04); relational (F(2,99) = 0.18, p = 0.83, η 2 = 0.04); and social (F(2,99) = 1.67, p = 0.19, η 2 = 0.03)], qualitative insights unveiled vital cultural considerations. Interpretation challenges related to concepts like hope and jealousy emerged during interviews. Notably, the social domain of FertiQoL was found to inadequately capture the social pressures experienced by infertile individuals in Sudan, underscoring the importance of region-specific research. Despite these challenges, participants perceived FertiQoL as a comprehensive and valuable tool with broader utility beyond assessing fertility-related quality of life.

Conclusion

Our findings emphasize the significance of incorporating cultural sensitivity into the interpretation of FertiQoL scores when implementing it globally. This approach aligns with the principles of science diplomacy and challenges neocolonial structures by acknowledging the unique lived experiences of local populations. By fostering cross-cultural understanding and inclusivity in research, we can enhance the implementation of FertiQoL and pave the way for novel interventions, increased funding, and policy developments in the Global South, ultimately promoting equitable global health.

The SCREENIVF Hungarian version is a valid and reliable measure accurately predicting possible depression in female infertility patients

Infertility patients, often in high distress, are entitled to being informed about their mental status compared to normative data. The objective of this study was to revalidate and test the accuracy of the SCREENIVF, a self-reported tool for screening psychological maladjustment in the assisted reproduction context. A cross-sectional, questionnaire-based online survey was carried out between December 2019 and February 2023 in a consecutive sample of female patients (N = 645, response rate 22.9%) in a university-based assisted reproduction center in Hungary. Confirmatory factor analysis and cluster and ROC analyses were applied to test validity, sensitivity and specificity in relation to Beck Depression Inventory (BDI) scores. Model fit was optimal (chi-square = 630.866, p < 0.001; comparative fit index = 0.99; root-mean-square error of approximation = 0.018 (90% CI 0.013-0.023); standardized-root-mean-square-residual = 0.044), and all dimensions were reliable (α > 0.80). A specific combination of cutoffs correctly predicted 87.4% of BDI-scores possibly indicative of moderate-to-severe depression (χ2(1) = 220.608, p < 0.001, Nagelkerke R2 = 0.462, J = 66.4). The Hungarian version of the SCREENIVF is a valid and reliable tool, with high accuracy in predicting BDI-scores. Low response rate may affect generalizability. The same instrument with different cutoffs can serve various clinical goals.

Depression, anxiety, quality of life, and infertility: a global lens on the last decade of research

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.

Efficacy of Dry Cupping versus Counselling with Mindfulness-based Cognitive Therapy Approach on Fertility Quality of Life and Conception Success in Infertile Women due to Polycystic Ovary Syndrome: A Pilot Randomized Clinical Trial

Background

Physical and psychological interventions could affect the quality of life (QoL) of women with infertility. The purpose of this study was to compare the effectiveness of dry cupping and counselling with the mindfulness-based cognitive therapy (MBCT) approach on fertility QoL and conception success in infertile women due to polycystic ovary syndrome (PCOS).

Methods

This was a two-arm pilot randomized clinical trial from first January 2021 to the end of November 2022. In this regard, 19 women with infertility who were referred to the health centers affiliated with Shiraz University of Medical Sciences and met the inclusion criteria were enrolled in the study. Participants were randomly divided into two groups (10 in the virtual MBCT group and 9 in the cupping group). All participants completed the fertility quality of life (FertiQol) tool before the intervention and three months after the end of the intervention. In addition, after the end of the intervention, a human chorionic gonadotropin test was performed monthly for three months, too. We used ANOVA/ANCOVA and its related effect sizes, including mean difference (MD) and standard mean difference (SMD: Hedges's g), and chi-square tests to compare the study group outcomes in Stata 14.2. P-values equal to or less than 0.10 were considered significant.

Results

The intervention resulted in significant differences in the mean overall scores of FertiQol between the counseling and cupping groups (61.76±14.28 and 50.65±12.53, respectively) [P=0.091, MD=11.11 (90% CI: 0.33 to 21.89), SMD=1.07 (90% CI: 0.279 to 1.84)]. No significant difference was found in conception rates between the groups after the intervention.

Conclusion

This pilot study found that MBCT improved the fertility QoL in PCOS-related infertility patients better than cupping therapy.

Trial registration

IRCT201706110334452N1.