Depression and associated factors among infertile women at Tu Du hospital, Vietnam: a cross-sectional study

Psychological impact of the COVID-19 pandemic on infertile patients: A systematic review and meta-analysis

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.

Examining the association between coping strategies and perceived social support among Vietnamese infertile women undergoing IVF treatment

The purpose of the study was to examine the association between coping strategies and perceived social support among women diagnosed with infertility and undergoing IVF treatment. A total of 383 Vietnamese women were invited to participate in this study. Participants completed a questionnaire consisting of The Multidimensional Scale of Perceived Social Support, the Copenhagen Multi-centre Psychosocial Infertility coping scales and the Fertility Problem Inventory, and other relevant questions. The results reveal that coping strategies significantly predict some specific types of perceived social supports among women undergoing IVF treatment. Specifically, passive-avoidance coping (PAC) and active-avoidance coping (AAC) predicts a decrease in receiving support from family and friends, whereas active-confronting coping (ACC) predicts an increase in receiving support from these two sources of support. Women who demonstrate increased meaning-based coping (MBC) received all three sources of support including family, friends, and significant others support. Despite some limitations, this study is useful in understanding how coping strategies among women undergoing IVF treatment affects the social support received in the Vietnamese social context. It also emphasizes the importance of psychological support for women facing IVF treatment distress.

Fertility status and depression: A case-control study among women in Herat, Afghanistan

Background and Aim

On a global scale, an estimated 17.5% of the reproductive-aged population experiences clinical infertility. Beyond its categorization as a reproductive health concern, infertility emerges as a substantial independent risk factor for the development of various mental health disorders. The current study aims to investigate the prevalence of depression among women experiencing infertility compared to fertile women in Herat city, Afghanistan.

Methods

This hospital-based case-control study was conducted in Herat city, Afghanistan, during the latter half of 2023 on women aged 15-49. Sociodemographic and infertility data were gathered by a gynecologist using a structured questionnaire with 14 items. Assessment of depression employed the Dari-translated version of the Patient Health Questionnaire. The data were scored and categorized following the instrument's guidelines. To examine the association between categorical variables, a chi-square test was conducted, with a significance level set at 0.05 for all analyses. These statistical procedures were performed using IBM Statistical Package for Social Sciences, version 27.

Results

Our investigation revealed a statistically significant association (p < 0.001) between infertility and depression. Infertility was associated with a markedly increased risk of depression, as evidenced by a prevalence of 79.0% in infertile women compared to 44.4% in fertile women. The study found a link between depression, health, and nutritional status in both infertile and fertile participants. Notably, within the infertile group, the longer a woman struggled with infertility, the more likely she was to experience depression.

Conclusion

Given the substantial prevalence and important correlates of depression among infertile women in Herat, Afghanistan, it is imperative for policymakers, mental health professionals, and gynecologists to specifically address the mental well-being of this vulnerable population.

Infertile women of Ethiopia: Psychological challenges and coping strategies

Worldwide, an estimated 48 million couples and 186 million individuals are infertile, according to estimates from the World Health Organization. Ethiopia has a higher rate of infertility than the World Health Organization estimated for the entire world. Though research on the issue of infertility is growing both globally and in Ethiopia, not much has been studied. Therefore, the main objective of this study was to explore the psychological and coping strategies of infertile women in Bichena town, Ethiopia. The study followed a qualitative research approach and a descriptive phenomenological design. Data were collected through in-depth interviews with 15 infertile women using a purpose-sampling technique. Thematic analysis was the method of data analysis. The findings of this study indicated that stress, anxiety, depression, low self-esteem, and sexual dissatisfaction were the main psychological challenges that infertile women experience. Infertile women also used a variety of coping strategies, such as religious strategies, traditional strategies, medical strategies, and other strategies (marital separation and acceptance). The study concluded that infertile women in the study area were challenged by psychological factors and used different coping strategies to manage their ongoing problems. This study also has theoretical implications for the current literature and practical implications for infertile women, non-governmental organizations, community and health professionals.

Coping styles among Vietnamese people with infertility diagnosis: does type of infertility-related stress really matter?

OBJECTIVES

The present study aims to investigate whether each coping style used by Vietnamese people living with infertility diagnosis is associated with specific types of infertility-related stress (IRS).

METHODS

In this cross-sectional design study, 997 patients with primary infertility diagnosis from three hospitals and two clinics in three regions of Vietnam completed questionnaire that consisted of Fertility Problem Inventory, the Copenhagen Multi-Centre Psychosocial Infertility and other questions. Four different linear regression analyses were performed on four coping styles. The five types of IRS and covariates were included in these models.

FINDINGS

The results show that participants who experience all five types of IRS reported the dominant use of active-avoidance coping, while having four types of IRS, except for social concern, was associated with higher use of meaning-based coping. Utilising active-confronting coping was reported to be the outcome of experiencing increasing need for parenthood and decreasing rejection of child-free lifestyle. Choice of passive-avoidance coping was more common among those with increasing social concern and need for parenthood. Age and educational level impacted infertile people's choice of avoidance coping strategies.

CONCLUSIONS

The results provide evidence to understand the direct impact of each type of IRS on infertile people's choice of coping styles to better support them during their individual and family therapy.

The social determinants of mental health disorders among women with infertility: a systematic review

INTRODUCTION

Infertility is associated with mental health disorders in women, even if a successful pregnancy resolves infertility. However, the link between social determinants of health (SDoH) and mental health in women with infertility is not well understood. We aimed to investigate the determinants thoroughly so that mental health screening and services can be tailored to suit women with infertility who are vulnerable to mental health disorders.

METHODOLOGY

All observational studies that included women participants of reproductive age with infertility and assessed social determinants associated with mental health disorders were searched using a combination of keywords from MEDLINE, EMBASE, CINAHL, PsycINFO, Scopus, and Web of Science databases and published in English. Two reviewers conducted screening, data extraction, quality assessment and risk of bias. The protocol was registered on PROSPERO (number CRD42022343962).

RESULTS

The systematic review included 32 studies out of 3405 screened articles from January 1st 2010 to 16th October 2023. Compared to women without infertility, the prevalence of mental health disorders, including anxiety, depression, psychological distress, and stress, is high among women with infertility, with the severity being influenced by social determinants-those with higher education, employment, higher personal or family income, private health insurance, higher social support, stronger religious beliefs, and higher spiritual well-being reported better mental health outcomes.

CONCLUSION

The study highlights the need for early detection, tailored interventions, and integrated and comprehensive support systems to address the mental health needs of women with infertility and improve their well-being.

Systematic Review: Risk Factors of Anxiety, Depressiveness, and (Lack of) Social Support in Women and Men Prior to Assisted Reproduction

This review provides a systematic overview of the state of knowledge to date of psychosocial risk factors with a focus on anxiety, depressiveness, and (lack of) social support among involuntarily childless women and men prior to assisted reproduction. The databases PubMed, PubPsych, PsycINFO-Ebsco, and Web of Science were searched for relevant publications in English or German, and finally a total of 20 publications were included in the systematic review. Of these, 18 studies focused on depressiveness, 15 studies focused on anxiety, and 9 studies focused on social support. Half of the studies included both men and women, while the other half included only women. Due to the large heterogeneity of the study results as well as limitations, no clear conclusions can be drawn regarding a difference between the risk profiles of men and women with an unfulfilled desire to have children. However, it has been shown that infertile couples or women experience higher levels of stress in the form of depressiveness and anxiety compared to fertile participants. Furthermore, it was found that social support, regardless of gender difference, within the couple and from family and friends may be associated with a lower risk for depressiveness and anxiety.

Women infertility and common mental disorders: A cross-sectional study from North India

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.

Service quality and accessibility of healthcare facilities: digital healthcare potential in Ho Chi Minh City

Background

Effective delivery of health services requires adequate quality in healthcare facilities and easy accessibility to health services physically or virtually. The purpose of this study was to reveal how the quality of healthcare facilities varies across the different parts of Ho Chi Minh City and how well residents (N = 9 million) can reach healthcare facilities. By demarcating the deficiently served areas of low accessibility, the study shows where urban planning and digital healthcare could improve accessibility to health services and the quality of services efficiently.

Methods

The analysis utilised geocoded information on hospitals, clinics, roads and population and the data of the quality scores of healthcare facilities. Quality scores were analysed by hot spot analysis and inverse distance weighting. Accessibility and formation of travel time-based service areas by travel time distances were calculated using road network, driving speed and population data.

Results

The results unveiled a centripetal spatial pattern of healthcare facilities and a similar pattern in their quality. Outside the travel time of 30 min for hospitals and 15 min for clinics, the deficiently served areas have a population of 1.1 to 1.2 million. Based on the results and the evidence of digital healthcare, this paper highlights how to develop and plan spatially effective service provision. Especially, it gives grounds to discuss how cost-effective digital healthcare could be applied to improve the accessibility and quality of health services in an urban structure of extensively varying accessibility to health services.

Conclusions

The results bring up the need and the means for improving the quality of health services and their cost-efficient availability by location optimisation, road improvements and implementing digital healthcare provided by hospitals and clinics in the city. At the same, this study provides a multidisciplinary approach for planning more equal and efficient health service provision geographically.

Quality of Infertility Care Services and Emotional Health of South Asian Women

Background

Treatment tolerability and treatment environment are two major spheres of infertility care that may associate with women’s emotional health and coping mechanisms.

Aim

The present study aimed at assessing the relationship between infertility treatment quality and various aspects of emotion-focus coping, problem-focus coping, and avoidance coping mechanisms.

Method

The study was completed by using standardized tools and data from this descriptive, cross-sectional, correlational study were collected from 350 women undergoing infertility treatments in private reproductive healthcare centers in Quetta, Pakistan.

Findings

Treatment tolerability was found to be positively associated with positive reframing (p < 0.02) and negatively associated with the use of emotional support (p < 0.03); acceptance (p < 0.01); humor (p < 0.03); behavioral disengagement (p < 0.01) and venting (p < 0.01). The quality of the treatment environment demonstrated a negative correlation between religious coping (p < 0.02) and behavioral disengagement (p < 0.01), whereas it showed a positive correlation with active coping (p < 0.03) and planning (p < 0.02). The linear regression analysis demonstrated that treatment tolerability significantly increased with positive reframing (R2 = 0.118, F(304) = 2.22, p < 0.03). Behavioral disengagement significantly decreased with better treatment environment (R2 = 0.111, F(304) = 2.09, p < 0.02).

Discussion

We discussed the findings keeping in view the role of social, cultural, and economic factors related to infertility care in the context South-Asian culture, and recommendations are made to promote women’s mental health and coping by improving some specific aspects of infertility treatment quality.

Conclusions

High treatment tolerability may associate with some useful aspects of emotion-focus coping, such as positive reframing, whereas low treatment tolerability may associate with avoidance coping, such as behavioral disengagement and venting. Besides, the quality of the infertility treatment environment enables women to use problem-focus coping mechanisms, such as planning and active coping.

Intergenerational effects of violence on women's perinatal wellbeing and infant health outcomes: evidence from a birth cohort study in Central Vietnam

BACKGROUND

Girls exposed to violence have a high risk of being victimized as adults and are more likely than non-abused women to have children who are treated violently. This intergenerational transmission may be especially serious when women suffer violence during pregnancy and early motherhood, as it impairs maternal wellbeing and infant health and development. This study examined the intergenerational effects of being exposed to childhood maltreatment (CM) and prenatal intimate partner violence (p-IPV) on perinatal mental distress and birth outcomes in central Vietnam.

METHODS

A birth cohort study in Hue City, Vietnam was conducted with 150 women in the third trimester of pregnancy (Wave 1) and 3 months after childbirth (Wave 2). Using multivariable logistic regression models, augmented inverse-probability-weighted estimators and structural equation modelling (SEM), we analyzed a theoretical model by evaluating adjusted risk differences and pathways between CM, p-IPV and subsequent perinatal adversity and indicators of infant health problems.

RESULTS

One in two pregnant women experienced at least one form of CM (55.03%) and one in ten pregnant women experienced both CM and p-IPV (10.67%). Mothers who experienced p-IPV or witnessed IPV as a child were approximately twice as likely to experience poor mental health during pregnancy [ARR 1.94, 95% CI (1.20-3.15)]. Infants had a two-fold higher risk of adverse birth outcomes (low birth weight, preterm birth, admission to neonatal intensive care) [ARR 2.45 95% CI (1.42, 4.25)] if their mothers experienced any form of p-IPV, with greater risk if their mothers were exposed to both CM and p-IPV [ARR 3.45 95% CI (1.40, 8.53)]. Notably, significant pathways to p-IPV were found via adverse childhood experience (ACE) events (β = 0.13), neighborhood disorder (β = 0.14) and partner support (β = - 1.3).

CONCLUSION

These results emphasize the detrimental and prolonged nature of the effect of violence during childhood and pregnancy. Exposure to childhood maltreatment and violence during pregnancy increases the risk of maternal mental health difficulties and adverse birth outcomes. Antenatal care systems need to be responsive to women's previous experiences of violence and maternal mental health. The significant protective role of partner support and social support should also be considered when designing tailored interventions to address violence during pregnancy.

Anaesthetic considerations for fertility-sparing surgery and uterine transplantation

A number of benign and malignant gynaecological conditions can cause infertility. Advancements in assisted reproductive technologies have facilitated the rapidly evolving subspecialty of fertility preservation. Regardless of clinical indication, women now have the reproductive autonomy to make fully informed decisions regarding their future fertility. In particular, there has been an increasing interest and demand among patients and healthcare professionals for fertility-sparing surgery. Gynaecologists find themselves continually adapting surgical techniques and introducing novel procedures to facilitate this rapidly emerging field and anaesthetists need to manage the consequent physiological demands intra-operatively. Not only is it important to understand the surgical procedures now undertaken, but also the intra-operative management in an ever evolving field. This article reviews the methods of fertility-sparing surgery and also describes important anaesthetic challenges including peri-operative care for women undergoing complex fertility-sparing surgeries such as uterus transplantation.

The prevalence of depression symptoms among infertile women: a systematic review and meta-analysis

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.

Depression among Infertile Women in Gaza Strip: Symptom Severity and Predictors

BACKGROUND

Mental disorders are expected for women suffering from infertility. Depression is a predictable consequence but requires more investigations and considerations. This study is aimed at determining the severity of depression symptoms and its predictors among infertile women in the Gaza Strip, Palestine.

MATERIALS AND METHODS

A cross-sectional study was conducted. Three hundred eighty-five infertile women participated and were selected by convenience sampling. The participated women were selected from three large and major in vitro fertilization treatment centers (Al Helo, Al Basma, and Hindawi). A validated Arabic version of the Beck Depression Inventory-II was used. Univariate and multivariate logistic regression was applied to determine potential predictors for depression symptoms, and p ≤ .05 was statistically significant.

RESULTS

The mean age of participated women was 29 ± 6.58 years, and the mean duration of marriage and infertility was 7.76 ± 5.31 and 5.43 ± 3.50 years, respectively. Half of the women had some form of depression symptoms (22.3%, 8.6%, and 10.6% showed to have mild depression, moderate, and severe depression symptoms, respectively). Predictors of depression symptoms were as follows: duration of marriage (Wald test: 10.493; CI95%: 0.248-0.774), at least one abortion (Wald test: 21.233; CI95%: 1.863-4.528), primary infertility (Wald test: 6.666; CI95%: 1.148-2.742), and husband cause of infertility (Wald test: 10.878; CI95%: 0.800-0.982).

CONCLUSION

Infertility affects the various aspect of women's life. Psychological intervention including counselling, support, and therapy would be necessary to limit the consequences of infertility. Such interventions could be implemented in infertility treatment clinics.

Depression and its associated factors among pregnant women in central Vietnam

To date, little attention has been given to prenatal depression, especially in low and middle-income countries. The aim of this research was to assess the prevalence of depression and its associated factors amongst pregnant women in a central Vietnamese city. This cross-sectional study included 150 pregnant women from 29 to 40 weeks of gestation, from eight wards of Hue city, via quota sampling from February to May 2019. We employed the Patient Health Questionnaire (PHQ-9) to assess depression. Findings suggest the need to provide routine screening of pregnant women in primary care for depressive symptoms and other mental health problems.

A single ovarian stimulation, as performed in assisted reproductive technologies, can modulate the anxiety-like behavior and neuronal activation in stress-related brain areas in rats

Infertility affects about 8 to 12% of couples of childbearing age around the world, and is recognized as a global public health issue by the WHO. From a psychosocial perspective, infertile individuals experience intense psychological distress, related to emotional disorders, which have repercussions on marital and social relationships. The symptoms persist even after seeking specialized treatment, such as assisted reproductive technologies (ART). While the stress impact of ART outcome has been comprehensively studied, the role of supraphysiological concentrations of gonadal hormones on stress response, remains to be elucidated. This study aimed to evaluate the effect of a single ovarian stimulation on the stress response in rats. To mimic the context of ART in rodents, female rats were submitted to the superovulation (150 UI/kg of PMSG and 75 UI/kg of hCG) and then to psychogenic stress (restraint stress for 30 min/day, repeated for three days). Anxiety-like behavior was evaluated in the elevated plus-maze, and neuronal activation in the stress-related brain areas assessed by Fos protein immunoreactivity. Corticosterone, estradiol, progesterone and corpora lutea were quantified. Data were analyzed using Generalized Linear Model (GzLM). Our findings indicate anxiolytic-like and protective effects of supraphysiological concentrations of gonadal hormones induced by a single ovarian stimulation on stress response. An activation of hypothalamus-pituitary-adrenal response inhibitory pathways, with participation of the prefrontal cortex, basomedial amygdala, lateral septum, medial preoptic area, dorsomedial and paraventricular hypothalamus, was detected.