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Shi LP, Geng YG, Mao ZW, Zhang Y, Sun SJ, Gu JJ. Infertility-related stress is associated with quality of life through negative emotions among infertile outpatients. Sci Rep 2024; 14:19690. [PMID: 39181935 PMCID: PMC11344845 DOI: 10.1038/s41598-024-70798-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 08/21/2024] [Indexed: 08/27/2024] Open
Abstract
Infertility is not a fatal disease but it really produces infertility-related stress and affects individuals' quality of life to a great extent. This study aims to investigate the relations among infertility-related stress, negative emotions and quality of life in infertile outpatients, and suppose gender difference as well as Dark Triad, which contained three dark personality traits: Machiavellianism, narcissism, and psychopathy, would moderate the relations. 105 infertile outpatients age range 20-49 completed a cross-sectional questionnaire on the Fertility Quality of Life scale, the Fertility Problem Inventory, the Hospital Anxiety and Depression Scale a the Chinese version of Dirty Dozen. Results showed that negative emotions mediated the relations between infertility-related stress and quality of life. Dark Triad could not moderate the relations between infertility-related stress, negative emotions, and quality of life, but gender can moderate the associations between infertility-related stress and negative emotions. Specifically, the association between infertility-related stress and negative emotions was stronger in men than in women. Infertility-related stress has direct and indirect effects on infertile outpatients' quality of life. It is important to consider the important roles of emotions and gender difference between patients, and delivering targeted intervention programs.
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Affiliation(s)
- Li-Ping Shi
- Department of Psychology, Fudan University, Shanghai, 200433, China
| | - Yao-Guo Geng
- School of Physical Education (School Headquarters), Zhengzhou University, Zhengzhou, 450001, China
| | - Zi-Wen Mao
- School of Education, Zhengzhou University, Zhengzhou, 450001, China
| | - Ying Zhang
- School of Education, Zhengzhou University, Zhengzhou, 450001, China
| | - Shi-Jin Sun
- Department of Psychology, Fudan University, Shanghai, 200433, China
| | - Jing-Jing Gu
- Center for Mental Health Education, Faculty of Psychology, Southwest University, Chongqing, 400715, China.
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2
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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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3
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Sahraian K, Abdollahpour Ranjbar H, Namavar Jahromi B, Cheung HN, Ciarrochi J, Habibi Asgarabad M. Effectiveness of mindful self-compassion therapy on psychopathology symptoms, psychological distress and life expectancy in infertile women treated with in vitro fertilization: a two-arm double-blind parallel randomized controlled trial. BMC Psychiatry 2024; 24:174. [PMID: 38429659 PMCID: PMC10908010 DOI: 10.1186/s12888-023-05411-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 11/28/2023] [Indexed: 03/03/2024] Open
Abstract
OBJECTIVES Infertility is a prominent problem affecting millions of couples worldwide. Recently, there has been a hightened emphasis on elucidating the subtle linkages between infertility treatment leveraging assisted reproductive technology and the complex realm of psychological challenges, as well as efforts in implementation of psychological interventions.The Mindful Self-Compassion (MSC) program seeks to improve self-compassion, compassion for others, mindfulness, and life satisfaction while reducing depression, anxiety, and stress. In the current study, an MSC intervention was performed on infertile women (IW) undergoing in vitro fertilization (IVF) to assess the effectiveness of this intervention in reducing psychological distress and psychopathological symptoms and enhancing life expectancy. METHODS Fifty-seven IW undergoing IVF were randomly allocated to two groups: MSC (n = 29) or treatment as usual (TAU; n = 28). Participants in MSC met once a week for two hours for eight weeks and attended a half-day meditation retreat. The Synder's Hope questionnaire and the Revised 90-Symptom Checklist (SCL-90-R) were used as the primary outcome measures. Data were obtained before the intervention, immediately after the intervention, and two months post-intervention. Repeated measures of ANCOVA and paired t-tests in all assessment points were used to compare the MSC and the TAU groups in outcomes. RESULTS In the MSC group, hopelessness, anger-hostility, anxiety, interpersonal sensitivity difficulties, and depression were significantly reduced compared with the TAU group, and those improvements persisted at the two-month follow-up. Reliable change index revealed that the MSC group's gains were both clinically significant and durable. CONCLUSIONS MSC can facilitate higher life satisfaction and mental well-being for IW undergoing IVF by reducing psychological distress, psychopathological symptoms, and hopelessness. These encouraging findings call for more research into the effectiveness of mindfulness-based therapies in addressing psychological problems among IW undergoing IVF.
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Affiliation(s)
- Kimia Sahraian
- Department of Psychology, Higher Education Center of Eghlid, Eghlid, Iran
- Infertility Research Centre, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Bahia Namavar Jahromi
- Infertility Research Centre, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Obstetrics and Gynecology, School of Medical Science, Shiraz University of Medical Science, Shiraz, Iran
| | - Ho Nam Cheung
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
| | - Joseph Ciarrochi
- Institute for Positive Psychology and Education, Australian Catholic University, North Sydney, NSW, Australia
| | - Mojtaba Habibi Asgarabad
- Department of Psychology, Norwegian University of Science and Technology, 7491 Dragvoll, Trondheim, Norway.
- Health Promotion Research Center, Iran University of Medical Sciences, Tehran, Iran.
- Department of Health Psychology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran.
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Pacheco RI, Cristo MI, Anjo SI, Silva AF, Sousa MI, Tavares RS, Sousa AP, Almeida Santos T, Moura-Ramos M, Caramelo F, Manadas B, Ramalho-Santos J, Amaral SG. New Insights on Sperm Function in Male Infertility of Unknown Origin: A Multimodal Approach. Biomolecules 2023; 13:1462. [PMID: 37892144 PMCID: PMC10605211 DOI: 10.3390/biom13101462] [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: 08/08/2023] [Revised: 09/21/2023] [Accepted: 09/23/2023] [Indexed: 10/29/2023] Open
Abstract
The global trend of rising (male) infertility is concerning, and the unidentifiable causes in half of the cases, the so-called unknown origin male infertility (UOMI), demands a better understanding and assessment of both external/internal factors and mechanisms potentially involved. In this work, it was our aim to obtain new insight on UOMI, specifically on idiopathic (ID) and Unexplained male infertility (UMI), relying on a detailed evaluation of the male gamete, including functional, metabolic and proteomic aspects. For this purpose, 1114 semen samples, from males in couples seeking infertility treatment, were collected at the Reproductive Medicine Unit from the Centro Hospitalar e Universitário de Coimbra (CHUC), from July 2018-July 2022. Based on the couples' clinical data, seminal/hormonal analysis, and strict eligibility criteria, samples were categorized in 3 groups, control (CTRL), ID and UMI. Lifestyle factors and anxiety/depression symptoms were assessed via survey. Sperm samples were evaluated functionally, mitochondrially and using proteomics. The results of Assisted Reproduction Techniques were assessed whenever available. According to our results, ID patients presented the worst sperm functional profile, while UMI patients were similar to controls. The proteomic analysis revealed 145 differentially expressed proteins, 8 of which were specifically altered in ID and UMI samples. Acrosin (ACRO) and sperm acrosome membrane-associated protein 4 (SACA4) were downregulated in ID patients while laminin subunit beta-2 (LAMB2), mannose 6-phosphate isomerase (MPI), ATP-dependent 6-phosphofructokinase liver type (PFKAL), STAR domain-containing protein 10 (STA10), serotransferrin (TRFE) and exportin-2 (XPO2) were downregulated in UMI patients. Using random forest analysis, SACA4 and LAMB2 were identified as the sperm proteins with a higher chance of distinguishing ID and UMI patients, and their function and expression variation were in accordance with the functional results. No alterations were observed in terms of lifestyle and psychological factors among the 3 groups. These findings obtained in an experimental setting based on 3 well-defined groups of subjects, might help to validate new biomarkers for unknown origin male infertility (ID and UMI) that, in the future, can be used to improve diagnostics and treatments.
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Affiliation(s)
- Rita I. Pacheco
- CNC—Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504 Coimbra, Portugal
| | - Maria I. Cristo
- CNC—Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504 Coimbra, Portugal
- IIIUC—Institute for Interdisciplinary Research, University of Coimbra, 3030-789 Coimbra, Portugal
| | - Sandra I. Anjo
- CNC—Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504 Coimbra, Portugal
- IIIUC—Institute for Interdisciplinary Research, University of Coimbra, 3030-789 Coimbra, Portugal
| | - Andreia F. Silva
- CNC—Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504 Coimbra, Portugal
- IIIUC—Institute for Interdisciplinary Research, University of Coimbra, 3030-789 Coimbra, Portugal
| | - Maria Inês Sousa
- CNC—Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504 Coimbra, Portugal
- Department of Life Sciences, Faculty of Sciences and Technology, University of Coimbra, 3000-456 Coimbra, Portugal
| | - Renata S. Tavares
- CNC—Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504 Coimbra, Portugal
- Department of Life Sciences, Faculty of Sciences and Technology, University of Coimbra, 3000-456 Coimbra, Portugal
| | - Ana Paula Sousa
- CNC—Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504 Coimbra, Portugal
- Reproductive Medicine Unit, Centro Hospitalar e Universitário de Coimbra, 3000-075 Coimbra, Portugal
- Eugin Coimbra, Rua Filipe Hodart 12, 3000-185 Coimbra, Portugal
| | - Teresa Almeida Santos
- CNC—Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504 Coimbra, Portugal
- Reproductive Medicine Unit, Centro Hospitalar e Universitário de Coimbra, 3000-075 Coimbra, Portugal
- Eugin Coimbra, Rua Filipe Hodart 12, 3000-185 Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
| | - Mariana Moura-Ramos
- Reproductive Medicine Unit, Centro Hospitalar e Universitário de Coimbra, 3000-075 Coimbra, Portugal
- Eugin Coimbra, Rua Filipe Hodart 12, 3000-185 Coimbra, Portugal
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, 3000-115 Coimbra, Portugal
- Clinical Psychology Unit, Centro Hospitalar e Universitário de Coimbra, 3000-075 Coimbra, Portugal
| | | | - Bruno Manadas
- CNC—Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504 Coimbra, Portugal
- IIIUC—Institute for Interdisciplinary Research, University of Coimbra, 3030-789 Coimbra, Portugal
| | - João Ramalho-Santos
- CNC—Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504 Coimbra, Portugal
- Department of Life Sciences, Faculty of Sciences and Technology, University of Coimbra, 3000-456 Coimbra, Portugal
| | - Sandra Gomes Amaral
- CNC—Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504 Coimbra, Portugal
- IIIUC—Institute for Interdisciplinary Research, University of Coimbra, 3030-789 Coimbra, Portugal
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Cirillo M, Basile V, Mazzoli L, Coccia ME, Fatini C. Impact of COVID-19 Pandemic on Women's Health and Obstetric Outcomes after Assisted Reproduction: A Survey from an Italian Fertility Center. J Pers Med 2023; 13:jpm13030563. [PMID: 36983744 PMCID: PMC10059757 DOI: 10.3390/jpm13030563] [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: 02/24/2023] [Revised: 03/17/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND the restrictive measures that were adopted during three waves of the COVID-19 pandemic had an impact on both the emotional state and lifestyle of the general population. We evaluated the impact of COVID-19 pandemic on lifestyles and emotional states of women planning assisted reproductive technology (ART), and whether these changes affected ART outcomes. METHODS quantitative research, using a web-based survey, was performed on 289 Caucasian women. RESULTS In preconception, we observed higher percentage of women with positive obstetric outcomes who reduced body weight (52.4% vs. 27.2%, p = 0.09). Over 60% of women with positive outcomes practiced physical activity vs. 47% of women with negative outcomes (p = 0.03), as well as having better quality of sleep (45% vs. 35%), and a more solid relationships with their partners (65.1% vs. 51.7%, p = 0.03). Women who increased their intake of whole grains, fruits, vegetables, and legumes (p < 0.05), according to the Mediterranean diet, showed positive outcomes. We observed that participants who experienced "very much" or "extreme" anxiety, sadness, and fear (p < 0.05) during pandemic were clearly more numerous in the group with negative pregnancy outcomes. CONCLUSIONS healthy lifestyle together with a positive emotional state in preconception can positively influence the obstetric outcomes after ART.
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Affiliation(s)
- Michela Cirillo
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
- Centre for Assisted Reproductive Technology, Division of Obstetrics and Gynaecology, Careggi University Hospital, 50134 Florence, Italy
| | - Valentina Basile
- Centre for Assisted Reproductive Technology, Division of Obstetrics and Gynaecology, Careggi University Hospital, 50134 Florence, Italy
| | - Letizia Mazzoli
- Centre for Assisted Reproductive Technology, Division of Obstetrics and Gynaecology, Careggi University Hospital, 50134 Florence, Italy
| | - Maria Elisabetta Coccia
- Centre for Assisted Reproductive Technology, Division of Obstetrics and Gynaecology, Careggi University Hospital, 50134 Florence, Italy
- Department of Clinical and Experimental Biomedical Sciences, University of Florence, 50134 Florence, Italy
| | - Cinzia Fatini
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
- Centre for Assisted Reproductive Technology, Division of Obstetrics and Gynaecology, Careggi University Hospital, 50134 Florence, Italy
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Pugi D, Ferretti F, Galeazzi M, Gualtieri G, Lorenzi L, Pappalardo N, Macrì PG, Garosi G, Coluccia A, Pozza A. Health-Related Quality of Life in pre-dialysis patients with chronic kidney disease: the role of Big-Five personality traits and illness denial. BMC Psychol 2022; 10:297. [PMID: 36496378 PMCID: PMC9737964 DOI: 10.1186/s40359-022-00992-5] [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: 06/27/2022] [Accepted: 11/17/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Health-Related Quality of Life (HRQoL) in patients with chronic kidney disease (CKD) is significantly affected, regardless of the stage of the disease, as regards the physical, psychological and social functioning dimension. Big-Five personality traits can affect patients' HRQoL and willingness to take treatment options. Illness denial consists of denial of negative emotions, resistance to change and conscious avoidance. Poorer HRQoL can predict a higher risk of hospitalization and mortality, and broadly a worse adjustment to the dialytic therapy. Thus, a clearer knowledge of the psychological variables associated with a worse HRQoL in the predialysis stage might improve the intervention planning. No study investigated illness denial and personality traits simultaneously. We investigated the role of illness denial and Big-Five personality traits in the domains of HRQoL in predialysis patients with CKD. METHODS One hundred adults (mean age: 75.87 years) with CKD participated. The Kidney Disease Quality of Life Short form, the Italian version of Ten Item Personality Inventory Revised, the Illness Denial Questionnaire, and the State-Trait Anxiety Inventory Form-Y were administered. RESULTS Illness denial was associated with increased HRQoL related to symptoms/problems, effect and burden of CKD and cognitive functions domains, and it was a predictor of higher HRQoL in the last three domains mentioned above. Extraversion was related to better work status and sexual function; agreeableness was linked to elevated cognitive function, quality of social interaction and sexual function; conscientiousness was related to better sexual function; neuroticism was linked to improved cognitive and sexual functions; in the end, openness to experience was related to fewer symptoms and problems. CONCLUSIONS This is the first study which simultaneously assessed Big-Five personality traits and illness denial in different domains of HRQoL of CKD patients. Personalised psychological interventions aimed at improving HRQoL in this population might focus on specific illness denial processes and personality traits.
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Affiliation(s)
- Daniele Pugi
- grid.9024.f0000 0004 1757 4641Department of Medical Science, Surgery and Neurosciences, University of Siena, Viale Mario Bracci 16, 53100 Siena, Italy
| | - Fabio Ferretti
- grid.9024.f0000 0004 1757 4641Department of Medical Science, Surgery and Neurosciences, University of Siena, Viale Mario Bracci 16, 53100 Siena, Italy
| | - Maddalena Galeazzi
- grid.411474.30000 0004 1760 2630Department of Cardio-Thoraco-Vascular Sciences and Public Health, School of Specialization of Legal Medicine, University Hospital of Padova, Padua, Italy
| | - Giacomo Gualtieri
- grid.411477.00000 0004 1759 0844Santa Maria Alle Scotte University Hospital of Siena, Siena, Italy
| | - Lore Lorenzi
- grid.411477.00000 0004 1759 0844Santa Maria Alle Scotte University Hospital of Siena, Siena, Italy
| | | | | | - Guido Garosi
- grid.411477.00000 0004 1759 0844UOC Nefrologia, Dialisi e Trapianti, Santa Maria alle Scotte University Hospital, Siena, Italy
| | - Anna Coluccia
- grid.9024.f0000 0004 1757 4641Department of Medical Science, Surgery and Neurosciences, University of Siena, Viale Mario Bracci 16, 53100 Siena, Italy
| | - Andrea Pozza
- grid.9024.f0000 0004 1757 4641Department of Medical Science, Surgery and Neurosciences, University of Siena, Viale Mario Bracci 16, 53100 Siena, Italy ,grid.411477.00000 0004 1759 0844Psychology Unit Santa Maria Alle Scotte University Hospital, Siena, Italy
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Starc A, Aljija S, Jukić T, Dahmane Gošnak R, Rotim A, Pavan Jukić D. SEXUAL FUNCTION AND IN VITRO FERTILIZATION. Acta Clin Croat 2022; 61:661-672. [PMID: 37868168 PMCID: PMC10588390 DOI: 10.20471/acc.2022.61.04.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 05/11/2022] [Indexed: 10/24/2023] Open
Abstract
The aim of the study was to investigate the sexuality of individuals undergoing in vitro fertilization as one of the methods of infertility treatment. The focus was on sexual dysfunction, sexual satisfaction and associated risk factors. Data were collected based on a validated, standardized procedure. The sample consisted of 119 individuals who had undergone in vitro fertilization, 61 (51.3%) women and 58 (48.7%) men, average age 35 years. Most of the 119 survey participants were in the 31-35 age group (37%), married (79.8%), with high school diploma (51.3%), Catholic denomination (89.9%), childless (78.2%), with a one sexual partner in their lifetime (51.3%), and in current sexual relationship for a period of 7 to 8 years (18.5%). The survey found statistically significantly higher satisfaction among male participants, participants in the 26-30 age group, those with a higher level of education, nonreligious, without children in marriage, with four sexual partners in life, over a period of 1 to 2 years in current partner (sexual) relationship, and without a diagnosed sexual disorder. There was a correlation between infertility, associated treatment, and sexuality. Infertility and involvement in treatment procedures increased the risk of sexual dysfunction. The risk factors identified in our study could help facilitate detection and timely treatment of sexual dysfunction, which would help maintain healthy sexuality in couples participating in in vitro fertilization procedures.
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Affiliation(s)
- Andrej Starc
- Faculty of Health Sciences, Department of Public Health, University of Ljubljana, Ljubljana, Slovenia
| | - Sanela Aljija
- Faculty of Health Sciences, University of Ljubljana, Ljubljana, Slovenia
| | - Tomislav Jukić
- Faculty of Medicine, Department of Internal Medicine, Family Medicine and History of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Raja Dahmane Gošnak
- Faculty of Health Sciences, Department of Biomedicine in Health Care, University of Ljubljana, Ljubljana, Slovenia
| | - Ante Rotim
- Sestre milosrdnice University Hospital Center, Department of Neurosurgery, Zagreb, Croatia
| | - Doroteja Pavan Jukić
- School of Medicine, University of Zagreb, Department of Reproductive Medicine, Merkur University Hospital, Zagreb, Croatia
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Santi D, Spaggiari G, Romeo M, Ebert R, Corradini F, Baraldi C, Granata ARM, Rochira V, Simoni M, Gavioli L, Niemants NSA. Qualitative and quantitative analysis of doctor-patient interactions during andrological consultations. Andrology 2022; 10:1240-1249. [PMID: 35785424 PMCID: PMC9540423 DOI: 10.1111/andr.13225] [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: 04/08/2022] [Revised: 06/06/2022] [Accepted: 06/28/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Although a trustworthy connection between doctor and patient is crucial in clinical practice, it could be hindered by different cultural and linguistic backgrounds. Moreover, an effective doctor-patient interaction could be even more challenging in andrological fields, in which psychological and social components are predominant. AIM To analyse the doctor-patient relationship in the andrological field, applying both qualitative and quantitative analyses. METHODS monocentric, cross-sectional, observational study was performed between May and December 2018. During the study, all patients aged >18 years attending the Modena Andrology Unit for couple infertility or erectile dysfunction were enrolled and the doctor-patients interaction recorded. Patients were divided into two groups depending on their medical seeking and were further divided between native and non-native speakers of Italian. All patients underwent a routine andrological examination. Every first medical consultation was audio-recorded and transcribed using "ELAN" software for socio-linguistic analysis. Transcriptions underwent qualitative analysis through conversation analysis. Then, quantitative analyses were performed, and interaction parameters underwent correlation analyses. RESULTS Twenty-five patients were enrolled. The analysis of the andrological interview allowed to recognize five consecutive phases, following a semi-standardized pattern. Patients without linguistic barriers and with infertility problems showed more autonomous contribution during the consultation. No difference arose in sexual dysfunctions group. Doctor's explanations were frequent, but when linguistic barrier was present or Italian patients seemed less talkative, explanations were shorter, and doctors tried to use other conversational mechanisms to promote understanding. Patient's variables were significantly lower compared to the doctor, considering the number of turns (p = 0.025) and their minimum (p = 0.032), maximum (p<0.001), and average durations (p<0.001). Only patient's latency was significantly higher than the doctor's (p = 0.001). CONCLUSION This is the first attempt to analyse the doctor-patient relationship in andrology using authentic audio-recorded consultations. The results confirmed that a patient-centred communication must be applied also in andrological consultations. However, the topics discussed may require more "medical formulation" to be acceptable to the participants in this context. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Daniele Santi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, Modena, Italy
| | - Giorgia Spaggiari
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, Modena, Italy
| | - Marilina Romeo
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, Modena, Italy
| | - Riccardo Ebert
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, Modena, Italy
| | - Federico Corradini
- Department of Studies on Language and Culture, University of Modena and Reggio Emilia, Modena, Italy
| | - Claudio Baraldi
- Department of Studies on Language and Culture, University of Modena and Reggio Emilia, Modena, Italy
| | - Antonio R M Granata
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, Modena, Italy
| | - Vincenzo Rochira
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, Modena, Italy
| | - Manuela Simoni
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, Modena, Italy
| | - Laura Gavioli
- Department of Studies on Language and Culture, University of Modena and Reggio Emilia, Modena, Italy
| | - Natacha S A Niemants
- Department of Interpretation and Translation, Alma Mater Studiorum - University of Bologna, Campus of Forlì, Italy
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Efficacy of Yushen Tongluo Granule Combined with Clomiphene Citrate for Anovulatory Infertility: A Double-Blind, Randomized, Placebo-Controlled Clinical Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:7933611. [PMID: 35126605 PMCID: PMC8813249 DOI: 10.1155/2022/7933611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 01/04/2022] [Accepted: 01/08/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To evaluate the efficacy and safety of Yushen Tongluo Granule (YSTLG) combined with clomiphene citrate (CC) in the treatment of anovulatory infertility. METHODS This randomized, double-blinded, placebo-controlled clinical trial was carried out in the Department of Obstetrics and Gynecology and the Department of Traditional Chinese Medicine (TCM). During the 3 menstrual cycle intervention periods, all subjects received 50 mg/day CC from day 5 until day 9 of the menstruation. If no ovulation, the amount of CC per cycle increased 50 mg/day until 150 mg/day. Participants in the experimental group received YSTLG, while participants in the control group received YSTLG placebo. The granules were orally taken from the end of menstruation until ovulation. When one leading follicle attained a diameter of 18 mm or more, 5000 U human chorionic gonadotropin (hCG) was given intramuscularly. The primary outcome measure was the ovulation rate, and follicular development was monitored by transvaginal ultrasound on the 10th day of the cycles until ovulation. Secondary outcome measures including the overall curative effect, endometrial thickness, and pregnancy outcomes were also compared between the two groups. RESULTS The ovulation rate in the experimental group was higher than that in the control group (P < 0.05). Compared with the control group, the overall curative effect of the experimental group was better than that of the control group (P < 0.05), and the endometrial thickness in the ovulation phase was significantly thicker than that in the control group (P < 0.01). There was no significant difference in pregnancy rate and miscarriage rate between the experimental group and control group (P > 0.05). CONCLUSION The combined YSTLG and CC used to treat anovulatory infertility can improve the ovulation rate without affecting endometrial thickness, which is efficacious and safe.
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Pugi D, Dèttore D, Marazziti D, Ferretti F, Coluccia A, Coccia ME, Pozza A. Fertility-Related Quality of Life in Men Undergoing Medically Assisted Reproduction During the Pandemic: Perfectionism and Thought Control Beliefs Moderate the Effects of the Type of Treatment. CLINICAL NEUROPSYCHIATRY 2021; 18:312-323. [PMID: 35096078 PMCID: PMC8785427 DOI: 10.36131/cnfioritieditore20210605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE After a diagnosis of infertility, an increasing number of couples turns to the Medically Assisted Reproduction (MAR) to achieve a pregnancy. A diagnosis of infertility has a negative impact on the individual's well-being and it can increase the risk of anxious-depressive symptoms, stress, and low self-esteem. Data associated with infertility-related Quality of Life (QoL) are lacking in men. Little is known about men's experience of infertility and its treatments during the pandemic. Among the variables potentially associated with infertility-related QoL, the role of obsessive beliefs is neglected, although preliminary studies considered perfectionistic traits. METHOD One hundred and fifty-one participants were included. Eighty men (mean age: 40.83 years) were attending a MAR pathway. Of these, 50 men (67.5%) were undergoing homologous MAR and 30 men (37.5%) were undergoing heterologous MAR. A control group consisting of 71 subjects (mean age: 36.69 years), paired by age, marital status, and number of children, was drawn from the general population. The Obsessive Beliefs Questionnaire-46, the Depression Anxiety Stress Scales-20, and the Fertility Quality of Life Questionnaire were administered. RESULTS High levels of anxiety, depression and stress were moderately associated with lower infertility-related Quality of Life. For men undergoing homologous MAR, perfectionism beliefs represented a vulnerability factor for a lower fertility-related QoL, while for men undergoing heterologous MAR, high thought control beliefs represented a risk factor for a lower fertility-related QoL. CONCLUSIONS A focus on the obsessive beliefs should be included in the psychological treatment of infertile men, specifically perfectionism in homologous MAR and control of thoughts in heterologous MAR. Therefore, psychological assessment and support interventions should be personalized according to the MAR pathway and be focused on men's cognitive features in order to improve their QoL during the MAR pathway.
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Affiliation(s)
- Daniele Pugi
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Davide Dèttore
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Donatella Marazziti
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Italy, UNICamillus University of Health Medical Sciences, Roma, Italy
| | - Fabio Ferretti
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Anna Coluccia
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Maria Elisabetta Coccia
- Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, Italy
| | - Andrea Pozza
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy,Corresponding author Andrea Pozza, PhD Department of Medical Sciences, Surgery, and Neurosciences, University of Siena, viale Bracci 16‐53100 Siena, Italy Phone: + 39 0577586409 Fax. +39 0577233222
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Caputo A, Langher V, Capri O, Muzii L, Fedele F. The need to restore generative identity in women undergoing assisted reproductive technology: Development and psychometric validation of the fertility reparation inventory. J Clin Psychol 2021; 78:1151-1169. [PMID: 34735723 PMCID: PMC9298421 DOI: 10.1002/jclp.23273] [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: 04/02/2021] [Accepted: 10/17/2021] [Indexed: 11/29/2022]
Abstract
Objective This study described the development and psychometric evaluation of the fertility reparation inventory, providing measures of manic and expiatory reparation as symbolic dynamics of restoring one's procreative and generative identity through Assisted Reproductive Technology (ART). Methods Two cross‐sectional studies were conducted on female patients undergoing ART (N = 150) and women from the general population (N = 250), respectively. Exploratory factor analysis and confirmatory factor analysis assessed construct validity and reliability. Pearson's bivariate correlations were used to provide convergent evidence of validity with omnipotence, perceived infertility‐related stress, anxiety, depression, need for reparation, fear of punishment, and hope. Results The results confirmed a two‐factor solution of the 12‐item instrument, with adequate fit, a very good internal consistency, and well‐supported forms of convergent validity. Conclusion This study provides a meaningful psychodynamic contribution, in both theoretical and empirical terms, for the understanding of emotional dynamics and psychological issues underlying the demand for ART.
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Affiliation(s)
- Andrea Caputo
- Department of Dynamic, Clinical and Health Psychology, "Sapienza" University of Rome, Rome, Italy
| | - Viviana Langher
- Department of Dynamic, Clinical and Health Psychology, "Sapienza" University of Rome, Rome, Italy
| | - Oriana Capri
- Sterility and Assisted Reproduction Unit, Department of Gynecologic-Obstetrical and Urologic Sciences, "Sapienza" University of Rome, Umberto I Hospital, Rome, Italy
| | - Ludovico Muzii
- Sterility and Assisted Reproduction Unit, Department of Gynecologic-Obstetrical and Urologic Sciences, "Sapienza" University of Rome, Umberto I Hospital, Rome, Italy
| | - Fabiola Fedele
- Department of Dynamic, Clinical and Health Psychology, "Sapienza" University of Rome, Rome, Italy
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Luca G, Parrettini S, Sansone A, Calafiore R, Jannini EA. The Inferto-Sex Syndrome (ISS): sexual dysfunction in fertility care setting and assisted reproduction. J Endocrinol Invest 2021; 44:2071-2102. [PMID: 33956331 PMCID: PMC8421318 DOI: 10.1007/s40618-021-01581-w] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 04/19/2021] [Indexed: 12/20/2022]
Abstract
PURPOSE Infertility represents a peculiar social burden affecting more than 15% of couples, provoking it a real threat to the general quality of life and to the sexual health. The medicalization (diagnosis, therapy and follow up) of the lack of fertility is frequently a challenge in term of personal and couple's involvement. In particular, while the Assisted Reproductive Technology (ART) has allowed many infertile couples to achieve pregnancy, the therapeutic process faced by the couple bears a strong psychological stress that can affect the couple's quality of life, relationship and sexuality. Despite infertility affects both female and male sexual health, only recently the interest in the effects of ART on the couple's sexuality has grown, especially for women. METHODS A literature research on the sexual dysfunction in fertility care and particularly in ART setting was performed. RESULTS Literature largely found that intimacy and sexuality appear specifically impaired by intrusiveness of treatments and medical prescriptions. Moreover, there is a close relationship between emotional, psychological and sexual aspects, which can be integrated in the new concept of Inferto-Sex Syndrome (ISS) that can impair the ART treatment outcomes. Evidence demonstrates that the assessment of sexual function is necessary in couples undergoing diagnosis of infertility and ART. CONCLUSION A close relationship between infertility and sexuality, both in the female and male partners, was detected. ART treatments may heavily impact on the couple's psychosexual health. A couple-centred program for the integrated management of psychological and sexual dysfunction should be considered in the context of ART programs.
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Affiliation(s)
- G Luca
- Unit of Andrology and Endocrinology of Reproduction, Department of Experimental Medicine, University Medical School, 06129, Perugia, Italy
| | - S Parrettini
- Section of Endocrinology and Metabolism, Department of Medicine, Perugia, University Medical School, 06129, Perugia, Italy
| | - A Sansone
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier, 1, E Tower South. Floor 4, Room E413, 00133, Rome, Italy
| | - R Calafiore
- Section of Endocrinology and Metabolism, Department of Medicine, Perugia, University Medical School, 06129, Perugia, Italy
| | - E A Jannini
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier, 1, E Tower South. Floor 4, Room E413, 00133, Rome, Italy.
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Pozza A, Dèttore D, Coccia ME. Quality of life and infertility stress in homologous and heterologous medically assisted reproduction: The role of common and specific psychopathological traits. Perspect Psychiatr Care 2021; 57:717-725. [PMID: 32776595 DOI: 10.1111/ppc.12603] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 07/03/2020] [Accepted: 08/02/2020] [Indexed: 11/28/2022] Open
Abstract
PURPOSE This study compared the quality of life/stress between individuals undergoing homologous and heterologous medically assisted reproduction (MAR) and explored the role of psychopathological traits. DESIGN AND METHODS Two hundred and twenty-six participants in homologous (52.2%) and heterologous MAR (47.8%) completed Symptom Checklist 90-R, Fertility Problem Inventory, and Fertility Quality of Life. FINDINGS The homologous group showed higher depressive/anxious and obsessive-compulsive traits, hostility and interpersonal detachment, and worse quality of life/stress than the heterologous one. In the homologous pathway, those with higher interpersonal detachment showed worse quality of life, in the heterologous one those with greater paranoid traits had greater stress. PRACTICE IMPLICATIONS Psychiatric nursing support should focus on interpersonal detachment in homologous and paranoid traits in heterologous MAR.
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Affiliation(s)
- Andrea Pozza
- Department of Medical Sciences, Surgery, and Neurosciences, University of Siena, Siena, Italy
| | - Davide Dèttore
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Maria E Coccia
- Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, Italy
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Conversano C, Orrù G, Pozza A, Miccoli M, Ciacchini R, Marchi L, Gemignani A. Is Mindfulness-Based Stress Reduction Effective for People with Hypertension? A Systematic Review and Meta-Analysis of 30 Years of Evidence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2882. [PMID: 33799828 PMCID: PMC8000213 DOI: 10.3390/ijerph18062882] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 03/01/2021] [Accepted: 03/03/2021] [Indexed: 12/13/2022]
Abstract
Background: Hypertension is among the most important risk factors for cardiovascular diseases, which are considered high mortality risk medical conditions. To date, several studies have reported positive effects of mindfulness-based stress reduction (MBSR) interventions on physical and psychological well-being in other medical conditions, but no meta-analysis on MBSR programs for hypertension has been conducted. Objectives: The objective of this study was to determine the effectiveness of MBSR programs for hypertension. Methods: A systematic review and meta-analysis of randomized controlled trials examining the effects of MBSR on systolic and diastolic blood pressure (BP), anxiety, depression, and perceived stress in people with hypertension or pre-hypertension was conducted. The PubMed/MEDLINE and PsycINFO databases were searched in November 2020 to identify relevant studies. Results: Six studies were included. The comparison of MBSR versus control conditions on diastolic BP was associated with a statistically significant mean effect size favoring MBSR over control conditions (MD = -2.029; 95% confidence interval (CI): -3.676 to -0.383, p = 0.016, k = 6; 22 effect sizes overall), without evidence of heterogeneity (I2 = 0.000%). The comparison of MBSR versus control conditions on systolic BP was associated with a mean effect size which was statistically significant only at a marginal level (MD = -3.894; 95% CI: -7.736-0.053, p = 0.047, k = 6; 22 effect sizes overall), without evidence of high heterogeneity (I2 = 20.772%). The higher the proportion of participants on antihypertensive medications was, the larger the effects of MBSR were on systolic BP (B = -0.750, z = -2.73, p = 0.003). Conclusions: MBSR seems to be a promising intervention, particularly effective on the reduction of diastolic BP. More well-conducted trials are required.
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Affiliation(s)
- Ciro Conversano
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, 56126 Pisa, Italy; (C.C.); (O.G.); (R.C.); (L.M.); (A.G.)
| | - Graziella Orrù
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Andrea Pozza
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy;
| | - Mario Miccoli
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Rebecca Ciacchini
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, 56126 Pisa, Italy; (C.C.); (O.G.); (R.C.); (L.M.); (A.G.)
| | - Laura Marchi
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, 56126 Pisa, Italy; (C.C.); (O.G.); (R.C.); (L.M.); (A.G.)
| | - Angelo Gemignani
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, 56126 Pisa, Italy; (C.C.); (O.G.); (R.C.); (L.M.); (A.G.)
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Ortac M, Tonyali S. The Effect of a Sharp Increase in Estrogen Levels on Overactive Bladder Symptoms in Women Undergoing Ovulation Induction. Urology 2021; 149:264-265. [PMID: 33453198 DOI: 10.1016/j.urology.2020.12.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Accepted: 12/28/2020] [Indexed: 10/22/2022]
Affiliation(s)
- Mazhar Ortac
- Istanbul University Istanbul School of Medicine, Department of Urology, Istanbul Turkey.
| | - Senol Tonyali
- Istanbul University Istanbul School of Medicine, Department of Urology, Istanbul Turkey
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Ngai FW, Loke AY. Relationships between infertility-related stress, family sense of coherence and quality of life of couples with infertility. HUM FERTIL 2021; 25:540-547. [PMID: 33432870 DOI: 10.1080/14647273.2021.1871781] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
This is a cross-sectional study with the objective to examine the relationships between infertility-related stress, family sense of coherence and quality of life of Chinese couples with infertility in Hong Kong. A convenience sample of 135 Chinese couples were recruited at the subfertility clinics of the Family Planning Association of Hong Kong. Data were collected using the Fertility Problem Inventory, Family Sense of Coherence Scale and Fertility Quality of Life. Path analysis was used for data analysis. The results showed that infertility-related stress had a negative association with the quality of life of infertile couples and family sense of coherence mediated the effect of infertility-related stress on quality of life for both partners. The infertility-related stress of women had a negative association with their husbands' quality of life. Infertile women had more infertility-related stress and a lower quality of life than their husbands. The findings provide new insights into the importance of family sense of coherence in facilitating couples' adjustment to infertility. Culturally competent heath care interventions should be developed to strengthen family sense of coherence among Chinese couples with infertility and help them reduce their infertility-related stress, thus improving their quality of life.
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Affiliation(s)
- Fei-Wan Ngai
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Alice Yuen Loke
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
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Zurlo MC, Cattaneo Della Volta MF, Vallone F. Re-examining the Role of Coping Strategies in the Associations Between Infertility-Related Stress Dimensions and State-Anxiety: Implications for Clinical Interventions With Infertile Couples. Front Psychol 2020; 11:614887. [PMID: 33414752 PMCID: PMC7782436 DOI: 10.3389/fpsyg.2020.614887] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 11/18/2020] [Indexed: 12/22/2022] Open
Abstract
Research has shown a direct relationship between infertility-related stress and anxiety in infertile patients. The present study goes into this relationship in depth, testing the moderating role of coping strategies (Seeking Social Support, Avoidant, Positive Attitude, Problem-Solving, Turning to Religion) in the associations between specific infertility-related stress dimensions (Social Concern, Need for Parenthood, Rejection of Childfree Lifestyle, Couple’s Relationship Concern) and State-Anxiety among male and female partners of infertile couples. Gender differences were also explored. Both members of 254 infertile couples completed a questionnaire consisting of Socio-demographics, Fertility Problem Inventory–Short Form (FPI-SF), Coping Orientation to Problem Experienced–New Italian Version (COPE-NIV), and State-Trait Anxiety Inventory-Y (STAI-Y). The results revealed that Social Concern and Couple’s Relationship Concern, in both partners, and Need for Parenthood, in female partners, had positive correlations with State-Anxiety. Seeking Social Support and Avoidant coping were related to increasing levels of State-Anxiety in both partners, whereas Positive Attitude coping strategies were related to lower levels of State-Anxiety in female partners. Problem-Solving and Avoidant coping played moderating roles between specific infertility-related stress dimensions and State-Anxiety in unexpected directions. Problem-Solving exacerbated the negative effects of Social Concern, whereas Avoidant coping buffered the negative effects of several infertility-related stress dimensions in both partners. Interventions to improve stress management and psychological health in infertile couples should consider that the adequacy of coping strategies is inherently situation specific. It therefore follows that patient-centered clinical interventions should consider the potential inadequacy of promoting Problem-Solving strategies, and that even Avoidance can be an efficient strategy for dealing with specific infertility-related stress dimensions.
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Affiliation(s)
- Maria Clelia Zurlo
- Dynamic Psychology Laboratory, Department of Political Science, University of Naples Federico II, Naples, Italy
| | - Maria Francesca Cattaneo Della Volta
- Dynamic Psychology Laboratory, Department of Political Science, 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 Science, University of Naples Federico II, Naples, Italy.,Department of Humanities, University of Naples Federico II, Naples, Italy
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Perinatal Mood and Anxiety Disorders in Women Undergoing Medically Assisted Reproduction. PSYCHIATRY INTERNATIONAL 2020. [DOI: 10.3390/psychiatryint1020011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Women taking advantage of medically assisted reproduction (MAR) techniques may differ from spontaneously conceiving women (nonMAR) in risk of depression and/or anxiety. We aimed to investigate possible differences between MAR and nonMAR through the use of the Edinburgh Postnatal Depression Scale in a sample of Italian-speaking women at their third trimester of pregnancy. Methods: We administered the Edinburgh Postnatal Depression Scale (EPDS) to two groups of pregnant women, MAR and nonMAR, at the third trimester of pregnancy (T0), one month after delivery (T1), and three months after delivery (T2) from February 2013 to December 2019. EPDS total scores cutoffs were ≥9 for risk of depression, 9–11 mild depression, ≥12 major depression, and the EPDS-3A cluster ≥4 was a proxy for anxiety. Results: Included were 1303 nonMAR women and 92 MAR, an expected disproportion. NonMAR and MAR women did not differ on depression or anxiety at any assessment timepoint. MAR women were older than nonMAR, consumed more alcohol and medical drugs, and displayed more complications during pregnancy. Scoring over the threshold on depression risk was associated with foreign nationality, unemployment, psychiatric history of the patient, family or partner, psychiatric problems in past pregnancies, hyperemesis, premenstrual syndrome (PMS), and stressful life events in the last year at baseline, and, for some of them, at other timepoints. In contrast, MAR past or current was associated with having suprathreshold depression at the first-month postpartum follow-up. Conclusions: Taken together, our data show that women opting for MAR do not differ from spontaneously conceiving women regarding psychiatric outcomes but do differ on some sociodemographic and clinical variables.
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