1
|
Renzi A, Mariani R, Fedele F, Maniaci VG, Petrovska E, D’Amelio R, Mazzoni G, Di Trani M. Women's Narratives on Infertility as a Traumatic Event: An Exploration of Emotional Processing through the Referential Activity Linguistic Program. Healthcare (Basel) 2023; 11:2919. [PMID: 37998411 PMCID: PMC10671616 DOI: 10.3390/healthcare11222919] [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: 09/18/2023] [Revised: 10/25/2023] [Accepted: 11/06/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND the diagnosis of infertility and its related treatment can be traumatic, leading to profound psychological distress and a variety of psychopathological symptoms. The primary objective of this study is to contrast the linguistic features of narratives from women undergoing Assisted Reproductive Treatment with those of women not undergoing any fertility treatment. This study examines the speech of both groups of individuals as an indicator of their capacity to cope with current and past distressing experiences. METHOD 44 women (mean age 36.05; SD = 4.66) enrolled in a fertility medical center in Rome, and 43 control women (mean age 36.07; SD = 3.47) completed a socio-demographic questionnaire and a semi-structured interview designed to collect their memories of a neutral, a positive, and a negative event. This interview also aimed to investigate: (a) (for women with fertility difficulties) how they realized they and their partner had fertility problems and a description of an event when they talked about these difficulties with their partner; and (b) (for control group participants) the most difficult moment of their pregnancy and an event when they talked about it with their partner. The interviews were audio recorded and transcribed, and the text was analyzed using the referential process (RP) linguistic measures software. RESULTS Mann-Whitney non-parametric U tests for the independent samples showed several significant differences regarding the linguistic measures applied to the narratives of neutral, positive, negative, and difficult experiences in the form of a linguistic style, with more intellectualization and defenses in all the narratives associated with the women with fertility problems compared to the women in the control group. CONCLUSIONS the traumatic and painful experience of infertility and ART seems to characterize the whole mode of narrating life experiences. Present findings sustain the importance of helping women to elaborate on their experience and to understand and recognize the difficult feelings that are activated in relation to the difficulties of having a child.
Collapse
Affiliation(s)
- Alessia Renzi
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, Via degli Apuli 1, 00185 Rome, Italy; (R.M.); (V.G.M.); (G.M.); (M.D.T.)
| | - Rachele Mariani
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, Via degli Apuli 1, 00185 Rome, Italy; (R.M.); (V.G.M.); (G.M.); (M.D.T.)
| | - Fabiola Fedele
- ART Italian National Register, National Centre for Diseases Prevention and Health Promotion, Italian National Health Institute, Viale Regina Elena 299, 00161 Rome, Italy;
| | - Vito Giuseppe Maniaci
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, Via degli Apuli 1, 00185 Rome, Italy; (R.M.); (V.G.M.); (G.M.); (M.D.T.)
| | - Elena Petrovska
- Derner School of Psychology, Adelphi University, Garden City, NY 11530-0701, USA;
| | - Renzo D’Amelio
- Department of Gynecologic-Obstetrical and Urologic Sciences, Umberto I Hospital, Sapienza University of Rome, 00185 Rome, Italy;
| | - Giuliana Mazzoni
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, Via degli Apuli 1, 00185 Rome, Italy; (R.M.); (V.G.M.); (G.M.); (M.D.T.)
| | - Michela Di Trani
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, Via degli Apuli 1, 00185 Rome, Italy; (R.M.); (V.G.M.); (G.M.); (M.D.T.)
| |
Collapse
|
2
|
Lehto S, Sevón E, Laakso ML, Rönkä A. Infertility as a lonely struggle? Coping stories of previously infertile women. Health Care Women Int 2023; 44:397-417. [PMID: 34936858 DOI: 10.1080/07399332.2021.2007246] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
In this narrative study, we explored the meaning infertile women attribute to social support in coping with their infertility-related challenges. Written accounts and episodic interviews with 26 previously infertile Finnish women were used as data. Two different coping story types emerged: coping alone and coping with support. In the coping alone type women neither sought nor received support. Their coping appeared as a lonely struggle. In the coping with stories, women turned to their spouses, peers, or professionals, but still emphasized that they would have needed more support. Based on our findings, we underline the need for individually tailored support.
Collapse
Affiliation(s)
- Siru Lehto
- School of Professional Teacher Education, JAMK University of Applied Sciences, Jyväskylä, Finland
| | - E Sevón
- Department of Education, University of Jyväskylä, Jyväskylä, Finland
| | - M-L Laakso
- Department of Education, University of Jyväskylä, Jyväskylä, Finland
| | - A Rönkä
- Department of Education, University of Jyväskylä, Jyväskylä, Finland
| |
Collapse
|
3
|
Childbearing Motivation Questionnaire. PSICO 2020. [DOI: 10.15448/1980-8623.2020.4.36089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
O presente artigo objetiva descrever os procedimentos de adaptação e evidências iniciais de validade do Childbearing Motivation Questionnaire (CBQ) para o Brasil. O CBQ está constituído por duas escalas: a primeira avalia as motivações positivas para ter filhos (PCM) e a segunda, as motivações negativas (NCM). A adaptação foi realizada em cinco etapas: 1) tradução do instrumento; 2) síntese das versões traduzidas; 3) avaliação por juízes experts; 4) avaliação pelo público-alvo e 5) tradução reversa. Para a avaliação da estrutura fatorial realizou-se análises fatoriais exploratórias e confirmatórias em uma amostra de 1894 brasileiros de 18 a 68 anos de 25 estados do Brasil. A escala PCM apresentou uma solução fatorial de segunda ordem similar à proposta pelo autor enquanto a NCM apresentou uma estrutura unifatorial com boas propriedades psicométricas. Os resultados mostram o CBQ como um instrumento válido para a mensuração das motivações para ter filhos na população brasileira.
Collapse
|
4
|
Molgora S, Baldini MP, Tamanza G, Somigliana E, Saita E. Individual and Relational Well-Being at the Start of an ART Treatment: A Focus on Partners' Gender Differences. Front Psychol 2020; 11:2027. [PMID: 33117204 PMCID: PMC7549400 DOI: 10.3389/fpsyg.2020.02027] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 07/21/2020] [Indexed: 12/17/2022] Open
Abstract
Infertility and ART treatments represent stressful experiences for the couples, impacting on the overall psychological well-being of partners as well as on their couple adjustment. Several variables were analyzed as risk factors for infertility-related distress. The impact of these experiences has been well-documented in both women and men, reporting important gender differences. The aim of this study was to assess gender differences in individual and relational well-being in infertile couples. Gender differences for psychological and medical variables predicting psychological distress were investigated. Two hundred and thirty couples who entered an ART program at a public hospital in Milan were recruited. Each partner completed the following scales: ScreenIVF, Dyadic Adjustment Scale, and Experience in Close Relationship Questionnaire. Findings revealed several gender differences with women reporting higher levels of both anxiety and depressive symptoms, anxiety and avoidance attachment, and helplessness, but lower levels of acceptance than men. Differences emerged also in factors predicting well-being: poor support predicted anxiety in men and depression in women. Furthermore, individual well-being was predicted only for men by attachment anxiety and previous treatment. Finally, in the women subsample, couple's adjustment was predicted by anxiety attachment, while in men predictors were helplessness and type of diagnosis. These results suggest the importance of implementing support interventions for couples which take into consideration the specific needs and fragility of each partner as well as focusing on enhancing a sense of partnership.
Collapse
Affiliation(s)
- Sara Molgora
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
| | - Maria Pia Baldini
- IRCCS Ca’Granda Foundation Maggiore Policlinico Hospital, Milan, Italy
| | | | | | - Emanuela Saita
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
| |
Collapse
|
5
|
Molgora S, Fenaroli V, Acquati C, De Donno A, Baldini MP, Saita E. Examining the Role of Dyadic Coping on the Marital Adjustment of Couples Undergoing Assisted Reproductive Technology (ART). Front Psychol 2019; 10:415. [PMID: 30906270 PMCID: PMC6418016 DOI: 10.3389/fpsyg.2019.00415] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 02/12/2019] [Indexed: 11/13/2022] Open
Abstract
A couple is considered to be infertile if unable to conceive after 12 months of unprotected sexual intercourse. An extended body of literature supports that infertility and infertility treatments contribute to emotional, social, sexual, and relational issues that can have a negative impact on each partner's well-being and on the couple relationship. Recent findings suggest that a dyadic approach should be used when working with couples coping with these stressors. However, most research to date has focused on the association between infertility and individual's psychological outcomes, rather than on the experience of infertility-related stress and coping from a relational perspective. Consequently, assuming that infertility is a dyadic stressor and that the ability of the partners to cope with this experience is the result of both individual and relational coping strategies, this study aimed to investigate dyadic coping and marital adjustment among couples at the beginning of an Assisted Reproductive Technology (ART) treatment. A sample of 167 heterosexual couples (N = 334) undergoing ART treatment at the fertility clinic of a large hospital in Milan from January to December 2017 was recruited. Each participant completed self-reported questionnaires examining marital adjustment (Dyadic Adjustment Scale) and dyadic coping (Dyadic Coping Questionnaire). Demographics and clinical variables were also collected. Data were analyzed using the Actor Partner Interdependence Model (APIM), testing the effect of each partner's dyadic coping style on their own and their partner's marital adjustment. Results revealed that both women and partners' scores on positive dyadic coping styles (common, emotion-focused, problem-focused, and delegated dyadic coping) contributed to higher marital adjustment. This result suggests that couples unable to engage in this type of reciprocal supportive behaviors and those unsatisfied with their coping efforts may be more vulnerable while undergoing ART treatments. Furthermore, findings highlighted some gender differences for stress communication and negative dyadic coping suggesting the presence of specific dynamics within couples facing an ART treatment. Implications for clinical practice and future research are discussed.
Collapse
Affiliation(s)
- Sara Molgora
- Department of Psychology, Catholic University of Sacred Hearth, Milan, Italy
| | - Valentina Fenaroli
- Department of Psychology, Catholic University of Sacred Hearth, Milan, Italy
| | - Chiara Acquati
- Graduate College of Social Work, University of Houston, Houston, TX, United States
| | - Arianna De Donno
- Department of Psychology, Catholic University of Sacred Hearth, Milan, Italy
| | - Maria Pia Baldini
- IRCCS Ca 'Granda Foundation Maggiore Policlinico Hospital, Milan, Italy
| | - Emanuela Saita
- Department of Psychology, Catholic University of Sacred Hearth, Milan, Italy
| |
Collapse
|
6
|
FROM MOTIVES THROUGH DESIRES TO INTENTIONS: INVESTIGATING THE REPRODUCTIVE CHOICES OF CHILDLESS MEN AND WOMEN IN POLAND. J Biosoc Sci 2017; 50:421-433. [DOI: 10.1017/s0021932017000190] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
SummaryThis study examined the potential of the theoretical model proposed by Warren Miller (the Traits/Motives–Desires–Intentions–Behaviour or TDIB model) for investigating the involuntary–voluntary childlessness continuum. The first three stages of the theoretical motivational sequence (motives to desires to intentions) were examined using a purposive sample of 314 childless Polish men and women aged 30–39 (at the time of data collection in September 2013). In Poland, this is the age range when the final decision for or against parenthood is taken. To model the motivational sequence, the Structural Equation Modelling (SEM) technique was applied. The results confirmed the hypothesized relations between the constructs for childless individuals in the analysed age group. Their childbearing desires were found to be good predictors of reproductive intentions, while negative and positive childbearing motives (independently) underpinned their desires. Moreover, positive motives appeared to have a stronger effect on desires than negative ones. The study also documented the psychometric properties of the Polish adaptation of the Childbearing Questionnaire, which was originally developed by Miller to measure childbearing motives. The advantages of using this tool for investigating the involuntary–voluntary childlessness continuum are discussed. Overall, the study validated the theoretical model as well as the adaptation of the Childbearing Questionnaire in the new research context: in the new cultural setting and for examining reproductive choices of a specific subpopulation. Directions for future research that could build on the TDIB model and allow for a deeper understanding of permanent childlessness are outlined.
Collapse
|
7
|
Milazzo A, Mnatzaganian G, Elshaug AG, Hemphill SA, Hiller JE. Depression and Anxiety Outcomes Associated with Failed Assisted Reproductive Technologies: A Systematic Review and Meta-Analysis. PLoS One 2016; 11:e0165805. [PMID: 27835654 PMCID: PMC5106043 DOI: 10.1371/journal.pone.0165805] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 10/18/2016] [Indexed: 11/18/2022] Open
Abstract
Objective Our study examined the psychological outcomes associated with failed ART treatment outcomes in men and women. Search Strategy A systematic search for studies published between January 1980 and August 2015 was performed across seven electronic databases. Inclusion Criteria Studies were included if they contained data on psychosocial outcomes taken pre and post ART treatment. Data Extraction and Synthesis A standardised form was used to extract data and was verified by two independent reviewers. Studies were meta-analysed to determine the association of depression and anxiety with ART treatment outcomes. Narrative synthesis identified factors to explain variations in the size and directions of effects and relationships explored within and between the studies. Main Results Both depression and anxiety increased after a ART treatment failure with an overall pooled standardised mean difference (SMD) of 0.41 (95% CI: 0.27, 0.55) for depression and 0.21 (95% CI: 0.13, 0.29) for anxiety. In contrast, depression decreased after a successful treatment, SMD of -0.24 (95% CI: -0.37,-0.11). Both depression and anxiety decreased as time passed from ART procedure. Nonetheless, these remained higher than baseline measures in the group with the failed outcome even six months after the procedure. Studies included in the narrative synthesis also confirmed an association with negative psychological outcomes in relation to marital satisfaction and general well-being following treatment failure. Conclusion Linking ART failure and psychosocial outcomes may elucidate the experience of treatment subgroups, influence deliberations around recommendations for resource allocation and health policy and guide patient and clinician decision making.
Collapse
Affiliation(s)
- Adriana Milazzo
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - George Mnatzaganian
- College of Science, Health and Engineering, La Trobe Rural Health School, La Trobe University, Victoria, Australia
| | - Adam G. Elshaug
- Menzies Centre for Health Policy, The University of Sydney, Sydney, New South Wales, Australia
| | - Sheryl A. Hemphill
- Learning Sciences Institute Australia, Faculty of Education and Arts, Australian Catholic University, Melbourne, Victoria, Australia
- School of Psychology, Faculty of Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia
| | - Janet E. Hiller
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
- School of Health Sciences, Swinburne University of Technology, Melbourne, Victoria Australia
- * E-mail:
| | | |
Collapse
|
8
|
Moura-Ramos M, Gameiro S, Canavarro MC, Soares I, Almeida-Santos T. Does infertility history affect the emotional adjustment of couples undergoing assisted reproduction? the mediating role of the importance of parenthood. Br J Health Psychol 2015; 21:302-17. [PMID: 27059275 PMCID: PMC5061027 DOI: 10.1111/bjhp.12169] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Revised: 09/25/2015] [Indexed: 11/29/2022]
Abstract
Objectives The emotional adjustment of couples undergoing assisted reproductive technology (ART) treatments has been widely studied; however, it remains unclear whether infertility history contributes to couples' adjustment. This study examined the impact of infertility history (duration of infertility and number of previous ART treatment cycles) on the emotional adjustment of couples undergoing an ART cycle and the mediating effect of importance of parenthood on that association. Methods In this cross‐sectional study, 70 infertile couples (70 women and 70 men) completed self‐report questionnaires assessing emotional adjustment and infertility stress during the hormonal stimulation phase of an ART cycle. Path models accounting for the dyadic nature of the data examined the direct and indirect effects (by affecting representations about parenthood and childlessness) of infertility history on emotional adjustment. Results The number of previous cycles affected men's, but not women's, emotional adjustment by affecting the representations on the importance of parenthood and of childlessness. Duration of infertility had the opposite effect, as couples with longer infertility reported heightened importance of parenthood, which negatively affected their emotional adjustment. Conclusions Infertility history was associated with emotional adjustment in men and women, although these associations were complex. The results suggest that progression through treatment is harder for those men and women who attribute higher importance to being parents, which is aggravated by longer infertility. Statement of contribution What is already known about the subject? Infertility is an unexpected and stressful life event Assisted reproductive treatments (ART) are emotionally demanding
What does this study add? The influence of infertility history on adjustment is mediated by the importance of parenthood Men and women are affected by their past history of infertility differently
Collapse
Affiliation(s)
- Mariana Moura-Ramos
- Faculty of Psychology and Educational Sciences, University of Coimbra, Portugal
| | - Sofia Gameiro
- Cardiff Fertility Studies Research Group, School of Psychology, Cardiff University, UK
| | | | - Isabel Soares
- School of Psychology, University of Minho, Braga, Portugal
| | | |
Collapse
|
9
|
Erdei M, Cserepes RE, Bugán A. [Knowledge and perception of medical students about infertility]. Orv Hetil 2015; 156:105-12. [PMID: 25577682 DOI: 10.1556/oh.2015.30055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The effectiveness of fertility treatments is influenced by the health care professionals' knowledge regarding infertility as well as their empathy. AIM The aim of the study was to examine infertility-related knowledge and perceptions of emotional and mind/body consequences of infertility among medical students. METHODS A questionnaire design was used. Data were obtained from 112 medical university students (76 women, 36 men) who participated involuntary and compensation-free. RESULTS Medical students' knowledge concerning infertility proved to be incomplete and ambiguous. Subjects underestimated the presence of mind/body and emotional symptoms caused by infertility in men particularly, and overestimated some emotional concerns in women, e.g. sadness. CONCLUSIONS Medical students have gaps in their subject-specific knowledge, so that they need more (even practical) information regarding infertility during their studies. Students' conceptions about emotional and physical consequences of infertility are distorted by stereotypes. The risk of these biases is that it could make it difficult to perceive patients in a non-distorted way, especially infertile male patients.
Collapse
Affiliation(s)
- Márta Erdei
- Debreceni Egyetem, Népegészségügyi Kar Magatartástudományi Intézet Debrecen Nagyerdei krt. 98. 4032
| | - Réka Eszter Cserepes
- Debreceni Egyetem, Népegészségügyi Kar Magatartástudományi Intézet Debrecen Nagyerdei krt. 98. 4032
| | - Antal Bugán
- Debreceni Egyetem, Népegészségügyi Kar Magatartástudományi Intézet Debrecen Nagyerdei krt. 98. 4032
| |
Collapse
|
10
|
Read SC, Carrier ME, Boucher ME, Whitley R, Bond S, Zelkowitz P. Psychosocial services for couples in infertility treatment: what do couples really want? PATIENT EDUCATION AND COUNSELING 2014; 94:390-5. [PMID: 24290241 DOI: 10.1016/j.pec.2013.10.025] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Revised: 10/04/2013] [Accepted: 10/26/2013] [Indexed: 05/25/2023]
Abstract
OBJECTIVES To describe the psychosocial supports that infertile couples desire to help cope with infertility-related distress, which psychosocial services they sought, and the benefits and drawbacks of these services. METHODS Qualitative interview study with 32 heterosexual infertile couples seeking infertility treatment. Maximum variation sampling was used; data were analyzed using thematic analysis. RESULTS Most couples desired psychosocial support, but only half of the sample sought support. Some couples met with psychologists for help with relationship conflict and coping strategies. Participants suggested peer mentoring to fulfill needs for coping, shared experience, and guidance through the treatment process. Couples also desired written information about practical and emotional aspects of treatment. Negative attitudes toward psychological counseling and a lack of information about support services prevented some couples from seeking support. CONCLUSIONS Infertile couples expressed numerous needs for psychosocial supports, but often felt that supports were not available. A variety of services should be offered in order to fulfill patients' varied needs. PRACTICE IMPLICATIONS Awareness of the reasons why patients desire psychosocial services will help clinicians to refer patients to currently available psychosocial supports, and will aid in the development of appropriate supports, including couples counseling, peer mentoring, and written information in lay language.
Collapse
Affiliation(s)
- Suzanne C Read
- Department of Psychiatry, McGill University, Montreal, Canada
| | | | - Marie-Eve Boucher
- Department of Psychiatry, McGill University, Montreal, Canada; Douglas Mental Health University Institute, Montreal, Canada
| | - Robert Whitley
- Department of Psychiatry, McGill University, Montreal, Canada; Douglas Mental Health University Institute, Montreal, Canada
| | - Sharon Bond
- Jewish General Hospital, Montreal, Canada; School of Social Work, McGill University, Montreal, Canada
| | - Phyllis Zelkowitz
- Department of Psychiatry, McGill University, Montreal, Canada; Jewish General Hospital, Montreal, Canada.
| |
Collapse
|
11
|
Milardi D, Grande G, Sacchini D, Astorri AL, Pompa G, Giampietro A, De Marinis L, Pontecorvi A, Spagnolo AG, Marana R. Male fertility and reduction in semen parameters: a single tertiary-care center experience. Int J Endocrinol 2012; 2012:649149. [PMID: 22319527 PMCID: PMC3272805 DOI: 10.1155/2012/649149] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2011] [Accepted: 10/19/2011] [Indexed: 11/24/2022] Open
Abstract
Background. Infertility is both a clinical and a public problem, affecting the life of the couple, the healthcare services, and social environment. Standard semen analysis is the surrogate measure of male fertility in clinical practice. Objective. To provide information about the relationship between semen parameters and spontaneous conception. Methods. We evaluated retrospectively 453 pregnancies that occurred among 2935 infertile couples evaluated at an infertility clinic of a tertiary-care university hospital, between 2004 and 2009. Results. Normal semen analysis was present only in 158 patients; 295 subfertile patients showed alterations in at least one seminal parameter. A reduction in all seminal parameters was observed in 41 patients. Etiological causes of male infertility were identified in 314 patients. Conclusion. Our data highlights the possibility of a spontaneous conception with semen parameters below WHO reference values. Therefore, we support the importance of defining reference values on a population of fertile men. Finally, we analyzed the related ethical issues.
Collapse
Affiliation(s)
- D. Milardi
- Department of Obstetrics and Gynecology, International Scientific Institute “Paolo VI”, Catholic University of the Sacred Heart, Largo A. Gemelli 8, 00168 Rome, Italy
- *D. Milardi:
| | - G. Grande
- Unit of Endocrinology, Department of Clinical Medicine, Catholic University of the Sacred Heart, Largo A. Gemelli 8, 00168 Rome, Italy
| | - D. Sacchini
- Institute of Bioethics, Catholic University of the Sacred Heart, Largo A. Gemelli 8, 00168 Rome, Italy
| | - A. L. Astorri
- Department of Obstetrics and Gynecology, International Scientific Institute “Paolo VI”, Catholic University of the Sacred Heart, Largo A. Gemelli 8, 00168 Rome, Italy
| | - G. Pompa
- Department of Obstetrics and Gynecology, International Scientific Institute “Paolo VI”, Catholic University of the Sacred Heart, Largo A. Gemelli 8, 00168 Rome, Italy
| | - A. Giampietro
- Unit of Endocrinology, Department of Clinical Medicine, Catholic University of the Sacred Heart, Largo A. Gemelli 8, 00168 Rome, Italy
| | - L. De Marinis
- Unit of Endocrinology, Department of Clinical Medicine, Catholic University of the Sacred Heart, Largo A. Gemelli 8, 00168 Rome, Italy
| | - A. Pontecorvi
- Unit of Endocrinology, Department of Clinical Medicine, Catholic University of the Sacred Heart, Largo A. Gemelli 8, 00168 Rome, Italy
| | - A. G. Spagnolo
- Institute of Bioethics, Catholic University of the Sacred Heart, Largo A. Gemelli 8, 00168 Rome, Italy
| | - R. Marana
- Department of Obstetrics and Gynecology, International Scientific Institute “Paolo VI”, Catholic University of the Sacred Heart, Largo A. Gemelli 8, 00168 Rome, Italy
| |
Collapse
|