Protective emotional regulation processes towards adjustment in infertile patients

Effects of Religious Versus Non-religious Self-compassion Interventions on Anxiety and Quality of Life of Iranian Infertile Women: A Randomized Controlled Trial

Anxiety is one of the common psychological problems among infertile women, which affects their quality of life. The purpose of this study was to compare the effects of self-compassion intervention based on a religious and non-religious perspective regarding the anxiety and quality of life of infertile women. A randomized clinical trial design with experimental and control groups was used. A total of 78 infertile women who lived in Yazd province, Iran, were referred to Yazd reproductive sciences institute, were selected by available sampling and randomly assigned to two experimental and one control groups. The participants of the first experimental group received eight sessions of self-compassion-focused intervention based on religious instructions. The second experimental group received eight sessions of non-religious self-compassion intervention, while the control group was put on the waiting list. Data were collected using Quality of Life in Infertile Couples Questionnaire (QOLICQ) and Beck anxiety inventory (BDI) in the pretest, posttest and 2-month follow-up phases and then analyzed using repeated measures as well as one-way analysis of variance. The results showed as compared to control group at the posttest and follow-up phases, the quality of life (p < 0.001) and anxiety (p < 0.001) of infertile women increased and decreased, respectively, across both experimental groups. Comparison of experimental groups showed that although the difference between the two groups in the subscales of social relationships and sexual satisfaction was not significant, the gain scores of quality of life and anxiety were significantly greater in the first experimental group. These findings indicate that given the religious background of infertile women, religious self-compassion intervention can be relatively more effective in improving the quality of life and anxiety of infertile women than non-religious intervention.

Identifying modifiable factors associated with psychological health in women experiencing infertility

This study assessed the relationship between modifiable psychological variables and depression, anxiety, and posttraumatic growth in women experiencing infertility. U.S. women (N = 457) who identified as experiencing infertility completed standardized self-report measures of mindfulness, self-compassion, positive affect, intolerance of uncertainty, relationship satisfaction, experiential avoidance, depression, anxiety, and posttraumatic growth. Clinical and demographic characteristics (age, duration trying to conceive, miscarriage, and childlessness) did not predict depression or anxiety. Lower positive affect and higher experiential avoidance were associated with depression and anxiety. Lower self-compassion was associated with depression; higher intolerance of uncertainty was associated with anxiety. There were indirect effects of mindfulness on anxiety and depression via these variables. Future research should explore whether intervening on these factors reduces depressive and anxiety symptoms. Promoting mindfulness may have beneficial effects on symptoms via its downstream effects on multiple coping variables. Counterintuitively, posttraumatic growth was associated with higher intolerance of uncertainty and experiential avoidance.

Personal Growth and Life Satisfaction during Fertility Treatment-A Comparison between Arab and Jewish Women

Coping with difficulty conceiving and the ensuing fertility treatments is a stressful experience that impacts many aspects of women's lives. On the basis of Lazarus and Folkman's model of stress and coping and Schaefer and Moos's model of personal growth, and in view of the sparse literature on cultural aspects of infertility and personal growth, this study examined the relationship between stress on the one hand and personal growth and life satisfaction on the other among Arab and Jewish Israeli women. Furthermore, it investigated the moderating role played by perceived stigma, coping flexibility, cultural orientation (individualism and collectivism), and ethnicity. Two hundred five Arab and Jewish Israeli women undergoing fertility treatment completed self-report questionnaires. The results show that Arab women reported higher levels of personal growth and individualism than Jewish women. In the whole sample, a linear negative relationship was found between stress and life satisfaction, and a curvilinear relationship was found between stress and personal growth. In addition, perceived stigma, collectivism, individualism, and coping flexibility were found to moderate the association between perceived stress and personal growth. The findings provide further understanding of personal growth in the context of infertility, showing that personal resources and perceptions are more important than cultural differences in this regard.

Ambivalence experienced by infertile couples undergoing IVF: a qualitative study

The emotional consequences of infertility are well documented. However, relatively few studies have emphasized the dyadic emotional interaction within couples, despite infertility being a shared life event. This study adopted a dyadic (between two people) approach to explore the emotional complexity that infertile couples face. A descriptive qualitative study was conducted with 24 participants, including eight infertile couples and eight wives undergoing infertility treatments. Conjoint and individual interviews were conducted through purposive sampling in a large fertility centre in Tianjin, China, between June and August 2015. Thematic analysis identified two main themes: (i) 'decisional ambivalence', with subthemes of 'ambivalent attitudes towards treatment', 'uncertainty about treatment outcomes', and 'treatment-related lifestyle changes'; and (ii) 'relational ambivalence' which included subthemes of 'intergenerational ambivalence' and 'partner ambivalence'. Complex emotions of ambivalence among infertile couples were common as infertility clearly shattered their assumptive world on family formation. With complex entanglement of mixed emotions, ambivalence was intimately associated with cultural norms, social expectations, and active or over engagement of family members in Chinese societies. Since ambivalence could threaten mental and physical health during pregnancy, healthcare professionals should be prepared to assist infertile couples with identifying, articulating, and normalizing decisional and relational ambivalence during the treatment process.

The impact of effective communication skills training on the status of marital burnout among married women

Background

This study aimed to determine the impact of effective communication skills training intervention on the marital burnout among married women referring to health centers.

Methods

In this quasi-experimental study, 94 participants were selected from a descriptive study from among 936 married women referring to health centers who had a high rate of marital burnout and were randomly divided to the experimental group (n = 47) and control group (n = 47). The educational intervention was designed and performed in 7 sessions of 45 min for the experimental group. In the two stages before and after the intervention, the demographic sections, the Pines Marital Burnout Scale and effective communication skills were used to collect data. Data were analyzed using SPSS software version 24 and inferential test of Chi-square, Paired sample t-test and Wilcoxon test.

Results

There was no significant difference between the two groups before the intervention (p > 0.05). Performing the intervention in the experimental group significantly reduced the mean score of total marital burnout from 60.51 (± 14.96) to 51.82 (± 11.90), and reduced the mean score of marital burnout subscales, including physical, mental and emotional burnout. Also, in this study, the educational intervention of the experimental group significantly improved effective communication skills, and the mean score of effective communication skills increased from 85.12 (± 15.86) to 97.95 (± 14.53) (p < 0.001).

Conclusion

Based on the positive impact of effective communication skills on reducing marital burnout, it is recommended that more attention should be paid to enhancing these skills in spouses and pre-marital programs.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12905-021-01372-8.

Exposure to traumatic events, emotion regulation, and traumatic stress among infertility patients: a moderation analysis

Exposure to traumatic events and emotion regulation were examined as predictors of posttraumatic stress symptoms (PTSS) among women seeking medical treatment for infertility. Emotion regulation difficulties were hypothesized to moderate the association between traumatic events and PTSS severity. Sixty-six participants completed the Trauma History Questionnaire, Posttraumatic Check List for DSM-5, and Difficulties in Emotion Regulation Scale. Regression analyses were conducted. Emotion regulation difficulties predicted PTSS. The interaction between lifetime exposure to traumatic events and emotion regulation significantly predicted PTSS (b = 0.02, p = 0.002) and the model accounted for 31% of the variance in symptoms. Among women pursuing medical fertility treatment with past exposure to traumatic events, brief interventions that enhance emotional regulation skills may decrease PTSS.

Mindfulness and fertility quality of life in Chinese women with infertility: assessing the mediating roles of acceptance, autonomy and self-regulation

Objectives: To examine whether high dispositional mindfulness was associated with heightened specific aspects of fertility quality of life (FertiQoL) in infertile women, and whether acceptance, autonomy and self-regulation, mediated any association. Background: Quality of life is one of the most important issues to be addressed in infertility counselling. A large body of evidence reveals that populations with higher dispositional mindfulness fare better than their less mindful counterparts on psychological well-being. However, no research has examined the influence of mindfulness on infertile women's FertiQoL and potential mechanisms underlying these associations. Methods: This was a cross-sectional study of infertile women attending to Southwest Hospital, China. Standardized measures of FertiQoL and proposed mediators (self-regulation, acceptance and autonomy) were administered at the conclusion of the patient's medical appointment from December 2015 to March 2016. Structural equation modelling was used to test the hypothesised mediation model. Results: Mindfulness was positively related to Core and Treatment FertiQoL. Higher mindfulness was related to higher autonomous and self-regulatory abilities, as well as lower experiential avoidance, which in turn resulted in better Treatment FertiQoL. Meanwhile, mindfulness exerted its indirect effect on Core FertiQoL through self-regulation. However, acceptance and autonomy could not mediate the link between mindfulness and Core FertiQoL. Conclusion: Mindfulness appears to be a protective individual characteristic of infertile women, and self-regulation, autonomy and acceptance may be implicated in the effects of mindfulness on specific aspects of FertiQoL. The findings can provide useful suggestions to design mindfulness-based interventions aiming at improving FertiQoL in infertile women, by adding or emphasising intentional self-regulation, autonomy and acceptance components.

Effects of a mindfulness-based intervention on fertility quality of life and pregnancy rates among women subjected to first in vitro fertilization treatment

Generally, undergoing an in vitro fertilization (IVF) treatment is an emotional and physical burden for the infertile woman, which may negatively influence the treatment outcome. We conducted a study to investigate the effectiveness of a mindfulness-based intervention (MBI) among women subjected to first IVF treatment at a fertility medical center in China. Among infertile women registered for their first IVF treatment, 58 completed the intervention, and 50 were assigned to a control group using a non-randomized controlled study. Standardized measures of mindfulness, self-compassion, emotion regulation difficulties, infertility-related coping strategies and fertility quality of life (FertiQoL) were endorsed pre- and post-MBI, and measure of pregnancy rates at the sixth months after the intervention. Both groups were shown to be equivalent at baseline. By the end of the intervention, women who attended the intervention revealed a significant increase in mindfulness, self-compassion, meaning-based coping strategies and all FertiQoL domains. Inversely, they presented a significant decrease in emotion regulation difficulties, active- and passive-avoidance coping strategies. Women in the control group did not present significant changes in any of the psychological measures. Moreover, there were statistically significant differences between participants in the pregnancy rates, the experiment group higher than the control group. Being fully aware of the present moment without the lens of judgment, seems to help women relate to their infertility and IVF treatment in new ways. This is beneficial for promoting their self-compassion, adaptive emotion regulation and infertility-related coping strategies, which, in turn, may influence the FertiQoL and pregnancy rates. The brief and nonpharmaceutical nature of this intervention makes it a promising candidate for women' use during first IVF treatment.

The Effectiveness of Emotionally Focused Couples Therapy on Sexual Satisfaction and Marital Adjustment of Infertile Couples with Marital Conflicts

BACKGROUND

The purpose of this investigation is to determine the efficacy of emotionally focused couples therapy (EFT-C) on enhancement of marital adjustment in infertile couples.

MATERIALS AND METHODS

This was a semi-experimental study with a pre- and post-test design. We selected 30 infertile couples (60 subjects) by purposive sampling. Couples were randomly assigned to two groups, sample and control. Each group consisted of 15 couples who had marital maladjustment and low sexual satisfaction. Couples answered the marital adjustment and sexual satisfaction questionnaires at baseline after which the sample group received 10 sessions of EFT-C.

RESULTS

Results of pre-test and post-test showed that EFT-C significantly impacted marital adjustment and sexual satisfaction.

CONCLUSION

EFT-C had a significant effect on enhancement of satisfaction, cohesion and affectional expression. This approach impacted physical and emotional sexual satisfaction of infertile couples.

The Effectiveness of Emotionally Focused Couples Therapy on Sexual Satisfaction and Marital Adjustment of Infertile Couples with Marital Conflicts

Background

The purpose of this investigation is to determine the efficacy of emotionally focused couples therapy (EFT-C) on enhancement of marital adjustment in infertile couples.

Materials and Methods

This was a semi-experimental study with a pre- and post-test design. We selected 30 infertile couples (60 subjects) by purposive sampling. Couples were randomly assigned to two groups, sample and control. Each group consisted of 15 couples who had marital maladjustment and low sexual satisfaction. Couples answered the marital adjustment and sexual satisfaction questionnaires at baseline after which the sample group received 10 sessions of EFT-C.

Results

Results of pre-test and post-test showed that EFT-C significantly impacted marital adjustment and sexual satisfaction.

Conclusion

EFT-C had a significant effect on enhancement of satisfaction, cohesion and affectional expression. This approach impacted physical and emotional sexual satisfaction of infertile couples.

The Effectiveness of Emotionally Focused Therapy on Enhancing Marital Adjustment and Quality of Life among Infertile Couples with Marital Conflicts

Background

The purpose of this study is to investigate the efficacy of emotionally fo- cused therapy (EFT-C) on promoting marital adjustment of infertile couples with marital conflicts by improving quality of life.

Materials and Methods

This is a semi-experimental study with a pre- and post–test design in which 30 infertile couples (60 individuals) were chosen by purposive sampling. Couples were randomly divided into two groups, sample and control, of 15 couples each. Next, couples in the sample population answered questionnaires for marital adjustment, sexual satisfaction and quality of life after which they received 10 sessions of EFT-C.

Results

Pre- and post-tests showed that EFT-C had a significant effect on marital adjust- ment and quality of life.

Conclusion

According to the results, EFT-C had a significant, positive effect on en- hancement of marital adjustment. Life quality of infertile couples significantly increased via application of EFT-C. This approach improved the physical, psychological and social relationships of infertile couples and enhanced their social environment.

Prevalence and predictors of major depressive disorder for fertility treatment patients and their partners

OBJECTIVE

To examine the prevalence and predictors of major depressive disorder (MDD) for women and their partners during the course of fertility treatment.

DESIGN

Prospective cohort study during an 18-month period. Participants completed interviews and questionnaires at baseline and at 4, 10, and 18 months of follow-up.

SETTING

Five community and academic fertility practices.

PATIENT(S)

A total of 174 women and 144 of their male partners who did not have a successful child-related outcome during the time frame of the study.

INTERVENTION(S)

No interventions administered.

MAIN OUTCOME MEASURE(S)

The MDD was assessed using the Composite International Diagnostic Interview Major Depression module, a structured diagnostic interview. Additional variables were assessed with self-report questionnaire measures.

RESULT(S)

Of the women 39.1% and of the men 15.3% met the criteria for MDD during the 18-month course of the study. A binary logistic covariate-adjusted model showed that, for both women and men, past MDD was a significant predictor of MDD during treatment. Past MDD further predicted significant risk for MDD during treatment after controlling for other well-established risk factors (i.e., baseline levels of depression, anxiety, and partner support).

CONCLUSION(S)

The MDD was highly prevalent for fertility treatment patients and their partners. Past MDD predicted risk for MDD during treatment, and it contributed to MDD risk more than other commonly assessed risk factors. This suggests that patients and their partners would benefit from being routinely assessed for a history of MDD before the start of treatment to best direct psychosocial support and interventions to those most in need.

Protective effect of Basella alba and Carpolobia alba extracts against maneb-induced male infertility

CONTEXT

Male infertility is one of the leading causes of social frustration and marginalization, mainly in the developing world. It is attributed to many factors including exposure to agropesticides such as manganese ethylenebis (dithiocarbamate) (maneb), which is one of the most frequently used fungicides in Cameroon. Previous reports support efficiency of some medicinal plants commonly used in Cameroonian folk medicine for the treatment of this disorder.

OBJECTIVE

The present study was aimed at assessing the protective effect of extracts from selected plant species, namely Basella alba L. (Basellaceae) (MEBa) and Carpolobia alba G. Don (Polygalaceae) (AECa), in alleviating the maneb-induced impairment of male reproductive function in Wistar albino rats.

MATERIALS AND METHODS

The rats were treated with vehicle, plant extract (MEBa or AECa), maneb and maneb plus plant extract, respectively, and their fertility was assessed. Animals were thereafter sacrificed and organs (liver, kidneys and reproductive organs) were dissected out and weighed. Serum androgens together with alanine aminotransferase, liver glutathione and thiobarbituric acid reactive species (TBARS) were also measured.

RESULTS AND DISCUSSION

From this study, both plant extracts stimulated testosterone and improved fertility. Administration of MEBa plus maneb prevented fertility reduction by maneb and minimized the inhibitory effect of maneb on testosterone levels. AECa also improved fertility of the maneb-exposed rats, though without restoring testosterone levels, and other investigated parameters remained unaffected by different treatments.

CONCLUSION

These findings emphasized the beneficial effects of B. alba and C. alba extracts on male fertility, and suggest their protective effect against maneb-induced toxicity in male reproductive function.

Cultural Validation of the Turkish Version of the Infertility Self-Efficacy Scale–Short Form (TISE-SF)

Purpose: To translate and test the psychometric properties of the Turkish version of the Infertility Self-Efficacy Scale–Short Form (TISE-SF). Methods: The convenience sample consisted of 120 infertile women. A psychometric research design was used with content and construct validity and reliability. Results: Cronbach’s alpha of .78 showed moderate reliability, whereas item–total correlations ranged from .30 to .54. Factor analysis extracted a single component, explaining 40.3% of the variance. Kendall W showed agreement with each expert regarding the appropriateness of the items, confirming the content validity of the translated TISE-SF. Conclusion: The results supported the construct validity and reliability of the TISE-SF for measuring infertility self-efficacy in a population of Turkish women. Implications: Evaluating infertile women’s perception of self-efficacy with the TISE-SF may be useful in clinical studies in Turkey. TISE-SF can be used by professionals as a counseling tool to help guide women in managing their treatments at infertility centers.

Stress and anxiety scores in first and repeat IVF cycles: a pilot study

Background

The role of stress in reproduction, particularly during treatment for infertility, has been of considerable interest; however, few studies have objectively measured stress and anxiety over the course of the IVF cycle or compared the experience of first-time and repeat patients.

Methods

This prospective cohort pilot study enrolled 44 women undergoing IVF at a university-based clinic to complete the State-Trait Anxiety Inventory (STAI), Perceived Stress Scale (PSS) and Infertility Self-Efficacy Scale (ISES) at three time points prior to ovarian stimulation (T1), one day prior to oocyte retrieval (T2), and 5–7 days post embryo transfer (T3).

Results

Mean STAI State scores were significantly elevated at all three time points (p<0.01). STAI State and PSS mean values did not change over time and did not differ in first-time vs. repeat patients. Self-efficacy (ISES) scores declined over time, with a greater decline for repeat patients. Of the 36 women who completed a cycle, 15 achieved clinical pregnancy. Using logistic regression modeling, all scores at T2 were correlated with pregnancy outcome with lower scores on the STAI State and PSS and higher scores on the ISES associated with higher pregnancy rates.

Conclusions

Stress and anxiety levels remained elevated across all cycles. Women with lower stress and anxiety levels on the day prior to oocyte retrieval had a higher pregnancy rate. These results emphasize the need to investigate stress reduction modalities throughout the IVF cycle.

General psychopathology, anxiety, depression and self-esteem in couples undergoing infertility treatment: a comparative study between men and women

OBJECTIVE

To compare measures of psychological distress between men and women undergoing ART in the Unit of Reproductive Medicine "UMR" in the Department of Obstetrics and Gynecology at "Farhat Hached" Hospital in Sousse, Tunisia.

STUDY DESIGN

We conducted a gender comparative study of psychological profile in infertile couples. Recruitment was done during period from January to May 2009. 100 infertile couples with primary infertility were recruited. Scores of general psychopathology, depression, anxiety and self-esteem were evaluated. We administrated questionnaires on psychological factors among infertile couples before starting a new infertility treatment cycle. Psychological factors included the symptom check-list (SCL-90-R), the hospital anxiety and depression scale (HAD-S) and the Rosenberg self-esteem scale (RSE).

RESULT(S)

Infertile women had higher scores than their spouses in the three global scores of the SCL-90-R and in several items such as somatisation, obsessive symptoms, interpersonal sensitivity and phobias. Scores of HADS were higher among women for both depression and anxiety. Scores of self-esteem were lower among women.

CONCLUSION(S)

Women endorsed higher psychological distress than men across multiple symptoms domains: general psychopathology, anxiety, depression and self esteem.