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Truong LQ, Luong TB, Khanh HTT. Examining the association between coping strategies and perceived social support among Vietnamese infertile women undergoing IVF treatment. PSYCHOL HEALTH MED 2024:1-14. [PMID: 38697127 DOI: 10.1080/13548506.2024.2345273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 04/15/2024] [Indexed: 05/04/2024]
Abstract
The purpose of the study was to examine the association between coping strategies and perceived social support among women diagnosed with infertility and undergoing IVF treatment. A total of 383 Vietnamese women were invited to participate in this study. Participants completed a questionnaire consisting of The Multidimensional Scale of Perceived Social Support, the Copenhagen Multi-centre Psychosocial Infertility coping scales and the Fertility Problem Inventory, and other relevant questions. The results reveal that coping strategies significantly predict some specific types of perceived social supports among women undergoing IVF treatment. Specifically, passive-avoidance coping (PAC) and active-avoidance coping (AAC) predicts a decrease in receiving support from family and friends, whereas active-confronting coping (ACC) predicts an increase in receiving support from these two sources of support. Women who demonstrate increased meaning-based coping (MBC) received all three sources of support including family, friends, and significant others support. Despite some limitations, this study is useful in understanding how coping strategies among women undergoing IVF treatment affects the social support received in the Vietnamese social context. It also emphasizes the importance of psychological support for women facing IVF treatment distress.
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Affiliation(s)
- Lam Quang Truong
- Faculty of Psychology, Vietnam National University, University of Social Sciences and Humanities, Hanoi, Vietnam
| | - Thuy Bich Luong
- Faculty of Sociology, Vietnam National University, University of Social Sciences and Humanities, Hanoi, Vietnam
| | - Ha Truong Thi Khanh
- Faculty of Psychology, Vietnam National University, University of Social Sciences and Humanities, Hanoi, Vietnam
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Salari N, Babajani F, Hosseinian-Far A, Hasheminezhad R, Abdoli N, Haydarisharaf P, Mohammadi M. Global prevalence of major depressive disorder, generalized anxiety, stress, and depression among infertile women: a systematic review and meta-analysis. Arch Gynecol Obstet 2024; 309:1833-1846. [PMID: 38459997 DOI: 10.1007/s00404-024-07444-y] [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: 12/04/2023] [Accepted: 02/16/2024] [Indexed: 03/11/2024]
Abstract
BACKGROUND In recent years, the global prevalence of infertility has increased among women (Talmor and Dunphy, Best Pract Res Clin Obstet Gynaecol 29(4):498-506, 2015) and is considered as a public health concern. One of the impacts of infertility is mental health problems in the patients, which can lead to complications such as stress, anxiety, and depression. The aim of this study is to investigate the global prevalence of major depressive disorder, general anxiety, stress, and depression in infertile women through a systematic review and meta-analysis. METHODS To identify studies that have reported the prevalence of major depressive disorder, generalized anxiety, stress, and depression in infertile women, the PubMed, Scopus, Web of Science, Embase, ScienceDirect, and Google Scholar repositories were systematically searched. Articles published up until February 2023 were included, while no lower time limit was imposed in the search strategy. Heterogeneity of studies was examined using the I2 test and, thus, random-effects model was used to perform the analysis. Data analysis was conducted within the Comprehensive Meta-Analysis (v.2) software. RESULTS In the review of 44 studies with a sample size of 53,300 infertile female patients, the overall prevalence of major depressive disorder (clinical depression), generalized anxiety, stress, and depression was found to be 22.9%, 13.3%, 78.8%, and 31.6% respectively. It was also found that mental health complications are more prevalent among infertile women in Asia (continent). CONCLUSION Considering the prevalence of mental disorders among infertile women, health policymakers can use the results of the present meta-analysis to pay more attention to the mental health of infertile women and devise suitable interventions and programs to reduce and prevent the spread of psychological disorders among infertile women.
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Affiliation(s)
- Nader Salari
- Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Fateme Babajani
- Department of Clinical Psychology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Amin Hosseinian-Far
- Department of Business Systems and Operations, University of Northampton, Northampton, UK
| | - Razie Hasheminezhad
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nasrin Abdoli
- Department of Psychiatry, Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Parisa Haydarisharaf
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Masoud Mohammadi
- Cellular and Molecular Research Center, Gerash University of Medical Sciences, Gerash, Iran.
- Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.
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Schon SB, Moritz L, Rabbani M, Meguid J, Juliano BR, Ruotolo BT, Aston K, Hammoud SS. Proteomic analysis of human sperm reveals changes in protamine 1 phosphorylation in men with infertility. F&S SCIENCE 2024; 5:121-129. [PMID: 38065301 PMCID: PMC11116066 DOI: 10.1016/j.xfss.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 11/21/2023] [Accepted: 12/01/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE To perform a comprehensive assessment of protamine (P) isoforms and modifications in human sperm with the aim of identifying how P modifications and isoforms are altered in men with reduced sperm motility and low sperm count. DESIGN Cross-sectional. SETTING Academic medical center. PATIENTS A total of 18 men with prior reported pregnancy and normozoospermia (normal sperm), 14 men from couples with infertility and asthenozoospermia (reduced sperm motility), and 24 men from couples with infertility and oligoasthenoteratozoospermia (low sperm count and motility and abnormal sperm morphology). INTERVENTION(S) Not applicable. MAIN OUTCOME MEASURE(S) Proteomic assessment using both top-down and bottom-up liquid chromatography mass spectrometry (MS) analysis. RESULTS A total of 13 posttranslational modifications were identified on P1 and P2 using bottom-up MS, including both phosphorylation and methylation. Top-down MS revealed an unmodified and phosphorylated isoform of P1 and the 3 major isoforms of P2, HP2, HP3, and HP4. Protamine 1 phosphorylation was overall higher in men with male factor infertility compared with those with normal semen analysis (40.5% vs. 32.6). There was no difference in P posttranslational modifications or isoforms of P2 in men with normal vs. abnormal fertility. CONCLUSION Human protamines bear a number of posttranslational modifications, with alterations in P1 phosphorylation noted in the setting of male factor infertility.
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Affiliation(s)
- Samantha B Schon
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan.
| | - Lindsay Moritz
- Department of Human Genetics, University of Michigan, Ann Arbor, Michigan
| | - Mashiat Rabbani
- Department of Human Genetics, University of Michigan, Ann Arbor, Michigan
| | - Julia Meguid
- Department of Human Genetics, University of Michigan, Ann Arbor, Michigan
| | - Brock R Juliano
- Department of Chemistry, University of Michigan, Ann Arbor, Michigan
| | - Brandon T Ruotolo
- Department of Chemistry, University of Michigan, Ann Arbor, Michigan
| | - Kenneth Aston
- Department of Surgery, University of Utah, Salt Lake City, Utah
| | - Saher Sue Hammoud
- Department of Human Genetics, University of Michigan, Ann Arbor, Michigan; Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan; Department of Urology, University of Michigan, Ann Arbor, Michigan
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4
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Hecht LM, Joseph-Mofford G, Iacobelli R, Ahmed M, Haley E, Loree AM, Miller-Matero LR. Anxiety, depression, and infertility-specific distress among women with female factor infertility. J Health Psychol 2024:13591053241235092. [PMID: 38413845 DOI: 10.1177/13591053241235092] [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: 02/29/2024] Open
Abstract
This study aimed to evaluate whether anxiety, depression, and infertility-specific distress differ among women with female infertility who are trying to conceive and/or seeking infertility treatment. Women with diagnosed female factor infertility in the past 2 years (N = 188) completed demographic questions, and measures of infertility-specific distress, anxiety, and depression. The majority of the sample were actively trying to conceive (78.7%, n = 148) and approximately one third (33.5%, n = 63) were undergoing fertility treatment. Anxiety and depression scores did not differ based on trying to conceive or treatment-seeking, although these subgroups reported higher levels of need for parenthood and rejection of a childfree lifestyle. High levels of mood and anxiety are experienced by women with female infertility. Although infertility-specific distress is experienced more so by women with anxiety and depression, a substantial proportion of those without mental health conditions had high levels of distress, underscoring the need for screening and treatment.
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Bogović A, Potkonjak AM, Djaković I, Vraneš HS. Depression, anxiety, and stress in infertile couples during the COVID-19 pandemic: the consequences we face. JBRA Assist Reprod 2024; 28:9-12. [PMID: 37962946 PMCID: PMC10936920 DOI: 10.5935/1518-0557.20230018] [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: 11/11/2022] [Accepted: 05/17/2023] [Indexed: 11/16/2023] Open
Abstract
OBJECTIVE Postponing assisted reproductive technology treatment can cause pronounced mental health problems. The aim of this study was to examine the level of depression, anxiety, stress, and overall infertility-related distress experienced by infertile couples during the pandemic, as well as the differences between men and women in the examined variables and the correlations between them. METHODS A total of 131 participants were included in the study, 65 men and 66 women. They were selected based on their responses in the Fertility Problems Inventory (FPI); the Depression, Anxiety, and Stress Scale-21 (DASS-21); and a general data questionnaire provided to them at the time of IVF. RESULTS The levels of depression, anxiety, and stress in women and men resided within the normal range. Depression (p<0.05), anxiety (p<0.01), stress (p<0.01), and social concern (p<0.05) were more pronounced among women. Significant correlations were found between depression, anxiety, stress, and global stress and its three dimensions: social concern, sexual concern, and relationship concern. CONCLUSIONS During the pandemic, women undergoing assisted reproductive technology treatment experienced significantly higher levels of depression, anxiety, stress, and overall infertility-related stress than men. Furthermore, depression, anxiety, and stress were apparently correlated with overall infertility-related stress.
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Affiliation(s)
- Anamarija Bogović
- Department of Psychiatry, Sestre Milosrdnice University Hospital
Center, Zagreb, Croatia
- Department of Psychology, Catholic University of Croatia, Zagreb,
Croatia
| | - Ana-Meyra Potkonjak
- Department of Gynecology and Obstetrics, Sestre Milosrdnice
University Hospital Center, Zagreb, Croatia
| | - Ivka Djaković
- Clinic for Gynecology, Bethesda Hospital, Basel, Switzerland
| | - Hrvojka Soljačić Vraneš
- Department of Gynecology and Obstetrics, Sestre Milosrdnice
University Hospital Center, Zagreb, Croatia
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Li QL, Wang C, Cao KX, Zhang L, Xu YS, Chang L, Liu ZH, Yang AJ, Xue YX. Sleep characteristics before assisted reproductive technology treatment predict reproductive outcomes: a prospective cohort study of Chinese infertile women. Front Endocrinol (Lausanne) 2023; 14:1178396. [PMID: 37908752 PMCID: PMC10614022 DOI: 10.3389/fendo.2023.1178396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 09/06/2023] [Indexed: 11/02/2023] Open
Abstract
Sleep disorders affect mental and physical health. Infertile women undergoing assisted reproductive technology (ART) treatment are prone to sleep disorders. Sleep condition, its influencing factors, and the association between sleep condition and ART treatment outcomes before treatment have not been explored within a population with a large sample size. Therefore, we investigated the sleep characteristics of 1002 Chinese infertile women before ovulation induction and investigated the influencing factors (negative and positive psychological factors, demographics, and fertility characteristics). We also examined whether sleep conditions before treatment predicted reproductive outcomes. We found that 24.1% of participants reported poor sleep quality. Women with primary infertility reported poorer sleep than women with secondary infertility. Negative psychological factors, including depression, anxiety, and perceived stress were associated with poor sleep, whereas positive affect was linked with good sleep. Adverse sleep characteristics, including poor subjective sleep quality, sleep disturbances, and poor sleep efficiency, decreased the quantity and quality of oocytes retrieved, fertilization rates, and clinical pregnancy rates. This study indicates that before ART treatment, a large number of females with infertility suffer from sleep problems, which are affected by psychological factors and infertility type, and unhealthy sleep characteristics may impair treatment outcomes. Our findings highlight the importance of screening and treatment for sleep disorders before the enrollment of ART treatment in infertile women.
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Affiliation(s)
- Qian-Ling Li
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
- Center for Reproductive Medicine, Affiliated Hospital of Jining Medical University, Jining, China
| | - Chao Wang
- Reproductive Medical Center, Department of Obstetrics and Gynecology, Peking University International Hospital, Beijing, China
| | - Ke-Xin Cao
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
- Department of Pharmacology, School of Basic Medical Sciences, Peking University, Beijing, China
| | - Lin Zhang
- Center for Reproductive Medicine, Affiliated Hospital of Jining Medical University, Jining, China
| | - Yun-Shuai Xu
- Department of Psychiatry, Shandong Daizhuang Hospital, Jining, China
| | - Liang Chang
- Henan Key Laboratory of Medical Tissue Regeneration, School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, China
| | - Zhen-Hui Liu
- Center for Reproductive Medicine, Affiliated Hospital of Jining Medical University, Jining, China
| | - Ai-Jun Yang
- Center for Reproductive Medicine, Affiliated Hospital of Jining Medical University, Jining, China
| | - Yan-Xue Xue
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
- Chinese Institute for Brain Research, Beijing, China
- Key Laboratory for Neuroscience, Ministry of Education/National Health Commission, Peking University, Beijing, China
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Kundarti FI, Titisari I, Rahayu DE, Kiswati, Jamhariyah. Mindfulness improves the mental health of infertile women: A systematic review. J Public Health Res 2023; 12:22799036231196693. [PMID: 37711728 PMCID: PMC10498716 DOI: 10.1177/22799036231196693] [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: 03/14/2023] [Accepted: 08/04/2023] [Indexed: 09/16/2023] Open
Abstract
Infertility in women causes mental health problems, the bad ones. Women with infertility need psychological treatment using mindfulness interventions. This study's purpose was to analyze mindfulness's effect on the mental health of women with infertility through a systematic review. The method used in this systematic review was by searching through the following databases; ProQuest database, Wiley Library, Pubmed, Scopus, Science Direct, Sage Journal, Cochrane Library, and Cambridge Core from January 2011 to December 2021. Nine articles met the inclusion criteria. Results show that the use of mindfulness was found to be effective in reducing mental disorders in women with infertility. Nine articles that meet the criteria for inclusion. According to a study on the effects of mindfulness on infertile women, affect increasing mental health levels by reducing mental health disorder scores. Mindfulness has been proven to be an effective intervention for women undergoing infertility-related mental disorders such as stress, anxiety, and depression. However, different types of mindfulness-based interventions are used to target different mental health issues. For example, Mindfulness-Based Stress Reduction (MBSR) targets stress and anxiety while Mindfulness-Based Cognitive Therapy (MBCT) targets depression. Additionally, specific mindfulness for example, for the midwifery profession can be developed to improve the quality and treatment outcomes of healthcare for women struggling with infertility problems.
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Affiliation(s)
- Finta Isti Kundarti
- Department of Midwifery, Polytechnic of Health, Ministry of Health, Malang, Indonesia
| | - Ira Titisari
- Department of Midwifery, Polytechnic of Health, Ministry of Health, Malang, Indonesia
| | - Dwi Estuning Rahayu
- Department of Midwifery, Polytechnic of Health, Ministry of Health, Malang, Indonesia
| | - Kiswati
- Department of Midwifery, Polytechnic of Health, Ministry of Health, Malang, Indonesia
| | - Jamhariyah
- Department of Midwifery, Polytechnic of Health, Ministry of Health, Malang, Indonesia
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Abu-Sharkia S, Taubman - Ben-Ari O, Mofareh A. Personal Growth and Life Satisfaction during Fertility Treatment-A Comparison between Arab and Jewish Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2187. [PMID: 36767553 PMCID: PMC9915886 DOI: 10.3390/ijerph20032187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/20/2023] [Accepted: 01/20/2023] [Indexed: 06/18/2023]
Abstract
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.
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Affiliation(s)
- Salam Abu-Sharkia
- The Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Ramat Gan 5290002, Israel
| | - Orit Taubman - Ben-Ari
- The Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Ramat Gan 5290002, Israel
| | - Ali Mofareh
- Clalit Health Services (Kupat Holim Clalit), Jerusalem 9112102, Israel
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Dar MA, Shah SB, Ahmad SN, Shora TN, Kumari P, Tailie JA. Psychiatric morbidity and quality of life in infertile females: a cross-sectional, case-controlled hospital-based study. MIDDLE EAST CURRENT PSYCHIATRY 2022. [DOI: 10.1186/s43045-022-00257-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Abstract
Background
Infertility is a huge global problem with a significant mental health burden. Infertility could become a source of continuous stress leading to psychosocial issues including stress, anxiety, depression, and low self-esteem in these women. A cross-sectional, case-controlled study was conducted between January 2021 and November 2021 to study the effect of infertility on mental health and quality of life. A semi-structured questionnaire was used for sociodemographic and clinical variables. The Oslo Social Support Scale-3 and FertiQol were used to study social support and quality of life respectively. Psychiatric morbidity was assessed using ICD-10 symptom checklist. A total of 56 cases and 102 controls were studied.
Results
The mean age of cases and controls was 30.4 ± 3.5 years and 31.9 ± 2.9 years, respectively. Young infertile females, primary infertility, and female factor for infertility were associated with higher psychiatric morbidity. Psychiatric morbidity was seen in 46.4% of infertile women. FertiQoL score for the infertile group was 64.61 ± 5 with the lowest score in the emotional domain (45.10) and mind-body domain (54.86) (p < 0.0001). The scores in the relational domain and social domain were higher (85.2 and 73.3, respectively). The scores in the mind-body domain and emotional domain were poor among the infertile women regardless of the presence of psychiatric morbidity (48.27 vs 59.80 and 43.57 vs 46.57) (p < 0.0001–0.04).
Conclusions
Our study emphasizes the role of more qualitative instruments like FertiQoL in studying the well-being of infertile women. Even in the absence of psychiatric morbidity, the QoL score could still predict mental well-being in fertility-related issues.
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Borowczak M, Rotoli S. Possible Gender Differences in the Level of Perceived Social Support in Couples Who Are Experiencing Issues With Infertility. Cureus 2022; 14:e29343. [DOI: 10.7759/cureus.29343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2022] [Indexed: 11/05/2022] Open
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Bhamani SS, Zahid N, Rizvi A, Shaheen F, Shah NZ, Sachwani S, Farooq S, Azam SI, Asad N. A dyadic approach to depression, resilience and quality of life on marital adjustment among infertile couples in Karachi, Pakistan: A cross-sectional study. Int J Nurs Pract 2022; 28:e13090. [PMID: 35983601 DOI: 10.1111/ijn.13090] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 07/14/2022] [Accepted: 07/22/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Infertility is a major reproductive health problem in Pakistan. It has the potential to cause serious negative impact on a couple's marital life and psychological health. AIM This study aimed to assess the factors associated with maladjustment among infertile couples. METHOD An analytical cross-sectional design was employed. Validated scales were used to assess marital adjustment, depression, resilience and quality of life among infertile couples. Purposive sampling was employed to enrol 334 infertile couples from a private infertility medical centre, of Karachi, Pakistan. RESULTS Among couples, marital adjustment scores were comparable, but resilience and quality of life were significantly low among wives whereas depression was significantly high among wives compared with husbands. Wives' marital adjustment was positively correlated with husband's resilience and quality of life and negatively related with his depression. After employing adjusted actor-partner interdependence modelling, wives' own depression and resilience had significant effect on their marital adjustment and their partner's resilience, depression and quality of life did not have any impact on their outcome. On the contrary, wives' resilience had a significant effect in increasing the marital adjustment of their husband. CONCLUSION This study highlights the need to promote psychological support (resilience building skills) or couples' therapy to all those couples undergoing infertility treatment.
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Affiliation(s)
| | - Nida Zahid
- Research Department of Surgery, Aga Khan University, Karachi, Pakistan
| | - Arjumand Rizvi
- Center of Excellence in Women & Child Health, Aga Khan University, Karachi, Pakistan
| | - Fariha Shaheen
- Department of Pediatrics & Child Health, Aga Khan University, Karachi, Pakistan
| | - Nasim Zahid Shah
- School of Nursing and Midwifery, Aga Khan University, Karachi, Pakistan
| | - Saima Sachwani
- School of Nursing and Midwifery, Aga Khan University, Karachi, Pakistan
| | - Salima Farooq
- School of Nursing and Midwifery, Aga Khan University, Karachi, Pakistan
| | - Syed Iqbal Azam
- Community Health Sciences Department, Aga Khan University, Karachi, Pakistan
| | - Nargis Asad
- Department of Psychiatry, Aga Khan University, Karachi, Pakistan
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12
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Amraei S, Abedi P, Nikbakht R, Tadayon M, Maraghi E. Does Infertility Stress Impair Sexual Function in Infertile Women and Men? A Cross-Sectional Study in Iran. Front Med (Lausanne) 2022; 9:896538. [PMID: 35814743 PMCID: PMC9258717 DOI: 10.3389/fmed.2022.896538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 05/16/2022] [Indexed: 11/13/2022] Open
Abstract
Background The issue of infertility is a worldwide challenge, estimated to affect around 50 million couples. This study aimed to evaluate the relationship between infertility stress and sexual function in men and women with infertility. Methods In this cross-sectional study, 300 men and women with infertility were recruited. A demographic questionnaire, the Fertility Problem Inventory, the Female Sexual Function Scale (FSFI), and the International Index of Erectile Function (IIEF) were used to collect data. Independent t-test, Chi-square, and linear and logistic regressions were used to assess the data. Results The total score of sexual function in women and men was 22.18 ± 7.86 and 57.7 ± 17.8, respectively. Infertility duration and the ability to pay for the costs of infertility treatment had a significant relationship with sexual function in women. A significant association was found between communication concerns and sexual function scores in men with infertility. Infertile women had more sexual concerns, while infertile men had more communication concerns. Conclusion This study showed that women with infertility had more infertility stress than men with infertility. Women with higher infertility duration and the inability to pay for the infertility treatment costs impaired sexual function. Women with infertility had more sexual concerns, while Men with infertility had more communication concerns. Policymakers need to consider strategies such as counseling for men and women with infertility to help them cope with their problems, especially their psychological problems. The lack of random enrollment of participants and lack of control group were the limitations of this study.
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Affiliation(s)
- Samira Amraei
- Reproductive Health Promotion Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Parvin Abedi
- Reproductive Health Promotion Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- *Correspondence: Parvin Abedi
| | - Roshan Nikbakht
- Gynecology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mitra Tadayon
- Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Elham Maraghi
- Biostatistics, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Teklemicheal AG, Kassa EM, Weldetensaye EK. Prevalence and correlates of infertility related psychological stress in women with infertility: a cross-sectional hospital based survey. BMC Psychol 2022; 10:91. [PMID: 35392978 PMCID: PMC8988399 DOI: 10.1186/s40359-022-00804-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 03/31/2022] [Indexed: 11/23/2022] Open
Abstract
Background Psychological stress is commonly found among infertile women. Untreated stress can affect negatively the success of infertility treatment. Most of the available knowledge is generated from developed countries and is largely based on women undergoing In vitro fertilization (IVF) treatment. However, very little is known on infertile women from Ethiopia including other countries in East Africa. The aim of this study was to determine the prevalence of psychological stress and possible demographic-clinical correlates in Ethiopian women suffering from infertility. Method This cross sectional descriptive correlation study was conducted from May to August, 2021 involving 96 women undergoing a non-IVF treatment for infertility at Gandhi Memorial and Tikur Anbessa hospitals. The sampling was continuous and based on inclusion criteria that include infertility duration of a minimum one year, female sex and Ethiopian nationality. Data on Infertility related stress was collected using the Copenhagen Multi‐Centre Psychosocial Infertility-Fertility Problem Stress questionner administered by an interviewer. The socio demographic and clinical factors were collected using Amharic version of structured interviewer administered questionnaire and chart review. The analysis of relationship between infertility related stress and background variables was done with an independent sample t-test or one-way ANOVA statistics supplemented with effect size assessment. Results The prevalence of infertility related stress was overall 92.71% (95% CI, 87–98%). The personal, marital, and social subdomain mean scores (SD) were 2.74 (.80), 1.54 (.81) and 1.90 (.80), respectively. Infertility related stress was higher for those women who were: aged above 35, living in a cohabitation marital type, has no living children, and with 4–6 years duration of infertility (all P < 0.05). Whereas, there was insufficient evidence to suggest that infertility related stress varies by education, income, knowledge of cause of infertility or history of past treatment (all P > 0.05). Conclusions The prevalence of psychological stress among Ethiopia women having infertility was very high. The results provide preliminary evidence that infertility related stress is associated with age, marital status, motherhood status and duration of infertility. Responsible bodies need to avail psychological screening and services prioritizing women at higher risk of developing stress.
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Affiliation(s)
- Ashebir Getachew Teklemicheal
- Gandhi Memorial Hospital, Addis Ababa, Ethiopia. .,Department of Obstetrics and Gynecology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Eyasu Mesfin Kassa
- Department of Obstetrics and Gynecology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
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14
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Interpersonal dynamics of women in midlife living with involuntary childlessness. JOURNAL OF ADULT DEVELOPMENT 2022. [DOI: 10.1007/s10804-022-09393-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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15
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Casu G, Zaia V, Montagna E, de Padua Serafim A, Bianco B, Barbosa CP, Gremigni P. The Infertility-Related Stress Scale: Validation of a Brazilian-Portuguese Version and Measurement Invariance Across Brazil and Italy. Front Psychol 2022; 12:784222. [PMID: 35095671 PMCID: PMC8792459 DOI: 10.3389/fpsyg.2021.784222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 12/24/2021] [Indexed: 12/28/2022] Open
Abstract
Infertility constitutes an essential source of stress in the individual and couple’s life. The Infertility-Related Stress Scale (IRSS) is of clinical interest for exploring infertility-related stress affecting the intrapersonal and interpersonal domains of infertile individuals’ lives. In the present study, the IRSS was translated into Brazilian–Portuguese, and its factor structure, reliability, and relations to sociodemographic and infertility-related characteristics and depression were examined. A sample of 553 Brazilian infertile individuals (54.2% female, mean aged 36 ± 6 years) completed the Brazilian–Portuguese IRSS (IRSS-BP), and a subsample of 222 participants also completed the BDI-II. A sample of 526 Italian infertile individuals (54.2% female, mean aged 38 ± 6 years) was used to test for the IRSS measurement invariance across Brazil and Italy. Results of exploratory structural equation modeling (ESEM) indicated that a bifactor solution best represented the structure underlying the IRSS-BP. Both the general and the two specific intrapersonal and interpersonal IRSS-BP factors showed satisfactory levels of composite reliability. The bifactor ESEM solution replicated well across countries. As evidence of relations to other variables, female gender, a longer duration of infertility, and higher depression were associated with higher scores in global and domain-specific infertility-related stress. The findings offer initial evidence of validity and reliability of the IRSS-BP, which could be used by fertility clinic staff to rapidly identify patients who need support to deal with the stressful impact of infertility in the intrapersonal and interpersonal life domains, as recommended by international guidelines for routine psychosocial care in infertility settings.
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Affiliation(s)
- Giulia Casu
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Victor Zaia
- Postgraduate Program in Health Sciences, Centro Universitário FMABC, Santo André, Brazil.,Ideia Fértil Institute of Reproductive Health, Centro Universitário FMABC, Santo André, Brazil
| | - Erik Montagna
- Postgraduate Program in Health Sciences, Centro Universitário FMABC, Santo André, Brazil
| | - Antonio de Padua Serafim
- Neuropsychology Unit, Department and Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil.,Department of Psychology, Methodist University of São Paulo, São Bernardo do Campo, Brazil
| | - Bianca Bianco
- Postgraduate Program in Health Sciences, Centro Universitário FMABC, Santo André, Brazil.,Ideia Fértil Institute of Reproductive Health, Centro Universitário FMABC, Santo André, Brazil
| | - Caio Parente Barbosa
- Postgraduate Program in Health Sciences, Centro Universitário FMABC, Santo André, Brazil.,Ideia Fértil Institute of Reproductive Health, Centro Universitário FMABC, Santo André, Brazil
| | - Paola Gremigni
- Department of Psychology, University of Bologna, Bologna, Italy
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16
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Tang N, Jia Y, Zhao Q, Liu H, Li J, Zhang H, Han L, Huangfu C. Influencing Factors of Dyadic Coping Among Infertile Women: A Path Analysis. Front Psychiatry 2022; 13:830039. [PMID: 35418892 PMCID: PMC8995970 DOI: 10.3389/fpsyt.2022.830039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 02/28/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The infertility prevalence of married couples in China is increasing gradually. The dyadic coping level and its influencing factors of infertile women in China are poorly reported. The relationship between dyadic coping and the family cohesion and adaptability in infertile women was investigated. METHODS A total of 482 infertile women in the reproductive clinics of three affiliated hospitals of the Lanzhou University were selected by the convenience sampling method. The self-made general information questionnaire, family adaptability and cohesion evaluation scale, and dyadic coping questionnaire were used in this study. RESULTS The average age of infertile women was 31.73 ± 4.57 years, the duration of infertility was 28.66 ± 27.99 months, the total score of dyadic coping was 132.66 ± 25.49, the total score of family cohesion and adaptability was 101.48 ± 20.96. A significant positive correlation between dyadic coping and family cohesion and adaptability was observed (r = 0.74, p < 0.01). The multiple linear regression analysis showed that religious belief, number of miscarriages, relationship between family members, family intimacy, and adaptability were the influencing factors of dyadic coping level in the family of infertile women (R 2 = 0.566, p < 0.01). CONCLUSIONS The dyadic coping level of infertile women is in the medium level, which is significantly positively correlated with family intimacy and adaptability. In clinical nursing, nurses try to improve the family relationship of patients to increase the level of dyadic coping of infertile women.
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Affiliation(s)
- Nan Tang
- Center for Evidence-Based Nursing, School of Nursing, Lanzhou University, Lanzhou, China
| | - Yingying Jia
- Center for Evidence-Based Nursing, School of Nursing, Lanzhou University, Lanzhou, China
| | - Qing Zhao
- Center for Evidence-Based Nursing, School of Nursing, Lanzhou University, Lanzhou, China
| | - Huihui Liu
- Center for Evidence-Based Nursing, School of Nursing, Lanzhou University, Lanzhou, China
| | - Junzheng Li
- Center for Disease Control and Prevention, Western Theater Command, Lanzhou, China
| | - Hongchen Zhang
- Center for Evidence-Based Nursing, School of Nursing, Lanzhou University, Lanzhou, China
| | - Lin Han
- Center for Evidence-Based Nursing, School of Nursing, Lanzhou University, Lanzhou, China
| | - Chaoji Huangfu
- Center for Disease Control and Prevention, Western Theater Command, Lanzhou, China
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17
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Dadhwal V, Choudhary V, Perumal V, Bhattacharya D. Depression, anxiety, quality of life and coping in women with infertility: A cross-sectional study from India. Int J Gynaecol Obstet 2021; 158:671-678. [PMID: 34957556 DOI: 10.1002/ijgo.14084] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 11/11/2021] [Accepted: 12/24/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The purpose of the present study was to assess the prevalence of depression and anxiety in women with infertility, elucidate the psycho-social factors affecting infertile women, identify the commonly employed coping strategies, and evaluate their self-esteem and quality of life. METHODS A total of 150 women with infertility, from a tertiary care hospital, participated in this study. Cross-sectional assessment was performed by using the Hamilton Depression Rating Scale and Hamilton Anxiety Rating Scale, Rosenberg Self-Esteem Scale, WHO-Quality of life-BREF, and Brief-COPE Inventory. RESULTS Overall, 58% (87/150) of women reported depression on HDRS, 24% (36/150) reported anxiety on HAM-A, and 24% (36/150) had both depression and anxiety on HDRS and HAM-A. Comparative analysis of women reporting depression and anxiety indicated that they were subjected to significant discrimination, received lower social acceptance, had financial problems, higher depression and anxiety, poorer quality of life, and employed maladaptive coping. Living in a joint family, and using maladaptive coping were significant risk factors for anxiety and depression. Conversely, the family's ability to provide support, share problems, and assist with decision-making, along with receiving support from their spouses, were chief protective factors. CONCLUSION Women with infertility experience depression, anxiety, poor quality of life, and employ maladaptive coping. Supportive relationships with one's family and spouse are chief protective factors.
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Affiliation(s)
- Vatsla Dadhwal
- Department of Obstetrics & Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Vandana Choudhary
- Department of Psychiatry, All India institute of Medical Sciences, New Delhi, India
| | - Vanamail Perumal
- Department of Obstetrics & Gynaecology, All India Institute of Medical Sciences, New Delhi, India
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18
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Darolia S, Ghosh D. Importance of Personality Factors in Determining the Psychological Consequences of Infertility: A Systematic Review. HEALTH EDUCATION & BEHAVIOR 2021; 49:708-723. [PMID: 34814759 DOI: 10.1177/10901981211057109] [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: 11/15/2022]
Abstract
BACKGROUND AND PURPOSE The diagnosis of infertility not only involves biological but the psychosocial links have also been established. Individual difference variables, such as personality and temperament have been found playing prominent role in modifying the psychological and biological aspects of infertility. This systematic review aimed to examine evidence-based research on the role of personality traits in determining vulnerability to stress in infertility, understand the gender-based differences, and deliver suggestions for future researches. METHOD The search for studies relating to the variables was accomplished using various electronic databases. The search was kept limited to a time span of about 20 years, that is, from January 2000 to April 2020. Additional researches were collected from library source and others were retrieved by contacting experts. Studies were selected on the basis of a predetermined inclusion and exclusion criteria, and quality of the studies was also taken into account. RESULTS The search of studies through above methods was fruitful in identifying 23 studies including six longitudinal and prospective studies, and 17 cross-sectional studies covering both individual- and model-based personality attributes related findings. The overall quality ratings of the studies ranged from fair to good. CONCLUSION The review revealed that personality factors such as neuroticism, harm avoidance, and psychoticism are the potential risk factors, whereas optimism has a protective impact in the context of fertility disorders. The long-term impact of personality on infertility needs further exploration. Trait modification interventions during the treatment of infertility were also suggested in the light of previous findings.
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Affiliation(s)
| | - Debasruti Ghosh
- Babasaheb Bhimrao Ambedkar Bihar University, Muzaffarpur, Bihar, India
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19
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Yüksekol ÖD, Baltaci N, Yilmaz AN, Ulucan M. Perception of genital self-image, sexual quality of life and marital adjustment in infertile women. SEXUAL AND RELATIONSHIP THERAPY 2021. [DOI: 10.1080/14681994.2021.1998422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Özlem Doğan Yüksekol
- Department of Midwifery, Faculty of Health Sciences, Firat University, Elazig, Turkey
| | - Nazli Baltaci
- Department of Nursing, Faculty of Health Sciences, Ondokuz Mayis University, Samsun, Turkey
| | - Ayşe Nur Yilmaz
- Department of Midwifery, Faculty of Health Sciences, Firat University, Elazig, Turkey
| | - Mihriban Ulucan
- Department of Midwifery, Faculty of Health Sciences, Firat University, Elazig, Turkey
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20
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Koparal B, Gürlek B, Hocaoğlu Ç, Polat S. Levels of anxiety sensitivity, somatosensory amplification and alexithymia in patients with unexplained infertility. Int J Clin Pract 2021; 75:e14761. [PMID: 34455676 DOI: 10.1111/ijcp.14761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 08/25/2021] [Accepted: 08/27/2021] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE In this study, we aimed to focus on the psychological aspect of unexplained infertility by comparing their psychological features to those of infertile patients with a known causes and fertile patients. PATIENTS AND METHODS Sixty unexplained infertility patients, 50 infertile patients with a known cause and 56 fertile patients were included in the study. Patients were evaluated using socio-demographic data form, Toronto Alexithymia Scale (TAS-20), Somatosensory Amplification Scale (SAS) and Anxiety Sensitivity Index (ASI-3). RESULTS No significant differences in the levels of alexithymia, somatosensory amplification and anxiety sensitivity were detected between the groups (P > .05). When the correlation of clinical scale scores with each other was analysed in the whole group of infertile patients regardless of the cause, a weak positive correlation was found between anxiety sensitivity and difficulty in identifying feelings. CONCLUSION In our study, it has been found out that; regardless of the knowledge of the aetiology of infertility, the levels of alexithymia, somatosensory amplification and anxiety sensitivity of infertile cases did not differ from those of fertile women. However, it has been shown that as the difficulty in identifying emotions increases in infertile cases, anxiety sensitivity, which may cause psychological infertility, also increases.
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Affiliation(s)
- Buket Koparal
- Department of Psychiatry, Recep Tayyip Erdogan University Training and Research Hospital, Rize, Turkey
| | - Beril Gürlek
- Department of Obstetrics and Gynecology, Recep Tayyip Erdogan University Training and Research Hospital, Rize, Turkey
| | - Çiçek Hocaoğlu
- Department of Psychiatry, Recep Tayyip Erdogan University Training and Research Hospital, Rize, Turkey
| | - Selim Polat
- Department of Psychiatry, Recep Tayyip Erdogan University Training and Research Hospital, Rize, Turkey
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21
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Barishansky SJ, Shapiro P, Meyman G, Pavone ME, Lawson AK. Reproductive endocrinologists' knowledge and attitudes in the identification of intimate partner violence. Fertil Steril 2021; 116:1622-1630. [PMID: 34538458 DOI: 10.1016/j.fertnstert.2021.08.011] [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: 03/31/2021] [Revised: 08/06/2021] [Accepted: 08/06/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To assess reproductive endocrinologists' attitudes, beliefs, knowledge, and experiences with intimate partner violence (IPV). DESIGN Cross-sectional survey of US reproductive endocrinologists. SETTING The survey was disseminated via both direct mail and e-mail to a voluntary, semirandomized US national sample of reproductive endocrinologists. We randomly selected a maximum of six clinics per state using the Centers for Disease Control and Prevention Fertility Clinic Success Rates Report. PATIENT(S) None. INTERVENTION(S) None. MAIN OUTCOME MEASURES Clinician perceptions and knowledge regarding IPV and its relevance to the infertility setting. RESULTS A total of 95 reproductive endocrinology and infertility physicians practicing in either academic or private clinics in the United States completed the survey with an overall response rate of 46% (95/200). General knowledge of IPV was good among respondents. Intimate partner violence assessment was very relevant among 39% (37/95) of respondents and possibly relevant among 56% (53/95) of respondents. A history of IPV awareness training was associated with a decreased frequency of reported barriers, including fewer perceived time constraints, decreased knowledge regarding IPV community resources, and less discomfort asking about IPV. Most respondents estimated the prevalence of IPV in their practice to be rare (≤1%). However, 33% (31/95) reported identifying between one and five active victims of IPV over the prior year, and 63% (60/95) reported identifying a victim of IPV throughout their careers. Only 17% (16/95) of respondents were certain that their clinic had guidelines for detection or management of IPV. CONCLUSION Reproductive endocrinology and infertility physicians would benefit from education and training in IPV to enable them to better identify and assist patients who are victims of IPV.
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Affiliation(s)
- Seth J Barishansky
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Periel Shapiro
- Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | - Gabrielle Meyman
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Mary Ellen Pavone
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Angela K Lawson
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
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22
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Satwik R, Kochhar M. Unexplained infertility categorization based on female laparoscopy and total motile sperm count, and its impact on cumulative live-births after one in-vitro fertilization cycle. A retrospective cohort study involving 721 cycles. Reprod Med Biol 2021; 20:190-198. [PMID: 33850452 PMCID: PMC8022093 DOI: 10.1002/rmb2.12368] [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: 09/22/2020] [Revised: 12/18/2020] [Accepted: 01/10/2021] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To determine how subcategorizing unexplained infertility based on female laparoscopy and total-motile-sperm-count assessment would impact cumulative live-births after one in-vitro fertilization (IVF) cycle. METHODS Seven hundred twenty one IVF cycles from Jan 2014-April 2019 performed at a single-center were retrospectively analyzed. Couples with unexplained infertility having normal uterine and endometrial morphology were subcategorized into three cohorts, UI (1): those with no tuboperitoneal pathology on laparoscopy and total-motile-sperm-count (TMSC) ≧20 million: n = 103; UI (2): tuboperitoneal pathology on laparoscopy or TMSC <20 million, n = 86; and UI(3): tuboperitoneal status not known: n = 114. Controls were severe male factor, bilateral tubal block, and grade 3/4 endometriosis: n = 418. Primary Outcome was cumulative-live-birth-per-initiated-IVF cycle (CLBR). Odds ratio for live-births were adjusted for confounding factors. RESULTS The CLBR in UI1 cohort was significantly lower than controls (29.1% vs 39; OR = 0.62; 95%CI = 0.39-0.98; P = .04); but similar in UI2 and UI3 vs. controls. (37.2% vs 39.95%; OR = 0.89, 95%CI = 0.55-1.44; P = .89) and (38.6% vs 39.95%; OR = 0.98, 95%CI = 0.64-1.55; P = .98). After adjusting for age, infertility duration, past live-births, and AMH, the adjusted odds for CLBR in UI1 was 0.48 (95%CI = 0.28-0.82; P = .007). CONCLUSIONS Unexplained infertility when defined after a normal laparoscopy and TMSC significantly lowered cumulative-live-births-per-initiated-IVF cycle when compared with traditional diagnosis of tubal, endometriosis, or male factor infertility. In UI subcategory with abnormal laparoscopy or TMSC, CLBR remained unaffected. This information could be useful for counseling couples prior to IVF. Large-scale prospective studies are needed to confirm this observation.
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Affiliation(s)
- Ruma Satwik
- Centre of IVF and Human ReproductionInstitute of Obstetrics and GynaecologySir Ganga Ram HospitalNew DelhiIndia
| | - Mohinder Kochhar
- Centre of IVF and Human ReproductionInstitute of Obstetrics and GynaecologySir Ganga Ram HospitalNew DelhiIndia
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Kirca N, Ongen M. Perceived stress and sleep quality before oocyte pick-up, embryo transfer, and pregnancy test in women receiving in vitro fertilization treatment. Sleep Breath 2021; 25:1977-1985. [PMID: 33624218 DOI: 10.1007/s11325-021-02328-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 02/05/2021] [Accepted: 02/12/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Infertility is a major health problem that affects both the family and the community. Women receiving infertility treatment may suffer from stress and even experience sleep disturbance. Sleep quality is an important factor of human health and well-being. Sleep disturbances tend to occur among infertile women during in vitro fertilization treatment. Many studies have focused on the stress and sleep quality associated with their treatment in infertile women. However, few studies have investigated factors linked to their sleep disturbances. OBJECTIVE This study investigated the relationship between perceived stress and sleep quality before oocyte pick-up, in vitro fertilization-embryo transfer, and pregnancy test in women receiving in vitro fertilization treatment. MATERIAL AND METHODS This prospective, longitudinal study was conducted between January and May 2020. One hundred fifty-seven women receiving infertility treatment were included in the study. A personal information form, the Perceived Stress Scale (PSS), and the Pittsburgh Sleep Quality Index (PSQI) were used to collect data. RESULTS The relationship between the Perceived Stress Scale scores and the Pittsburgh Sleep Quality Index scores in all stages of infertility treatment was found to be positively significant at the p < .001 significance level. CONCLUSION Perceived stress level was high in women throughout the infertility treatment. Our study suggested that sleep quality was impaired as stress increased. TRIAL REGISTRATION 70904504/38.
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Affiliation(s)
- Nurcan Kirca
- Department of Obstetrics & Gynecological Nursing, Faculty of Nursing, Akdeniz University, Dumlupinar Boulevard, Antalya, Turkey.
| | - Meryem Ongen
- Department of Obstetrics & Gynecological Nursing, Faculty of Nursing, Akdeniz University, Dumlupinar Boulevard, Antalya, Turkey
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Azimi-Nezhad M, Sistani MN, Vahedian-Shahroodi M. Women's Attempts Related to Complementary and Alternative Medicine Use in Infertility Causes and Diagnosis: A Narrative Inquiry. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2021; 42:272684X21996902. [PMID: 33626983 DOI: 10.1177/0272684x21996902] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In most cultures of the world, infertility is seen as a disaster and is associated with a myriad of emotional and psychological problems for women. Using Complementary and alternative medicine (CAM) can help treat infertility. The present qualitative study aimed to explore women's attempts related to CAM use in infertility causes and diagnosis. This qualitative study has been carried out through a purposive sampling technique on 78 women living in Neyshabur, Iran. An individual interview and focus group discussions (FGDs) was used to collect data. Purposive sampling was used based on the objective of the study and the characteristics of a population. The data collection was discontinued when saturation occurred, and no new themes or information were explored in the data. Data analysis was performed by content analysis and Atlas T software. This study revealed medical diagnosis and traditional medicine, custom activity, medicine causes, and nutrition issues influence women's view pints and attempt towards infertility and CAM use. Results suggested that infertility should be understood not only in biomedical terms but in light of cultural beliefs and the contingent need for culturally-appropriate supportive CAM. The application of CAM along with medical medicine is an essential element in assisting couples in infertility causes.
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Affiliation(s)
- Mohsen Azimi-Nezhad
- Department of Basic Sciences, Neyshabur University of Medical Sciences, Neyshabur, Iran
- Department of Public Health, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Malihe Noori Sistani
- Department of Public Health, Neyshabur University of Medical Sciences, Neyshabur, Iran
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Evaluation of Infertility-related Stress and its Associated Factors in Infertile Clients: A Cross-Sectional Study. PREVENTIVE CARE IN NURSING AND MIDWIFERY JOURNAL 2021. [DOI: 10.52547/pcnm.11.1.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Marom Haham L, Youngster M, Kuperman Shani A, Yee S, Ben-Kimhy R, Medina-Artom TR, Hourvitz A, Kedem A, Librach C. Suspension of fertility treatment during the COVID-19 pandemic: views, emotional reactions and psychological distress among women undergoing fertility treatment. Reprod Biomed Online 2021; 42:849-858. [PMID: 33558171 PMCID: PMC7816616 DOI: 10.1016/j.rbmo.2021.01.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 12/23/2020] [Accepted: 01/12/2021] [Indexed: 12/19/2022]
Abstract
RESEARCH QUESTION What are the views and emotional reactions of patients towards the suspension of fertility treatment during the COVID-19 pandemic, and what are the factors affecting their psychological distress? DESIGN A cross-sectional study conducted in an academic fertility centre. Online questionnaires were distributed between 18 April 2020 and 23 April 2020 to patients whose treatment cycle had been postponed or discontinued. The outcome measures included agreement with the reproductive society guidelines to postpone treatments; willingness to resume treatments, given the choice; patients' emotional reactions; and psychological distress level, measured by the Mental Health Inventory validated scale. A multivariate linear regression was conducted to identify factors associated with psychological distress. RESULTS Because of the small number of male respondents, only women were included in the analysis (n = 181). Forty-three per cent expressed disagreement with the guidelines and 82% were willing to resume treatments, given the choice. Sadness and anxiety were the most common emotional reactions expressed towards the guidelines. In the multivariate analysis, COVID-19-related anxiety (B = 0.145, P = 0.04) and disagreement with treatment suspension (B = -0.44, P = 0.001) were found to be significantly associated with patients' psychological distress. Background characteristics of patients did not contribute significantly to their distress. CONCLUSIONS Suspension of fertility treatment during the initial phase of the COVID-19 pandemic was associated with patients' negative emotional reactions. Anxiety related to COVID-19 and disagreement with treatment suspension were found to be significantly associated with psychological distress among women undergoing fertility treatment, regardless of their background characteristics. Our findings suggest the need to monitor the mental health of patients and provide psychological support should a shutdown of fertility care re-occur.
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Affiliation(s)
- Lilach Marom Haham
- CReATe Fertility Centre, Toronto, Canada; Department of Obstetrics and Gynecology, University of Toronto, Toronto, Canada
| | - Michal Youngster
- IVF Unit, Department of Obstetrics & Gynecology, Shamir Medical Center, Zerifin, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Adi Kuperman Shani
- CReATe Fertility Centre, Toronto, Canada; Department of Obstetrics and Gynecology, University of Toronto, Toronto, Canada
| | | | - Reut Ben-Kimhy
- IVF Unit, Department of Obstetrics & Gynecology, Meir (Sapir) Medical Center, Kfar-Saba, Israel; The Gender Studies Program, Bar-Ilan University, Ramat Gan, Israel
| | - Tamar R Medina-Artom
- Smokler Center for Health Policy Research, Myers-JDC-Brookdale Institute Jerusalem, Israel; The Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
| | - Ariel Hourvitz
- IVF Unit, Department of Obstetrics & Gynecology, Shamir Medical Center, Zerifin, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Alon Kedem
- IVF Unit, Department of Obstetrics & Gynecology, Shamir Medical Center, Zerifin, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Clifford Librach
- CReATe Fertility Centre, Toronto, Canada; Department of Obstetrics and Gynecology, University of Toronto, Toronto, Canada; Institute of Medical Sciences, University of Toronto, Toronto, Canada; Department of Physiology, University of Toronto, Toronto, Canada.
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Naina Purkayastha, Sharma H. Prevalence and potential determinants of primary infertility in India: Evidence from Indian demographic health survey. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021. [DOI: 10.1016/j.cegh.2020.08.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Raad G, Tanios J, Azoury J, Daher A, Fakih C, Bakos HW. Neurophysiology of cognitive behavioural therapy, deep breathing and progressive muscle relaxation used in conjunction with ART treatments: a narrative review. Hum Reprod Update 2020; 27:324-338. [PMID: 33238001 DOI: 10.1093/humupd/dmaa048] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 09/13/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Infertility is defined as the failure to achieve clinical pregnancy after 12 months of regular unprotected intercourse. It could be due to male or female factors, each requiring different treatment options. ART treatment exposes couples to numerous psychological stressors. Therefore, it has been recommended by the ESHRE Psychology and Counselling Guideline Development Group recently that psychosocial support should be offered as a complementary therapy during infertility treatments. In this context, the efficiency of different psychological interventions, such as cognitive behaviour therapy (CBT), deep breathing (DB), and progressive muscle relaxation (PMR), was evaluated in several clinical trials in terms of couples' mental health and pregnancy outcomes. OBJECTIVE AND RATIONALE The neurophysiology of CBT, DB and PMR, which are used in interventional studies, in both men and women undergoing ART, has not yet been fully elucidated. This review represents a comprehensive report, aiming to collate novel insights into the neurobiological processes and physiological mechanisms that occur during the practice of CBT, DB and PMR. SEARCH METHODS PubMed, Google Scholar and Cochrane Library were interrogated to conduct this comprehensive literature review. The search was carried out using combinations of MeSH terms and keywords: infertility, assisted reproductive techniques, IVF, ICSI, emotions, psychological stress, cognitive behavioural therapy, mind-body therapies and relaxation. Relevant information related to the mechanism of action of stress management techniques were obtained from original articles and reviews published in English without taking into consideration the time of publication. Moreover, as it was not the major focus of the review, only recent systematic reviews (2015-2019) pinpointing the effects of psychological interventions on infertility treatment outcomes were also retrieved from the above-mentioned databases. OUTCOMES CBT, DB and PMR may modify the activity of stress-related brain regions such as the prefrontal cortex, amygdala, hypothalamus and hippocampus, as demonstrated by functional MRI and electroencephalogram studies. Furthermore, applying these techniques was associated with mood improvements and a decline in stress biomarkers, and, hypothetically, reducing stress biomarkers attenuates the stress-induced effects on ART outcomes. WIDER IMPLICATIONS Increasing the knowledge of fertility staff, researchers and physicians regarding the mechanisms of action of these stress management techniques has several advantages. For instance, understanding the underlying neurophysiological pathways would assist practitioners to engage ART couples in the practice of these techniques. Also, it may enhance the quality of the support programmes and psychological research. Accordingly, this will ensure that these interventions reach their full potential and therefore improve clinical outcomes.
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Affiliation(s)
- Georges Raad
- IVF Department, Al-Hadi Laboratory and Medical Center, Beirut, Lebanon
| | - Judy Tanios
- Embryology Department, IVF Lebanon, Hazmieh, Lebanon
| | - Joseph Azoury
- Azoury IVF clinic, Mount-Lebanon Hospital, Hazmieh, Lebanon
| | - Alain Daher
- Ob-Gyn department, St Joseph University, Beirut, Lebanon
| | - Chadi Fakih
- IVF Department, Al-Hadi Laboratory and Medical Center, Beirut, Lebanon
| | - Hassan W Bakos
- Monash IVF Group, Sydney, NSW, Australia.,School of Environmental and Life Sciences Faculty of Science, University of Newcastle, NSW, Australia
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Roberts L, Renati S, Solomon S, Montgomery S. Women and Infertility in a Pronatalist Culture: Mental Health in the Slums of Mumbai. Int J Womens Health 2020; 12:993-1003. [PMID: 33192102 PMCID: PMC7654515 DOI: 10.2147/ijwh.s273149] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 10/12/2020] [Indexed: 01/07/2023] Open
Abstract
Background Infertility is a global problem, with high prevalence in India. As a pronatalist society, infertility is particularly problematic in India, causing stigma, shame, and blame especially for women. Infertility consequences for women include discrimination, social exclusion, and abandonment, putting them at high risk for mental health distress. Furthermore, mental health is highly stigmatized and specialized care is largely unavailable. Despite the cultural importance of childbearing, research on infertility distress and resulting mental health sequelae is lacking, particularly among low-income women. The purpose of this study is to assess mental health, using validated scales, among Mumbai slum-dwelling women with a history of infertility. Methods We conducted a mixed-method, cross-sectional study. A focus group discussion with community health workers (n = 7) informed the development of a comprehensive survey. The survey consisted of validated scales whenever possible, in addition to questions pertaining to women’s sociodemographic and reproductive history. After rigorous forward and back translation, the surveys were conducted as face-to-face structured interviews due to low literacy levels and the research naiveté of our respondents. Interviews were conducted by culturally, linguistically, gender-matched, trained research assistants. Results Mumbai slum-dwelling women of reproductive age suffering from infertility (N = 74) participated. Most (85%) women and their husbands (66%) reported previous infertility testing. Participants had elevated mental health distress (anxiety and depression symptomology) largely explained by general health, length of marriage, and coping strategy employed. Conclusion Women facing the double stigma of mental health and infertility need innovative programs to address their challenges.
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Affiliation(s)
- Lisa Roberts
- School of Nursing, Loma Linda University, Loma Linda, CA 92350, USA
| | - Solomon Renati
- Department of Psychology, Veer Wajekar A. S. & C. College, Navi Mumbai 400702, India
| | | | - Susanne Montgomery
- School of Behavioral Health, Behavioral Health Institute, Loma Linda University, Loma Linda, CA 92350, USA
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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.
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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
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Patel A, Venkata Narasimha Sharma PS, Kumar P. Psychiatric Disorders in Women Seeking Fertility Treatments: A Clinical Investigation in India. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2020; 14:68-71. [PMID: 32112639 PMCID: PMC7139230 DOI: 10.22074/ijfs.2020.5759] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 06/15/2019] [Indexed: 11/04/2022]
Abstract
Fertility treatments began in several countries, including India, in the1970s. Despite various advancements in intra uterine insemination (IUI) and in vitro fertilization (IVF), empirical investigations on the psychological endurance and emotional tolerance of Indian women to such treatments are rather scarce. Thus, the aim of this study is to estimate the prevalence of psychiatric disorders in Indian women seeking fertility treatments. It is a cross-sectional study with three hundred women participants undergoing various treatments at the Manipal Assisted Reproductive Centre, Kasturba Medical College, Karnataka, India. Psychiatric disorders were assessed in women using the "ICD- 10 Classification of Mental and Behavioural Disorders" followed by descriptive data analysis. The results show that 78% of women have psychological issues and 45% of them have a diagnosable psychiatric condition. Adjustment Disorders, Anxiety Disorders and Mixed Anxiety and Depression Disorder are established as the top three categories of diagnoses. The findings of this study suggest that women have a high emotional stake in infertility treatments. The data highlights the need for modification of the existing treatment protocol (in Indian clinics) in ways that ensure the emotional wellbeing of patients.
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Affiliation(s)
- Ansha Patel
- Department of Psychiatry, Kasturba Medical College, MAHE, Manipal, Karnataka, India
| | | | - Pratap Kumar
- Department of Obstetrics and Gynaecology, The Manipal Assisted Reproduction Centre, Kasturba Medical College, MAHE, Manipal, Karnataka, India
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Gabnai-Nagy E, Bugán A, Bodnár B, Papp G, Nagy BE. Association between Emotional State Changes in Infertile Couples and Outcome of Fertility Treatment. Geburtshilfe Frauenheilkd 2020; 80:200-210. [PMID: 32109972 PMCID: PMC7035132 DOI: 10.1055/a-0854-5987] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 12/14/2018] [Accepted: 02/10/2019] [Indexed: 11/26/2022] Open
Abstract
Aims Infertility and its treatment are associated with considerable psychological distress for infertile couples. The aim of our study was to explore to what extent positive and negative affectivity and a predisposition to depression and anxiety appear in infertile couples during in vitro fertilization (IVF) treatment. We also aimed to explore how the emotional state of couples changed during IVF in relation to treatment outcomes. Method In our longitudinal study, 174 people (87 couples) were followed up during treatment by means of questionnaires. Their emotional state was assessed with PANAS, BDI-R, and STAI at the beginning of treatment, before embryo transfer, and before taking a pregnancy test. Couples who achieved pregnancy after treatment were included in the successful group (n = 82), while those who did not were included in the unsuccessful group (n = 92). Results We found more favorable emotional states in IVF couples compared to patient populations and the average population. In successful IVF couples, positive affectivity decreased, and negative affectivity increased in women until the time of embryo transfer. This was accompanied by an increase in positive affectivity in men, which remained until the time of the pregnancy test and provided emotional support to their partner. These results were confirmed by changes in the levels of depression. Conclusion Our study suggests the importance of couples' emotional dynamics for having a child and an association between couples' emotional reactions during IVF cycles and treatment success.
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Affiliation(s)
- Erika Gabnai-Nagy
- Institute of Behavioural Sciences, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - Antal Bugán
- Institute of Behavioural Sciences, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - Béla Bodnár
- Assisted Reproduction Center, Clinical Centre, University of Debrecen, Debrecen, Hungary
| | - Gábor Papp
- Institute of Psychology, Faculty of Humanities, University of Debrecen, Debrecen, Hungary
| | - Beáta Erika Nagy
- Department of Pediatrics, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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Deshpande PS, Gupta AS. Causes and Prevalence of Factors Causing Infertility in a Public Health Facility. J Hum Reprod Sci 2019; 12:287-293. [PMID: 32038077 PMCID: PMC6937760 DOI: 10.4103/jhrs.jhrs_140_18] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 04/15/2019] [Accepted: 11/01/2019] [Indexed: 11/25/2022] Open
Abstract
Background: Infertility causes change according to local demographics. There is thus the need to find the causes of infertility in context to local population to aid and direct management strategies accordingly. Aims: The aims were to study the causes of infertility and to calculate the proportion of the individual factors contributing to it in the population coming to a tertiary level public health facility. Setting and Design: This cross-sectional, observational study was done in an infertility clinic in a medical college and government hospital. Materials and Methods: The study comprised 120 couples who came for infertility evaluation and treatment. Cause of infertility in the couple was assigned on the basis of history and examination findings. The prevalence of each cause was evaluated. Statistical Analysis: Results were tabulated, and the prevalence of individual factors was calculated. Intratable analysis was done using SPSS 16.0. Results: Primary infertility (57.5%) was more prevalent than secondary infertility (42.5%). Female factor accounted for 46.6% of the cases with polycystic ovarian syndrome (PCOS) being the leading cause (46%). Infertility was seen equally in lean and obese PCOS cases. Infectious causes such as pelvic inflammatory disease and tuberculosis were significantly associated with tubal factor infertility (P = 0.001). Infertility causes changed as the age of marriage increased. In couples married for less than 5 years, PCOS was the main cause whereas later,male factor and unexplained infertility were the most common causes seen. Male factor contributed to 20% of the cases of infertility, and both tobacco and alcohol consumption were significantly associated with abnormal semen reports (P = 0.001). Conclusion: Causes of infertility vary according to the age of the couples and age of marriage. Although PCOS remains the main cause, infections are a major cause of tubal factor infertility, and tobacco and alcohol worsen the male factor. One-third of the cases still remain unexplained.
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Affiliation(s)
- Priyanka Sanjay Deshpande
- Department of Obstetrics and Gynaecology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - Alka ShantiPrakash Gupta
- Department of Obstetrics and Gynaecology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
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Jacob L, Gerhard C, Kostev K, Kalder M. Association between induced abortion, spontaneous abortion, and infertility respectively and the risk of psychiatric disorders in 57,770 women followed in gynecological practices in Germany. J Affect Disord 2019; 251:107-113. [PMID: 30921593 DOI: 10.1016/j.jad.2019.03.060] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Revised: 03/06/2019] [Accepted: 03/19/2019] [Indexed: 10/27/2022]
Abstract
AIM Our goal was to analyze the association between induced abortion, spontaneous abortion, and infertility respectively and the risk of psychiatric disorders in 57,770 women followed in gynecological practices in Germany. METHODS This case-control study was based on data from the Disease Analyzer database (IQVIA). Women with a first documentation of depression, anxiety, adjustment disorder, or somatoform disorder in one of 281 gynecological practices in Germany between January 2013 and December 2017 were included in this study (index date). Controls without depression, anxiety, adjustment disorder, or somatoform disorder were matched (1:1) to cases by age, index year, and physician. A total of 57,770 women were included in the present study. The main outcome of the study was the risk of psychiatric disorders (i.e. depression, anxiety, adjustment disorder, somatoform disorder) as a function of induced abortion, spontaneous abortion, and infertility. RESULTS The mean age was 29.2 years (SD = 6.4 years) in women with and without psychiatric disorders. Induced abortion (odds ratios [ORs] ranging from 1.75 to 2.01), spontaneous abortion (ORs ranging from 2.16 to 2.60), and infertility (OR = 2.13) were positively associated with the risk of psychiatric disorders. CONCLUSIONS A positive relationship between induced abortion, spontaneous abortion, and infertility respectively and psychiatric disorders was observed in gynecological practices in Germany.
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Affiliation(s)
- Louis Jacob
- Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | - Christian Gerhard
- Department of Gynecology and Obstetrics, Philipps University of Marburg, Marburg, Germany
| | | | - Matthias Kalder
- Department of Gynecology and Obstetrics, Philipps University of Marburg, Marburg, Germany
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Caparros-Gonzalez RA, Romero-Gonzalez B, Quesada-Soto JM, Gonzalez-Perez R, Marinas-Lirola JC, Peralta-Ramírez MI. Maternal hair cortisol levels affect neonatal development among women conceiving with assisted reproductive technology. J Reprod Infant Psychol 2019; 37:480-498. [DOI: 10.1080/02646838.2019.1578949] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Rafael A. Caparros-Gonzalez
- Mind, Brain and Behavior Research Center (CIMCYC), Faculty of Psychology, University of Granada, Granada, Spain
- Department of Obstetrics and Gynaecology, Hospital de Poniente, Almeria, Spain
| | - Borja Romero-Gonzalez
- Mind, Brain and Behavior Research Center (CIMCYC), Faculty of Psychology, University of Granada, Granada, Spain
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Granada, Granada, Spain
| | - Juan M. Quesada-Soto
- Mind, Brain and Behavior Research Center (CIMCYC), Faculty of Psychology, University of Granada, Granada, Spain
| | - Raquel Gonzalez-Perez
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Granada, Granada, Spain
- Department of Pharmacology, CIBERehd, Instituto de Investigacion Biosanitaria ibs.GRANADA, School of Pharmacy, University of Granada, Granada, Spain
| | - Juan C. Marinas-Lirola
- Department of Pharmacology, CIBERehd, Instituto de Investigacion Biosanitaria ibs.GRANADA, School of Pharmacy, University of Granada, Granada, Spain
| | - María Isabel Peralta-Ramírez
- Mind, Brain and Behavior Research Center (CIMCYC), Faculty of Psychology, University of Granada, Granada, Spain
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Granada, Granada, Spain
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Sis Çelik A, Kırca N. Prevalence and risk factors for domestic violence against infertile women in a Turkish setting. Eur J Obstet Gynecol Reprod Biol 2018; 231:111-116. [PMID: 30342312 DOI: 10.1016/j.ejogrb.2018.10.032] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 10/09/2018] [Accepted: 10/12/2018] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Our objective was to estimate the prevalence and risk factors for domestic violence among women seeking infertility treatment at an IVF center. STUDY DESIGN This cross-sectional study was conducted with 423 infertile women who referred to the IVF Center in the southwest of Turkey between 1 January and 31 July 2016. The women were interviewed without their male partners by using the questionnaire and Infertile Women's Exposure to Violence Determination Scale. RESULTS A total of 306 participants (72%) declared having experienced domestic violence. It was found that 30% of the women exposed to violence stated that they were subject to physical violence, 6% to sexual violence, 62% to emotional violence, and 19% to economic violence. It was determined that the total mean score obtained by the women exposed to violence from Infertile Women's Exposure to Violence Determination Scale was 120.04 ± 12.69 and when it was evaluated based on the total mean scores to be obtained from the scale, level of violence experienced by the women was found to be severe. CONCLUSIONS The rate of exposure to violence was determined to be high in women included in the study. The most common type of domestic violence is psychological violence.
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Affiliation(s)
- Aslı Sis Çelik
- Atatürk University, Nursing Faculty, Department of Birth, Women Health and Gynecology Nursing Erzurum, Turkey.
| | - Nurcan Kırca
- Akdeniz University, Nursing Faculty, Department of Birth, Women Health and Gynecology Nursing Antalya, Turkey.
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Patel A, Sharma PSVN, Kumar P. "In Cycles of Dreams, Despair, and Desperation:" Research Perspectives on Infertility Specific Distress in Patients Undergoing Fertility Treatments. J Hum Reprod Sci 2018; 11:320-328. [PMID: 30787515 PMCID: PMC6333040 DOI: 10.4103/jhrs.jhrs_42_18] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
"Emotional distress in infertility" is a broad expression that loosely denotes anxiety, depression, grief, crisis, depleting psychological well-being, and all forms of affective and interpersonal disturbances faced by individuals with infertility. The distress is usually associated with involuntary childlessness as it is an unwelcoming event. The developmental crisis associated with childlessness poses a threat to one's sense of self at all levels (individual, family and social). Distress may begin before or during treatments as a person experiences the loss of control over attaining parenthood, anxiety or dejection after the diagnosis, treatments, its complications particularly its limited success rates. This paper reviews the basic concepts, theoretical models related to infertility specific distress (ISD). It elaborates on the effects of individual and treatment-specific variables on ISD with special highlights gathered from the national and international research.
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Affiliation(s)
- Ansha Patel
- Department of Psychiatry, Kasturba Medical College, Manipal, Karnataka, India
| | - P. S. V. N. Sharma
- Department of Psychiatry, Kasturba Medical College, Manipal, Karnataka, India
| | - Pratap Kumar
- Department of Obstetrics and Gynaecology, Kasturba Medical College, Manipal, Karnataka, India
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Cheng CY, Stevenson EL, Yang CT, Liou SR. Stress and Quality of Life for Taiwanese Women Who Underwent Infertility Treatment. J Obstet Gynecol Neonatal Nurs 2018; 47:498-508. [DOI: 10.1016/j.jogn.2018.03.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2018] [Indexed: 01/29/2023] Open
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Patel A, Sharma PSVN, Kumar P, Binu VS. Illness Cognitions, Anxiety, and Depression in Men and Women Undergoing Fertility Treatments: A Dyadic Approach. J Hum Reprod Sci 2018; 11:180-189. [PMID: 30158816 PMCID: PMC6094532 DOI: 10.4103/jhrs.jhrs_119_17] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background Emotional response to infertility is mediated by numerous interrelated psychological variables such as personality, health perceptions, cognitive appraisals, coping, and social support. While men and women respond to infertility differently, illness cognitions are a vital component of their emotional adjustment. The aim of this study is to compare the infertile men and women undergoing fertility treatments on perceived distress, helplessness, acceptance, benefits, anxiety, and depression. Materials and Methods Eighty-one infertile couples, undergoing intrauterine insemination participated in the study. They were assessed on the presence of infertility distress using the fertility problem inventory, for psychiatric morbidity using the Mini International Neuropsychiatric Interview, for affective disturbances using the Hamilton Anxiety and Depression scales, and for illness cognitions using the Illness Cognition Questionnaire. Statistical Analysis Data are analyzed using SPSS version 15. The paired sample t-test is performed for assessing differences on normally distributed data. The Wilcoxon Signed-Rank test is performed for assessing differences in medians obtained on data that was skewed. Results and Discussion Infertile women (wives) were more emotionally distressed, anxious, and depressed than men (husbands). Gender-wise differences were found for perceptions of helplessness and acceptance of infertility. Infertility was perceived to be a nonbeneficial event for both partners investigated. Conclusion Negative cognitions and affective disturbances may contribute to higher treatment burden in couples seeking-assisted conception. The present study suggests that psychosocial intervention for couples plays a central role and should be integrated within the conventional treatments for infertility.
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Affiliation(s)
- Ansha Patel
- Department of Psychiatry, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
| | - P S V N Sharma
- Department of Psychiatry, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
| | - Pratap Kumar
- Department of Obstetrics and Gynaecology, The Manipal Assisted Reproduction Centre, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.,The Manipal Assisted Reproduction Centre, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
| | - V S Binu
- Department of Biostatistics, Dr. M.V. Govindasamy Centre, National Institute of Mental Health and Neuro Sciences (An Institute of National Importance), Bengaluru, Bengaluru, Karnataka, India
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Patel A, Sharma PSVN, Kumar P, Binu VS. Sociocultural Determinants of Infertility Stress in Patients Undergoing Fertility Treatments. J Hum Reprod Sci 2018; 11:172-179. [PMID: 30158815 PMCID: PMC6094542 DOI: 10.4103/jhrs.jhrs_134_17] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introduction Involuntary childlessness is a distressing condition that has considerable social implications in developing nations. Aim The present study aims to investigate the less known sociocultural determinants of infertility stress in patients undergoing assisted conception and reproductive treatments. Methods This cross-sectional research was conducted on 300 men and women with primary infertility. The profile of sociodemographic variables, clinical variables, and sociocultural variables was collected using a locally devised questionnaire. Infertility stress was assessed using the psychological evaluation test. Statistical Analysis Research data were analyzed using SPSS 15. Chi-square test is used for univariate analysis. Multiple logistic regression with enter method is used to examine the association between infertility stress and sociocultural variables. Results The findings suggest that in both men and women, low spousal support, financial constraints, and social coercion in early years of marriage predicts infertility distress. Peer-support neither predicts nor protects against distress. Discussion Family acceptance and social security for infertility is low. Stigma, concealment, and discrimination among men are reported to be high. Distress is three times greater in women with overinvolved family members who had unrealistic expectations from treatments. Taking continuous cycles of fertility treatments seems unaffordable for most patients. Subfertile individuals were socially perceived to be deprived, blemished, incomplete, and sexually incompetent. Conclusion Data from this investigation, provides a glimpse into sociocultural aspects of infertility. The findings may be useful for identifying targets for individual and family-focused psychological interventions for distress reduction in infertility.
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Affiliation(s)
- Ansha Patel
- Department of Psychiatry, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
| | - P S V N Sharma
- Department of Psychiatry, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
| | - Pratap Kumar
- Department of Obstetrics and Gynaecology, The Manipal Assisted Reproduction Centre, Manipal University, Manipal, Karnataka, India.,The Manipal Assisted Reproduction Centre, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
| | - V S Binu
- Department of Biostatistics, Dr. M.V. Govindasamy Centre, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
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Basu BR, Chowdhury O, Saha SK. Possible Link Between Stress-related Factors and Altered Body Composition in Women with Polycystic Ovarian Syndrome. J Hum Reprod Sci 2018; 11:10-18. [PMID: 29681710 PMCID: PMC5892097 DOI: 10.4103/jhrs.jhrs_78_17] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Stress is an invisible factor affecting modern day living and is strongly associated with many disease pathogenesis including polycystic ovarian syndrome (PCOS) in women. PCOS is the most frequent endocrinological disorder that affects women of reproductive age, leading to metabolic dysfunction and body composition alterations. Salivary amylase and cortisol are major stress mediators that have been implicated in PCOS. However, their role in altering body composition in PCOS is yet to be deciphered. Aim The present study aimed at understanding the relation between stress-associated factors and alterations in body composition among PCOS patients. Design This study enrolled a total of 100 patients (PCOS) and 60 age-matched controls. The female patients were of ages between 13 and 30 years. Materials and Methods Standard assay kits were used to evaluate the α-amylase activity and cortisol level in saliva. The participants were chosen on the basis of the Rotterdam American Society for Reproductive Medicine/European Society of Human Reproduction criteria. Saliva was collected from each participant as per the protocol of Salimetrics, USA. Statistical Analysis Statistical analysis was performed using SPSS version 20 for Windows. The quantitative variables are described as mean ± standard deviation. P < 0.05 was considered significant. Results Increased salivary cortisol level and α-amylase activity were seen in the PCOS population as compared to age-matched controls suggesting patients a sustained stress scenario in their system. Moreover, overweight PCOS participants reflected higher amylase activity than the lean patients participants. Pulse rate, body mass index (BMI), visceral adiposity, and waist-hip ratio (WHR) was considerably higher in the PCOS patients participants compared to controls. A significant correlation could be drawn between the α-amylase activity and BMI or WHR, respectively, among PCOS patients. These observations indicate a strong link between the stress marker and alterations in the body composition parameters of PCOS patients participants. Conclusion Higher prevalence of stress in PCOS patients participants has a critical role in their altered body composition.
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Affiliation(s)
- Barnali Ray Basu
- Department of Physiology, Surendranath College, Kolkata, West Bengal, India
| | - Olivia Chowdhury
- Department of Physiology, Surendranath College, Kolkata, West Bengal, India
| | - Sudip Kumar Saha
- Department of Gynecology and Obstetrics, IPGMER, SSKM Medical College and Hospital, Kolkata, West Bengal, India
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Patel A, Sharma PSVN, Kumar P. Psychosocial Aspects of Therapeutic Donor Insemination. J Hum Reprod Sci 2018; 11:315-319. [PMID: 30787514 PMCID: PMC6333032 DOI: 10.4103/jhrs.jhrs_108_18] [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] [Indexed: 11/04/2022] Open
Abstract
The experience of delays in conception or possibility of remaining childless has the potential to create considerable psychological discomfort. In couples with severe male factor infertility, therapeutic intrauterine insemination using donor sperms (TDI) is offered as a treatment, second to in vitro fertilization using donor sperms. TDI is lucrative, less invasive, and a hopeful treatment. However, there are intricacies associated with it. Its immediate outcomes involve limited success rates, nonresponse, and chances of implantation failures, miscarriages, and multifetal pregnancies. Due to this, couples experience distress when they are advised to undergo three to six cycles of TDI in order to meet the expectations of having a baby. TDI has long-term issues on the triad comprising the "recipients," the "donors," and the "the children born out of TDI." Nevertheless, managing psychosocial needs for couples undergoing TDI and other treatments in Indian clinics are grey areas of the conventional treatment pathway. The present review expands on the psychological issues and needs in couples opting for TDI.
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Affiliation(s)
- Ansha Patel
- Department of Psychiatry, Kasturba Medical College, Manipal, Karnataka, India,Address for correspondence: Dr. Ansha Patel, Room No. 33, Department of Psychiatry, Third Floor, OPD Building, Kasturba Medical College, Manipal, Karnataka, India. E-mail:
| | - P. S. V. N. Sharma
- Department of Psychiatry, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
| | - Pratap Kumar
- Department of Obstetrics and Gynaecology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
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Zaidouni A, Fatima O, Amal B, Siham A, Houyam H, Jalal K, Rachid B. Predictors of Infertility Stress among Couples Diagnosed in a Public Center for Assisted Reproductive Technology. J Hum Reprod Sci 2018; 11:376-383. [PMID: 30787524 PMCID: PMC6333041 DOI: 10.4103/jhrs.jhrs_93_18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background: All around the world, infertility, in many ways, is recognized as a stressful and a critical experience that can have impact on social and marital life of a couple. Infertility stress may affect the treatment and its outcome for such couples. The objective of the present study is to assess the predictors of high stress of infertility among married couples. Materials and Methods: This cross-sectional study was conducted on 120 couples (240 patients) who were diagnosed with primary and secondary infertility from June 2017 to June 2018. A psychological self-assessment questionnaire (Perceived Stress Scale-10) was used as a tool to evaluate the presence of high infertility stress among couples after obtaining their consent. Furthermore, other socioepidemiological data of patients were collected. Statistical Analysis: Data were analyzed using SPSS software (version 20). Univariate statistical analysis was used followed by multiple logistic regressions between high infertility stress and the predictor variables. Results and Discussion: The prevalence of high infertility stress was 53.3% among women and 40.8% among men. For women, multivariate analysis showed leading associations of high infertility stress with level of education, infertility type, infertility duration, and etiologies of infertility. However, for men, multivariate analysis showed leading associations between high infertility stress and alcohol status and inadequate sleep and infertility type.
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Affiliation(s)
- Asmaa Zaidouni
- Assisted Reproductive Technology Center of the Reproductive Health Hospital, University Hospital Ibn Sina, Rabat, Morocco.,Departement of Medical Biotechnology (Med Biotech), Faculty of Medicine and Pharmacy, University Mohamed V, Rabat, Morocco
| | - Ouasmani Fatima
- Department of Nursing, Higher Institute of Nursing Professions and Technics of Health, Rabat, Morocco
| | - Benbella Amal
- Assisted Reproductive Technology Center of the Reproductive Health Hospital, University Hospital Ibn Sina, Rabat, Morocco.,Departement of Medical Biotechnology (Med Biotech), Faculty of Medicine and Pharmacy, University Mohamed V, Rabat, Morocco
| | - Aboulmakarim Siham
- Assisted Reproductive Technology Center of the Reproductive Health Hospital, University Hospital Ibn Sina, Rabat, Morocco.,Departement of Medical Biotechnology (Med Biotech), Faculty of Medicine and Pharmacy, University Mohamed V, Rabat, Morocco
| | - Hardizi Houyam
- Assisted Reproductive Technology Center of the Reproductive Health Hospital, University Hospital Ibn Sina, Rabat, Morocco.,Departement of Medical Biotechnology (Med Biotech), Faculty of Medicine and Pharmacy, University Mohamed V, Rabat, Morocco
| | - Kasouati Jalal
- Department of Bacteriology, Military Teaching Hospital Mohamed V, Rabat, Morocco.,Laboratory of Biostatistics, Epidemiology and Clinical Research, Faculty of Medicine and Pharmacy, University Mohamed V, Rabat, Morocco
| | - Bezad Rachid
- Assisted Reproductive Technology Center of the Reproductive Health Hospital, University Hospital Ibn Sina, Rabat, Morocco.,Departement of Medical Biotechnology (Med Biotech), Faculty of Medicine and Pharmacy, University Mohamed V, Rabat, Morocco
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Kathrins M, Abhyankar N, Shoshany O, Liebermann J, Uhler M, Prins G, Niederberger C. Post-thaw recovery of rare or very low concentrations of cryopreserved human sperm. Fertil Steril 2017; 107:1300-1304. [PMID: 28483505 DOI: 10.1016/j.fertnstert.2017.04.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 04/18/2017] [Accepted: 04/18/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To analyze cases in which no sperm could be identified after thawing among cryopreserved samples of rare or very low concentrations of sperm. DESIGN Retrospective, single-institution, cross-sectional. SETTING Male infertility clinic. PATIENT(S) We identified couples that underwent intracytoplasmic sperm injection (ICSI) with the use of either ejaculated or testicular cryopreserved-thawed sperm. Inclusion criteria were men with <100,000 total ejaculated sperm or men with azoospermia due to spermatogenic dysfunction who underwent microsurgical testicular sperm extraction with similarly low pre-cryopreservation sperm counts. Pre-cryopreservation specimens were categorized as "rare sperm only" (Group 1) or <100,000 total sperm (group 2). "Rare sperm only" applied to cases in which only one to three sperm were identified in a search of >20 high-power fields. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Cases in which no sperm were able to be found post-thaw (i.e., complete cellular loss) for use at the time of a programmed IVF cycle. RESULT(S) We analyzed 55 men (83 ICSI cycles). There were five ICSI cycles (6.0%) among five different couples in which no sperm could be identified post-thaw. Of these, four cases were from group 1 (8.5%) and one from group 2 (2.8%). Complete cellular loss occurred in 5.8% of testicular sperm samples and 7.1% of ejaculated sperm samples. There were no statistical associations between the ability to locate sperm post-thaw and the pre-cryopreservation parameters or sperm source. CONCLUSION(S) Failure to retrieve any sperm after thawing of rare or very low concentrations of cryopreserved sperm is an infrequent event and largely limited to those patients with rare quantities of sperm.
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Affiliation(s)
- Martin Kathrins
- Division of Urology, Brigham and Women's Hospital, Boston, Massachusetts.
| | - Nikita Abhyankar
- Department of Urology, University of Illinois, Chicago, Illinois
| | - Ohad Shoshany
- Department of Urology, University of Illinois, Chicago, Illinois
| | | | - Meike Uhler
- Fertility Centers of Illinois, Chicago, Illinois
| | - Gail Prins
- Department of Urology, University of Illinois, Chicago, Illinois
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Alzoubi A, Mahdi H, Al Bashir S, Halalsheh O, Al Ebbini M, Alzarir M, Al-Ahmar K, Alfaqih M, Al-Hadidi AH. NORMALIZATION OF SERUM VITAMIN D IMPROVES SEMEN MOTILITY PARAMETERS IN PATIENTS WITH IDIOPATHIC MALE INFERTILITY. ACTA ENDOCRINOLOGICA-BUCHAREST 2017; 13:180-187. [PMID: 31149171 DOI: 10.4183/aeb.2017.180] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Context Idiopathic male infertility is evident in half of infertile males. Vitamin D receptors are expressed throughout male reproductive tract, including spermatozoa, promoting motility. Epidemiological studies revealed the positive association between serum vitamin D and semen quality. However, there are no clinical studies examining the differential role of vitamin D in idiopathic male infertility. Objectives 1) To investigate the association between vitamin D deficiency and idiopathic male infertility, and 2) To determine whether vitamin D deficient males would show restoration of semen quality parameters upon supplementation with vitamin D. Design This was a year-long case-control study from November 2015 to November 2016. A therapeutic intervention cohort for 2 months was also performed. Subjects and Methods 117 Jordanian males were enrolled. Following a clinical evaluation by a urologist, baseline serum vitamin D and semen fluid analyses were collected. Participants were stratified into 3 groups: controls (n=30), idiopathic infertility (n=67), and secondary infertility (n=20). Idiopathic infertility patients with low vitamin D (n= 45) were supplemented with oral vitamin D, 5000 IU, once daily for two months. Thereafter, serum vitamin D and semen fluid analyses were reassessed (n= 34; 11 patients were lost to follow up). Results Vitamin D was significantly lower in patients with idiopathic infertility than in both controls and men with secondary infertility. Significant improvement of progressive and total sperm motility was observed after vitamin D treatment. Vitamin D correlated significantly with semen quality in the study population. However, no correlation was found between vitamin D and any of the semen quality parameters in the idiopathic infertility group. Conclusions Vitamin D supplementation improves sperm motility in idiopathic male infertility patients with low vitamin D. Larger and longer clinical trials are warranted to validate the use of vitamin D in these cases.
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Affiliation(s)
- A Alzoubi
- Jordan University of Science and Technology, College of Medicine, Departments of Pharmacology, Irbid, Jordan
| | - H Mahdi
- Jordan University of Science and Technology, College of Medicine, Departments of Pharmacology, Irbid, Jordan
| | - S Al Bashir
- Jordan University of Science and Technology, College of Medicine, Departments of Pathology, Irbid, Jordan
| | - O Halalsheh
- Jordan University of Science and Technology, College of Medicine, Departments of Urology, Irbid, Jordan
| | - M Al Ebbini
- Jordan University of Science and Technology, College of Medicine, Departments of Pharmacology, Irbid, Jordan
| | - M Alzarir
- Jordan University of Science and Technology, College of Medicine, Departments of Pharmacology, Irbid, Jordan
| | - K Al-Ahmar
- Jordan University of Science and Technology, College of Medicine, Departments of Pharmacology, Irbid, Jordan
| | - M Alfaqih
- Jordan University of Science and Technology, College of Medicine, Departments of Biochemistry, Irbid, Jordan
| | - A H Al-Hadidi
- Jordan University of Science and Technology, College of Medicine, Departments of Pharmacology, Irbid, Jordan
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