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Sambasivam I, Jennifer HG. Understanding the experiences of helplessness, fatigue and coping strategies among women seeking treatment for infertility - A qualitative study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:309. [PMID: 38023084 PMCID: PMC10670859 DOI: 10.4103/jehp.jehp_1600_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 02/10/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND Infertility impacts families and communities worldwide, affecting millions of people of reproductive age. The fertility rate in India is alarming. Fertility is valued in the majority of cultures, and having children is a fundamental motivation. The frustration and anger of an infertile woman affect her family, friends, and even her husband. This study aims to assess the factors that contribute to helplessness, fatigue, and coping strategies among women with infertility. MATERIALS AND METHODS An in-depth interview was conducted among ten participants, to collect information about the challenges faced by women experiencing infertility. The participants were selected using a purposive sampling technique and they had at least 1 year of experience with infertility. A phenomenological study was utilized and themes and sub-themes were developed. Data was collected by using a list of probing open-ended questions and analyzed by colaizzi method. RESULTS Women receiving infertility treatment over a long period of time disclosed that they are dealing with stressful situations in their lives. The experience left them feeling helpless in some stressful conditions. Due to a lack of both financial and emotional support from their family, when they are helpless, they are too worn out to continue their treatment. Some of these women are using different coping strategies to overcome their problems. We found seven common themes from this in-depth interview; 1) Lack of hope and support, 2) Spiritual resources, 3) Negative thoughts, 4) Social abstain, 5) Mental engagement, 6) Emotional concealment, and 7) Coping strategies. CONCLUSION This study provides social, emotion and spiritual condition of infertile women in society. The majority of these women struggle with having negative thoughts due to a lack of support, concern, and involvement from their families. These results highlight the need to promote coping strategies, importance of financial and emotional support from the family members.
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Affiliation(s)
- Indra Sambasivam
- Research Scholar, School of Public Health, SRM Institute of Science and Technology, Chengalpattu, Tamil Nadu, India
| | - H. Gladius Jennifer
- Associate Professor, School of Public Health, SRM Institute of Science and Technology, Kattankulathur, Chengalpet, Tamil Nadu, India
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Koochaksaraei FY, Simbar M, Khoshnoodifar M, Faramarzi M, Nasiri M. Interventions promoting mental health dimensions in infertile women: a systematic review. BMC Psychol 2023; 11:254. [PMID: 37653562 PMCID: PMC10472670 DOI: 10.1186/s40359-023-01285-1] [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: 11/09/2022] [Accepted: 08/14/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Scientific developments have brought hope to infertile couples; however, the results are not always favorable. This makes women suffer psychological pressure. Therefore, previous studies have investigated the effectiveness of many psychological interventions but no research identified the most common psychological interventions. In this regard, the present review aimed to investigate different psychological interventions that promote mental health in infertile to identify the most frequent (common) ones. METHODS In the present study, the search was carried out using appropriate keywords Infertility, psychological interventions, mental health, stress, anxiety, depression and women in the Google Scholar، Magiran، SID، Pubmed، Scopus، Science Direct، ProQuest، Web of Science databases and One of the leading websites in health- WHO with Persian and English languages and two operators of "AND" and "OR" between 2000 and 2021. RESULTS First, 7319 articles were searched, 6948 articles of which were removed due to irrelevant subjects, and 31 articles were removed due to duplication. 340 abstracts were examined and the results of 60 articles were extracted. Two approaches (examining the type and content of intervention) were used to extract findings. The first approach indicated high diversity in psychological interventions, leading to the categorization of the interventions into 4 categories of cognitive behavioral therapy (CBT), mind-body interventions (MBI), stress management skills, and others. CBT and MBI and stress management skills were found as the most frequent promoting interventions for mental health in infertile women. The second approach indicated the differences in protocols (number of sessions and time of interventions). CONCLUSION Despite differences in protocol of interventions under study, the results of all articles revealed the effectiveness of interventions in improving infertile women's mental health; therefore, it is suggested to apply the most common psychological interventions based on scientific evidence (CBT, MBI, and stress management skills) along with infertility treatment methods. The results will help the specialists, policy-makers, and planners to select and implement the most appropriate psychological interventions for infertile women.
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Affiliation(s)
- Fatemeh Yahyavi Koochaksaraei
- Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoumeh Simbar
- Department of Midwifery and Reproductive Health, Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Mehrnoosh Khoshnoodifar
- E-Learning Department, Virtual school of Medical Education and management, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahbobeh Faramarzi
- Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
- Population and Family Spiritual Health Research Center, Health Research Institute, Babol University of Medical Science, Babol, Iran
| | - Malihe Nasiri
- Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Zhang L, Gu W, Jing X, Zhi S, Zhou N, Zhang L, Wang W, Jiang Y. Predicting the dyadic coping through self-esteem among infertile couples undergoing in vitro fertilization and embryo transfer: An actor-partner interdependence model. Front Psychol 2023; 14:1127464. [PMID: 37609490 PMCID: PMC10442154 DOI: 10.3389/fpsyg.2023.1127464] [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: 12/19/2022] [Accepted: 03/02/2023] [Indexed: 08/24/2023] Open
Abstract
Background The population of infertile couples receiving in vitro fertilization and embryo transfer in China is increasing gradually. The association of self-esteem and dyadic coping of infertile couples undergoing in vitro fertilization and embryo transfer has not been reported. This investigation aimed to examine the predictive effect of self-esteem of infertile couples undergoing in vitro fertilization and embryo transfer on coping strategies at the dyadic level. Methods A cross-sectional study involving 283 infertile couples was conducted at the Reproductive Center of Northwest Women and Children's Hospital in China. Participants were asked to complete two self-administered questionnaires, to assess self-esteem (Rosenberg Self-Esteem Scale) and dyadic coping (Dyadic Coping Inventory). Paired t-test and Pearson correlation were used to analyze the difference and correlation of variables between wife and husband. The actor-partner interdependence model was used to test the predictive effect of each individual's self-esteem on their own and their partners' dyadic coping. Results Infertile couples' self-esteem and dyadic coping are in the medium range. The self-esteem of wives and husbands can fully predict their own dyadic coping. Meanwhile, the husband's self-esteem can predict the wife's stress communication (β = 0.135, p = 0.025), support dyadic coping (β = 0.142, p = 0.019), and negative dyadic coping (β = 0.133, p = 0.024), and the wife's perceived partners' supportive dyadic coping (β = 0.147, p = 0.014) and negative dyadic coping (β = 0.144, p = 0.016). Similarly, the wife's self-esteem can predict the husband's supportive dyadic coping (β = 0.195, p < 0.001), and the husband's perceived partners' stress communication (β = 0.184, p = 0.003) and supportive dyadic coping (β = 0.180, p = 0.002). Conclusion The actor-partner analyses revealed insight into how infertile couples undergoing in vitro fertilization and embryo transfer interact and highlighted the importance of self-esteem in dyadic coping styles. Future psychological interventions can enhance self-esteem as an effective way to improve dyadic coping of infertile couples.
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Affiliation(s)
- Lihong Zhang
- School of Nursing, Health Science Center, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Wei Gu
- School of Nursing, Health Science Center, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Xiaoyu Jing
- Gynecologic & Reproductive Ward, Northwest Women’s and Children’s Hospital, Xi’an, Shaanxi, China
| | - Shihan Zhi
- School of Nursing, Health Science Center, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Nan Zhou
- School of Nursing, Health Science Center, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Lu Zhang
- Medical College, Xijing University, Xi’an, Shaanxi, China
| | - Wenru Wang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ying Jiang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Reisi M, Kazemi A, Abedi MR, Nazarian N. Spouse's coping strategies mediate the relationship between women's coping strategies and their psychological health among infertile couples. Sci Rep 2023; 13:10675. [PMID: 37393323 PMCID: PMC10314934 DOI: 10.1038/s41598-023-37380-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 06/21/2023] [Indexed: 07/03/2023] Open
Abstract
Social problems and suffering from the treatment process for infertile couples, especially for women, require the couples to cope with them to balance the infertility crisis. According to the close interactions of the couples with each other, the objective of the present study was to explore a theoretical framework for the relationships between women's coping strategies, spouses' coping strategies, and women's psychological health in infertile couples who were candidates for assisted reproductive technology (ART). This cross-sectional study was carried out on 212 couples undergoing ART. The couples' coping strategies were evaluated using a validated self-report questionnaire. The women's psychological health was assessed using a 21-item stress, anxiety, and depression scale (DASS-21). Statistical analysis was performed using the plug-in application PROCESS macro for SPSS. The direct effect of the women's self-blame and self-focused rumination strategies (p < .0001), and the indirect effect of the women's self-blame on stress and depression by mediating spouses' self-blame and self-focused rumination strategies, was significant. The indirect effect of the women's self-focused rumination on the anxiety and depression levels by mediating spouses' self-blame strategy was significant. The women's self-blame and self-focused rumination strategies had a negative effect on the women's psychological health who were undergoing ART. This negative effect was mediated by the spouse's coping strategies.
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Affiliation(s)
- Marzie Reisi
- School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ashraf Kazemi
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Hezarjerib AV., Isfahan, Iran.
| | - Mohammad Reza Abedi
- Counseling Department, School of Psychology and Education Sciences, University of Isfahan, Isfahan, Iran
| | - Naser Nazarian
- Social Sciences Department, University of Isfahan, Isfahan, Iran
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Violette CJ, Nguyen BT. Expectations for family building, assisted reproduction, and adoption among lesbians in the National Survey of Family Growth, 2017-2019. F S Rep 2023; 4:190-195. [PMID: 37398611 PMCID: PMC10310959 DOI: 10.1016/j.xfre.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/06/2023] [Accepted: 04/10/2023] [Indexed: 07/04/2023] Open
Abstract
Objective To characterize the family-building goals and experiences of lesbians compared with those of heterosexual females in the United States. Design Secondary analysis of nationally representative, cross-sectional survey data. Setting National Survey of Family Growth 2017-2019. Patients 159 reproductive-age lesbian respondents and 5,127 reproductive-age heterosexual respondents. Interventions We characterized family-building goals and the use of assisted reproduction and adoption among lesbians using nationally representative female respondent data from the 2017-2019 National Survey of Family Growth. We performed bivariate analyses examining variations in these outcomes between lesbian and heterosexual individuals. Main Outcome Measures Wantedness of children, use of assisted reproductive technology, and pursuit of adoption among reproductive-age lesbian and heterosexual participants. Results We identified 159 reproductive-age lesbian respondents of the National Survey of Family Growth, representing 2.3% or approximately 1.75 million US individuals of reproductive age. The lesbian respondents were younger, less religious, and less likely to have children than heterosexual respondents. These groups did not differ significantly by race/ethnicity, education, or income. More than half of the individuals reported wanting a child in the future, with proportions similar between the lesbian and heterosexual individuals (48% vs. 51%, respectively; P = .52). Accordingly, 18% of both the lesbian and heterosexual individuals reported that they would be greatly bothered if they were unable to have children. Nevertheless, health care providers reportedly asked the lesbians about their desire to get pregnant less frequently than they asked the heterosexual individuals (21% vs. 32%, respectively; P = .04). Only 26% of the lesbians had ever been pregnant compared with 64% of the heterosexual individuals (P<.01). Approximately one third (31%) of lesbians with medical insurance were seeking reproductive services compared with 10% of heterosexual individuals (P = .05). Lesbians were significantly more likely to be seeking adoption than heterosexual individuals (7.0% vs. 1.3%, respectively; P = .01), although they were more likely to report being turned down (17% vs. 10%, respectively; P = .03), not knowing why they were unable to adopt (19% vs. 1%, respectively; P = .02), and quitting because of the adoption process (100% vs. 45%, respectively; P = .04). Conclusions Approximately half of US females of reproductive age desire to have a child, a proportion that is not different between lesbian and heterosexual individuals. However, fewer lesbians are asked about their desires to get pregnant, and fewer ever become pregnant. Lesbians are significantly more likely to pursue assisted reproductive services when covered by insurance and more likely to seek adoption. Unfortunately, lesbians are more likely to face challenges with adoption.
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Affiliation(s)
- Caroline J. Violette
- Department of Obstetrics and Gynecology, Keck School of Medicine of the University of Southern California, Los Angeles, California
| | - Brian T. Nguyen
- Section of Family Planning, Department of Obstetrics and Gynecology, Keck School of Medicine of the University of Southern California, Los Angeles, California
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Shafierizi S, Basirat Z, Nasiri-Amiri F, Kheirkhah F, Chehrazi M, Pasha H, Faramarzi M. The prevalence of adjustment disorder and predisposing factors in infertile women. BMC Psychol 2023; 11:142. [PMID: 37131228 PMCID: PMC10152011 DOI: 10.1186/s40359-023-01193-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 04/27/2023] [Indexed: 05/04/2023] Open
Abstract
BACKGROUND Infertility is a stressful life event that increases the risk of developing mental disorders, particularly adjustment disorder (AD). Given the paucity of data on the prevalence of AD symptoms in infertility, the purpose of this study was to ascertain the prevalence, clinical presentation, and risk factors for AD symptoms in infertile women. METHOD In a cross-sectional study, 386 infertile women completed questionnaires including the Adjustment Disorder New Module-20 (ADNM), the Fertility Problem Inventory (FPI), the Coronavirus Anxiety Scale (CAS), and the Primary Care Posttraumatic Stress Disorder (PC-PTSD-5) at an infertility center between September 2020 and January 2022. RESULT The results indicated that 60.1% of infertile women exhibited AD symptoms (based on ADNM > 47.5). In terms of clinical presentation, impulsive behavior was more common. No significant relationship was observed between prevalence and women's age or duration of infertility. Infertility stress (β = 0.27, p < 0.001), coronavirus anxiety (β = 0.59, p = 0.13), and a history of unsuccessful assisted reproductive therapies (β = 2.72, p = 0.008) were several predisposing factors for AD symptoms in infertile women. CONCLUSIONS The findings suggest that all infertile women be screened from the start of infertility treatment. Additionally, the study suggests that infertility specialists should focus on combining medical and psychological treatments for individuals predisposed to AD, particularly infertile women who exhibit impulsive behaviors.
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Affiliation(s)
- Shiva Shafierizi
- Counselling in Midwifery, Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Zahra Basirat
- Department of Obstetrics and Gynecology, Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Fatemeh Nasiri-Amiri
- Department of Reproductive Health, Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Farzan Kheirkhah
- Department of Psychiatry, Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mohammad Chehrazi
- Department of Biostatistics and Epidemiology, School of Public Health, Babol University of Medical Sciences, Babol, Iran
| | - Hajar Pasha
- Department of Reproductive Health, Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mahbobeh Faramarzi
- Department of Psychology, Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
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Almutawa YM, AlGhareeb M, Daraj LR, Karaidi N, Jahrami H. A Systematic Review and Meta-analysis of the Psychiatric Morbidities and Quality of Life Differences Between Men and Women in Infertile Couples. Cureus 2023; 15:e37327. [PMID: 37181965 PMCID: PMC10168134 DOI: 10.7759/cureus.37327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2023] [Indexed: 05/16/2023] Open
Abstract
Infertility is often associated with diverse psychiatric morbidities and quality of life impairments. Hence, this meta-analysis aimed to compare stress, depression, anxiety and quality of life (QoL) among infertile men and women. We retrieved the relevant articles from multiple databases. For the statistical analyses, we used Comprehensive Meta-Analysis software v. 3.7 (Biostat Inc., Englewood, NJ). Standardized mean differences (SMD) with 95% confidence intervals (CI) were calculated and displayed in forest plots. Among the 4123 articles identified, 35 studies met the inclusion criteria. Our results revealed that stress, depression, and anxiety were higher in infertile women compared to men. Similarly, infertile women presented a lower QoL than infertile men. Subgroup analysis revealed that the assessment tool used, study design, and geographical origin were a source of heterogeneity. This meta-analysis showed that psychological disturbances were higher in infertile women compared to men. Physicians need to consider this difference to enable couples to better understand and support each other.
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Affiliation(s)
- Yaser Mansoor Almutawa
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, BHR
| | - Muneera AlGhareeb
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, BHR
| | - Lateefa Rashed Daraj
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, BHR
| | - Noor Karaidi
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, BHR
| | - Haitham Jahrami
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, BHR
- Department of Psychiatry, Psychiatry Hospital, Ministry of Health, Manama, BHR
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Jaber DJ, Basheer HA, Albsoul-Younes AM, Elsalem LM, Hamadneh JM, Dweib MK, Ahmedah HT. Prevalence and predictive factors for infertility-related stress among infertile couples: A cross-sectional study from Jordan and the occupied Palestinian territories. Saudi Med J 2022; 43:1149-1156. [PMID: 36261208 PMCID: PMC9994507 DOI: 10.15537/smj.2022.43.10.20220411] [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: 07/27/2022] [Accepted: 09/25/2022] [Indexed: 06/16/2023] Open
Abstract
OBJECTIVES To assess the level of infertility-related stress, associated socio-economic, and demographic factors among infertile couples living in Jordan and those living under the chronic Israeli-Palestinian conflict in the occupied Palestinian territories. METHODS A cross-sectional study was carried out in a number of fertility and reproductive clinics in Jordan and occupied Palestinian territories over a period of 6 months. Trained clinical pharmacists interviewed the identified couples. RESULTS A total of 443 participants were interviewed. Three variables were significantly and independently associated with global stress scores. The need of parenthood appears higher in women than men among infertile couples in Jordan and Palestine (p=0.005). The country of origin (p<0.001) made the greatest contribution of unique variance followed by family type (p=0.035). Additionally, a significant contribution to the model was carried out by the number of clinicians who followed up on the case (p=0.013). The average total cost of treatment since the problem had been diagnosed was 2936±4529 Jordanian dinar, which may be of concern to both Jordanians and Palestinians given the limited resources available in developing nations. CONCLUSION This study shows a significant degree of stress among infertile couples. The place of origin, family structure, and presence of medical insurance had a significant impact on the infertility global stress score. This study emphasizes the necessity for specific psychological therapies that are currently lacking in public healthcare practices in both Jordan and Palestine.
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Affiliation(s)
- Deema J. Jaber
- From the Department of Clinical Pharmacy (Jaber, Basheer), Faculty of Pharmacy, Zarqa University, Zarqa, from the Department of Clinical Pharmacy (Albsoul-Younes), University of Jordan, Amman, from the Department of Pharmacology (Elsalem); from the Department of Obstetrics and Gynecology (Hamadneh), Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan, from the Department of Clinical Pharmacy (Dweib), Faculty of Pharmacy, Hebron University, Hebron, Palestine, and from the Department of Medical Laboratory Technology (Ahmedah), Faculty of Applied Medical Sciences, King Abdulaziz University, Rabigh, Kingdom of Saudi Arabia.
| | - Haneen A. Basheer
- From the Department of Clinical Pharmacy (Jaber, Basheer), Faculty of Pharmacy, Zarqa University, Zarqa, from the Department of Clinical Pharmacy (Albsoul-Younes), University of Jordan, Amman, from the Department of Pharmacology (Elsalem); from the Department of Obstetrics and Gynecology (Hamadneh), Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan, from the Department of Clinical Pharmacy (Dweib), Faculty of Pharmacy, Hebron University, Hebron, Palestine, and from the Department of Medical Laboratory Technology (Ahmedah), Faculty of Applied Medical Sciences, King Abdulaziz University, Rabigh, Kingdom of Saudi Arabia.
| | - Abla M. Albsoul-Younes
- From the Department of Clinical Pharmacy (Jaber, Basheer), Faculty of Pharmacy, Zarqa University, Zarqa, from the Department of Clinical Pharmacy (Albsoul-Younes), University of Jordan, Amman, from the Department of Pharmacology (Elsalem); from the Department of Obstetrics and Gynecology (Hamadneh), Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan, from the Department of Clinical Pharmacy (Dweib), Faculty of Pharmacy, Hebron University, Hebron, Palestine, and from the Department of Medical Laboratory Technology (Ahmedah), Faculty of Applied Medical Sciences, King Abdulaziz University, Rabigh, Kingdom of Saudi Arabia.
| | - Lina M. Elsalem
- From the Department of Clinical Pharmacy (Jaber, Basheer), Faculty of Pharmacy, Zarqa University, Zarqa, from the Department of Clinical Pharmacy (Albsoul-Younes), University of Jordan, Amman, from the Department of Pharmacology (Elsalem); from the Department of Obstetrics and Gynecology (Hamadneh), Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan, from the Department of Clinical Pharmacy (Dweib), Faculty of Pharmacy, Hebron University, Hebron, Palestine, and from the Department of Medical Laboratory Technology (Ahmedah), Faculty of Applied Medical Sciences, King Abdulaziz University, Rabigh, Kingdom of Saudi Arabia.
| | - Jehan M. Hamadneh
- From the Department of Clinical Pharmacy (Jaber, Basheer), Faculty of Pharmacy, Zarqa University, Zarqa, from the Department of Clinical Pharmacy (Albsoul-Younes), University of Jordan, Amman, from the Department of Pharmacology (Elsalem); from the Department of Obstetrics and Gynecology (Hamadneh), Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan, from the Department of Clinical Pharmacy (Dweib), Faculty of Pharmacy, Hebron University, Hebron, Palestine, and from the Department of Medical Laboratory Technology (Ahmedah), Faculty of Applied Medical Sciences, King Abdulaziz University, Rabigh, Kingdom of Saudi Arabia.
| | - Mohammad K. Dweib
- From the Department of Clinical Pharmacy (Jaber, Basheer), Faculty of Pharmacy, Zarqa University, Zarqa, from the Department of Clinical Pharmacy (Albsoul-Younes), University of Jordan, Amman, from the Department of Pharmacology (Elsalem); from the Department of Obstetrics and Gynecology (Hamadneh), Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan, from the Department of Clinical Pharmacy (Dweib), Faculty of Pharmacy, Hebron University, Hebron, Palestine, and from the Department of Medical Laboratory Technology (Ahmedah), Faculty of Applied Medical Sciences, King Abdulaziz University, Rabigh, Kingdom of Saudi Arabia.
| | - Hanadi T. Ahmedah
- From the Department of Clinical Pharmacy (Jaber, Basheer), Faculty of Pharmacy, Zarqa University, Zarqa, from the Department of Clinical Pharmacy (Albsoul-Younes), University of Jordan, Amman, from the Department of Pharmacology (Elsalem); from the Department of Obstetrics and Gynecology (Hamadneh), Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan, from the Department of Clinical Pharmacy (Dweib), Faculty of Pharmacy, Hebron University, Hebron, Palestine, and from the Department of Medical Laboratory Technology (Ahmedah), Faculty of Applied Medical Sciences, King Abdulaziz University, Rabigh, Kingdom of Saudi Arabia.
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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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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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11
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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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12
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Iordăchescu DA, Paica CI, Boca AE, Gică C, Panaitescu AM, Peltecu G, Veduță A, Gică N. Anxiety, Difficulties, and Coping of Infertile Women. Healthcare (Basel) 2021; 9:healthcare9040466. [PMID: 33920767 PMCID: PMC8071148 DOI: 10.3390/healthcare9040466] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 04/11/2021] [Accepted: 04/13/2021] [Indexed: 11/24/2022] Open
Abstract
The present study aims to highlight how women perceive and adapt to infertility difficulties. To better understand the difficulties that women diagnosed with infertility are experiencing, the study explores this concept in correlation with anxiety and coping. 240 women with fertility problems from various parts of Romania completed the State-Trait Anxiety Inventory (STAI-Form Y), Brief COPE and the scale “Difficulties With Infertility and Its Treatment.” Statistical analyzes showed that women who were at the beginning of treatment obtained higher scores on the anxiety [F(2,237) = 4.76, p = 0.009] and on the difficulties scale [F(2,237) = 3.53, p = 0.031], compared to participants who resorted to repeated fertilization procedures. It is important to emphasize that there is a significant positive correlation between the perception of infertility difficulties and coping, and also between difficulties and state anxiety. Regarding the relationship between state anxiety and coping, there were significant positive associations between maladaptive coping strategies and state anxiety, while adaptive strategies were negatively associated with state anxiety. In addition, regarding coping strategies, venting and self-blame occurred predominantly in women who know that the cause of infertility is female-related. These findings draws attention to the fact that infertile women live this experience at very high levels of anxiety, using quite a few adaptive coping mechanisms. These results highlight the need to investigate ways to reduce anxiety and optimizing adaptive coping strategies.
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Affiliation(s)
- Diana Antonia Iordăchescu
- Faculty of Psychology and Educational Sciences, University of Bucharest, 90, Panduri Avenue, 050653 Bucharest, Romania; (D.A.I.); (C.I.P.); (A.E.B.)
| | - Corina Ioana Paica
- Faculty of Psychology and Educational Sciences, University of Bucharest, 90, Panduri Avenue, 050653 Bucharest, Romania; (D.A.I.); (C.I.P.); (A.E.B.)
| | - Alina Estera Boca
- Faculty of Psychology and Educational Sciences, University of Bucharest, 90, Panduri Avenue, 050653 Bucharest, Romania; (D.A.I.); (C.I.P.); (A.E.B.)
| | - Corina Gică
- Filantropia Clinical Hospital, 011132 Bucharest, Romania; (A.M.P.); (G.P.); (A.V.); (N.G.)
- Correspondence: or ; Tel.: +40-721-952600
| | - Anca Maria Panaitescu
- Filantropia Clinical Hospital, 011132 Bucharest, Romania; (A.M.P.); (G.P.); (A.V.); (N.G.)
- Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Gheorghe Peltecu
- Filantropia Clinical Hospital, 011132 Bucharest, Romania; (A.M.P.); (G.P.); (A.V.); (N.G.)
- Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Alina Veduță
- Filantropia Clinical Hospital, 011132 Bucharest, Romania; (A.M.P.); (G.P.); (A.V.); (N.G.)
| | - Nicolae Gică
- Filantropia Clinical Hospital, 011132 Bucharest, Romania; (A.M.P.); (G.P.); (A.V.); (N.G.)
- Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
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13
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Cocchiaro T, Meneghini C, Dal Lago A, Fabiani C, Amodei M, Miriello D, Crisafulli ML, Meneghini C, Capone B, Cannarella R, Condorelli RA, La Vignera S, Calogero AE, Lenzi A, Rago R. Assessment of sexual and emotional distress in infertile couple: validation of a new specific psychometric tool. J Endocrinol Invest 2020; 43:1729-1737. [PMID: 32333331 DOI: 10.1007/s40618-020-01263-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Accepted: 04/16/2020] [Indexed: 01/04/2023]
Abstract
BACKGROUND The diagnosis of infertility strongly impacts on psychological and sexological couple health. In this regard, some feelings and psychological states were demonstrated in association with reproductive problems. Depression and anxiety are the most common psychopathologies associated with infertility, although also sexuality is strongly involved in infertility conditions. OBJECTIVES The aim of this study is to develop a tool to probe and assess the emotional aspects, sexuality, and social relationships of the couple seeking medical care for infertility. MATERIALS AND METHODS A self-reported questionnaire that we will refer to as SEIq (Sexuality and Emotions in Infertility questionnaire) was constructed and developed and, consequently, administered to 162 heterosexual couples (324 subjects) seeking help for reproductive problems. Hence, we performed a specific statistical analysis to assess and validate this new psychometric tool. RESULTS About 60% of men and women (both partners in 43% of couples) declare that infertility has changed their life (Q10). Moreover, the incidence of sexual disorder declared by the subjects is quite rare in men (10%) but more frequent in women (29%) (p < 0.01). CONCLUSION AND DISCUSSION The results of this pilot test show that the diagnosis of infertility impacts on the couple relationship affecting the emotional area, interpersonal relationships, and sexual functions of the couples. Moreover, the SEIq appears a valuable tool to coherently probe and relate sexological, psychological, relational, and emotive aspects in partners and couples facing the infertility diagnosis. The explorative factor analysis of SEIq data allows to understand the women, men, and couples' behavior in our sample, individuating a reduced set of factors, prone to an easier evaluation. On the whole, the psychometric evaluation through SEIq might be suitable for the couples during Assisted Reproductive Technologies treatments.
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Affiliation(s)
- T Cocchiaro
- Department of Gender, Parenting, Child and Adolescent Medicine, Unit of Reproductive Pathophysiology and Andrology, "Sandro Pertini" Hospital, Rome, Italy
| | - C Meneghini
- Department of Gender, Parenting, Child and Adolescent Medicine, Unit of Reproductive Pathophysiology and Andrology, "Sandro Pertini" Hospital, Rome, Italy
| | - A Dal Lago
- Department of Gender, Parenting, Child and Adolescent Medicine, Unit of Reproductive Pathophysiology and Andrology, "Sandro Pertini" Hospital, Rome, Italy
| | - C Fabiani
- Department of Gender, Parenting, Child and Adolescent Medicine, Unit of Reproductive Pathophysiology and Andrology, "Sandro Pertini" Hospital, Rome, Italy
| | - M Amodei
- Department of Gender, Parenting, Child and Adolescent Medicine, Unit of Reproductive Pathophysiology and Andrology, "Sandro Pertini" Hospital, Rome, Italy
| | - D Miriello
- Department of Gender, Parenting, Child and Adolescent Medicine, Unit of Reproductive Pathophysiology and Andrology, "Sandro Pertini" Hospital, Rome, Italy
| | - M L Crisafulli
- Department of Gender, Parenting, Child and Adolescent Medicine, Unit of Reproductive Pathophysiology and Andrology, "Sandro Pertini" Hospital, Rome, Italy
| | - C Meneghini
- Department of Science, University of Roma TRE, Rome, Italy
| | - B Capone
- Department of Science, University of Roma TRE, Rome, Italy
| | - R Cannarella
- Department of Clinical and Experimental Medicine, University of Catania, Policlinico "G. Rodolico", via S. Sofia 78, 95123, Catania, Italy
| | - R A Condorelli
- Department of Clinical and Experimental Medicine, University of Catania, Policlinico "G. Rodolico", via S. Sofia 78, 95123, Catania, Italy
| | - S La Vignera
- Department of Clinical and Experimental Medicine, University of Catania, Policlinico "G. Rodolico", via S. Sofia 78, 95123, Catania, Italy.
| | - A E Calogero
- Department of Clinical and Experimental Medicine, University of Catania, Policlinico "G. Rodolico", via S. Sofia 78, 95123, Catania, Italy
| | - A Lenzi
- Section of Medical Pathophysiology, Food Science and Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - R Rago
- Department of Gender, Parenting, Child and Adolescent Medicine, Unit of Reproductive Pathophysiology and Andrology, "Sandro Pertini" Hospital, Rome, Italy
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14
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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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15
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Courbiere B, Lacan A, Grynberg M, Grelat A, Rio V, Arbo E, Solignac C. Psychosocial and professional burden of Medically Assisted Reproduction (MAR): Results from a French survey. PLoS One 2020; 15:e0238945. [PMID: 32970695 PMCID: PMC7514013 DOI: 10.1371/journal.pone.0238945] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 08/26/2020] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To evaluate the impact of infertility and Medically Assisted Reproduction (MAR) throughout all aspects of life among infertile women and men. MATERIALS AND METHODS An online survey included 1 045 French patients (355 men, 690 women) who were living or had lived the experience of infertility and MAR. The questionnaire included 56 questions on several domains: global feelings, treatment burden, rapport with medical staff, psychosocial impact, sexual life and professional consequences. RESULTS Respondents had experienced an average of 3.6 (95% CI: 3.3-3.9) MAR cycles: 5% (n = 46) were pregnant, 4% (n = 47) were waiting to start MAR, 50% (n = 522) succeeded in having a live birth following MAR, 19% (n = 199) were currently undergoing ART, and 21% (n = 221) dropped out of the MAR process without a live birth. Satisfaction rates regarding the received medical care were above 80%, but 42% of patients pointed out the lack of information about non-medical support. An important impact on sexual life was reported, with 21% of patients admitted having not had intercourse for several weeks or even several months. Concerning the impact on professional life, 63% of active workers currently in an MAR program (n = 185) considered that MAR had strong repercussions on the organization of their working life with 49% of them reporting a negative impact on the quality of their work, and 46% of them reporting the necessity to lie about missing work during their treatment. CONCLUSION Despite a high overall level of satisfaction regarding medical care, the burden of infertility and MAR on quality of life is strong, especially on sexuality and professional organization. Clinical staff should be encouraged to develop non-medical support for all patients at any stage of infertility treatment. Enterprises should be warned about the professional impact of infertility and MAR to help their employees reconcile personal and professional life.
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Affiliation(s)
- Blandine Courbiere
- Pôle Femmes-Parents-Enfants–Centre Clinico-Biologique d’AMP, AP-HM La Conception, Marseille, France
- CNRS, IRD, Aix Marseille Univ, Avignon Université, IMBE, Marseille, France
- * E-mail:
| | - Arnaud Lacan
- Kedge Business School, AMSE, CNRS, EHESS, UMR 7316, Marseille, France
| | - Michael Grynberg
- Department of Reproductive Medicine & Fertility Preservation, Hôpital Antoine Beclère, Clamart, France
| | - Anne Grelat
- Centre Mistral, Clinique Pasteur, Guilherand-Granges, France
| | - Virginie Rio
- Collectif bAMP, Association de patients de l’AMP et de personnes infertiles, Quincy sous Sénart, France
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16
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Esposito V, Rania E, Lico D, Pedri S, Fiorenza A, Strati MF, Conforti A, Marrone V, Carosso A, Revelli A, Zullo F, Di Carlo C, Venturella R. Influence of COVID-19 pandemic on the psychological status of infertile couples. Eur J Obstet Gynecol Reprod Biol 2020; 253:148-153. [PMID: 32866858 PMCID: PMC7443353 DOI: 10.1016/j.ejogrb.2020.08.025] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 08/20/2020] [Accepted: 08/21/2020] [Indexed: 02/07/2023]
Abstract
No data are available to the distress of infertile couples during COVID-19. Stop performing ART treatments during COVID-19 contributed to increase anxiety. The psychological impact was more severe for women than for men. Psychological impact of COVID-19 in infertility couple should not be underestimated.
Objective(s) to evaluate the impact of the COVID-19 pandemic on infertile couples’ emotions, anxiety and future plans. Study design An observational study was perfomed by Italian ART centers and online forums. In this study, infertile couples candidate to ART and whose treatment was blocked due to the COVID-19 lockdown were enrolled through an online survey. The psychological impact of COVID-19 was measured by Impact of Event Scale-Revised (IES-R) and by a short form of the Spielberger State-Trait Anxiety Inventory (STAI); Self-perceived anxiety related either to pregnancy safety and to economic crisis measured by VAS scale. Results 627 patients completed the survey. The COVID-19 lock-down had a moderate/severe psychological impact on infertile patients (mean IES-R score 36.4 ± 16.6). The mean STAI score was 49.8 ± 15.3, with an overall incidence of STAI > 36 of 71 %. The mean VAS scale for anxiety perception was 45.3 ± 15.3. Women were more emotionally distressed, anxious and depressed than men (36.8 ± 16.4 vs 31.0 ± 18.4 for IES-R, respectively; p = 0.03). Notwithstanding the uncertainty about pregnancy safety, 64.6 % of respondents chose to maintain their reproductive programme. Economic crisis induced 11.5 % of the surveyed patients to give up their ART program. Respondents who had at least one relative affected by COVID-19 had a significantly higher IES-R score and anxiety VAS, but not higher STAI scores, than patients belonging to unaffected families. Conclusion(s) COVID-19 pandemic itself and the recommendation to stop ART program generated higher distress levels in infertile couples. The psychological impact of COVID-19 pandemic in infertility patients should not be underestimated, and a specific psychological support should be planned.
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Affiliation(s)
- Veronica Esposito
- Department of Experimental and Clinical Medicine, Chair of Obstetrics and Gynecology, Magna Graecia University of Catanzaro, ART Public Centre, Pugliese Ciaccio Hospital, viale Pio X, 88100 Catanzaro, Italy
| | - Erika Rania
- Department of Experimental and Clinical Medicine, Chair of Obstetrics and Gynecology, Magna Graecia University of Catanzaro, ART Public Centre, Pugliese Ciaccio Hospital, viale Pio X, 88100 Catanzaro, Italy.
| | - Daniela Lico
- Department of Experimental and Clinical Medicine, Chair of Obstetrics and Gynecology, Magna Graecia University of Catanzaro, ART Public Centre, Pugliese Ciaccio Hospital, viale Pio X, 88100 Catanzaro, Italy
| | - Sara Pedri
- Department of Experimental and Clinical Medicine, Chair of Obstetrics and Gynecology, Magna Graecia University of Catanzaro, ART Public Centre, Pugliese Ciaccio Hospital, viale Pio X, 88100 Catanzaro, Italy
| | - Alessia Fiorenza
- Department of Experimental and Clinical Medicine, Chair of Obstetrics and Gynecology, Magna Graecia University of Catanzaro, ART Public Centre, Pugliese Ciaccio Hospital, viale Pio X, 88100 Catanzaro, Italy
| | - Marina Francesca Strati
- Department of Experimental and Clinical Medicine, Chair of Obstetrics and Gynecology, Magna Graecia University of Catanzaro, ART Public Centre, Pugliese Ciaccio Hospital, viale Pio X, 88100 Catanzaro, Italy
| | - Alessandro Conforti
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples, Federico II Via Pansini 5, 80131 Naples, Italy
| | - Vinenzo Marrone
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples, Federico II Via Pansini 5, 80131 Naples, Italy
| | - Andrea Carosso
- Gynecology and Obstetrics 1, Physiopathology of Reproduction and IVF Unit, Department of Surgical Sciences, S. Anna Hospital, University of Torino, Via Ventimiglia 3, 10126, Turin, Italy
| | - Alberto Revelli
- Gynecology and Obstetrics 1, Physiopathology of Reproduction and IVF Unit, Department of Surgical Sciences, S. Anna Hospital, University of Torino, Via Ventimiglia 3, 10126, Turin, Italy
| | - Fulvio Zullo
- Department of Experimental and Clinical Medicine, Chair of Obstetrics and Gynecology, Magna Graecia University of Catanzaro, ART Public Centre, Pugliese Ciaccio Hospital, viale Pio X, 88100 Catanzaro, Italy; Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples, Federico II Via Pansini 5, 80131 Naples, Italy
| | - Costantino Di Carlo
- Department of Experimental and Clinical Medicine, Chair of Obstetrics and Gynecology, Magna Graecia University of Catanzaro, ART Public Centre, Pugliese Ciaccio Hospital, viale Pio X, 88100 Catanzaro, Italy
| | - Roberta Venturella
- Department of Experimental and Clinical Medicine, Chair of Obstetrics and Gynecology, Magna Graecia University of Catanzaro, ART Public Centre, Pugliese Ciaccio Hospital, viale Pio X, 88100 Catanzaro, Italy
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17
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Mariotti FFN, Gonçalves BSM, Pimpão G, Mônico-Neto M, Antunes HKM, Viana MDB, Céspedes IC, Le Sueur-Maluf L. A single ovarian stimulation, as performed in assisted reproductive technologies, can modulate the anxiety-like behavior and neuronal activation in stress-related brain areas in rats. Horm Behav 2020; 124:104805. [PMID: 32531398 DOI: 10.1016/j.yhbeh.2020.104805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 06/05/2020] [Accepted: 06/07/2020] [Indexed: 10/24/2022]
Abstract
Infertility affects about 8 to 12% of couples of childbearing age around the world, and is recognized as a global public health issue by the WHO. From a psychosocial perspective, infertile individuals experience intense psychological distress, related to emotional disorders, which have repercussions on marital and social relationships. The symptoms persist even after seeking specialized treatment, such as assisted reproductive technologies (ART). While the stress impact of ART outcome has been comprehensively studied, the role of supraphysiological concentrations of gonadal hormones on stress response, remains to be elucidated. This study aimed to evaluate the effect of a single ovarian stimulation on the stress response in rats. To mimic the context of ART in rodents, female rats were submitted to the superovulation (150 UI/kg of PMSG and 75 UI/kg of hCG) and then to psychogenic stress (restraint stress for 30 min/day, repeated for three days). Anxiety-like behavior was evaluated in the elevated plus-maze, and neuronal activation in the stress-related brain areas assessed by Fos protein immunoreactivity. Corticosterone, estradiol, progesterone and corpora lutea were quantified. Data were analyzed using Generalized Linear Model (GzLM). Our findings indicate anxiolytic-like and protective effects of supraphysiological concentrations of gonadal hormones induced by a single ovarian stimulation on stress response. An activation of hypothalamus-pituitary-adrenal response inhibitory pathways, with participation of the prefrontal cortex, basomedial amygdala, lateral septum, medial preoptic area, dorsomedial and paraventricular hypothalamus, was detected.
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MESH Headings
- Animals
- Anti-Anxiety Agents/pharmacology
- Anxiety/metabolism
- Anxiety/physiopathology
- Anxiety/prevention & control
- Anxiety/psychology
- Behavior, Animal/drug effects
- Behavior, Animal/physiology
- Brain/drug effects
- Brain/pathology
- Brain/physiopathology
- Corticosterone/metabolism
- Female
- Fertility Agents, Female/pharmacology
- Neurons/physiology
- Neuroprotection/drug effects
- Neuroprotection/physiology
- Ovulation Induction
- Prefrontal Cortex/drug effects
- Prefrontal Cortex/pathology
- Prefrontal Cortex/physiopathology
- Rats
- Rats, Wistar
- Reproductive Techniques, Assisted
- Restraint, Physical/adverse effects
- Restraint, Physical/psychology
- Stress, Psychological/metabolism
- Stress, Psychological/physiopathology
- Stress, Psychological/psychology
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Affiliation(s)
| | | | - Giovanna Pimpão
- Departamento de Biociências, Universidade Federal de São Paulo, UNIFESP, 11015-020 Santos, SP, Brazil
| | - Marcos Mônico-Neto
- Departamento de Biociências, Universidade Federal de São Paulo, UNIFESP, 11015-020 Santos, SP, Brazil; Departmento de Psicobiologia, Universidade Federal de São Paulo, UNIFESP, 04024-002 São Paulo, SP, Brazil
| | | | - Milena de Barros Viana
- Departamento de Biociências, Universidade Federal de São Paulo, UNIFESP, 11015-020 Santos, SP, Brazil
| | - Isabel Cristina Céspedes
- Departamento de Biociências, Universidade Federal de São Paulo, UNIFESP, 11015-020 Santos, SP, Brazil
| | - Luciana Le Sueur-Maluf
- Departamento de Biociências, Universidade Federal de São Paulo, UNIFESP, 11015-020 Santos, SP, Brazil.
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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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Abdishahshahani M, Torabi M, Kazemi A. Investigating related factors to psychological symptoms of infertile couples undergoing assisted reproductive treatment. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2020; 9:21. [PMID: 32154316 PMCID: PMC7034165 DOI: 10.4103/jehp.jehp_412_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 11/24/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND The impact of infertility and assisted reproductive treatment on the mental health of infertile couples is documented, and the identification of its predictor factors can be helpful in identifying susceptible individuals. Therefore, the aim of this study was to identify the factors associated with psychological symptoms of infertile couples undergoing assisted reproductive treatment. MATERIALS AND METHODS Using convenience sampling method, this cross-sectional study was conducted on 212 couples undergoing assisted reproductive treatments. The levels of mental disorders (depression, anxiety, and stress) of the couples undergoing assisted reproductive treatments were assessed via self-report questionnaire of Depression, Anxiety, and Stress Scales. Data analysis was performed using paired t-test, independent t-test, Wilcoxon signed-rank test, Pearson correlation coefficient, Spearman correlation, and multivariate linear regression. RESULTS The mean scores of stress, anxiety, and depression in women (14, 9.93, and 10.7) were significantly higher than that in men (9, 5.51, and 6.6). Correlation coefficient of stress, anxiety, and depression scores in women was inversely correlated with their age. Moreover, stress, anxiety, and depression scores in men were significantly correlated with the duration of infertility. In both men and women, stress, anxiety, and depression scores were inversely correlated with the level of education and economic situation. CONCLUSION The results showed that during assisted reproductive treatment, women are more likely to experience psychological problems than their spouses. In addition, underlying factors such as age, duration of infertility, and educational level do not similarly cause of lower mental health in men and women.
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Affiliation(s)
- Mahshid Abdishahshahani
- Department of Midwifery, Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Marjan Torabi
- Department of Midwifery and Reproductive Health, Student Research Committee, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ashraf Kazemi
- Department of Reproductive Health, Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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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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