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Boeri L, Belladelli F, Pozzi E, Pagliardini L, Fallara G, Cilio S, Candela L, Corsini C, Raffo M, Capogrosso P, D'Arma A, Montorsi F, Salonia A. Low Birth Weight is Associated with Sperm DNA Fragmentation and Assisted Reproductive Technology Outcomes in Primary Infertile Men: Results of a Cross-Sectional Study. World J Mens Health 2024; 42:384-393. [PMID: 37635336 PMCID: PMC10949032 DOI: 10.5534/wjmh.220283] [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: 01/02/2023] [Revised: 03/24/2023] [Accepted: 04/16/2023] [Indexed: 08/29/2023] Open
Abstract
PURPOSE To assess the relationship between clinical and semen characteristics and assisted reproductive technology (ART) outcomes with different birth weight (BW) categories in a cohort of infertile men. MATERIALS AND METHODS Data from 1,063 infertile men were analyzed. Patients with BW ≤2,500, 2,500-4,000, and ≥4,000 g were considered as having low BW (LBW), normal BW (NBW), and high BW (HBW), respectively. Testicular volume (TV) was assessed with a Prader orchidometer. Serum hormones were measured in all cases. Semen analyses were categorized based on 2021 World Health Organization reference criteria. Sperm DNA fragmentation (SDF) was tested in every patient and considered pathological for SDF >30%. ART outcomes were available for 282 (26.5%) patients. Descriptive statistics and logistic regression analyses detailed the association between semen parameters and clinical characteristics and the defined BW categories. RESULTS Of all, LBW, NBW, and HBW categories were found in 79 (7.5%), 807 (76.0%), and 177 (16.5%) men, respectively. LBW men had smaller TV, presented higher follicle-stimulating hormone (FSH) but lower total testosterone levels compared to other groups (all p<0.01). Sperm progressive motility (p=0.01) and normal morphology (p<0.01) were lower and SDF values were higher (all p<0.01) in LBW compared to other groups. ART pregnancy outcomes were lower in LBW compared to both NBW and HBW categories (26.1% vs. 34.5% vs. 34.5%, p=0.01). At multivariable logistic regression analysis, LBW was associated with SDF >30% (odd ratio [OR] 3.7; p<0.001), after accounting for age, Charlson Comorbidity Index (CCI), FSH, and TV. Similarly, LBW (OR 2.2; p<0.001), SDF >30% (OR 2.9; p<0.001) and partner's age (OR 1.3; p=0.001) were associated with negative ART outcomes, after accounting for the same predictors. CONCLUSIONS LBW was associated with impaired clinical and semen characteristics in infertile men compared to both NBW and HBW. SDF and ART outcomes were significantly worse in the LBW group.
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Affiliation(s)
- Luca Boeri
- Department of Urology, Foundation IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Federico Belladelli
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Edoardo Pozzi
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Luca Pagliardini
- Division of Genetics and Cell Biology, Reproductive Sciences Laboratory, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Giuseppe Fallara
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Simone Cilio
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | - Luigi Candela
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Christian Corsini
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Massimiliano Raffo
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Paolo Capogrosso
- Department of Urology and Andrology, Ospedale di Circolo and Macchi Foundation, Varese, Italy
| | - Alessia D'Arma
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Francesco Montorsi
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Andrea Salonia
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy.
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Sotoudeh M, Rezapour-Mirsaleh Y, Choobforoushzadeh A. The relationship between acceptance, self-compassion and hope in infertile women: a structural equation analysis. J Reprod Infant Psychol 2024; 42:365-376. [PMID: 35634993 DOI: 10.1080/02646838.2022.2078485] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 05/11/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE This study aimed to determine the relationship between psychological acceptance, self-compassion and hope in infertile women. BACKGROUND Infertility distress can make women more vulnerable than men. Acceptance, self-compassion and hope can help infertile women to alleviate their distresses and to peruse the medical treatments. METHODS This study was performed using a cross-sectional descriptive correlational design; A total of 346 women with primary infertility referred to infertility centres of Yazd, Isfahan and Kerman provinces, Iran, participated in the study by completing the self-compassion scale, hope scale and Acceptance and Action Questionnaire-II (AAQ-II). Data were analysed using structural equation analysis. RESULTS The results of structural equation analysis showed that the path coefficient of self-compassion on acceptance (r = .69, p < .01) and hope (r = .29, p < .05) in infertile women was direct and significant. Acceptance also had a direct effect on hope in infertile women (r = .31, p < .05) and played a significant mediating role in the relationship between self-compassion and hope in infertile women. CONCLUSIONS The findings suggest that self-compassion is likely to be an important strategic intervention alongside medical treatments for infertile women, because it leads to problem acceptance and then increases hope in them.
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Affiliation(s)
- Mansoureh Sotoudeh
- Department of Psychology, Faculty of Humanities & Social Sciences, Ardakan University, Ardakan, Iran
| | - Yasser Rezapour-Mirsaleh
- Department of Counseling, Faculty of Humanities & Social Sciences, Ardakan University, Ardakan, Iran
| | - Azadeh Choobforoushzadeh
- Department of Psychology, Faculty of Humanities & Social Sciences, Ardakan University, Ardakan, Iran
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Duran S, Can Öz Y. The Association Between Spirituality and Hope Among Turkish Women Undergoing Infertility Treatment. JOURNAL OF RELIGION AND HEALTH 2023; 62:764-777. [PMID: 36409430 DOI: 10.1007/s10943-022-01689-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/06/2022] [Indexed: 06/16/2023]
Abstract
The aim of this study was to determine the effect of spirituality on the levels of hope in women undergoing infertility treatment. This cross-sectional study was completed with the participation of 150 women undergoing IVF treatment at a university hospital in Kocaeli. In this study the women's spiritual well-being levels were high, and their hope levels were above the average score. Significant correlations were found between hope, spirituality, educational status, and age. Since attempts to boost hope will increase the chance of success in treatment, it is thought that factors affecting the level of hope should be determined and addressed. It is also thought that health professionals can apply hope therapy to women and take initiatives to provide spiritual support.
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Affiliation(s)
- Songul Duran
- Health Services Vocational College, Care of Elderly Program, Izmir Demokrasi University, Izmir, Turkey.
| | - Yüksel Can Öz
- Department of Psychiatric Nursing, Faculty of Health Sciences, Kocaeli University, Izmir, Kocaeli, Turkey
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Brigance CA, Cottone RR. Addressing Infertility Through Family Therapy: An Emotionally-Focused Family Therapy Approach. CONTEMPORARY FAMILY THERAPY 2022. [DOI: 10.1007/s10591-022-09657-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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5
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Labude MK, Xafis V, Lai PS, Mills C. Vulnerability and the Ethics of Human Germline Genome Editing. CRISPR J 2022; 5:358-363. [PMID: 35580124 PMCID: PMC9347293 DOI: 10.1089/crispr.2021.0053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 04/03/2022] [Indexed: 11/20/2022] Open
Abstract
The concept of vulnerability has played an important role in theoretical bioethics as well as in numerous authoritative guidelines on research ethics. The concept helps to identify situations in which research participants and other individuals may be at a heightened risk of experiencing harm. However, existing guidance documents on the ethics of human germline gene editing largely fail to make any reference to considerations of vulnerability. In this article, we discuss this oversight and we highlight the role that vulnerability can play in ethical debates about human heritable genome editing. Future guidance documents on germline gene editing should pay attention to considerations of vulnerability and reference these appropriately.
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Affiliation(s)
- Markus K. Labude
- SHAPES Initiative, Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Vicki Xafis
- SHAPES Initiative, Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Poh San Lai
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Catherine Mills
- Monash Bioethics Centre, Faculty of Arts, Monash University, Clayton, Australia
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Pfennig CL, Wilson CA, Britt TW, Pirrallo RG, Checura CM. A comparative analysis on fertility success among physician specialties. Acad Emerg Med 2022; 29:792-794. [PMID: 35178827 PMCID: PMC9305146 DOI: 10.1111/acem.14463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 02/14/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Camiron L. Pfennig
- Department of Emergency Medicine University of South Carolina School of Medicine Greenville Greenville South Carolina USA
| | - Chloe A. Wilson
- Department of Psychology Clemson University Clemson South Carolina USA
| | - Thomas W. Britt
- Department of Psychology Clemson University Clemson South Carolina USA
| | - Ronald G. Pirrallo
- Department of Emergency Medicine University of South Carolina School of Medicine Greenville Greenville South Carolina USA
| | - Celina M. Checura
- Department of Animal and Veterinary Sciences Clemson University Clemson South Carolina USA
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van der Reest J, Nardini Cecchino G, Haigis MC, Kordowitzki P. Mitochondria: Their relevance during oocyte ageing. Ageing Res Rev 2021; 70:101378. [PMID: 34091076 DOI: 10.1016/j.arr.2021.101378] [Citation(s) in RCA: 92] [Impact Index Per Article: 30.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 05/24/2021] [Accepted: 06/01/2021] [Indexed: 12/14/2022]
Abstract
The oocyte is recognised as the largest cell in mammalian species and other multicellular organisms. Mitochondria represent a high proportion of the cytoplasm in oocytes and mitochondrial architecture is different in oocytes than in somatic cells, characterised by a rounder appearance and fragmented network. Although the number of mitochondria per oocyte is higher than in any other mammalian cell, their number and activity decrease with advancing age. Mitochondria integrate numerous processes essential for cellular function, such as metabolic processes related to energy production, biosynthesis, and waste removal, as well as Ca2+ signalling and reactive oxygen species (ROS) homeostasis. Further, mitochondria are responsible for the cellular adaptation to different types of stressors such as oxidative stress or DNA damage. When these stressors outstrip the adaptive capacity of mitochondria to restore homeostasis, it leads to mitochondrial dysfunction. Decades of studies indicate that mitochondrial function is multifaceted, which is reflected in the oocyte, where mitochondria support numerous processes during oocyte maturation, fertilization, and early embryonic development. Dysregulation of mitochondrial processes has been consistently reported in ageing and age-related diseases. In this review, we describe the functions of mitochondria as bioenergetic powerhouses and signal transducers in oocytes, how dysfunction of mitochondrial processes contributes to reproductive ageing, and whether mitochondria could be targeted to promote oocyte rejuvenation.
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Boz İ, Teskereci G, Akgün M. The experience of becoming a mother following successful in vitro fertilization: A grounded theory. J Adv Nurs 2021; 77:4170-4183. [PMID: 34227135 DOI: 10.1111/jan.14958] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 05/28/2021] [Accepted: 06/15/2021] [Indexed: 11/30/2022]
Abstract
AIM To develop a theory to explain women's experiences about becoming a mother following successful in vitro fertilization treatment. DESIGN This study is a qualitative study based on a constructivist grounded theory approach. METHODS Data were collected using a semi-structured interview guide initially that was later to be changed to a flexible interview guide between June 2018 and 2019. Interviews were conducted with 18 women, who became pregnant and mothers following successful in vitro fertilization treatment. Data collection and analysis were performed in a cyclic manner using open, axial and selective coding. This study was reported based on consolidated criteria and was used to report qualitative research data. FINDINGS The core category, 'non-spontaneous path to motherhood', involved the following four categories: 'the treatment process is exhausting', 'leaving the infertility world', 'pregnancy under the shadow of fear' and 'getting stuck between fertile and infertile worlds' with 10 sub-categories. CONCLUSION This study provides valuable insight into experiences of these women about becoming a mother. Unlike the Becoming a Mother Theory, it can be said that the anticipation stage, the first stage in the Becoming a Mother Theory, begins at the moment of embryo transfer in these women. Furthermore, the personal stage, the final stage in the Becoming a Mother Theory, is not completed within the first year after birth, even women were found to conceal experiences of in vitro fertilization treatment from the social environment even after birth. IMPACT This study will provide potential support for obstetric healthcare professionals in better understanding women's experiences about becoming a mother following successful in vitro fertilization treatment.
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Affiliation(s)
- İlkay Boz
- Department of Maternity and Gynecological Nursing, Akdeniz University Nursing Faculty, Antalya, Turkey
| | - Gamze Teskereci
- Department of Maternity and Gynecological Nursing, Akdeniz University Kumluca Health Science Faculty, Antalya, Turkey
| | - Mehtap Akgün
- Department of Maternity and Gynecological Nursing, Akdeniz University Nursing Faculty, Antalya, Turkey
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Vasta FN, Girelli R. An Epistemological Perspective of Integrated Multidisciplinary Treatment When Dealing With Infertile Women With a Parenthood Goal: The Importance of Matterpsychic Perspective. Front Psychol 2021; 12:634028. [PMID: 33763003 PMCID: PMC7982840 DOI: 10.3389/fpsyg.2021.634028] [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: 11/26/2020] [Accepted: 02/05/2021] [Indexed: 11/28/2022] Open
Abstract
This article proposes a multidisciplinary work perspective on couples who undergo assisted reproductive technology (ART) treatments, with particular attention paid to the treatment of women. The epistemological references underlying a vision of infertility and sterility that respect the psyche–soma unity of the person are illustrated: the biopsychosocial model and the psychoneuroimmunology and psychosomatic contemporary models of health and illness. Based on clinical experience in a private and institutional setting, different steps in the course of treatment are described with the related areas of psychological work: from the search for pregnancy to the choice of adhering to an ART treatment, to conception, up to delivery and beyond. The implications of the work are targeted at a better qualification of psychological interventions in this specific multidisciplinary area.
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Affiliation(s)
- Francesca Natascia Vasta
- Confederation of Italian Organizations for Analytical Research on Groups - Research Board, Rome, Italy
| | - Raffaella Girelli
- Confederation of Italian Organizations for Analytical Research on Groups, Rome, Italy
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Mosconi L, Crescioli G, Vannacci A, Ravaldi C. Communication of Diagnosis of Infertility: A Systematic Review. Front Psychol 2021; 12:615699. [PMID: 33815202 PMCID: PMC8015870 DOI: 10.3389/fpsyg.2021.615699] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 02/02/2021] [Indexed: 11/22/2022] Open
Abstract
Background: When infertility is diagnosed, physicians have the difficult task to break bad news. Their communication skills play a central role in improving patients' coping abilities and adherence to infertility treatments. However, specific guidelines and training courses on this topic are still lacking. The aim of the present study is to provide some practical advice for improving breaking bad news in infertility diagnosis through a systematic literature review of qualitative and quantitative studies. Methods: Electronic searches were performed in the MEDLINE, Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Psychology and Behavioral Sciences Collection databases. All articles focusing on the communication of the diagnosis of infertility were included. The main findings of each included article were then summarized. Results: Literature search identified 11,838 references that were screened for eligibility. Full texts of 81 articles were retrieved, and their analysis led to the inclusion of 4 articles, which treated the theme of communication of infertility only partially. The main addressed aspects concerning the communication of the infertility diagnosis were the following: (i) the value that patients give to healthcare professionals' communication skills; (ii) the importance of giving clear information on diagnostic procedures and treatments in order to decrease patients' anxiety; and (iii) the importance of involving both partners. Conclusions: This review pointed out that the communication of the infertility diagnosis is still underinvestigated. Specific guidelines are currently not available, but other protocols could be used. Taking into account the principal aspects of communication highlighted with this review, in this study, we suggested an adaptation of the original SPIKES protocol that could be used by healthcare professionals for the communication of the infertility status.
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Affiliation(s)
- Laura Mosconi
- CiaoLapo Foundation for Perinatal Health, Prato, Italy
| | - Giada Crescioli
- Perinatal Research Laboratory (PeaRL), University of Florence, Florence, Italy.,Section of Pharmacology and Toxicology, Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Alfredo Vannacci
- CiaoLapo Foundation for Perinatal Health, Prato, Italy.,Perinatal Research Laboratory (PeaRL), University of Florence, Florence, Italy.,Section of Pharmacology and Toxicology, Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Claudia Ravaldi
- CiaoLapo Foundation for Perinatal Health, Prato, Italy.,Perinatal Research Laboratory (PeaRL), University of Florence, Florence, Italy.,Section of Pharmacology and Toxicology, Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
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Facchin F, Leone D, Tamanza G, Costa M, Sulpizio P, Canzi E, Vegni E. Working With Infertile Couples Seeking Assisted Reproduction: An Interpretative Phenomenological Study With Infertility Care Providers. Front Psychol 2020; 11:586873. [PMID: 33391106 PMCID: PMC7773748 DOI: 10.3389/fpsyg.2020.586873] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 11/26/2020] [Indexed: 11/13/2022] Open
Abstract
Although most studies investigated the impact of infertility and its treatment on the couple, a small body of evidence suggested that infertility care providers may experience different sources of stress related for instance to excessive workload, the complexity of the technique, and relational difficulties with patients. The current study aimed at providing further insight into the understanding of the subjective experience of infertility care providers by highlighting their feelings and emotions, personal meanings, challenges, and opportunities. Following the methodological guidelines of Interpretative Phenomenological Analysis, we conducted individual semi-structured interviews with 23 members of two different fertility units. Interviews were audiotaped and transcribed verbatim. Textual analysis was then conducted to identify emerging dominant themes and subthemes. Three main themes were extracted: (i) dealing with infertile patients and their specificities, (ii) performing assisted reproductive technology (ART), (iii) being part of a team. These themes related to participants experiencing: (i) difficulties in establishing an empathic connection and communicating with couples, such that women were sometimes perceived as "particular patients" and men as poorly involved in the process; (ii) difficulties in dealing with a complex procedure in which errors are not allowed (as reported by embryologists), with a growing number of women aged > 40 seeking assisted reproduction, despite the risks for their health; (iii) being part of a team as a resource, although the huge amount of time spent together can involve conflicts and organizational problems. These findings suggested that patients' overpersistence (rather than just dropout) represents an important source of stress for infertility care providers. At the same time, the concept of particular or difficult patient derives from the combination of multiple factors, including providers' own history and subjective experience. The presence of mental health professionals in fertility units is essential to help providers improve the quality of doctor-patient communication and relieve the stress related to organizational issues and conflicts.
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Affiliation(s)
- Federica Facchin
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Daniela Leone
- Unit of Clinical Psychology, San Paolo University Hospital, Asst-Santi Paolo e Carlo, Milan, Italy
| | - Giancarlo Tamanza
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Mauro Costa
- Reproductive Medicine Unit, Ospedale Evangelico Internazionale, Genoa, Italy
| | - Patrizia Sulpizio
- Reproductive Medicine Unit, San Paolo University Hospital, Asst-Santi Paolo e Carlo, Milan, Italy
| | - Elena Canzi
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Elena Vegni
- Unit of Clinical Psychology, San Paolo University Hospital, Asst-Santi Paolo e Carlo, Milan, Italy.,Department of Health Sciences, University of Milan, Milan, Italy
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Kordowitzki P, Kranc W, Bryl R, Kempisty B, Skowronska A, Skowronski MT. The Relevance of Aquaporins for the Physiology, Pathology, and Aging of the Female Reproductive System in Mammals. Cells 2020; 9:cells9122570. [PMID: 33271827 PMCID: PMC7760214 DOI: 10.3390/cells9122570] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 11/23/2020] [Accepted: 11/29/2020] [Indexed: 12/26/2022] Open
Abstract
Aquaporins constitute a group of water channel proteins located in numerous cell types. These are pore-forming transmembrane proteins, which mediate the specific passage of water molecules through membranes. It is well-known that water homeostasis plays a crucial role in different reproductive processes, e.g., oocyte transport, hormonal secretion, completion of successful fertilization, blastocyst formation, pregnancy, and birth. Further, aquaporins are involved in the process of spermatogenesis, and they have been reported to be involved during the storage of spermatozoa. It is noteworthy that aquaporins are relevant for the physiological function of specific parts in the female reproductive system, which will be presented in detail in the first section of this review. Moreover, they are relevant in different pathologies in the female reproductive system. The contribution of aquaporins in selected reproductive disorders and aging will be summarized in the second section of this review, followed by a section dedicated to aquaporin-related proteins. Since the relevance of aquaporins for the male reproductive system has been reviewed several times in the recent past, this review aims to provide an update on the distribution and impact of aquaporins only in the female reproductive system. Therefore, this paper seeks to determine the physiological and patho-physiological relevance of aquaporins on female reproduction, and female reproductive aging.
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Affiliation(s)
- Paweł Kordowitzki
- Department of Basic and Preclinical Sciences, Institute for Veterinary Medicine, Nicolaus Copernicus University, 87-100 Torun, Poland;
- Institute of Animal Reproduction and Food Research of Polish Academy of Sciences, 10-243 Olsztyn, Poland
| | - Wiesława Kranc
- Department of Anatomy, Poznan University of Medical Sciences, 60-781 Poznan, Poland; (W.K.); (R.B.); (B.K.)
| | - Rut Bryl
- Department of Anatomy, Poznan University of Medical Sciences, 60-781 Poznan, Poland; (W.K.); (R.B.); (B.K.)
| | - Bartosz Kempisty
- Department of Anatomy, Poznan University of Medical Sciences, 60-781 Poznan, Poland; (W.K.); (R.B.); (B.K.)
- Department of Histology and Embryology, Poznan University of Medical Sciences, 60-781 Poznan, Poland
- Department of Veterinary Surgery, Institute for Veterinary Medicine, Nicolaus Copernicus University, 87-100 Torun, Poland
| | - Agnieszka Skowronska
- Department of Human Physiology and Pathophysiology, School of Medicine, Collegium Medicum, University of Warmia and Mazury, Warszawska Street 30, 10-082 Olsztyn, Poland;
| | - Mariusz T. Skowronski
- Department of Basic and Preclinical Sciences, Institute for Veterinary Medicine, Nicolaus Copernicus University, 87-100 Torun, Poland;
- Correspondence: ; Tel.: +48-56-611-2231
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Cui Y, Li D, Zhou B, Lin Y, Zeng Y. Mediating role of social support between sleep quality, anxiety and depressive symptoms in Chinese women undergoing in vitro fertilization treatment. SAGE Open Med 2020; 8:2050312120930163. [PMID: 32566228 PMCID: PMC7288797 DOI: 10.1177/2050312120930163] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 05/07/2020] [Indexed: 11/28/2022] Open
Abstract
Introduction: Infertility is a significant health problem, and the prevalence of infertility among women is increasing in developing countries. This study aims to explore whether social support plays a mediating role in the links between exogenous variables, sleep quality, anxiety, and depressive symptoms in Chinese women undergoing in vitro fertilization. Methods: This is a cross-sectional study comprising a sample of Chinese women undergoing in vitro fertilization treatment at a tertiary reproductive medicine center located in South China. Results: The final testing model showed good fit, with normed χ2 = 39.317, p = 0.055, comparative fit index = 0.948, Tucker–Lewis index = 0.902, incremental fit index = 0.951, normed fit index = 0.906, root mean square error of approximation = 0.046). The final path model supported the proposed model: partner relationship, a woman’s age, financial strain, duration of infertility, and cycles of in vitro fertilization were exogenous variables for depressive symptoms, while social support was a significant mediator between sleep quality, anxiety, and depressive symptoms. Conclusion: The empirical support from this study could facilitate the development of appropriate interventions to reduce depressive symptoms, and to promote the mental health of Chinese women undergoing in vitro fertilization treatment.
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Affiliation(s)
- Ying Cui
- Department of Psychiatry, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Danian Li
- Department of Brain Disease, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Borong Zhou
- Department of Psychiatry, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yanshan Lin
- Reproductive Medicine Center, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yingchun Zeng
- Research Institute of Gynecology and Obstetrics, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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Qian J, Zhou X, Sun X, Wu M, Sun S, Yu X. Effects of expressive writing intervention for women's PTSD, depression, anxiety and stress related to pregnancy: A meta-analysis of randomized controlled trials. Psychiatry Res 2020; 288:112933. [PMID: 32315889 DOI: 10.1016/j.psychres.2020.112933] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 03/10/2020] [Accepted: 03/18/2020] [Indexed: 12/22/2022]
Abstract
Expressive writing (EW) is a common psychological intervention that aims to improve the mental health of traumatized individuals. Pregnancy is considered an anxious or traumatic experience for some women, and any crisis in relation to pregnancy is closely associated with their psychological well-being. Post-traumatic stress disorder (PTSD), depression, anxiety and stress are the most prominent emotional and psychological responses that may occur during the process. However, the effects of EW in mediating women's PTSD, depression, anxiety and stress related to pregnancy remain uncertain, and no qualified meta-analysis has assessed such effects. The aim of this study was to assess the effectiveness of EW as a psychological intervention for women. Five databases, including PubMed, EMBASE, Cochrane, Web of Science and PsycINFO, were searched from inception to September 2019 for eligible studies. Finally, a total of 929 participants from 8 randomized controlled trial (RCT) studies were included. A pooled analysis demonstrated that EW was an efficient therapy for decreasing PTSD. However, the results showed that the EW intervention was not associated with the expected effects on anxiety and stress symptoms. The efficacy of EW for depression was inconclusive. More RCTs are necessary to verify the effectiveness of EW for depression. Studies concentrating on EW's effects on physical symptoms are necessary, and researchers should create an EW intervention group, neutral writing group and no writing group to examine the true effects of EW. Future research should examine whether longer, more frequent, and more targeted writing interventions would result in different conclusions.
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Affiliation(s)
- Jialu Qian
- Zhejiang University School of Medicine, Hangzhou, China; Department of Obstetrics and Gynecology, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, China.
| | - Xiaoli Zhou
- Zhejiang University School of Medicine, Hangzhou, China; Department of Obstetrics and Gynecology, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, China.
| | - Xueshan Sun
- Zhejiang University School of Medicine, Hangzhou, China.
| | - Mengwei Wu
- Zhejiang University School of Medicine, Hangzhou, China; Department of Obstetrics and Gynecology, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, China.
| | - Shiwen Sun
- Department of Obstetrics and Gynecology, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, China.
| | - Xiaoyan Yu
- Department of Obstetrics and Gynecology, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, China.
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Marshall AL, Arora VM, Salles A. Physician Fertility: A Call to Action. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2020; 95:679-681. [PMID: 31738214 DOI: 10.1097/acm.0000000000003079] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Infertility is more prevalent in female physicians than in the U.S. general population. While pregnancy and its potential medical and career development consequences among physicians have been explored in the literature, infertility and its consequences remain understudied and unaddressed. Fertility issues are important for all physicians hoping to start families, including male physicians, transgender physicians, single physicians, and physicians with same-sex partners.Infertility has numerous physical, emotional, and financial consequences and may have a negative impact on physician well-being. Options to preserve fertility (such as egg, embryo, and sperm cryopreservation) are available, yet physicians may not be aware of or have the financial ability to make use of such resources. Physician reproductive health, including the ability to build a family if and when a physician chooses, is a vital aspect of well-being. The risks and consequences of infertility and the management of fertility should be studied and addressed from policy and advocacy standpoints.The authors, who have experienced and sought treatment for infertility, bring attention to the challenges around both physician infertility and preservation of fertility. They propose 3 strategies to address physician infertility: increasing fertility education and awareness starting at the undergraduate medical education level and continuing throughout training and practice, providing insurance coverage for and access to fertility assessment and management, and offering support for those undergoing fertility treatments. The authors believe that implementing these suggestions would make a significant positive impact on trainees and practicing physicians and help build a health care workforce that is healthy and well physically, emotionally, and financially.
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Affiliation(s)
- Ariela L Marshall
- A.L. Marshall is associate professor of medicine, Division of Hematology, Department of Internal Medicine, and assistant professor, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota; ORCID: http://orcid.org/0000-0001-7388-0422. V.M. Arora is professor and associate chief medical officer-clinical learning environment, University of Chicago Medicine, Chicago, Illinois. A. Salles is a scholar in residence, Stanford University School of Medicine, Stanford, California
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Fieldsend M, Smith JA. 'Either stay grieving, or deal with it': the psychological impact of involuntary childlessness for women living in midlife. Hum Reprod 2020; 35:876-885. [PMID: 32268357 DOI: 10.1093/humrep/deaa033] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 01/29/2020] [Accepted: 02/10/2020] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION What is it like for women to be involuntarily childless in midlife? SUMMARY ANSWER Involuntarily childless women may be suffering from prolonged grief due to its ambiguous and intangible nature; however, they are also striving to find ways of dealing with their internal pain in order to live with their loss. WHAT IS KNOWN ALREADY Many studies examining issues around human reproduction have tended to place childlessness in the realm of medicalised infertility and report generalised mental issues, such as depression and psychological distress, existing amongst women undergoing fertility treatments. Few studies, however, have focused on the individual with regard to the experiential significance of involuntary childlessness and living beyond the phase of trying for a baby. STUDY DESIGN, SIZE, DURATION A phenomenologically oriented person-centred qualitative design was used. In-depth semi-structured interviews were conducted with 12 White British women, who identified themselves as involuntarily childless, recruited via three leading childless support networks in the UK. PARTICIPANTS/MATERIALS, SETTING, METHODS In order to retain an idiographic commitment to the detailed account of a person's experience, a homogeneous and purposive sampling was used applying the following criteria: women aged between 45 and 55; in long-term heterosexual relationships with no adopted children, stepchildren or children of a partner from a previous marriage or relationship; and no longer trying to have a child. Considering the homogeneity of ethnic background and wishing to respect cultural differences, this study focused on White British women living in the UK. Of the 12, one woman was found to not meet the criteria, and therefore, the experiential data of 11 interviews were used for the study and analysed using interpretative phenomenological analysis (IPA). MAIN RESULTS AND THE ROLE OF CHANCE Two higher-order levels of themes that illustrate intrapersonal features were identified: the intrapersonal consequences of loss and confronting internal pain. The former explicated the depth of internal pain while the latter revealed ways in which the participants deal with it in their everyday lives. The important finding here is that both themes are co-existing internal features and dynamically experienced by the participants as they live with the absence of much-hoped-for children. LIMITATIONS, REASONS FOR CAUTION Given the homogeneous sampling and the small number of participants, which is consistent with IPA, we want to be cautious in generalising our study findings. WIDER IMPLICATIONS OF THE FINDINGS This study offers the view that there might be potential mental health issues surrounding involuntary childlessness that are currently overlooked. Particularly because the loss of hope cannot be pathologised, and the grief is ambiguous and intangible, it might make people's grieving process more complicated. An ongoing sense of uncertainty also may persist in that involuntarily childless people may develop symptoms similar to those diagnosed with prolonged grief disorder (PGD). The overall findings elucidate the need for clinicians, counsellors and health professionals to be aware of the possible association with PGD and promote long-term support and care in helping to maintain psychological well-being for people dealing with involuntary childlessness. Furthermore, this research points to an educational application for younger people by offering information beyond an explanation of infertility and fertility treatment, helping to understand the lived experience of involuntary childlessness. STUDY FUNDING/COMPETING INTEREST(S) No funding was obtained for this study. The authors have no conflicts of interest to declare. TRIAL REGISTRATION NUMBER Not applicable.
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Affiliation(s)
- Megumi Fieldsend
- Department of Psychological Sciences, Birkbeck, University of London, Malet Street, London WC1E 7HX, UK
| | - Jonathan A Smith
- Department of Psychological Sciences, Birkbeck, University of London, Malet Street, London WC1E 7HX, UK
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17
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Kaya Z, Oskay U. Stigma, hopelessness and coping experiences of Turkish women with infertility. J Reprod Infant Psychol 2019; 38:485-496. [DOI: 10.1080/02646838.2019.1650904] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Zehra Kaya
- Department of Gynecologic and Obstetrics Nursing, Istanbul University-Cerrahpaşa Florence Nightingale Nursing Faculty, Istanbul, Turkey
| | - Umran Oskay
- Department of Gynecologic and Obstetrics Nursing, Istanbul University-Cerrahpaşa Florence Nightingale Nursing Faculty, Istanbul, Turkey
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