Effect of infertility on the quality of life, a cross- sectional study

Health-related quality of life and its associated factors among infertile women compared with fertile women in public hospital Addis Ababa, Ethiopia: a comparative cross-sectional study

BACKGROUND

Infertility can have detrimental physical, psychological, and social effects that significantly impact health-related quality of life. Although the impact of infertility on quality of life is well established, there is a lack of research comparing the quality of life between fertile and infertile women in Ethiopia.

METHODS

A hospital-based comparative cross-sectional study was conducted among 287 infertile and 301 fertile women. Participants were selected using systematic random sampling. A structured, validated tool was used to collect data. An independent sample t-test was conducted to determine if there was a difference in the study participants' quality of life domains and the mean total quality of life score. Multiple linear regressions were used to correlate quality of life scores with significant predictor factors for the infertile group.

RESULTS

Infertile women had a mean total Herbal of 66.54 ± 10.18, and fertile women (72.68 ± 7.57) were found to be statistically different between the groups. All domains except the physical domain were significantly different between the groups. Duration of marriage (β = -0.529), number of previous sexual partners (β = -0.410), total number of working hours per day (β = -0.345), types of infertility (β = -0.34), and history of the sexually transmitted disease (β = -0.277), in decreasing order of effect, were found to be associated with the quality of life of infertile women (R2 = 0.725).

CONCLUSIONS

The study found that infertile women had a lower mean HRQoL score compared to fertile women, with all domains except for the physical domain being significantly different between the two groups. This suggests that infertility can have a significant impact on various aspects of a woman's life, including her emotional well-being, social functioning, and psychological health. The factors associated with the quality of life of infertile women were the duration of marriage, the number of previous sexual partners, the total number of working hours per day, the types of infertility, and the history of sexually transmitted diseases, with duration of marriage having the strongest association. These findings highlight the need for healthcare providers to address the psychological and social aspects of infertility.

Effects of mindfulness-based intervention for women with infertility: a systematic review and meta-analysis

This review aimed to examine the effects of mindfulness-based interventions on physical and psychological outcomes in women with infertility. Studies were included if participants were women diagnosed with infertility, were over the age of 18, and the design was a randomized controlled trial of a mindfulness-based intervention program. Two independent reviewers undertook eligibility screening, data extraction, and methodological quality assessment. We used RevMan software version 5.4 (The Cochrane Collaboration) to conduct the meta-analyses. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) was followed. Ten articles were finally included in the current meta-analysis. The results of the meta-analysis revealed large, significant effects of mindfulness-based interventions that can effectively reduce depression[SMD = -1.28, 95% CI (-1.95, -0.60), P < 0.0001], anxiety [SMD = -0.89, 95% CI (-1.26, -0.51), P < 0.00001] symptoms, and improve five domains of health-related quality of life (physical function [MD = 9.47, 95% CI (4.33, 14.61), P = 0.0003], general health [MD = 15.77, 95% CI (7.62, 23.92), P = 0.0002], vitality [MD = 14.85, 95% CI (4.95, 24.74), P = 0.003], role-physical [MD = 22.44, 95% CI (14.97, 29.91), P < 0.00001] and social function [MD = 8.27, 95% CI (3.56, 12.97), P = 0.0006)] in women with infertility. The current meta-analysis results revealed that mindfulness-based interventions could effectively reduce depression and anxiety symptoms and improve health-related quality of life in women with infertility. Future rigorously designed, high-quality research is required to demonstrate whether mindfulness-based intervention programs can effectively reduce perceived stress and BMI.

Development and evaluation of couple-based coping strategies with infertility: a protocol for a mixed-methods study

Background

Different coping strategies have been associated with various effects on infertile couples’ mental health. Considering the close interaction between couples, the present study aims to develop coping strategies for infertile couples using a couple-based approach.

Methods

The present mixed-methods study will be conducted in three phases. In order to develop coping strategies, a qualitative study will be conducted in the first phase, during which semi-structured interviews will be implemented with infertile couples in order to collect data related to their lived experiences in using coping strategies. These data will be inductively analyzed using qualitative content analysis and interpretative phenomenological analysis. In the second phase, using the Delphi method, an initial draft of coping strategies will be designed using a couple-based approach based on the data obtained from the qualitative study and the related literature review. In the third phase, the designed couple-based strategies will be provided to two groups of infertile couples as a randomized field superiority trial study. The couples’ levels of stress, anxiety, depression, and adjustment will be evaluated using validated questionnaires before and 3 months after the intervention.

Discussion

Couple-based coping strategies encourage couples to become aware of each other’s feelings while interacting and choose a strategy based on such feelings.

Trial registration

Iranian Registry of Clinical Trials IRCT20191014045102N1. Registered on 19 October 2021. Protocol version: Current protocol: version 1 (22 May 2022)

The effect of male and female factor infertility on women's anxiety, depression, self-esteem, quality of life and sexual function parameters: a prospective, cross-sectional study from Turkey

OBJECTIVES

Despite the development of diagnosis and treatment methods, the psychological effects of infertility on women were not adequately addressed. This study investigated the effect of male and female factor infertility on women's anxiety, depression, self-esteem, quality of life, and sexual function parameters.

METHODS

In this prospective, cross-sectional study, 480 women [n = 234, with male factor infertility (MFI) (MFI group) and n = 246, with female factor infertility (FFI) (FFI group)], who could not conceive despite unprotected intercourse for 1 year, and 242 fertile healthy women (control group) who had children within the last 1 year were included. Beck Anxiety Inventory (BAI), Beck Depression Inventory-II (BDI-II), Rosenberg Self Esteem Scale (RSES), Fertility Quality of Life (FertiQol) and Female Sexual Function Index (FSFI) questionnaires were used for patients' evaluation.

RESULTS

RSES, BAI and BDI-II scores were significantly higher and FSFI score was significantly lower in the FFI group compared to other groups. RSES, BAI and BDI-II scores were also significantly higher and FSFI score was significantly lower in the MFI group compared to the control group. FertiQol total score was significantly lower in the FFI group compared to the MFI group. RSES score was positively correlated with BDI-II and BAI scores; however, it was negatively correlated with FertiQol and FSFI scores.

CONCLUSIONS

The negative psychological effects of infertility are ignored by many centres, especially in the treatment process of infertility. Regardless of the infertility factor (male or female), we believe that psychological support should be given to all women to improve their life quality.

Effectiveness of Counseling for Infertile Couples on Women's Emotional Disturbance: A Randomized Clinical Trial

OBJECTIVE

 The psychosocial burden of infertility among couples can be one of the most important reasons for women's emotional disturbance. The goal of the present study was to investigate the effect of counseling on different emotional aspects of infertile women.

METHODS

 The present randomized clinical trial was performed on 60 couples with primary infertility who were referred for treatment for the first time and did not receive psychiatric or psychological treatment. Samples were allocated to an intervention group (30 couples) and a control group (30 couples) by simple randomization. The intervention group received infertility counseling for 6 45-minute sessions twice a week, and the control group received routine care. The Screening on Distress in Fertility Treatment (SCREENIVF) questionnaire was completed before and after the intervention. Samples were collected from November to December 2016 for 3 months. For the data analysis, we used the Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, IBM Corp., Armonk, NY, United States) software, version 19.0, and the paired t-test, the independent t-test, the Mann-Whitney test, the Wilcoxon test, and the Chi-squared test.

RESULTS

 The mean age of the participants was 33.39 ± 5.67 years. All studied couples had primary infertility and no children. The mean duration of the couples' infertility was 3 years. There was a significant difference regarding depression (1.55 ± 1.92; p < 0.0001), social support (15.73 ± 3.41; p < 0.0001), and cognitions regarding domains of fertility problems (26.48 ± 3.05; p = 0.001) between the 2 groups after the intervention, but there was no significant difference regarding anxiety (25.03 ± 3.09; p = 0.35).

CONCLUSION

 The findings showed that infertility counseling did not affect the total score of infertile women' emotional status, but improved the domains of it except, anxiety.

Comparison of the effect of two methods of counseling (face to face and telephone) on awareness and attitude toward adoption in infertile couples

INTRODUCTION

Many infertile people have heard about adoption, but little is known about the true meaning of adoption and how it is accepted. Giving the right information about adoption is effective in making the right decision for couples. As a result, there is a need to intervene and provide training to improve community attitudes and increase adoption among infertile people. Therefore, the present study aimed to determine the effect of two counseling methods (face-to-face and telephone) on awareness and attitude toward adoption in infertile couples.

MATERIALS AND METHODS

The present study is a randomized quasi-experimental study of two groups in the Milad Infertility Center of Mashhad on 34 (each group of 17 couples) infertile couples with the criteria to enter the study. Couples were randomly assigned to two telephone and face-to-face counseling groups, and each individual's awareness and attitudes toward adoption were completed separately before and after counseling. The average number of face-to-face sessions for face-to-face counseling was three 60-min sessions and six 30-min sessions for telephone counseling.

RESULTS

Based on the results of t-test, there was a statistically significant difference between the average score of awareness of adoption before and after the intervention (2 weeks after the last counseling session), in infertile couples in face-to-face training group and in telephone training group (P < 0.0001). The score of the attitude toward adoption before counseling in the face-to-face counseling group was 60.55 ± 5.5, which reached 66.76 ± 4.7 after counseling. Based on the results of the T-pair test, this difference was significant (P < 0.0001). In addition, in the telephone counseling group, the score of attitude toward adoption increased from 59.53. 7.4 to 67.73 ± 7.5, which was a significant difference in terms of t-pair test. The mean score of attitudes toward adoption was not statistically significant in the two groups (P = 0.653).

CONCLUSION

The results of this study showed that both counseling methods (face to face and telephone) increase the level of awareness and attitude of couples about adoption, but neither method was superior to the other.

Level of Happiness and Its Associated Factors Among Pregnant Women in South Gondar Zone Hospitals, North Central Ethiopia

Background

Happiness is the most indicator of good quality of life particularly for pregnant women. Reduced happiness of pregnant women can result in reduced maternal health services utilization and can result in adverse newborn and maternal outcomes. Assessing the level of happiness and its factors are important for pregnant women and the next generation. Hence, the current research paper aimed to assess the level of happiness and its associated factors among pregnant women who attended antenatal care follow-up in South Gondar Zone Hospitals.

Methods

Institution-based cross-sectional study was carried out from September 2018 to February 2019 among 1606 expectant pregnant women in the last 6 months. The Oxford Happiness Questionnaire (OHQ) was used as a measure of the degree of happiness and used four as average person score. Besides, bivariate, multivariable logistic analyses were deployed to identify associations.

Results

A total of 1606 pregnant women were participating in this study. The prevalence of low level of pregnancy happiness in this study was 24% (95% CI: 20.7 −26.6). Mothers who exposed to unintended pregnancy (AOR; 1.94, CI 95% 1.86–4.52), reported intimate partner violence (AOR; 2.42, 95% CI 1.67–3.54) and being in the third trimester (AOR; 1.89 95% CI 1.19–3.01) were the most predictor variables with the low level of happiness.

Conclusion

Approximately one-fourth of the pregnant women had a low level of pregnancy happiness. Mothers who were exposed to unintended pregnancy encountered intimate partner violence, who were in the third trimester were the most significant variables associated with a low level of happiness. Governmental and non-governmental organizations work on women’s reproduction rights and the zonal health department with local health offices should educate on the prevention of intimate partner violence and unintended pregnancy and its consequences and also empower women to cope with changes and challenges of pregnancy and childbirth.

Clinical aspects and the quality of life among women with endometriosis and infertility: a cross-sectional study

Background

The quality of life (QoL) of patients with endometriosis and infertility was assessed in different stages and correlated with the clinical features of the cases.

Methods

The present study was a cross-sectional study; 106 women were included, divided in two endometriosis groups (Grade I/II, 26 women, and Grade II/IV, 74 women). All participants attended the Endometriosis and Infertility Outpatient Clinic of the Instituto Ideia Fértil de Saúde Reprodutiva, Faculdade de Medicina do ABC, São Paulo, Brazil, were and responded to the Short Form (SF) Health Survey-36. Convenience sampling was used due to the authors’ access to the study population; however, the sample number was calculated to be sufficient for 95% power in both groups.

Results

Homogeneity was observed between Grade I/II and Grade III/IV staging, with similar mean ages (35.27, ±3.64 years and 34.04, ±3.39 years, respectively, p = 0.133); types of infertility (p = 0.535); infertility time (p = 0.654); degrees of pain (p = 0.849); and symptoms common to endometriosis, namely, dysmenorrhea (p = 0.841), dyspareunia (0.466), chronic pelvic pain (p = 0.295), and intestinal (p = 0.573) or urinary (p = 0.809) diseases. Comparisons of median scores in the QoL domains demonstrated that the distributions of QoL and clinical symptoms were significantly related between the types of dyspareunia and the following domains: physical functioning (p = 0.017), role- emotional (p = 0.013), and general health (p = 0.001). Regarding pain outside of menstruation, there was significance in the pain domain (p = 0.017), and degree of pain was significance in physical functioning (p = 0.005) and role-physical (p = 0.011) domains.

Conclusions

The present study pointed out that it is not the stage of endometriosis that interferes in the quality of life of women with endometriosis and infertility but rather the clinical manifestations, such as dyspareunia and pain. Thus, we can conclude that the patient’s perception of the disease should be considered in health care and that the losses are independent of the degree of endometriosis in this population with the aggravating factor of infertility.

Effect of a lifestyle intervention in obese infertile women on cardiometabolic health and quality of life: A randomized controlled trial

Background

The prevalence of obesity, an important cardiometabolic risk factor, is rising in women. Lifestyle improvements are the first step in treatment of obesity, but the success depends on factors like timing and motivation. Women are especially receptive to advice about lifestyle before and during pregnancy. Therefore, we hypothesize that the pre-pregnancy period provides the perfect window of opportunity to improve cardiometabolic health and quality of life of obese infertile women, by means of a lifestyle intervention.

Methods and findings

Between 2009–2012, 577 infertile women between 18 and 39 years of age, with a Body Mass Index of ≥ 29 kg/m2, were randomized to a six month lifestyle intervention preceding infertility treatment, or to direct infertility treatment. The goal of the intervention was 5–10% weight loss or a BMI < 29 kg/m². Cardiometabolic outcomes included weight, waist- and hip circumference, body mass index, systolic and diastolic blood pressure, fasting glucose and insulin, HOMA-IR, hs-CRP, lipids and metabolic syndrome. All outcomes were measured by research nurses at randomization, 3 and 6 months. Self-reported quality of life was also measured at 12 months. Three participants withdrew their informed consent, and 63 participants discontinued the intervention program. Intention to treat analysis was conducted. Mixed effects regression models analyses were performed. Results are displayed as estimated mean differences between intervention and control group. Weight (-3.1 kg 95% CI: -4.0 to -2.2 kg; P < .001), waist circumference (-2.4 cm 95% CI: -3.6 to -1.1 cm; P < .001), hip circumference (-3.0 95% CI: -4.2 to -1.9 cm; P < .001), BMI (-1.2 kg/m² 95% CI: -1.5 to -0.8 kg/m²; P < .001), systolic blood pressure (-2.8 mmHg 95% CI: -5.0 to -0.7 mmHg; P = .01) and HOMA-IR (-0.5 95% CI: -0.8 to -0.1; P = .01) were lower in the intervention group compared to controls. Hs-CRP and lipids did not differ between groups. The odds ratio for metabolic syndrome in the intervention group was 0.53 (95% CI: 0.33 to 0.85; P < .01) compared to controls. Physical QoL scores were higher in the lifestyle intervention group (2.2 95% CI: 0.9 to 3.5; P = .001) while mental QoL scores did not differ.

Conclusions

In obese infertile women, a lifestyle intervention prior to infertility treatment improves cardiometabolic health and self-reported physical quality of life (LIFEstyle study: Netherlands Trial Register: NTR1530).

Predictors of Infertility Stress among Couples Diagnosed in a Public Center for Assisted Reproductive Technology

Background:

All around the world, infertility, in many ways, is recognized as a stressful and a critical experience that can have impact on social and marital life of a couple. Infertility stress may affect the treatment and its outcome for such couples. The objective of the present study is to assess the predictors of high stress of infertility among married couples.

Materials and Methods:

This cross-sectional study was conducted on 120 couples (240 patients) who were diagnosed with primary and secondary infertility from June 2017 to June 2018. A psychological self-assessment questionnaire (Perceived Stress Scale-10) was used as a tool to evaluate the presence of high infertility stress among couples after obtaining their consent. Furthermore, other socioepidemiological data of patients were collected.

Statistical Analysis:

Data were analyzed using SPSS software (version 20). Univariate statistical analysis was used followed by multiple logistic regressions between high infertility stress and the predictor variables.

Results and Discussion:

The prevalence of high infertility stress was 53.3% among women and 40.8% among men. For women, multivariate analysis showed leading associations of high infertility stress with level of education, infertility type, infertility duration, and etiologies of infertility. However, for men, multivariate analysis showed leading associations between high infertility stress and alcohol status and inadequate sleep and infertility type.

Quality of life in Turkish infertile couples and related factors

Infertility is a major life crisis affecting couples' psychosocial and physical health. We aimed to assess the quality of life in Turkish infertile couples. This cross-sectional survey was carried out in 127 infertile couples admitted to a University Hospital. The quality of life was measured using the fertility quality of life tool (FertiQoL) scale. Women had lower overall quality of life than men. Women and men who were married for fewer than 10 years had a significantly lower emotional score. Women who had a history of infertility treatment, men who have lived in the town or village men with primary infertility and men who have had primary education or lower, had lower scores for mind/body subscale. Social scores were found lower in women under the age of 30, women with middle or low income, men who were married for fewer than 10 years, men who did not have children for 5 years or more and men with primary infertility. The tolerability and environment scores were significantly higher in women who had been married more than once. We conclude that health care providers should be aware of the factors affecting the quality of life (QoL) and give counselling to improve couples' quality of life at infertility clinics.

Quality of Life among Iranian Infertile Women in Postmenopausal Period: A Cross-sectional Study

Objectives

Infertility has a significant impact on a women's quality of life (QOL). Infertile women face with physical and mental challenges during their postmenopausal period. Therefore, the present study aimed to evaluate the QOL among Iranian infertile women in the postmenopausal period using a valid and reliable instrument.

Methods

In this cross-sectional study both snowball and social networking methods were used for sampling. Two demographic and QOL questionnaire were used for data collection. The QOL questionnaire includes 41 items which measure the QOL in five dimensions: socioeconomic, mental health, religiousness, physical health and future imagining. Data analyzed was carried out in IBM SPSS ver. 20.0 using descriptive statistic, χ² test, and Fisher test. A P value of 0.01 or less was considered significant.

Results

Overall 211 eligible participants were studied. Some participants obtained full score on socioeconomic, religiousness, physical health and future imagining dimensions of QOL but none on the mental health dimension of the QOL. Only, 6.6% of study participants have a good QOL. There was a significant relationship between age and financial provider whit status of QOL.

Conclusion

Most Iranian infertile women in the postmenopausal period have poor or moderate QOL. Therefore, improving the QOL among these women should be considered.

Quality of Life in Infertile Menopausal Women; Development and Psychometric of an Instrument

INTRODUCTION

So far few studies have been designed to evaluate the quality of life instrument in infertile women.

AIM

The present study was decided to design a valid and reliable instrument to assess quality of life in Iranian infertile women in postmenopausal period.

MATERIALS AND METHODS

Both quantitative and qualitative research methods were applied. The process was divided into three main stages including: instrument development, instrument validity and instrument reliability. Instrument development used three main steps, including determining content domain, item generation and instrument construction. Instrument was validated using face validity, content validity and factor analysis. Both internal consistency and test-retest reliability methods were used to confirm the reliability of the questionnaire.

RESULTS

During content development, domain step obtained 83 items in all demission of life in infertile women. In the qualitative and quantitative face validity, 25 items had item impact less than 1.5 and were excluded from the questionnaire. In the content validity section, 17 items failure to obtain necessary score based on Lawshe formula, so were excluded from the questionnaire. Overall, 8 factors were extracted by factor analysis test. However, 67.38% of the total variance was explained by 4 factors, other 4 next factors explained the remaining 32.62% of the total variance. Totally, 34.01% of rotation variance was explained by first factor and 24.37% by second factor. In questionnaire internal consistency, 8 items had Cronbach's alpha 0.942.

CONCLUSION

Therefore, we recommend the use of present questionnaire as a valid tool to evaluate the quality of life in infertile women during postmenopausal period.

Factors Affecting Happiness: A Cross-Sectional Study in the Iranian Youth

INTRODUCTION

Happiness is one of the most important concepts in the mental health that has an impact on different aspects of young people.

AIM

The present study was conducted to identify the factors influencing on happiness among young persons in Liam, Iran during 2014.

MATERIALS AND METHODS

A cross-sectional study was conducted among young population 15-29-year-old. Multistage cluster random sampling method was used to select the participants. Data were collected using two demographic and Oxford Happiness Inventory. SPSS software Package 14 was used to analyse the data.

RESULTS

A total of 500 young people, including 272 men and 228 women were enrolled. The Mean ± SD of the participants' age was 20 ± 2.18 years. There was a significant relationship between the happiness score and location in urban and rural, employment status and physical activity. There was not a significant relationship between gender, marital status and education level with happiness score among participants.

CONCLUSION

The age groups, type of occupation, physical activity and place of residence were factors associated with happiness in young persons. However, there was not significant relationship between gender, marital status and education level with a happiness score among study participants.

Relationship Between the Parenting Styles and Students' Educational Performance Among Iranian Girl High School Students, A Cross- Sectional Study

INTRODUCTION

Parenting styles are effective in the educational performance of their child. The present study aimed to investigate the relationship between the parenting styles and students' educational performance among Iranian girl high school students.

MATERIALS AND METHODS

In a cross-sectional survey, female students in high schools of Ilam (Iran) evaluated during the academic year 2014-15. Multistage cluster random sampling was used to select the participants. Data were collected by two demographic and Baumrind's parenting styles questionnaire. The Cronbach's alpha coefficient was measured as an index of internal identicalness of the questionnaire to verify its reliability.

RESULTS

A total 400 students were studied. The Mean±SD of the students' age were 14±1.08. The students' school grades were the first year of high school to pre-university course. The Mean±SD of parenting styles were 35.37±5.8, 34.69±6.34 and 19.17±6.64 for permissive parenting style, authoritarian parenting style and authoritative parenting styles, respectively. There was a significant relationship between the score of permissive parenting style (p= 0.001, r= 0.151), authoritarian parenting style (p= 0.001, r= 0.343) and authoritative parenting style (p=0. 001, r= 0.261) with the students' average score for studying.

CONCLUSION

The results of this study demonstrate that parental influence plays an important role in students' educational performance.

Effect of Infertility on Sexual Function: A Cross-Sectional Study

INTRODUCTION

Sexual dysfunction is an important psychological disorder that may increase in infertile couples.

AIM

To evaluate the effect of infertility on sexual function in women attending in private and public institutions in Ilam during 2013.

MATERIALS AND METHODS

In a cross - sectional study evaluated the sexual function among 384 women attending in health care centers of Ilam western of Iran during 2013. Participants were divided in two groups, fertilities and infertilities women. Data was collected by trained research midwives using demographic and FSFI questionnaires. SPSS software Package 16 was used to analyse the data of this project. Differences were regarded statistically significant with an alpha error of 0.05.

RESULTS

The mean age was 29.29 ± 6.7 years in fertile and 31.74 ± 8.07 in infertile women. Significant difference was reported in mean age between fertile and infertile women (p=0.014). The Mean± SD of all demissions of female sexual function was difference between fertile and infertile women. Sexual function was lower in infertile women.

CONCLUSION

All dimensions of sexual function were lower in infertile women in compared with fertile women. Further research should be done on this subject and ways to address such problems should be found.