Stress management and In Vitro Fertilization (IVF): A pilot randomized controlled trial

The objective of the study was to evaluate the psychological effect of an intervention of 8 stress-management sessions in women undergoing in vitro fertilization (IVF). Moreover, the overall IVF success was assessed against the fluctuation of the participants' stress levels. A total of 144 women participated in the study with 74 of them in the intervention group and 70 women in the control group. Demographics and medical history of all participants were recorded. The intervention group only underwent 8 weekly stress management sessions. During the 1st and 8th week of the study, both groups completed the Depression, Anxiety, Stress Scale 21 (DASS-21), the Perceived Stress Scale 14 (PSS-14) and the Fertility Problem Inventory (FPI). Following the intervention, the outcome of the IVF cycles, as defined by clinical pregnancy rates, were recorded. Our results indicated that total stress in the intervention group declined significantly (p<0.001) in respect to all the parameters of the PSS-14, DASS-21 and FPI scales, with the exception of the need for parenthood dimension that did not change significantly in the intervention group (p=0.002), while significantly increased in the control group (p<0.001). The difference of stress levels between the two groups for each scale as well as in total was also significant. There were no significant differences in the demographic data, lifestyle and medical history of the participants and their spouses between the two groups. The IVF success rate was found to be related to the levels of perceived stress on the PSS-14 scale (p=0.029) but not to any of the dimensions of DASS-21(p=0.197) and FPI (p=0.611) scales. Definitive factors affecting the IVF success were the participants' age (p=0.046), which was negatively correlated to IVF success, and the spouses' medical history of cryptorchidism (undescended testicles) (p=0.05). The high significance of these variables probably limited the effect of the intervention for stress relief on IVF success. This pilot study revealed encouraging results regarding the positive effect of interventions for stress management in women undergoing fertility treatment, however the possible contribution of such interventions to overall IVF success rates requires further investigation.

Marital Duration, and Fertility-Related Stress as Predictors of Quality of life: Gender Differences among Primary Infertile Couples

Context

Infertility is a global public health issue, and the current data suggest that the problem is growing. Various infertility-related issues are responsible for poorer mental health and well-being in couples with primary infertility.

Aim

The present study aimed to understand the gender differences of psychological factors related to infertility in couples with primary infertility. Furthermore, an attempt was also made to understand gender-specific associations that could interact with the fertility-related quality of life (FertiQoL).

Settings and Design

This cross-sectional hospital-based study included 100 married couples with the diagnosis of primary infertility, irrespective of the cause of infertility. The study was conducted at Infertility centers in the Eastern region of India.

Subject and Methods

One hundred men and women (n = 100 couples) with the diagnosis of primary infertility were recruited in the study. The fertility problem inventory and FertiQoL were used to measure the couples fertility-related stress and FertiQoL, respectively.

Statistical Analysis Used

Descriptive statistics, independent t-statistics, Pearson correlation, linear regression, and mediation analysis were conducted.

Results

A significantly higher social and sexual concern of infertility and "need for parenthood" were found in women. Men had a significantly better quality of life compared to women. Significant negative predictors of quality of life were noted for both men and women separately. Fertility stress was a significant mediating factor between marital duration and global FertiQoL in men. However, women showed a direct negative association between marital duration and FertiQoL.

Conclusions

The study provides important insights into the couple's experiences with various infertility problems that may potentially be addressed during psychotherapy or during infertility counseling.

The Effect of Nursing Consultation Based on Orem's Theory of Self-care and Bandura's Concept on Infertility Stress

INTRODUCTION

Infertility is one of the most stressful experiences in a couple's life. Several approaches have been proposed to manage infertility stress during the medically assisted technology process.

OBJECTIVE

The objective was to examine the effect of nursing consultation on the stress experienced by infertile couples before starting infertility treatment.

MATERIALS AND METHODS

This cross-sectional study was conducted from November 2017 to November 2018 among 120 infertile couples (240 patients) for whom stress was assessed. One hundred and thirteen patients of them who had a high infertility stress level were invited to participate in this randomized study (57 were assigned to the control group and 56 were included in the intervention group). The intervention group received nursing consultation based on Orem's theory and Bandura's concept in addition to the routine nursing care. Perceived Stress Scale-10 (PSS-10) and General Self-Efficacy Scale (GSES) were used before and after nursing intervention.

STATISTICAL ANALYSIS

The Chi-square test followed by a paired t-test and independent t-test was used for data analysis by SPSS software (version 20).

RESULTS AND DISCUSSION

There were no statistically significant differences before nursing intervention between the two groups in terms of PSS-10 (t = 1.18, P = 0.23) and GSES (t = -0.40, P = 0.689) scores, but a significant difference emerged in the intervention group following the nursing intervention: a reduction of the PSS score (t = -8.91, P = 0.000) and an increase in the GSES score (t = -5.25, P = 0.000, with 95% confidence interval (CI)).

CONCLUSION

Nursing consultation has been shown to be beneficial in decreasing perceived stress and increased self-efficacy for infertile couples undergoing assisted reproductive technologies.

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.