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Swift A, Thomas E, Larson K, Swanson M, Fernandez-Pineda M. Infertility-related stress, quality of life, and reasons for fertility treatment discontinuation among US women: A secondary analysis of a cross-sectional study. SEXUAL & REPRODUCTIVE HEALTHCARE 2024; 39:100955. [PMID: 38394810 DOI: 10.1016/j.srhc.2024.100955] [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: 11/01/2023] [Revised: 02/16/2024] [Accepted: 02/18/2024] [Indexed: 02/25/2024]
Abstract
OBJECTIVE Fertility treatments often cause women high levels of stress and low quality of life (QoL). Women discontinue fertility treatments for a variety of reasons, yet little is known about infertility-related stress and QoL among women who discontinue treatments. The purpose of this study was to examine infertility-related stress and QoL among women who discontinued fertility treatments compared to those who continued treatments, and reasons for treatment discontinuation. METHODS A secondary analysis was conducted to examine infertility-related stress and QoL among 70 women who discontinued from fertility treatments compared to 166 women who received fertility treatments. Statistical analysis included descriptive statistics, chi-square test for independence, independent t-tests, and binary logistic regression analysis. Conventional content analysis was conducted on responses to an open-text question about reasons for treatment discontinuation. RESULTS No differences in infertility-related stress and QoL were found between groups. Explanatory variables of treatment discontinuation included income [odds ratios (OR) 2.50, 95% CI 1.12-5.61], QoL dissatisfaction (OR 2.49, 95% CI 1.33-4.69), and infertility duration three years or greater (OR 2.40, 95% CI 1.30-4.42). Three themes of treatment discontinuation were identified: Covering the Cost; Waiting for a Resolution; Re-envisioning Family Identity. CONCLUSION Infertility-related stress and QoL are similar among women who discontinued and who received fertility treatments, highlighting the need for emotional support services for women regardless of their treatment status. During the period of infertility, treatment discontinuation related to cost, waiting for a resolution, or re-envisioning family identity occurred, suggesting opportunities for specific interventions to support women's mental health needs.
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Affiliation(s)
- Alison Swift
- Department of Advanced Nursing Practice and Education, East Carolina University College of Nursing, 2205 W 5(th) St., Greenville, NC, USA.
| | | | - Kim Larson
- Department of Nursing Science, East Carolina University, College of Nursing, 2205 W 5th St., Greenville, NC, USA.
| | - Melvin Swanson
- Department of Nursing Science, East Carolina University, College of Nursing, 2205 W 5th St., Greenville, NC, USA.
| | - Madeline Fernandez-Pineda
- Department of Nursing Science, East Carolina University, College of Nursing, 2205 W 5th St., Greenville, NC, USA.
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Dias L, Willems SG, Luyten J, De Loecker P, D'Hooghe TM, Peeraer K, Dancet EAF. The need for longitudinal data on the value of fertility treatment for infertile patients' quality of life: A review and pilot study. Best Pract Res Clin Obstet Gynaecol 2023:102324. [PMID: 36948947 DOI: 10.1016/j.bpobgyn.2023.102324] [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: 10/31/2022] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 02/23/2023]
Abstract
Infertility threatens the life goal of parenthood and, hence, quality of life (QoL) of (wo)men, but the fertility clinic trajectory might be burdensome. This review of longitudinal studies and pilot longitudinal study examines the impact of the pre-in vitro fertilization (IVF) fertility clinic trajectory on patient-reported outcome measures (PROMs) for emotional well-being, including QoL. A publication found that the diagnostic workup decreases men's infertility-specific distress while publications disagree whether it decreases (wo)men's anxious and depressive reactions. Intrauterine insemination (IUI) was found to increase (wo)men's depressive reactions. Publications on infertility-specific, health-related, and overall QoL were missing. The pilot indicated that (wo)men's overall QoL is not affected by the diagnostic workup but is decreased by the time of the third IUI. Longitudinal studies on the impact of starting the fertility clinic trajectory on PROMs are needed as they are essential for patient-centered clinical decision-making and patient-centered policy-level decision-making.
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Affiliation(s)
- L Dias
- Fertiliteitscentrum Antwerpen, GZA Ziekenhuizen, Oosterveldlaan 24, 2610 Wilrijk, Belgium; Department of Development and Regeneration, University of Leuven, Herestraat 49, 3000 Leuven, Belgium.
| | - S G Willems
- Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 35 Blok D - Bus 7001, 3000 Leuven, Belgium.
| | - J Luyten
- Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 35 Blok D - Bus 7001, 3000 Leuven, Belgium.
| | - P De Loecker
- Fertiliteitscentrum Antwerpen, GZA Ziekenhuizen, Oosterveldlaan 24, 2610 Wilrijk, Belgium.
| | - T M D'Hooghe
- Department of Development and Regeneration, University of Leuven, Herestraat 49, 3000 Leuven, Belgium; Merck, United States.
| | - K Peeraer
- Department of Development and Regeneration, University of Leuven, Herestraat 49, 3000 Leuven, Belgium; Leuven University Fertility Centre, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium.
| | - E A F Dancet
- Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 35 Blok D - Bus 7001, 3000 Leuven, Belgium.
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Warchol-Biedermann K. The Etiology of Infertility Affects Fertility Quality of Life of Males Undergoing Fertility Workup and Treatment. Am J Mens Health 2021; 15:1557988320982167. [PMID: 33834914 PMCID: PMC8040574 DOI: 10.1177/1557988320982167] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
This panel study explored the effects of male, female, mixed, or idiopathic factor of infertility on the fertility quality of life (FertiQoL) in involuntarily childless males undergoing fertility workup for the first time. A convenience sample of 255 married males (age range = 22–51 years, mean = 30.24 years), 254 (99.6%) of whom suffered from primary infertility were assessed (1) at the baseline, before their initial fertility evaluation (T1); (2) before their second andrological appointment, 2–3 months after diagnostic disclosure (T2); and (3) before subsequent treatment-related/ follow-up appointments (T3, T4). The timing of psychological assessment was strictly related to andrological appointments and routine medical procedures. Respondents completed Emotional, Mind–Body, Relational, and Social subscales of the Polish version of FertiQoL and a baseline demographic survey. The research demonstrated that the FertiQoL scores across the Emotional, Mind–Body, and Relational subscales markedly decreased after the diagnostic disclosure, particularly in the subgroups with male and concurrent male and female factor. Social subscale scores in all subgroups remained stable after the diagnostic disclosure (at T2) but significantly decreased in the follow-up (at T3 and T4). Significant differences in FertiQoL scores associated with respondents’ infertility factor could be demonstrated at each time point. The study identifies the FertiQoL in unintentionally childless males is significantly affected by their factor of infertility and evolves across the pathway of treatment-related/follow-up appointments.
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Vatanparast M, Yasini Ardekani SM, Anvari M, Kalantari A, Yaghmaie F, Royani Z. Resilience as the predictor of quality of life in the infertile couples as the most neglected and silent minorities. J Reprod Infant Psychol 2020; 40:216-227. [PMID: 33167710 DOI: 10.1080/02646838.2020.1843613] [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] [Indexed: 10/23/2022]
Abstract
Background: It has been demonstrated that infertility can affect quality of life (QoL) in infertile couples. Resilience is considered a protective factor against the distress caused by infertility and the quality of life status. There is a new definition for Fertility Quality of Life that evaluates particularly the impact of infertility on various aspects of life.Material and methods: In this couple-based study, the main objective was investigating the quality of life based on the gender and resilience of infertile couples. Measurement tools were three questionnaires including a demographic one, a quality of life of infertile couples questionnaire and the Connor-Davidson Resilience Scale. Data analysis was done through paired t-test and linear multiple regressions test.Results: Overall the difference of mean score for QoL is statistically significant (P > 0.001) between men and women (69.48% vs 58.87%), which means that QoL status was positive in men and neutral in women. In addition, the mean score of male resilience was more than female resilience (P = 0.009). The results showed there was a significant and positive correlation between the QoL status and resilience score (P = 0.008, r = 0.13) (P < 0.1), and resilience (β = 0.04 and P = 0.04) had a significant protective effect on the quality of life.Conclusion: Low resilience status in infertile couples is better to be considered as a risk factor compromising the quality of life and infertility consolers should keep in mind this issue and provide a comprehensive and holistic approach for a better outcome of infertility treatment.Abbreviations: QoLICQ: Quality of Life in Infertile Couple Questionnaire; CD-RISC: Connor-Davidson Resilience Scale; IVF: in vitro fertilisation; ART: assisted reproductive technique; PTSD: posttraumatic stress disorder; IUI: intrauterine insemination; ICSI: intracytoplasmic sperm injection.
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Affiliation(s)
- Mahboubeh Vatanparast
- Molecular Medicine Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.,Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | - Morteza Anvari
- Department of Biology and Anatomical Sciences, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Department of Nursing, Zanjan Branchg, Islamic Azad University, Zanjan, Iran
| | - Athareh Kalantari
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | - Zahra Royani
- Laboratory Sciences Research Center, Department of Paramedical School,Golestan Medical University of Science, Gorgan, Iran
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Szigeti F J, Grevenstein D, Wischmann T, Lakatos E, Balog P, Sexty R. Quality of life and related constructs in a group of infertile Hungarian women: a validation study of the FertiQoL. HUM FERTIL 2020; 25:456-469. [PMID: 32985277 DOI: 10.1080/14647273.2020.1824079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Quality-of-life measurement is a basic prerequisite for psychologically sensitive fertility care and the FertiQoL is a psychometrically sound outcome measure in this field. The aim of the present research was to investigate the reliability and validity of the Hungarian Core FertiQoL. Two independent samples of infertile women were merged (n = 320). While the model fit of the four-factor Confirmatory Factor Analysis was under the level of acceptability (χ2(246) = 626.36, p < 0.001, RMSEA = 0.070 [CI90 = 0.063-0.076], CFI = 0.878, SRMR = 0.071), the four-factor Exploratory Structural Equation Model showed much improved model fit (χ2(186) = 395.63, p < 0.001, RMSEA = 0.059 [CI90 = 0.051-0.067], CFI = 0.933, SRMR = 0.035). Good internal consistency (Cronbach's Alphas 0.77-0.92) and construct reliability (0.75-0.95) were found for both factor structures. Depression correlated negatively with fertility-specific quality of life. Almost a quarter of the sample suffered from moderate-to-severe depression. Multivariate analysis of variance indicated that Beck Depression Inventory categories (mild, moderate etc.) co-occurred with significantly distinct FertiQoL score ranges, leading to a possible, clinically meaningful threshold on the Core FertiQoL. Pearson coefficients showed secondary infertility, rural residency and pre-treatment status to be associated with better fertility quality of life.
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Affiliation(s)
- Judit Szigeti F
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | | | - Tewes Wischmann
- Institute of Medical Psychology, University Hospital Heidelberg, Heidelberg, Germany
| | - Enikő Lakatos
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | - Piroska Balog
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | - Réka Sexty
- Department of Neonatology, Children's Hospital, University Hospital Bonn, Bonn, Germany
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Li Y, Zhang X, Shi M, Guo S, Wang L. Resilience acts as a moderator in the relationship between infertility-related stress and fertility quality of life among women with infertility: a cross-sectional study. Health Qual Life Outcomes 2019; 17:38. [PMID: 30770738 PMCID: PMC6377764 DOI: 10.1186/s12955-019-1099-8] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 01/24/2019] [Indexed: 02/08/2023] Open
Abstract
Background Infertility-related stress can seriously impact the fertility quality of life (QoL) of infertile women. Resilience, as a coping resource, can effectively combat psychological stress. This study aimed to evaluate the fertility QoL of infertile women and to examine whether resilience moderates the association of infertility-related stress with fertility QoL. Methods This cross-sectional study was conducted in northeast of China from December 2017 to February 2018. Out of 559 women outpatients with infertility, 498 (89.1%) completed self-reported questionnaires including the FertiQoL Scale, Fertility Problem Inventory (FPI) and Connor-Davidson Resilience Scale (CD-RISC). Hierarchical multiple regression analysis and simple slope analysis were applied to explore the influencing factors related to fertility QoL as well as to examine the moderating effect of resilience on the association of infertility-related stress with fertility QoL. Results The mean FertiQoL score was 64.54 ± 16.90 among the participants. Household monthly income and causes of infertility were significantly related to fertility QoL. In addition, infertility-related stress was negatively related to fertility QoL, and resilience was positively associated with fertility QoL, explaining 36.3% of the variance. Resilience moderated the association of infertility-related stress with fertility QoL. Specifically, the effect of infertility-related stress on fertility QoL varied by low(1 SD below the mean, B = - 0.496, β = - 0.714, P < 0.001), mean (B = - 0.293, β = - 0.422, P < 0.001) and high (1 SD above the mean, B = - 0.090, β = - 0.130, P < 0.001) levels of resilience. The higher resilience was, the weaker the effect of infertility-related stress on fertility QoL was. Conclusions Overall, women with infertility in China had relatively low FertiQoL scores. Resilience influenced the association of infertility-related stress with fertility QoL. Infertile patients’ psychological status must be addressed and adequate resilience-based interventions such as mindfulness-based skills should be provided to improve fertility QoL of women with infertility.
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Affiliation(s)
- Yifei Li
- Department of Social Medicine, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122, China
| | - Xin Zhang
- Department of Social Medicine, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122, China
| | - Meng Shi
- English Department, School of Fundamental Sciences, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122, China
| | - Shuaishuai Guo
- Reproductive Medicine Center, Shenyang Women's and Children's Hospital, No.87 Danan Road, Shenhe Area, Shenyang, 110000, China.
| | - Lie Wang
- Department of Social Medicine, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122, China.
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Smith CA, de Lacey S, Chapman M, Ratcliffe J, Norman RJ, Johnson NP, Fahey P. The effects of acupuncture on the secondary outcomes of anxiety and quality of life for women undergoing IVF: A randomized controlled trial. Acta Obstet Gynecol Scand 2019; 98:460-469. [DOI: 10.1111/aogs.13528] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Accepted: 12/20/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Caroline A. Smith
- NICM Health Research Institute; Western Sydney University; Penrith NSW Australia
| | - Sheryl de Lacey
- College of Nursing and Health Sciences; Flinders University; Adelaide SA Australia
| | - Michael Chapman
- School of Women's & Children Health; University of New South Wales; IVF Australia; Sydney NSW Australia
| | - Julie Ratcliffe
- Institute for Choice; Business School; University of South Australia; Adelaide SA Australia
| | - Robert J. Norman
- Robinson Research Institute; University of Adelaide; Adelaide SA Australia
- Fertility SA; Adelaide SA Australia
| | - Neil P. Johnson
- Robinson Research Institute; University of Adelaide; Adelaide SA Australia
- Repromed; Auckland New Zealand
| | - Paul Fahey
- School of Science and Health; Western Sydney University; Penrith NSW Australia
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