The virtual infertility community: a qualitative analysis of patient experiences shared on Instagram

Does IVF make people happy?

Research has been focused on exploring the negative side of IVF. However, a comprehensive picture of the overall impact of IVF needs to acknowledge its positive side. Prospective and cross-sectional research have shown that happiness can be experienced before, during and after IVF, irrespective of whether or not a live birth is achieved. Psychosocial models within positive psychology support the intrinsic benefit and adaptative effect of the action of undergoing IVF on well-being and mental health through the opportunity it affords people to achieve, accept and make meaning of their (un)realized parenthood goals. The PERMA model was used to explore the concept of happiness, with evidence showing that happiness can be achieved in IVF via positive emotions (most investigated), a sense of being engaged, positive relationships, and a sense of meaning and accomplishment. The positive lived experience of IVF can be moderated by individual patient characteristics, and enhanced by positive-focused approaches to care. High-quality research and patient-centred models of care are needed to evaluate and promote the holistic positive value of IVF in all dimensions of happiness.

Health care experiences of individuals accessing or undergoing in vitro fertilization (IVF) in the U.S.: a narrative review of qualitative studies

Background

In vitro fertilization (IVF) is an increasingly common method of assisted reproduction given the high rates of infertility in the United States (U.S.). However, despite growing utilization of IVF technologies, there is little known about the experiences of those accessing or undergoing IVF, particularly among adults in the U.S. The aims of this review are to (1) explore how economic, emotional and physical health, and interpersonal relationships impact and are impacted by accessing or undergoing IVF, and (2) understand the role of healthcare providers and the healthcare system.

Methods

A narrative review was conducted to summarize the current literature and provide insight into potential channels for care improvement. Eligible studies were published in English from 2013 to 2024 which qualitatively evaluated experiences of individuals and couples accessing or undergoing IVF. Peer-reviewed publications were identified from three electronic bibliographic databases. Methodologic rigor was assessed by two reviewers who also abstracted data on the study's characteristics as they pertained to four domains: health systems, economic, interpersonal, and physical and emotional health. Among the 32 papers retrieved for review, 22 met inclusion criteria and were retained for analysis.

Results

The available literature suggests accessing and undergoing IVF can be positively and negatively influenced by health systems, economic, interpersonal, and physical and emotional health factors. Often an individual or couple experiences multiple factors that compound to create a complex situation. Health systems-related factors included physician interaction and challenges with information volume and processing. Economic challenges primarily pertained to financing IVF and navigating insurance coverage. Interpersonal factors related to changes in relationships with partners, family members, and friends due to IVF. Physical health concerns (e.g., pain) and emotional health concerns (e.g., sadness, stress) were also noted by all included papers.

Conclusions

Efforts to improve care experiences of adults accessing or undergoing IVF are urgently needed. The evidence base points to a need for provider sensitivity trainings, clinic-based intervention, and community education in both physical and virtual spaces.

TikTok as a Resource for Fertility Information and Support: A Patient Survey

Objective

TikTok is a rapidly growing social media platform with over 800 million users worldwide. Many patients access fertility-related content across social media platforms, however, this has never been studied related to TikTok. This study aimed to describe patient perspectives and experiences using TikTok for fertility-related content.

Materials and methods

We conducted a cross-sectional web-based survey from April 1st 2023 to October 1st 2023 at a large fertility center in Toronto, Canada. Patients were eligible for inclusion if they self-identified that they use TikTok for fertility-related content and had pursued any form of fertility care. Results of the survey were described with descriptive statistics and thematic analysis.

Results

A total of 23 patients with a mean age of 36.74±6.67 years participated in the online survey. Fertility-related TikTok content included lived experiences of fertility journeys descriptions of fertility treatments or procedures, live-streaming of fertility treatments or procedures, interactive questions and answers, and educational videos. Creators of fertility-related TikTok content include patients undergoing fertility treatments, physicians, naturopaths, counselors, and patient advocates. The most common reasons for liking TikTok for fertility content included empathy or shared experiences, stress relief, and self-education. Reasons for disliking TikTok for fertility information included misinformation, commercialization or advertisements, and negative emotions of stress, anxiety, or emotional upset. Misconceptions seen on TikTok included misinformation about complications and success rates for assisted reproductive therapy, as well as nutritional advice.

Conclusion

Fertility providers should have a growing awareness of information available on TikTok for patients accessing fertility care and assisted reproductive technology.

Oocyte cryopreservation on TikTok and Instagram: Who is teaching whom?

PURPOSE

Oocyte cryopreservation (OC) is a medical intervention for reproductive-aged women, a demographic that uses social media heavily. This study characterizes the top TikTok videos and Instagram reels on OC.

METHODS

Five hashtags pertaining to OC were selected: #oocytepreservation, #oocytecryopreservation, #eggfreezing, #oocytefreezing, and #fertilitypreservation. Top videos for each hashtag were evaluated for source, content, impact, and quality on both platforms. Descriptive and inferential statistics were performed to analyze differences between laypeople and medical professionals.

RESULTS

From March to April 2023, 332 posts were reviewed. The most popular hashtags on TikTok and Instagram were #eggfreezing (n = 5.6 million views, n = 68,500 + posts) and #fertilitypreservation (n = 9 million views, n = 20,700 + posts). Laypeople dominated as sources (57.8%, 35.2%), followed by physicians (17.0%, 32.4%). No professional societies videos were found. Educational information (53.1%, 48.6%) was most frequently shared on both platforms respectively, followed by personal experiences (36.1%, 21.6%). Laypersons' posts were dominated by personal experiences (62.0%) with educational content second (33.3%). Educational content by medical professionals was more accurate on both TikTok and Instagram than patients (p < 0.001, p < 0.001). #Eggfreezing had the greatest impact for both patients and medical professionals based on shares (n = 9653, n = 3093), likes (n = 713,263, n = 120,700), and comments (n = 35,453, n = 1478). Notably, laypersons had a larger follower count than medical professionals (p < 0.001).

CONCLUSION

The majority of available videos are from laypeople, focus on education topics, and are less accurate in comparison to those from medical professionals. Professional societies have an opportunity to enhance their social media presence for better availability and accuracy of OC information.

Experiences of Women With Medical Abortion Care Reflected in Social Media (VEILLE Study): Noninterventional Retrospective Exploratory Infodemiology Study

BACKGROUND

Abortion (also known as termination of pregnancy) is an essential element of women's reproductive health care. Feedback from women who underwent medical termination of pregnancy about their experience is crucial to help practitioners identify women's needs and develop necessary tools to improve the abortion care process. However, the collection of this feedback is quite challenging. Social media offer anonymity for women who share their abortion experience.

OBJECTIVE

This exploratory infodemiology study aimed to analyze, through French social media posts, personal medical symptoms and the different experiences and information dynamics associated with the medical abortion process.

METHODS

A retrospective study was performed by analyzing posts geolocated in France and published from January 1, 2017, to November 30, 2021. Posts were extracted from all French-language general and specialized publicly available web forums using specific keywords. Extracted messages were cleaned and pseudonymized. Automatic natural language processing methods were used to identify posts from women having experienced medical abortion. Biterm topic modeling was used to identify the main discussion themes and the Medical Dictionary for Regulatory Activities was used to identify medical terms. Encountered difficulties were explored using qualitative research methods until the saturation of concepts was reached.

RESULTS

Analysis of 5398 identified posts (3409 users) led to the identification of 9 major topics: personal experience (n=2413 posts, 44.7%), community support (n=1058, 19.6%), pain and bleeding (n=797, 14.8%), psychological experience (n=760, 14.1%), questioned efficacy (n=410, 7.6%), social pressure (n=373, 6.9%), positive experiences (n=257, 4.8%), menstrual cycle disorders (n=107, 2%), and reported inefficacy (n=104, 1.9%). Pain, which was mentioned in 1627 (30.1%) of the 5398 posts by 1024 (30.0%) of the 3409 users, was the most frequently reported medical term. Pain was considered severe to unbearable in 24.5% of the cases (399 of the 1627 posts). Lack of information was the most frequently reported difficulty during and after the process.

CONCLUSIONS

Our findings suggest that French women used social media to share their experiences, offer and find support, and provide and receive information regarding medical abortion. Infodemiology appears to be a useful tool to obtain women's feedback, therefore offering the opportunity to enhance care in women undergoing medical abortion.

The effect of self-compassion-based programs for infertility (SCPI) on anxiety and depression among women pursuing fertility treatment: a three-armed, randomised controlled trial

PURPOSE

To examine the effects of self-compassion training using videos (SCV) versus self-compassion training using digital stories (SC-DS) as compared to a control group (CG) on reducing anxiety and depression symptoms among women pursuing fertility treatment.

METHODS

A three-armed, randomised controlled trial randomly assigned 200 eligible women to SCV(n = 65), SC-DS (n = 67), and CG (n = 68). All three randomised groups completed questionnaires immediately after randomisation (T1), after completing the interventions (T2), and 10 weeks after the interventions (T3). A generalised estimation equation was used with the intention-to-treat analysis. The primary outcomes were anxiety and depression, and secondary outcomes were self-compassion, infertility self-efficacy, and pregnancy rates.

RESULTS

SCV and SC-DS participants experienced a significant reduction in anxiety and depression from T1 to T2 and from T1 to T3 (p < 0.001; d > 0.8). SCV and SC-DS participants experienced a significant increase in self-compassion and infertility self-efficacy from T1 to T2 and from T1 to T3 (p < 0.001; d > 0.8). SC-DS seemed to be superior to SCV and CG. No significant differences were found among the three groups in pregnancy rates. SCV and SC-DS participants rated self-compassion training programs positively and said they would highly recommend them to others.

CONCLUSION

These findings suggest that SCV and SC-DS were effective in reducing anxiety and depression and increasing self-compassion and infertility self-efficacy. Online flexible self-compassion interventions could make psychological support more accessible for women undergoing fertility treatment in resource-poor settings.

TRIAL REGISTRATION

(ChiCTR2100046065) [12/04/2021].

Online peer support communities in the infertility journey: A systematic mixed-studies review

BACKGROUND

Infertile individuals desire support, as they are highly vulnerable to multi-dimensional distress. However, support from family, friends and professionals has been found to be inadequate for their needs. Online peer support communities are avenues where infertile individuals come together virtually to share experiences and provide peer support. Though they are known to fulfil the major need of understanding and sharing experiences, little is known about their actual role in supporting individuals struggling with infertility.

OBJECTIVE

To systematically consolidate and explore the role of online peer support communities for infertile individuals.

DESIGN

This is a systematic mixed-studies review.

METHODS

Eight published and unpublished databases were screened for English studies from inception to October 2022: PubMed, EMBASE, Cochrane, PsycINFO, CINAHL, Scopus and ProQuest. Forty-nine studies were included, and quality was appraised using the Mixed Methods Appraisal Tool. Data-based convergent qualitative (narrative and thematic) synthesis was conducted.

RESULTS

An overarching theme titled: Online peer support, a 'double-edged sword' and four themes were identified: 1) Receiving varied types of support with mutual benefits; 2) convenient and "safe haven" with diverse options for struggling couples; 3) herd mentality and negative collective emotions; and 4) credibility, confidentiality, and misinformation. The online communities were mainly utilised by couples in their late 20s to early 30s and the users were predominantly females. Online communities were mostly on forums and popular social media sites, public and unmoderated. Findings revealed that there were two-way benefits for both providers and receivers of peer support. Online communities were also found to be convenient and "safe haven" with diverse options for struggling couples. Conversely for some couples, online communities led to negative collective emotions and feelings of "unrelatedness" despite being among "similar others". Lastly, some couples raised concerns around the credibility, confidentiality, and misinformation from the online communities.

CONCLUSIONS

Whilst online communities are crucial in the individuals' journey through infertility, they can act as a 'double-edged' sword if not managed by professionals. Healthcare professionals can monitor online communities to improve fertility care for individuals; advice individuals to use online communities with caution, rain peer volunteers and develop expert-moderated peer support online communities.

REGISTRATION NUMBER

PROSPERO [CRD42022291461].

TWEETABLE ABSTRACT

Online peer-to-peer support communities may be a double-edged sword for infertile individuals.

A Year of Child Injury Prevention on Instagram

Injury is the leading cause of death for children but little is known about what types of injury prevention messages are communicated on Instagram. Conducted in the United States, the aim of this study was to better understand child injury prevention messages on Instagram to develop recommendations for the future. Informed by Social Cognitive Theory, a quantitative content analysis was conducted on all Instagram posts from selected organizations from May 2018 through April 2019. Of the 818 injury prevention posts, almost all included an image (575, 70%) or video (211, 26%). Of the 575 images, 245 (42.46%) had in image that did not match the topic of the post. Regarding injury prevention recommendations, 579 posts (71%) provided a clear action that parents should take. For these posts, 115 (20%) had an image that communicated the desired safety recommendation, but many more (285, 50%) did not; in 23 cases it was not clear if there was a match or not. There are missed opportunities for child health and injury organizations to reach parents and caregivers through Instagram. Posts made during the study period often lacked specificity about action-oriented measures and failed to utilize images that demonstrated the recommended practices. Organizations posting on Instagram and other social media platforms should provide clear action tips and utilize images that depict child injury prevention recommendations.