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Tetecher L, Cocchiaro T, Guarino A, Giannini T, Maucione S, Di Trani M, Rago R, Ciocca G. Sexological and traumatic aspects in reproductive difficulties: a psychometric study on couples seeking help for infertility. J Endocrinol Invest 2024; 47:179-189. [PMID: 37311972 DOI: 10.1007/s40618-023-02134-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 06/06/2023] [Indexed: 06/15/2023]
Abstract
PURPOSE To investigate the impact of infertility in gender differences on psycho-traumatological, sexological, relational and emotional aspects and gender differences in couples requiring assisted reproductive treatment. METHODS 151 couples were recruited with a mean age of 36.7 ± 4.8 years for women and 39.8 ± 6.6f or men. 43% of women and 34% of men had already received the diagnosis of infertility. To recruited subjects was administered the following psychometric tests: Sexological and Emotional in Infertility questionnaire (SEIq), Arizona Sexual Experience Scale (ASEX), the Orgasmomether and the International Trauma Questionnaire (ITQ). RESULTS There was a significant difference in traumatic symptoms between men and women (t = 5,859, p < 0.05). Gender differences were found in the sexological dimension of the SEIq (t = 7,858, p < .001) and in the total ASEX score (t = 3,979, p < .001). Specifically, significant correlations emerged between the ASEX domains and the emotional and sexological aspects related to infertility only in women. The reaction to the diagnosis was negatively correlated with the emotional area of the couple (r = -0.683, p < .001) and positively with the couple relationship (r = 0.815, p < .001). Multiple regression revealed that the overall functioning of the couple, rather than the single scales, is the main predictor of sexuality (R2 = 0.77). CONCLUSION A clear impact of infertility on the couple's psycho-traumatological, psycho-sexological and relational aspects emerged. It could be useful to promote targeted support interventions on the most compromised areas of couple functioning in assisted reproductive centers.
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Affiliation(s)
- L Tetecher
- Department of Dynamic and Clinical Psychology, and Health Studies, School of Health Psychology, Sapienza University of Rome, Rome, Italy
| | - T Cocchiaro
- Physiopathology of Reproduction and Andrology Unit, Sandro Pertini Hospital, Rome, Italy
| | - A Guarino
- Physiopathology of Reproduction and Andrology Unit, Sandro Pertini Hospital, Rome, Italy
| | - T Giannini
- Section of Sexual Psychopathology, Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Via Degli Apuli, 1, 00185, Rome, Italy
| | - S Maucione
- Section of Sexual Psychopathology, Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Via Degli Apuli, 1, 00185, Rome, Italy
| | - M Di Trani
- Department of Dynamic and Clinical Psychology, and Health Studies, School of Health Psychology, Sapienza University of Rome, Rome, Italy
| | - R Rago
- Physiopathology of Reproduction and Andrology Unit, Sandro Pertini Hospital, Rome, Italy
| | - G Ciocca
- Section of Sexual Psychopathology, Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Via Degli Apuli, 1, 00185, Rome, Italy.
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Tarín JJ, Pascual E, García-Pérez MA, Monllor-Tormos A, Cano A. Both reduced ovarian reserve and severe semen alterations are overrepresented in couples seeking assisted reproductive technology treatment for the first time: a cross-sectional study. Reprod Health 2023; 20:117. [PMID: 37582738 PMCID: PMC10428570 DOI: 10.1186/s12978-023-01666-0] [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: 03/29/2023] [Accepted: 08/10/2023] [Indexed: 08/17/2023] Open
Abstract
BACKGROUND Once a mate choice decision has been made, couples that fail to reach a live birth in natural and/or intrauterine insemination (IUI) cycles will likely visit fertility clinics seeking assisted reproductive technology (ART) treatment. During the more or less prolonged period of infertility experienced, those couples with mild/moderate reproductive anomalies would have advantage over couples displaying more severe reproductive alterations in achieving a natural or IUI conception. Thus, we can expect to find a progressive increase in the proportion of couples with more severe reproductive anomalies as duration of infertility rises. In this study, we aim to ascertain whether there is an association between male and female infertility diagnoses and duration of infertility in couples seeking ART treatment for the first time. METHODS A cross-sectional analysis of 1383 infertile couples that sought ART treatment for the first time. Forward-stepwise binary logistic regression analyses were applied to calculate exponentiated regression coefficients. RESULTS Men suffering from any combination of oligo-, astheno-, and teratozoospermia (ACOAT) exhibited higher odds of having a duration of infertility > 2 years compared with non-ACOAT men [odds ratio (95% confidence interval): 1.340 (1.030-1.744)]. Women from ACOAT couples displaying a duration of infertility > 2 years presented shorter menstrual cycles (P ≤ 0.047) and lower antral follicular count (AFC) values (P ≤ 0.008) and serum anti-Müllerian hormone (AMH) levels (P ≤ 0.007) than women from non-ACOAT couples exhibiting > 2 years of infertility. Likewise, AFC values (P ≤ 0.013) and serum AMH levels (P ≤ 0.001) were decreased when compared with women from ACOAT couples displaying ≤ 2 years of infertility. A relative low but significant percentage of ACOAT couples displaying > 2 years of infertility stood out for their smoking habits. CONCLUSIONS Couples consisting of ACOAT men and women with a relative low ovarian reserve are overrepresented in couples seeking ART treatment for the first time after experiencing > 2 years of infertility. This outcome leads us to develop a general hypothesis proposing that the origin of couple's infertility is a consequence of a process of positive assortative mating shaped by sexual selection forces.
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Affiliation(s)
- Juan J Tarín
- Department of Cellular Biology, Functional Biology and Physical Anthropology, Faculty of Biological Sciences, University of Valencia, Burjassot, Valencia, Spain.
- Institute of Health Research INCLIVA, Valencia, Spain.
| | - Eva Pascual
- Institute of Health Research INCLIVA, Valencia, Spain
| | - Miguel A García-Pérez
- Institute of Health Research INCLIVA, Valencia, Spain
- Department of Genetics, Faculty of Biological Sciences, University of Valencia, Burjassot, Valencia, Spain
| | | | - Antonio Cano
- Institute of Health Research INCLIVA, Valencia, Spain
- Service of Obstetrics and Gynecology, University Clinic Hospital, Valencia, Spain
- Department of Pediatrics, Obstetrics and Gynecology, Faculty of Medicine, University of Valencia, Valencia, Spain
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Kiani Z, Simbar M, Hajian S, Zayeri F, RashidiFakari F, Chimeh FJ. Investigating different dimensions of infertile women's quality of life: a descriptive cross-sectional study. BMC Public Health 2022; 22:2436. [PMID: 36575427 PMCID: PMC9793385 DOI: 10.1186/s12889-022-14924-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 12/21/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Infertility is a major challenge in the life of women which affects their quality of life. Infertile women's quality of life is a relatively new field of research that has recently been considered by health researchers. However, there has been no standard tool for measuring different aspects of infertile women's quality of life with female factors, and general and specific tools of infertile couples have been used to assess their quality of life. This study, thus, aimed to analyze different aspects of the quality of life of infertile women. METHODS This descriptive cross-sectional study was conducted on 320 infertile women referred to a teaching hospital affiliated with Mazandaran University of Medical Sciences and private infertility treatment centers in Sari, Iran. Demographic and fertility characteristics and the quality of life questionnaire for infertile women questionnaire (a 25-item tool was designed which measured 7 factors of psychological effects, sexual life with infertility family and social effects, infertility-related concerns, physical effects, adaptive approaches and factors preventing infertility adaptation), were recruited for data gathering. Data were analyzed using SPSS version 22. Descriptive statistics (percentage, mean, standard deviation), correlation coefficient, independent sample t-test, and multiple linear regression were used. P-values less than 0.05 were considered statistically significant. RESULTS The total mean score of infertile women's quality of life was 65.68 ± 8.91%. Findings were indicative of infertile women's quality of life in the dimensions of adaptive approach (70.48 ± 15.02%), psychological (67.88 ± 12.06%), family and social (64.63 ± 10.76%), physical, 63.42 ± 11.36%), inhibitory factors/ factors preventing adaptation (60.98 ± 8.24%), related concerns (51.52 ± 10.21%) and sexual life (40.12 ± 14.28%). According to the final multiple linear regression model, women's education (B = 2.57, p < 0.001), spouse's education (B = 1.56, p = 0.046), economic status (B = 1.64, p < 0.001), age of women (B = -0.62, p < 0.001), age of spouse (B = -0.65, p < 0.001), duration of infertility (B = -0.36, p = 0.024) and duration of marriage (B = -0.39, p = 0.022) were the final predictors of the quality of life score in infertile women of the study. CONCLUSION Given that infertility causes extensive changes in individuals, families, and social dimensions of infertile women, it can affect their quality of life. We can take steps to improve the health of infertile women by promoting various dimensions of their quality of life.
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Affiliation(s)
- Zahra Kiani
- grid.411600.2Midwifery and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoumeh Simbar
- grid.411600.2Midwifery and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran ,grid.411600.2Midwifery and Reproductive Health Research Center, Department of Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sepideh Hajian
- grid.411600.2Department of Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farid Zayeri
- grid.411600.2Proteomics Research Center and Department of Biostatistics, Faculty of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzaneh RashidiFakari
- grid.464653.60000 0004 0459 3173Department of Midwifery, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Fatemeh Jalali Chimeh
- grid.411600.2Midwifery and Reproductive Health Research Center, Department of Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Entwistle PA. Nurse Practitioner–Led Retrograde Ejaculation Management Can Help Optimize Integration of Care. J Nurse Pract 2022. [DOI: 10.1016/j.nurpra.2022.07.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Ghorbani S, Abedi P, Hekmat K, Ghanbari S, Dibavand N. Recurrent implantation failure and sexual function in infertile Iranian women: a comparative cross sectional study. Reprod Health 2022; 19:103. [PMID: 35477422 PMCID: PMC9044669 DOI: 10.1186/s12978-022-01409-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 04/08/2022] [Indexed: 11/29/2022] Open
Abstract
Background Recurrent implantation failure (RIF) which means failing to implant after two or more high-quality embryo transfer cycles, affects 3% to 5% of women worldwide. The aim of this study was to assess the relationship between recurrent implantation failure and sexual function in infertile Iranian women. Methods This was a comparative cross-sectional study on 180 infertile Iranian women (90 infertile women with recurrent implantation failure and 90 infertile women who did not start infertility treatment). A demographic questionnaire and the Female Sexual Function Index were used for data collection. Data were analyzed using Chi-square, independent t-test, and multiple linear regression. Results The mean scores of different domains of sexual function (desire, lubrication, arousal, orgasm, pain, and satisfaction) were significantly lower in the group with RIF compared to the group without RIF. The total score of sexual function was significantly lower in the RIF group compared with the group without RIF (23.11 ± 2.24, vs. 25.99 ± 2.35, p < 0.001). The overall sexual function scores in women with RIF were 2.65 units lower than women without RIF (p < 0.001). Conclusion The results of this study showed that women with RIF had significantly lower sexual function than that in women without RIF. Therefore, sexual function issues should be treated as an important component of comprehensive care. This study did not measure the impact of economic factors on sexual function, however, the majority of the sample were classified as having weak or moderate economic status and this, along with the high cost of infertility treatments, could potentially have played a role in the participants' experience. This relationship will need to be investigated in future research. Recurrent implantation failure (RIF) means inability to implant after two or more high-quality embryo transfer cycles. The aim of this study was to assess the relationship between recurrent implantation failure and sexual function in infertile Iranian women. In this study, 180 infertile Iranian women (including 90 infertile women with recurrent implantation failure and 90 infertile women with no implantation failure) were recruited. A demographic questionnaire and the Female Sexual Function Index were used for data collection. The mean scores of different domains of sexual function (desire, lubrication, arousal, orgasm, pain, and satisfaction) were significantly lower in the group with recurrent implantation failure compared to the group without. The overall sexual function scores in the RIF group were 2.65 units lower than those of women without RIF. Women experiencing recurrent implantation failure may be at a particular risk of reduced sexual function. Therefore, sexual function issues should be treated as an important component of comprehensive care.
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Affiliation(s)
- Samira Ghorbani
- Midwifery Department, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Parvin Abedi
- Midwifery Department, Reproductive Health Promotion Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Khadije Hekmat
- Midwifery Department, Reproductive Health Promotion Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. .,Fertility Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences, Golestan BLV, Ahvaz, Iran.
| | - Saeed Ghanbari
- Department of Midwifery, Reproductive Health Promotion Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Narjes Dibavand
- Department of Biostatistics, School of Health, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran
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Luca G, Parrettini S, Sansone A, Calafiore R, Jannini EA. The Inferto-Sex Syndrome (ISS): sexual dysfunction in fertility care setting and assisted reproduction. J Endocrinol Invest 2021; 44:2071-2102. [PMID: 33956331 PMCID: PMC8421318 DOI: 10.1007/s40618-021-01581-w] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 04/19/2021] [Indexed: 12/20/2022]
Abstract
PURPOSE Infertility represents a peculiar social burden affecting more than 15% of couples, provoking it a real threat to the general quality of life and to the sexual health. The medicalization (diagnosis, therapy and follow up) of the lack of fertility is frequently a challenge in term of personal and couple's involvement. In particular, while the Assisted Reproductive Technology (ART) has allowed many infertile couples to achieve pregnancy, the therapeutic process faced by the couple bears a strong psychological stress that can affect the couple's quality of life, relationship and sexuality. Despite infertility affects both female and male sexual health, only recently the interest in the effects of ART on the couple's sexuality has grown, especially for women. METHODS A literature research on the sexual dysfunction in fertility care and particularly in ART setting was performed. RESULTS Literature largely found that intimacy and sexuality appear specifically impaired by intrusiveness of treatments and medical prescriptions. Moreover, there is a close relationship between emotional, psychological and sexual aspects, which can be integrated in the new concept of Inferto-Sex Syndrome (ISS) that can impair the ART treatment outcomes. Evidence demonstrates that the assessment of sexual function is necessary in couples undergoing diagnosis of infertility and ART. CONCLUSION A close relationship between infertility and sexuality, both in the female and male partners, was detected. ART treatments may heavily impact on the couple's psychosexual health. A couple-centred program for the integrated management of psychological and sexual dysfunction should be considered in the context of ART programs.
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Affiliation(s)
- G Luca
- Unit of Andrology and Endocrinology of Reproduction, Department of Experimental Medicine, University Medical School, 06129, Perugia, Italy
| | - S Parrettini
- Section of Endocrinology and Metabolism, Department of Medicine, Perugia, University Medical School, 06129, Perugia, Italy
| | - A Sansone
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier, 1, E Tower South. Floor 4, Room E413, 00133, Rome, Italy
| | - R Calafiore
- Section of Endocrinology and Metabolism, Department of Medicine, Perugia, University Medical School, 06129, Perugia, Italy
| | - E A Jannini
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier, 1, E Tower South. Floor 4, Room E413, 00133, Rome, Italy.
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