Psychological domain of quality of life, depression and anxiety levels in in vitro fertilization/intracytoplasmic sperm injection cycles of women with endometriosis: a prospective study

Mental health in women undergoing gynecological surgery at risk of infertility

Surgery for benign gynecologic conditions may lead to infertility complications. In a cross-sectional study we investigated depressive and anxiety symptoms, Quality of Life (QoL), and coping strategies in women with benign gynecologic conditions undergoing surgical treatment (G1, N = 45) compared with women that did not need surgery (G2, N = 43), through the Patient's Health Questionnaire, the Short Form Health Survey-12 items, the Self-Rating Anxiety State, and the Brief COPE. Statistical analyses showed that women in G1 had significant higher depressive (p=.04) and anxiety (p=.03) symptoms, and lower QoL (p=.01), than did those in G2. Moreover, women with more depressive or anxiety symptoms in both groups were more likely to present maladaptive coping modalities. A careful evaluation of the mental health of women undergoing gynecological surgery at risk of infertility should be included in the care for benign gynecologic conditions, in order to prevent psychosocial distress and alleviate the burden on QoL.

The impact of music therapy on anxiety and pregnancy rate among infertile women undergoing assisted reproductive technologies: a systematic review and meta-analysis

Objective: We aimed to perform a systematic review and meta-analysis to evaluate the effect of music therapy on anxiety and pregnancy rates among infertile women undergoing to perform assisted reproductive technologies (ART).Methods: Cochrane Library, PubMed, ISI web of science, and Scopus were searched from inception to May 2021. We included randomized controlled trials (RCTs) that compared music therapy (intervention group) to no music intervention (control group). Our primary outcomes were anxiety score using the State-Trait Anxiety Inventory (STAI) tool and pain score utilizing the Visual Analog Scale (VAS). Our secondary outcomes were the overall satisfaction score and clinical pregnancy rate. We extracted the available data from included studies and pooled them in a meta-analysis model using RevMan software. The overall quality of evidence was assessed through GRADEpro GDT software.Results: Seven RCTs with a total number of 793 patients were included in our study. Music therapy significantly reduced the anxiety score compared to control group (MD= -3.09, 95% CI [-5.57, -0.61], p = 0.01). Moreover, pain score was significantly improved after music treatment (MD= -2.93, 95% CI [-3.86, -2.00], p > 0.001). A significant improvement in the overall satisfaction score was found among music therapy group (MD= 1.51, 95% CI [0.40, 2.61], p = 0.008). Although more women in music therapy group experienced an increase in the clinical pregnancy rate in comparison with control group, the result was not statistically significant (RR= 1.08, 95% CI [0.94, 1.26], p = 0.28). The GRADEpro GDT tool showed a moderate quality of evidence for the evaluated outcomes.Conclusions: There is evidence of moderate quality that music therapy improves anxiety, pain, and satisfaction scores among infertile women undergoing ART. Moreover, it increases the clinical pregnancy rate but without statistical significance. More trials with a larger sample size are needed to investigate the influence of music therapy on the clinical outcomes of ART.

Experiences of women undergoing infertility treatment from embryo transfer until pregnancy test and their conceptualization of their embryo

AIM

This study aims to explore women's experiences with embryo transfer (ET) until pregnancy test and their conceptualization of their embryo.

METHOD

The sample of this descriptive phenomenology study consists of 17 women with ET. The data were collected through in-depth interviews. The thematic analysis developed by Braun and Clarke was used for data analysis.

RESULTS

Analysis of the interviews led to the emergence of five themes and 14 sub-themes. The theme "pregnancy in biological terms" has two sub-themes: "considering herself pregnant" and "the first moment with the baby". The theme "not an embryo, my child" has three sub-themes: "world of hope", " unnatural but normal" and "attachment to embryo". The theme "daily life after ET" has three sub-themes: "living life in the usual way", "process of self-listening", and "the negative effects of drugs on the body". The theme "seeking ways to ensure fertility" has four sub-themes: "complete bed rest", "the search for information: the internet", "practice an infertility diet" and "spiritual support with prayer". Finally, the theme "caring after the transfer" has two sub-themes: "need more information" and "unmet women-oriented care".

CONCLUSION

In this study, it was determined that women had intense physical and emotional experiences during the waiting period after ET and their daily lives were affected. It was also understood that the embryo means "baby/child/son/daughter" to them and that they establish a close bond with their embryos. Women's needs are not sufficiently known until post-ET pregnancy testing. Explaining the experiences of women after IVF-ET and the meanings of their embryo will help determine the issues they need in holistic care.

The State of Health and the Quality of Life in Women Suffering from Endometriosis

Quality of life is related to good health, family relations, feeling of self-esteem, and ability to cope with difficult situations. Endometriosis is a chronic condition which affects different areas of life. The lack of satisfaction in everyday life is mainly due to constant pain. The process of adjusting to a life with illness is associated with negative emotions. The aim of the article is to review the current state of knowledge concerning the impact of social and medical factors on a population of women affected by endometriosis. Women with endometriosis have an impaired quality of life compared to the general female population. Psychological consequences of endometriosis include: depression, anxiety, powerlessness, guilt, self-directed violence, and deterioration of interpersonal relations. It may contribute to lower productivity at work and less satisfying intimate life. A multi-disciplinary, evidence-based care is needed. The disease can take away the ability to be physically active, obtain an education, work continuously, and interact with friends. Social support and cognitive-behavioral therapy are extremely important for healing.

Living with endometriosis: a phenomenological study

Purpose: To explore and understand the lived experiences of women with endometriosis. Method: Qualitative study using Cohen phenomenology. Results: The data analysis identified four main themes and two sub-themes. The main themes are: delay in diagnosis, which includes the sub-theme of the misunderstanding of one's state; worsening of one's life, which includes the sub-theme of a painful life; disastrous intimate life with one's partner; and uncertainty about being able to have one's own children. Conclusions: The themes that emerged represent the starting point for further research and for the implementation of specific educational and support strategies that improve self-care, commitment and quality of life for women with endometriosis.