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Wang G, Liu X, Zhu S, Lei J. Experience of mental health in women with Polycystic Ovary Syndrome: a descriptive phenomenological study. J Psychosom Obstet Gynaecol 2023; 44:2218987. [PMID: 37267127 DOI: 10.1080/0167482x.2023.2218987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/18/2023] [Accepted: 05/23/2023] [Indexed: 06/04/2023] Open
Abstract
Purpose: This study aims to investigate the experiences, emotional coping strategies, and help-seeking needs of women with PCOS from their perspective, considering common psychological issues such as stress, anxiety, and depression that are prevalent among individuals with PCOS. Materials and Methods: The study recruited 14 women with PCOS for semi-structured interviews between October and November 2022, using a descriptive phenomenology method design. The interviews were analyzed using NVivo 12 software. Results: Four themes and eleven subthemes were derived from the semi-structured interviews: (1) Negative Mental Health Status; (2) Four Patterns of Emotion Regulation; (3) The Psychological Double-Edged Sword: Family Social Network; (4) Strong Demands for Psychological Counseling and Lifestyle Guidance. Conclusion: The study suggests that interventions should focus on fostering internalized self-efficacy and emotional expression, promoting constructive familial support, and providing psychological counseling and lifestyle recommendations to alleviate psychological distress experienced by women with PCOS.
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Affiliation(s)
- Guangpeng Wang
- The Third Xiangya Hospital of Central South University, Changsha, China
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Xueyan Liu
- School of Nursing, Shandong University, Jinan, China
| | - Shujuan Zhu
- The Third Xiangya Hospital of Central South University, Changsha, China
| | - Jun Lei
- The Third Xiangya Hospital of Central South University, Changsha, China
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Mikaeili N, Eyni S, Mousavi SE, Ebadi M. Mediating role of relational aggression in the association between infertility stigma and marital relationship distress in infertile women. Women Health 2023; 63:756-765. [PMID: 37822291 DOI: 10.1080/03630242.2023.2265497] [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: 07/12/2022] [Accepted: 09/24/2023] [Indexed: 10/13/2023]
Abstract
Infertility is a multifaceted problem that can cause significant impairments with emotional, social, and psychological consequences, including problems in the marital relationship. This study aimed to mediate the role of relational aggression in the association between infertility stigma and marital relationship distress in infertile women. The research method was descriptive and path analysis. The statistical population of the study consisted of all infertile women who were referred to infertility centers and obstetrics and gynecology medical centers in Tehran in 2021 (July to October), and due to lack of full access to them, 300 people were selected by available sampling method who participated in the research through an online questionnaire. Data were collected using the Marital Self-Reporting Questionnaire, Infertility Stigma, and Relational Aggression Questionnaire. Data analysis was performed using structural equation modeling. The results showed that the causal model of the relationship between infertility stigma, relational aggression, and marital relationship distress in infertile women was confirmed based on different fitting indices. Infertility stigma and associated aggression directly affect the marital turmoil of infertile women. On the other hand, infertility stigma indirectly affects infertile women's marital distress through relational aggression (P < .05). Therefore, the infertility stigma and relational aggression play an important role in marital distress in infertile women, and targeting these two components in psychological therapies can effectively reduce marital chaos.
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Affiliation(s)
- Niloofar Mikaeili
- Department of Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
| | - Sanaz Eyni
- Department of Psychology, University of Kurdistan, Sanandaj, Iran
| | - Seyede Elham Mousavi
- Department of Educational Science, Psychological Counseling and Guidance Branch, Ataturk University, Erzurum, Turkey
| | - Matine Ebadi
- Department of Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
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Reisi M, Kazemi A, Abedi MR, Nazarian N. Spouse's coping strategies mediate the relationship between women's coping strategies and their psychological health among infertile couples. Sci Rep 2023; 13:10675. [PMID: 37393323 PMCID: PMC10314934 DOI: 10.1038/s41598-023-37380-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 06/21/2023] [Indexed: 07/03/2023] Open
Abstract
Social problems and suffering from the treatment process for infertile couples, especially for women, require the couples to cope with them to balance the infertility crisis. According to the close interactions of the couples with each other, the objective of the present study was to explore a theoretical framework for the relationships between women's coping strategies, spouses' coping strategies, and women's psychological health in infertile couples who were candidates for assisted reproductive technology (ART). This cross-sectional study was carried out on 212 couples undergoing ART. The couples' coping strategies were evaluated using a validated self-report questionnaire. The women's psychological health was assessed using a 21-item stress, anxiety, and depression scale (DASS-21). Statistical analysis was performed using the plug-in application PROCESS macro for SPSS. The direct effect of the women's self-blame and self-focused rumination strategies (p < .0001), and the indirect effect of the women's self-blame on stress and depression by mediating spouses' self-blame and self-focused rumination strategies, was significant. The indirect effect of the women's self-focused rumination on the anxiety and depression levels by mediating spouses' self-blame strategy was significant. The women's self-blame and self-focused rumination strategies had a negative effect on the women's psychological health who were undergoing ART. This negative effect was mediated by the spouse's coping strategies.
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Affiliation(s)
- Marzie Reisi
- School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ashraf Kazemi
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Hezarjerib AV., Isfahan, Iran.
| | - Mohammad Reza Abedi
- Counseling Department, School of Psychology and Education Sciences, University of Isfahan, Isfahan, Iran
| | - Naser Nazarian
- Social Sciences Department, University of Isfahan, Isfahan, Iran
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Kuug AK, James S, Sihaam JB. Exploring the cultural perspectives and implications of infertility among couples in the Talensi and Nabdam Districts of the upper east region of Ghana. Contracept Reprod Med 2023; 8:28. [PMID: 37076914 PMCID: PMC10114423 DOI: 10.1186/s40834-023-00225-z] [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: 01/23/2023] [Accepted: 03/31/2023] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND Infertility remains a major clinical and social problem, affecting approximately one in every 10 couples. It is a reproductive health condition that is silently experienced with deep repercussions in the essence of self. In Ghana childbearing is considered a social prestige, where the couples are unduly pressurized to bear children for purposes of genealogical continuity. PURPOSE This study explored the cultural perspectives and implications among males and females experiencing infertility in the Talensi and Nabdam districts of the Upper East Region of Ghana. METHODS This study used an ethnographic design to explore the perspectives of couples on socio-cultural beliefs about infertility on 15 participants made up of 8 male and 7 female couple units. Participants were selected using a purposive sampling technique while semi-structured interviews were used to explore the cultural implications on male and female couple units. The data were analysed using Tesch's method of analysing qualitative data. RESULTS Two broad themes and five subthemes emerged from the data analysis regarding the cultural implications of infertility. The major themes and subthemes include: (1) Varying cultural perceptions of infertility (Cultural beliefs and perceptions regarding causes of infertility, cultural consequences of infertility and traditional remedies for infertility), and (2) family dynamics stemming from infertility (abuse from family members, and parenthood as a standard for family inheritance). CONCLUSIONS This study adduces evidence of the cultural implications of infertility in rural Ghana. Considering the cultural inclination of most Ghanaian communities, especially the current study setting, it is imperative that policymakers and public health practitioners should consider fertility interventions that are culturally sensitive. Also, culturally sensitive intervention programs that are targeted at increasing the awareness of the rural population on fertility and its treatment should be considered.
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Affiliation(s)
- Anthony Kolsabilik Kuug
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana.
| | - Sindiwe James
- Department of Nursing Science, Nelson Mandela University, Port Elizabeth, P O Box X77000, Gqeberha, 6013, South Africa
| | - Jardien-Baboo Sihaam
- Department of Nursing Science, Nelson Mandela University, Port Elizabeth, P O Box X77000, Gqeberha, 6013, South Africa
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Rolfes V, Bittner U, Gerhards H, Krüssel JS, Fehm T, Ranisch R, Fangerau H. Artificial Intelligence in Reproductive Medicine - An Ethical Perspective. Geburtshilfe Frauenheilkd 2023; 83:106-115. [PMID: 36643877 PMCID: PMC9833891 DOI: 10.1055/a-1866-2792] [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: 12/23/2021] [Accepted: 05/29/2022] [Indexed: 01/13/2023] Open
Abstract
Artificial intelligence is steadily being integrated into all areas of medicine. In reproductive medicine, artificial intelligence methods can be utilized to improve the selection and prediction of sperm cells, oocytes, and embryos and to generate better predictive models for in vitro fertilization. The use of artificial intelligence in this field is justified by the suffering of persons or couples who wish to have children but are unable to conceive. However, research into the use of artificial intelligence in reproductive medicine is still in the early experimental stage and furthermore raises complex normative questions. There are ethical research challenges because evidence of the efficacy of certain pertinent systems is often lacking and because of the increased difficulty of ensuring informed consent on the part of the affected persons. Other ethically relevant issues include the potential risks for offspring and the difficulty of providing sufficient information. The opportunity to fulfill the desire to have children affects the welfare of patients and their reproductive autonomy. Ultimately, ensuring more accurate predictions and allowing physicians to devote more time to their patients will have a positive effect. Nevertheless, clinicians must be able to process patient data conscientiously. When using artificial intelligence, numerous actors are involved in making the diagnosis and deciding on the appropriate therapy, raising questions about who is ultimately responsible when mistakes occur. Questions of fairness arise with regard to resource allocation and cost reimbursement. Thus, before implementing artificial intelligence in clinical practice, it is necessary to critically examine the quantity and quality of the data used and to address issues of transparency. In the medium and long term, it would be necessary to confront the undesirable impact and social dynamics that may accompany the use of artificial intelligence in reproductive medicine.
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Affiliation(s)
- Vasilija Rolfes
- 9170Institut für Geschichte, Theorie und Ethik der Medizin, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany,Korrespondenzadresse Vasilija Rolfes 9170Institut für Geschichte, Theorie und Ethik der Medizin, Medizinische Fakultät,
Heinrich-Heine-Universität DüsseldorfMoorenstraße 540225
DüsseldorfGermany
| | - Uta Bittner
- 9170Institut für Geschichte, Theorie und Ethik der Medizin, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany,84614Institut für Sozialforschung und Technikfolgenabschätzung, Ostbayerische Technische Hochschule Regensburg, Regensburg, Germany
| | - Helene Gerhards
- 84614Institut für Sozialforschung und Technikfolgenabschätzung, Ostbayerische Technische Hochschule Regensburg, Regensburg, Germany
| | - Jan-Steffen Krüssel
- Klinik für Frauenheilkunde und Geburtshilfe, Universitäres interdisziplinäres Kinderwunschzentrum Düsseldorf, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf,
Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Tanja Fehm
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Düsseldorf, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany
| | - Robert Ranisch
- Juniorprofessur für Medizinische Ethik mit Schwerpunkt auf Digitalisierung, Universität Potsdam, Fakultät für Gesundheitswissenschaften Brandenburg, Potsdam, Germany,Forschungsstelle „Ethik der Genom-Editierung“, Institut für Ethik und Geschichte der Medizin, Eberhard-Karls-Universität Tübingen Medizinische Fakultät, Tübingen,
Germany
| | - Heiner Fangerau
- 9170Institut für Geschichte, Theorie und Ethik der Medizin, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany
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Xie Y, Ren Y, Niu C, Zheng Y, Yu P, Li L. The impact of stigma on mental health and quality of life of infertile women: A systematic review. Front Psychol 2023; 13:1093459. [PMID: 36698573 PMCID: PMC9869765 DOI: 10.3389/fpsyg.2022.1093459] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 11/30/2022] [Indexed: 01/11/2023] Open
Abstract
Introduction The stigma of not giving birth to children affects approximately 53. 08~64% of female infertility patients worldwide. This stigma not only causes harm to the mental health of these infertility patients, but also affects their quality of life, making them bear the adverse social consequences such as domestic violence, marriage breakdown, or even delay in receiving the treatment. Therefore, it is crucial to have a deep understanding of the patients' stigma and effective intervention in alleviating it. Aims/Question This study aims to discuss and summarize the stigma in infertile women and its impact on patients, and to provide a theoretical basis for the clinical treatment and nursing intervention of disease stigma in infertile female patients. Methods The literature search used four English databases (Cochrane Library, EMBASE, Web of Science, and PubMed) and two Chinese databases (CNKI and Wanfang). The search time of the literature ranges from the establishment of the library to 2022, with no language restriction. Results The review included 28 studies, with 20 cross-sectional studies and 8 qualitative studies. This study found that social support, living environment, education level, occupation, and fertility awareness were the major influencing factors of infertility stigma. Conclusions Infertility stigma can bring heavy mental pressure and psychological burden to female infertility patients and affect their quality of life. Therefore, effective and targeted psychological interventions should be developed to reduce the patients' stigma and improve their quality of life. Implications for practice Healthcare workers must develop targeted nursing interventions, provide professional counseling services to reduce the level of stigma in female infertility patients, alleviate fertility stress, and improve their quality of life.
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Affiliation(s)
- Yue Xie
- School of Nursing and Public Health, Yangzhou University, Yangzhou, China
| | - Yue Ren
- School of Nursing and Public Health, Yangzhou University, Yangzhou, China
| | - Changmin Niu
- School of Nursing and Public Health, Yangzhou University, Yangzhou, China
| | - Ying Zheng
- School of Nursing and Public Health, Yangzhou University, Yangzhou, China
| | - Ping Yu
- Affiliated Hospital of Yangzhou University, Yangzhou, China
| | - Lin Li
- Affiliated Hospital of Yangzhou University, Yangzhou, China
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Leeners B, Tschudin S, Wischmann T, Kalaitzopoulos DR. Sexual dysfunction and disorders as a consequence of infertility: a systematic review and meta-analysis. Hum Reprod Update 2023; 29:95-125. [PMID: 35900268 DOI: 10.1093/humupd/dmac030] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 04/06/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Sexuality has a key impact on quality of life and on reproductive health. Infertility often results in sexual dysfunction. Despite this close association, addressing sexuality is not a standard component of infertility counselling, especially since in most countries sexual medicine is not a core element of specialist training. Even today, many doctors and patients consider discussing sexuality to be more challenging than other aspects of reproductive medicine. The present review addresses the complex consequences of infertility on sexuality. OBJECTIVE AND RATIONALE Our goals were: (i) to identify the prevalence of sexual problems resulting from infertility, (ii) to evaluate characteristics of sexual difficulties and disorders resulting from infertility and (iii) to analyse factors involved in the complex association between sexual problems and infertility. SEARCH METHODS A systematic search for publications containing keywords related to sexual disorders and infertility was performed via PubMed, Web of Science and Psyndex. A total of 170 manuscripts published between January 1966 and April 2021 were identified after verification of inclusion and exclusion criteria. The reference lists in these manuscripts were searched for further relevant literature. Studies were reviewed for quality-related methodological details. OUTCOMES Couples diagnosed with infertility have an increased risk of sexual disorders. Loss of sexual desire and erectile dysfunction are among the most frequent sexual disorders resulting from infertility. Currently available literature reflects only fragmentarily the complexity of the diverse interactions. Sexuality plays out against the backdrop of interactions among personal, cultural, infertility-related and sexuality-related factors. Considering this complexity, it is crucial to evaluate individual profiles as well as partnership interactions to avoid a negative impact of infertility on a couple's sexual life. WIDER IMPLICATIONS Identifying sexual disorders as relevant considerations in the context of infertility and exploring their impact during the entire course of diagnosis and treatment constitute an important contribution to comprehensively care for the couples concerned. Counselling should focus on preventing the onset and aggravation of sexual disorders. As sexuality represents a major component of quality of life and of partnership, such support may improve not only the current overall wellbeing but also the chances of a satisfactory long-term partnership and family life.
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Affiliation(s)
- Brigitte Leeners
- Department of Reproductive Endocrinology, University Hospital Zurich, Zurich, Switzerland
| | - Sibil Tschudin
- Division of Social Medicine and Psychosomatics, University Hospital Basel, Basel, Switzerland
| | - Tewes Wischmann
- Institute for Medical Psychology, University Hospital Heidelberg, Heidelberg, Germany
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Taebi M, Kariman N, Montazeri A, Alavi Majd H, jahangirifar M. Development and psychometric properties of Female Infertility Stigma Instrument (ISI-F): A sequential mixed method study. BMC Womens Health 2022; 22:557. [PMID: 36581923 PMCID: PMC9801592 DOI: 10.1186/s12905-022-02139-5] [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: 07/31/2022] [Accepted: 12/20/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Infertility stigma is a hidden burden that overshadows the dimensions of reproductive and sexual health in infertile women. The aim of this study was to develop and evaluate the psychometric properties of the Female Infertility Stigma Instrument (ISI-F). METHODS This mixed method study with sequential exploratory design was conducted in qualitative and quantitative phases. In the first phase, the initial item pool of the Female Infertility Stigma Instrument (ISI-F) was generated using in-depth interviews. In the quantitative phase, psychometric properties of the ISI-f including content, face and construct validity, as well as reliability (internal consistency and stability) were assessed. Exploratory factor analysis was performed on the collected data from 300 infertile women for evaluation of construct validity. Data was analyzed using SPSS version 20. This study has followed the Mixed Methods Article Reporting Standards checklist. RESULTS The final version of ISI-F had 20 items. Total CVI and CVR were 0.94 and 0.87, respectively. Explanatory factor analysis identified 3 main factors that explained 54.013% of the variance. These factors consisted of stigma profile (7 items), self-stigma (6 items) and escaping from stigma (7 items). Internal consistency and stability of the ISI-F has been approved by Cronbach's alpha, McDonald's Omega (0.909, 0.916) and Intraclass Correlation Coefficient (ICC = 0.878). CONCLUSION The Female Infertility Stigma Instrument (ISI-F) is a valid and reliable tool for evaluation of the perceived female infertility stigma, that was developed in this study.
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Affiliation(s)
- Mahboube Taebi
- grid.411036.10000 0001 1498 685XReproductive Sciences and Sexual Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nourossadat Kariman
- grid.411600.2Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, Shahid Beheshti University of Medical Sciences, P.O. Box 1996835119, Tehran, Iran
| | - Ali Montazeri
- grid.417689.5Health Metrics Research Centre, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
| | - Hamid Alavi Majd
- grid.411600.2Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam jahangirifar
- grid.1002.30000 0004 1936 7857Faculty of Medicine, Nursing and Health Sciences, School of Nursing and Midwifery, Monash University, Melbourne, Australia
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Kim M, Ban M. [The Reliability and Validity of Korean Version of the Infertility Stigma Scale (K-ISS)]. J Korean Acad Nurs 2022; 52:582-597. [PMID: 36620956 DOI: 10.4040/jkan.22068] [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: 07/07/2022] [Revised: 10/31/2022] [Accepted: 11/14/2022] [Indexed: 01/04/2023]
Abstract
PURPOSE This study aimed to translate the Infertility Stigma Scale (ISS) into Korean and to evaluate its reliability and validity in the Korean context. METHODS Data were collected from 350 women who underwent in vitro fertilization (IVF). Data were analyzed using SPSS WIN 25.0 and AMOS 22.0. Content validity was analyzed using the item-level content validity index (I-CVI) and scale-level content validity index/averaging (S-CVI/Ave). The preliminary survey was conducted on 20 women who had experienced IVF at least once to check the level of understanding of the tool and the time required to fill out the questionnaire. Exploratory and confirmatory factor analyses were used to test construct validity. Additionally, hypothesis-testing construct validity were tested. Cronbach's α was used to assess the reliability. RESULTS The Korean-ISS (K-ISS) consists of 25 items, excluding two items from the original ISS questionnaire. Exploratory factor analysis identified four factors, which explained 75.6% of the total variance. The four distinct factors were infertility stigma with self-devaluation (56.8%), public stigma (8.1%), social withdrawal (6.5%), and family stigma (4.2%). In the confirmatory factor analysis, the 25 items in the four-factor structure were validated (χ²/df ≤ 3, RMSEA ≤ 10). The hypothesis-testing construct validity of K-ISS against FPI (r = .58~.71, p < .001) and FQI (r = -.49~-.65, p < .001) was tested and found to be significant. The internal consistency reliability of the K-ISS, assessed using Cronbach's α, was .97. CONCLUSION The K-ISS has satisfactory construct validity and reliability; therefore, it can help minimize the negative impact of stigma by measuring the stigma associated with women experiencing infertility.
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Affiliation(s)
- Miok Kim
- Department of Nursing, College of Nursing, Dankook University, Cheonan, Korea
| | - Minkyung Ban
- Department of Nursing, Dongju College, Busan, Korea.
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Associations between Stigma, Cognitive Appraisals, Coping Strategies and Stress Responses among Japanese Women Undergoing Infertility Treatment. Healthcare (Basel) 2022; 10:healthcare10101907. [PMID: 36292354 PMCID: PMC9601508 DOI: 10.3390/healthcare10101907] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/22/2022] [Accepted: 09/27/2022] [Indexed: 11/20/2022] Open
Abstract
The number of infertility treatment cycles in Japan is the highest worldwide. Studies have shown that stigma is a predictor of stress-related symptoms including anxiety and depression in women undergoing infertility treatment. Stress management to prevent stress-related symptoms may be crucial; however, few studies have examined the model of stigma and stress responses. Based on the stress-coping model, we hypothesized that stigma threatens the identity of such women and that coping failure increases stress responses. We aimed to explore the role of cognitive appraisals and coping strategies as mediators of the association between the stigma of infertility and stress responses. In December 2021, we conducted a cross-sectional study in Japan, in which 254 women undergoing infertility treatment completed a web-based survey. Hierarchical multiple regression analysis was conducted to analyze the associations between stigma, cognitive appraisals, coping strategies, and stress responses. The results showed that explanatory power increased with each additional variable in the following order: stigma, cognitive appraisals, and coping. Participants with a high level of stigma evaluated it as threatening, and used self-blame and venting coping strategies, and showed higher stress responses. Conversely, participants who used positive reframing coping strategies exhibited lower stress responses. Based on this, effective strategies to address stigma and stress responses are necessitated.
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Yokota R, Okuhara T, Okada H, Goto E, Sakakibara K, Kiuchi T. Association between Stigma and Anxiety, Depression, and Psychological Distress among Japanese Women Undergoing Infertility Treatment. Healthcare (Basel) 2022; 10:healthcare10071300. [PMID: 35885826 PMCID: PMC9325025 DOI: 10.3390/healthcare10071300] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/11/2022] [Accepted: 07/12/2022] [Indexed: 01/05/2023] Open
Abstract
Japan has the highest number of cases of infertility treatment in the world. Studies have indicated that women undergoing infertility treatment feel stigmatized and suffer from psychological symptoms such as anxiety and depression. However, in Japan, few studies have quantitatively examined the association between the stigma of infertility and psychological symptoms, and, to our knowledge, no study has examined its association using a scale with tested reliability and validity. This study aims to quantitatively examine the relationship between infertility stigma and anxiety, depression, and psychological distress among women undergoing infertility treatment, using a scale that has been validated for reliability and validity. The cross-sectional study was conducted in December 2021 through a web-based survey of 254 participants undergoing infertility treatment. A multiple regression analysis was performed to examine the relationship between stigma and anxiety, depression, and psychological distress. Stigma was a statistically significant predictor of anxiety, depression, and psychological distress (standardized β = 0.58, p < 0.001; β = 0.50, p < 0.001; β = 0.62, p < 0.001, respectively) after controlling for sociodemographic and infertility characteristics. Future studies should examine the causal relationship between stigma and anxiety, depression, and psychological distress and how to intervene to reduce stigma among women undergoing infertility treatment.
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Affiliation(s)
- Rie Yokota
- Department of Health Communication, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
- Correspondence: ; Tel.: +81-3-5800-6549
| | - Tsuyoshi Okuhara
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo 113-8655, Japan; (T.O.); (H.O.); (E.G.); (T.K.)
| | - Hiroko Okada
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo 113-8655, Japan; (T.O.); (H.O.); (E.G.); (T.K.)
| | - Eiko Goto
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo 113-8655, Japan; (T.O.); (H.O.); (E.G.); (T.K.)
| | - Keiko Sakakibara
- Department of Social Psychology, Faculty of Sociology, Toyo University, Tokyo 112-8606, Japan;
| | - Takahiro Kiuchi
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo 113-8655, Japan; (T.O.); (H.O.); (E.G.); (T.K.)
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Jing X, Gu W, Xu X, Yan C, Jiao P, Zhang L, Li X, Wang X, Wang W. Stigma predicting fertility quality of life among Chinese infertile women undergoing in vitro fertilization-embryo transfer. J Psychosom Obstet Gynaecol 2022; 43:35-41. [PMID: 32633181 DOI: 10.1080/0167482x.2020.1778665] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE To investigate stigma and fertility quality of life (FertiQoL) and identify predictors of FertiQoL in Chinese infertile women undergoing in vitro fertilization-embryo transfer (IVF-ET). METHODS A descriptive correlational design was adopted to investigate the association between stigma and FertiQoL in 588 infertile women undergoing IVF-ET. The personal information questionnaire, Infertility Stigma Scale (ISS) and FertiQoL tool were used to measure study variables. RESULTS The mean scores of ISS and FertiQoL were 62.59 (SD = 21.58) and 63.64 (SD = 13.72), respectively. There were significant differences of ISS scores among participants with different educational level, residence, occupation, religious belief, financial condition, age group, duration of infertility and infertility treatment, while significant differences of the FertiQoL scores were found in participants with different insurance status, determinism of etiology, infertile type, duration of infertility treatment and cycles of IVF-ET. Pearson's correlation analysis showed stigma was negatively correlated with FertiQoL (r = -0.081 to -0.669, p < .05). The self-devaluation (β = -0.290, p < .001), social withdrawal (β = -0.237, p < .001), family stigma (β = -0.217, p < .001) and insurance status (β = 0.066, p=.035) were identified as the significant predictor of FertiQoL accounting for 43.5% of variance. CONCLUSIONS The stigma was significantly associated with FertiQoL in infertile women undergoing IVF-ET with higher level of stigma predicting poorer FertiQoL. More psychological support should be provided to infertile women to reduce stigma and improve FertiQoL.
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Affiliation(s)
- Xiaoyu Jing
- School of Nursing, Xi'an Jiaotong University, Xi'an, PR China
| | - Wei Gu
- School of Nursing, Xi'an Jiaotong University, Xi'an, PR China
| | - Xiuli Xu
- Northwest Women's and Children's Hospital, Xi'an, PR China
| | | | - Peijuan Jiao
- School of Nursing, Xi'an Jiaotong University, Xi'an, PR China
| | - Lu Zhang
- School of Nursing, Xi'an Jiaotong University, Xi'an, PR China
| | - Xiaomei Li
- School of Nursing, Xi'an Jiaotong University, Xi'an, PR China
| | - Xiaoqin Wang
- School of Nursing, Xi'an Jiaotong University, Xi'an, PR China
| | - Wenru Wang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Nisbet M, O'Connor R, Mason A, Hunter E. A qualitative study utilizing Interpretative phenomenological analysis to explore disclosure in adolescents with turner syndrome. Br J Health Psychol 2022; 27:990-1010. [PMID: 35156277 PMCID: PMC9545481 DOI: 10.1111/bjhp.12586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 12/10/2021] [Accepted: 01/25/2022] [Indexed: 12/02/2022]
Abstract
Objectives To explore the experiences of diagnostic disclosure and disclosure to others in adolescents with Turner syndrome (TS) and their parents/guardians. In addition, we sought to examine the impact of TS on girls with TS and their family’s lives. Design A qualitative method utilizing interpretative phenomenological analysis (IPA) was employed. Methods Five girls with TS and one parent/guardian of each girl completed dyadic and individual semi‐structured interviews. Interviews were audio recorded and analysed verbatim. Data were analysed in accordance with IPA guidelines, with a focus on the dynamic interactions within dyads. Results Analyses identified three superordinate themes across the 10 participant accounts: communication and support, stigmatization of TS, and psychological consequences. Ten related subthemes are described alongside relevant quotations, highlighting a gradual process of diagnostic disclosure within families and wider health care systems. Both girls and their parents appeared to express a general desire to conceal TS from others, indicating possible TS‐related stigma. The results also demonstrate the varying impact TS can have within families. Conclusions The findings provide insight into the lived experience of receiving a diagnosis of TS and the possible difficulties around disclosure to others. Potential recommendations for clinicians and parents include ensuring direct conversations about infertility occur within treatment and facilitating open, honest communication.
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Affiliation(s)
- Mhairi Nisbet
- Mental Health & Wellbeing, Academic Centre, Gartnavel Royal Hospital, University of Glasgow, Glasgow, UK
| | - Rory O'Connor
- Mental Health & Wellbeing, Academic Centre, Gartnavel Royal Hospital, University of Glasgow, Glasgow, UK
| | - Avril Mason
- Mental Health & Wellbeing, Academic Centre, Gartnavel Royal Hospital, University of Glasgow, Glasgow, UK
| | - Elizabeth Hunter
- Mental Health & Wellbeing, Academic Centre, Gartnavel Royal Hospital, University of Glasgow, Glasgow, UK
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Darolia S, Ghosh D. Importance of Personality Factors in Determining the Psychological Consequences of Infertility: A Systematic Review. HEALTH EDUCATION & BEHAVIOR 2021; 49:708-723. [PMID: 34814759 DOI: 10.1177/10901981211057109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND PURPOSE The diagnosis of infertility not only involves biological but the psychosocial links have also been established. Individual difference variables, such as personality and temperament have been found playing prominent role in modifying the psychological and biological aspects of infertility. This systematic review aimed to examine evidence-based research on the role of personality traits in determining vulnerability to stress in infertility, understand the gender-based differences, and deliver suggestions for future researches. METHOD The search for studies relating to the variables was accomplished using various electronic databases. The search was kept limited to a time span of about 20 years, that is, from January 2000 to April 2020. Additional researches were collected from library source and others were retrieved by contacting experts. Studies were selected on the basis of a predetermined inclusion and exclusion criteria, and quality of the studies was also taken into account. RESULTS The search of studies through above methods was fruitful in identifying 23 studies including six longitudinal and prospective studies, and 17 cross-sectional studies covering both individual- and model-based personality attributes related findings. The overall quality ratings of the studies ranged from fair to good. CONCLUSION The review revealed that personality factors such as neuroticism, harm avoidance, and psychoticism are the potential risk factors, whereas optimism has a protective impact in the context of fertility disorders. The long-term impact of personality on infertility needs further exploration. Trait modification interventions during the treatment of infertility were also suggested in the light of previous findings.
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Affiliation(s)
| | - Debasruti Ghosh
- Babasaheb Bhimrao Ambedkar Bihar University, Muzaffarpur, Bihar, India
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15
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Jing X, Gu W, Zhang L, Miao R, Xu X, Wang M, Ramachandran HJ, Wang W. Coping strategies mediate the association between stigma and fertility quality of life in infertile women undergoing in vitro fertilization-embryo transfer. BMC WOMENS HEALTH 2021; 21:386. [PMID: 34727911 PMCID: PMC8561985 DOI: 10.1186/s12905-021-01525-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 10/25/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND The mediating role of coping strategies and its relationship with psychological well-being and quality of life has been considered in the literature. However, there is little research to explore the mechanism of coping strategies on stigma and fertility quality of life (FertiQoL) in infertile women undergoing In Vitro Fertilization Embryo Transfer (IVF-ET). The aim of this study was to examine the mediating effect of coping strategies on the relationship between stigma and fertility quality of life (FertiQoL) in Chinese infertile women undergoing In Vitro Fertilization Embryo Transfer (IVF-ET). METHODS In this cross-sectional study, a total of 768 infertile women undergoing IVF-ET were recruited from Assisted Reproductive Center of Shaanxi Province, China. The personal information, infertility stigma scale, coping strategy scale and FertiQoL scale were measured using a set of questionnaires. The multiple mediator model was performed using AMOS 21.0. RESULTS The model showed a significant negative direct effect between stigma on FertiQoL. There were significantly negative indirect effects of stigma on FertiQoL through active-avoidance, active-confronting and passive-avoidance, respectively. The meaning-based coping played a positive intermediary role. The model explained 69.4% of the variance in FertiQoL. CONCLUSION Active-avoidance coping strategy is the most important mediator factor between stigma and FertiQoL in infertile women undergoing IVF-ET treatment. Meaning-based coping strategy plays a positive mediating role between stigma and FertiQoL.
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Affiliation(s)
- Xiaoyu Jing
- Northwest Women's and Children's Hospital, No. 73 Houzaimen, Xi'an, 710003, Shaanxi, China
| | - Wei Gu
- School of Nursing, Xi'an Jiaotong University Health Science Centre, No. 76 Yantaxi Road, Xi'an, 710061, Shaanxi, China.
| | - Lu Zhang
- School of Nursing, Xi'an Jiaotong University Health Science Centre, No. 76 Yantaxi Road, Xi'an, 710061, Shaanxi, China
| | - Runna Miao
- School of Nursing, Xi'an Jiaotong University Health Science Centre, No. 76 Yantaxi Road, Xi'an, 710061, Shaanxi, China
| | - Xiuli Xu
- Northwest Women's and Children's Hospital, No. 73 Houzaimen, Xi'an, 710003, Shaanxi, China
| | - Min Wang
- Northwest Women's and Children's Hospital, No. 73 Houzaimen, Xi'an, 710003, Shaanxi, China
| | - Hadassah Joann Ramachandran
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Block MD11, level 2 10 Medical Drive, Singapore, 117597, Singapore
| | - Wenru Wang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Block MD11, level 2 10 Medical Drive, Singapore, 117597, Singapore
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Vioreanu AM. Psychological Impact of Infertility. Directions for the Development of Interventions. Ment Health (Lond) 2021. [DOI: 10.32437/mhgcj.v4i1.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction: Infertility represents a major health problem that oftentimes is experienced as a crisis situation. Because it interposes with achieving an important life goal, that of having children, its implications on the psycho-emotional level are robust.
Purpose: The present article aimed at exploring the multidimensional effects of infertility on mental health, as well as suitable psychological intervention strategies for patients both at an individual and couple level.
Methodology: An extensive literature review was conducted to select the most relevant information. Articles included were searched in PubMed, Google Scholar and other similar databases within a seven years interval (2014-2021) to assure the up-to-date quality of the paper. The main criteria of inclusion were: studies about the consequences of infertility on mental health, epidemiology, risk and protective factors, psychological models for infertility, psychological evaluation, established instruments, psycho-social and therapeutic interventions, intervention protocols used in public health for infertility patients.
Results and Discussion: Infertility is often experienced as a crisis situation, in which the most common consequences are visible at the level of mood disorders (e.g. anxiety, depression, marked distress) and at the social level (stigma, divorce, social isolation, financial difficulties). Psychological counseling is needed throughout medical treatment and therapeutic interventions (e.g. cognitive-behavioral therapy) have shown favorable results in managing the emotional balance of the individual/couple and reducing the risk of psychopathology.
Conclusions: Research highlights the beneficial effects of psychological interventions on reducing levels of stress related to infertility, anxiety and depressive symptoms and on improving the quality of life and couple dynamics
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The relationship between psychological coping and mood across the menstrual cycle among distressed women struggling to conceive. J Psychosom Res 2021; 145:110465. [PMID: 33820644 DOI: 10.1016/j.jpsychores.2021.110465] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 03/21/2021] [Accepted: 03/23/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Infertility is disproportionately associated with distress in women yet there has been limited research focusing on the relationship between coping strategies and fertility-monitoring techniques on distress in women struggling to conceive naturally. METHODS Fifty-eight distressed women with infertility were recruited via social media. Every second day women's depressive and anxious mood was assessed in the morning and again in the evening along with their psychological coping strategies, the use of fertility monitoring techniques, and Fertility Quality of Life emotion subscale, over the course of one full menstrual cycle. RESULTS During menstruation and statistically adjusting for morning depressive mood, active coping (β(SE) = -1.35 (0.36), p < .001) and behavioural engagement (β(SE) = -0.98 (0.35), p = .006) were associated with less depressive mood in the evening. Across all phases, social support seeking was associated with greater anxiety (β(SE) = 0.50 (0.20), p = .013) and lower emotional quality of life (β(SE) = -0.82 (0.32), p = .011). Use of fertility monitoring techniques was associated with heightened anxiety (M(SE) = 6.7 (0.2) vs. 5.9 (0.2), p < .001). The use of avoidance strategies (β(SE) = 3.22 (1.29), p = .016), endorsement of optimism (β(SE) = -4.72 (1.78), p = .011) and social support seeking (β(SE) = 3.09 (1.18), p = .012) throughout the cycle were significantly predictive of depression ratings following a negative pregnancy test, despite statistically adjusting for mean depression ratings throughout the menstrual cycle. CONCLUSION These findings highlight a number of cognitive and behavioural strategies that could be manipulated via psychological interventions to improve distress among women struggling to conceive.
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Zhang X, Mo Y, Yan C, Li Y, Li H. Psychometric properties of two abbreviated Connor-Davidson Resilience scales in Chinese infertile couples. Qual Life Res 2021; 30:2405-2414. [PMID: 33811628 DOI: 10.1007/s11136-021-02820-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2021] [Indexed: 12/17/2022]
Abstract
PURPOSE This study aimed to evaluate the psychometric properties of the 10-item and 2-item Connor-Davidson Resilience Scale (CD-RISC), the agreement between these two versions, and the measurement invariance of the CD-RISC-10 across genders in Chinese infertile couples. METHODS A total of 170 infertile couples were enrolled from an infertility outpatient clinic between September 2019 and January 2020. The CD-RISC scores were tested for floor and ceiling effects. Reliability was evaluated by calculating Cronbach's α. Convergent and divergent validity were assessed by bivariate correlations between resilience and infertility-related stress, depression, anxiety, and two divergent variables. Agreement between the two versions was evaluated using the intraclass correlation coefficient (ICC) and Bland-Altman analysis. A multiple-group confirmatory factor analysis (CFA) was conducted to assess the measurement equivalence of CD-RISC-10 across genders. RESULTS No floor or ceiling effects were observed. Internal consistencies of CD-RISC-10 and CD-RISC-2 were 0.91 and 0.63, respectively. The CFA analysis indicated an excellent model fit for a one-factor structure of CD-RISC-10 (TLI > 0.950, CFI > 0.950, RMSEA < 0.060). Both scales displayed good convergent and divergent validity, and the agreement between them was significant with an ICC of 0.80 (95% CI ranging from 0.76 to 0.84). Measurement invariance across genders was supported by multigroup CFA, and a higher level of resilience was found in men than in women. CONCLUSION Our findings showed significant reliability, validity, and stability of CD-RISC-10 and acceptable internal consistency and validity of CD-RISC-2. CD-RISC-10 is recommended as a resilience measure in clinical evaluations of infertile patients.
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Affiliation(s)
- Xuekun Zhang
- School of Nursing, Medical College, Soochow University, Suzhou, China
| | - Yuanyuan Mo
- School of Nursing, Medical College, Soochow University, Suzhou, China
| | - Chunxia Yan
- The Reproductive Medicine Center, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yang Li
- School of Nursing, The University of Texas at Austin, Austin, USA
| | - Huiling Li
- School of Nursing, Medical College, Soochow University, Suzhou, China. .,The First Affiliated Hospital of Soochow University, Suzhou, China.
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Du K, Dong Y. The dyadic interaction model of relationship quality and the impact of attachment orientation and empathy on infertile couples in China. Nurs Open 2021; 8:2664-2672. [PMID: 33630423 PMCID: PMC8363387 DOI: 10.1002/nop2.819] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 12/10/2020] [Accepted: 01/29/2021] [Indexed: 12/21/2022] Open
Abstract
Aim The study was conducted to examine the effect of attachment orientation and empathy on the relationship quality of infertile couples and assess the inter‐dependency model of these factors. Design A cross‐sectional survey. Method In this study, 168 infertile couples (336 individuals) were enrolled and asked to finish the following questionnaires: the revised Adult Attachment Scales, the Interpersonal Response Index questionnaire and the Relationship Quality sub‐scale of the Fertility Quality of Life (FertiQol). Hierarchical regression and path analysis were used to analyse the unique and combined contribution of the independent variables to relationship quality of couples. Results The attachment orientation of infertile couples can influence their relationship quality, and empathetic wives and husbands have actor and partner effects on the infertile couples' relationship quality. Empathetic infertile couples are conducive to the harmony of the relationship.
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Affiliation(s)
- Kun Du
- Reproductive Medical Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yuezhi Dong
- Reproductive Medical Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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20
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de Wert G, van der Hout S, Goddijn M, Vassena R, Frith L, Vermeulen N, Eichenlaub-Ritter U. The ethics of preconception expanded carrier screening in patients seeking assisted reproduction. Hum Reprod Open 2021; 2021:hoaa063. [PMID: 33604456 PMCID: PMC7880037 DOI: 10.1093/hropen/hoaa063] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 10/30/2020] [Indexed: 02/02/2023] Open
Abstract
Expanded carrier screening (ECS) entails a screening offer for carrier status for multiple recessive disorders simultaneously and allows testing of couples or individuals regardless of ancestry or geographic origin. Although universal ECS—referring to a screening offer for the general population—has generated considerable ethical debate, little attention has been given to the ethics of preconception ECS for patients applying for assisted reproduction using their own gametes. There are several reasons why it is time for a systematic reflection on this practice. Firstly, various European fertility clinics already offer preconception ECS on a routine basis, and others are considering such a screening offer. Professionals involved in assisted reproduction have indicated a need for ethical guidance for ECS. Secondly, it is expected that patients seeking assisted reproduction will be particularly interested in preconception ECS, as they are already undertaking the physical, emotional and economic burdens of such reproduction. Thirdly, an offer of preconception ECS to patients seeking assisted reproduction raises particular ethical questions that do not arise in the context of universal ECS: the professional’s involvement in the conception implies that both parental and professional responsibilities should be taken into account. This paper reflects on and provides ethical guidance for a responsible implementation of preconception ECS to patients seeking assisted reproduction using their own gametes by assessing the proportionality of such a screening offer: do the possible benefits clearly outweigh the possible harms and disadvantages? If so, for what kinds of disorders and under what conditions?
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Affiliation(s)
- Guido de Wert
- Department of Health, Ethics and Society; CAPHRI School for Public Health and Primary Care, Maastricht University; and GROW School for Oncology and Developmental Biology, Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Sanne van der Hout
- Department of Health, Ethics and Society; CAPHRI School for Public Health and Primary Care, Maastricht University; and GROW School for Oncology and Developmental Biology, Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Mariëtte Goddijn
- Centre for Reproductive Medicine, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
| | - Rita Vassena
- Clinica EUGIN, Carrer de Balmes 236, Barcelona 08006, Spain
| | - Lucy Frith
- Department of Public Health, Policy & Systems, Institute of Population Health, University of Liverpool, Liverpool L69 3BX, UK
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Kazemi A, Torabi M, Abdishahshahani M. Adjustment toward infertility mediates the relationship between coping, depression and anxiety in men: A confirmatory analysis. Eur J Obstet Gynecol Reprod Biol 2021; 258:48-52. [PMID: 33412462 DOI: 10.1016/j.ejogrb.2020.12.049] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 11/10/2020] [Accepted: 12/21/2020] [Indexed: 01/25/2023]
Abstract
OBJECTIVE The aim of the present study was to develop a theoretical framework for the relationships between coping, adjustment toward infertility, depression and anxiety and to present a confirmatory analysis of the developed theoretical framework in men who, together with their spouses, were candidates for assisted reproductive technology (ART) treatment. STUDY DESIGN This cross-sectional study was conducted on 212 men selected from the couples who were candidate for ART. Depression and anxiety, adjustment toward infertility, and coping strategies were assessed using self-report questionnaire. Statistical analysis was performed using the plug-in application PROCESS macro and AMOS software. RESULTS The results showed that higher depression and anxiety scores were related to lower adjustment to infertility. Higher adjustment score was associated with lower self-blame, self-focused rumination, active confronting and avoidance coping strategies scores significantly. In the depression and anxiety pathway models, the positive relationship between active confronting and elf-focused rumination coping strategies were mediated by adjustment. However, the effect of active confronting on depression and anxiety was significant only with mediating role of adjustment. The direct and indirect relationship of self-focused rumination and the indirect relationship of active confronting with depression and anxiety had a good fitness (CMIN/ DF = .419). CONCLUSION The self-focused rumination and active confronting coping strategies, having negative association with adjustment to infertility, and may increase depression and anxiety in men undergoing ART; however, higher adjustment is associated with decreased depression and anxiety. Therefore, mental health programs for men undergoing ART may need to focus on improving the skills of adaptive coping strategies.
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Affiliation(s)
- Ashraf Kazemi
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Marjan Torabi
- Student Research Committee, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Mahshid Abdishahshahani
- Midwifery Department, Nursing and Midwifery Health Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
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22
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The relationship between infertility family stigma, self-stigma and psychological well-being in female first-visit patients at a reproductive medicine center in Taiwan. HEALTH PSYCHOLOGY REPORT 2021. [DOI: 10.5114/hpr.2021.107335] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Park J, Shin N. Development and Application of a Web-based Integrated Support Service Program for Infertile Women. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2021; 58:469580211028582. [PMID: 34229533 PMCID: PMC8267035 DOI: 10.1177/00469580211028582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/25/2021] [Accepted: 06/07/2021] [Indexed: 11/17/2022]
Abstract
Online-based infertility education provides a health management system to patients using electronic information and technology and no face-to-face interaction with patients and experts. This is a study to develop a web-based integrated support service system to meet the health care and nursing needs of infertile women. To develop a system that is most suitable and practically helpful to infertile women, who are end users of this system, research was conducted. This education system consists of introduction to women's health care, information on women's health, information on organizations for women, community for infertile women, and request for consultation for health management and nursing education of infertile women. This study introduced and applied a user-centered design that maximizes the value of use by first understanding the user's convenience and needs when developing a program.
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YILDIZ S, UĞUR K, SARIDOĞAN E, YAĞIN F, AKKUŞ M. İnfertilite tanılı kadın hastalarda mizaç özellikleri, aleksitimi, psikiyatrik belirtiler ve yaşam kalitesinin değerlendirilmesi. CUKUROVA MEDICAL JOURNAL 2020. [DOI: 10.17826/cumj.692985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Taebi M, Kariman N, Montazeri A, Majd HA. Development and psychometric evaluation of the female infertility stigma instrument (ISI-F): protocol for a mixed method study. Reprod Health 2020; 17:70. [PMID: 32448294 PMCID: PMC7245766 DOI: 10.1186/s12978-020-0904-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Accepted: 04/01/2020] [Indexed: 11/10/2022] Open
Abstract
Background Infertility stigma is one of the greatest challenges in most societies for reproduction and sexual health of infertile women. Since no specific tool exists for assessing the infertility stigma in women, this study would be conducted to develop and evaluate the psychometric properties of Female Infertility Stigma Instrument (ISI-F). Methods This is a mixed method study with sequential exploratory design (qualitative and quantitative phase). In the first qualitative phase, semi-structured interviews would be performed with infertile female who had experienced infertility whithout any psychological disorder. Women who are eligible for participating in the study will be selected using purposeful sampling method with maximum variation in terms of age, education, occupation and infertility duration. Data would be analyzed using conventional content analysis and in this phase the primary item pool will be developed for the Female Infertility Stigma Instrument (ISI-F). In the quantitative phase, the psychometric properties of the Instrument would be evaluated, including the content, face and construct validity as well as reliability via the internal consistency and stability. The psychometric properties described in the COSMIN checklist will be utilized for designing the instrument. Discussion Developing a valid and reliable scale for Female Infertility Stigma Instrument (ISI-F) would be helpful for future studies to assess the status of this situation. It also helps planning interventional studies for improvement of the reproductive health of infertile women.
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Affiliation(s)
- Mahboubeh Taebi
- Student Research Committee, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nourossadat Kariman
- Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Ali Montazeri
- Health Metrics Research Centre, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
| | - Hamid Alavi Majd
- Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Honarvar N, Taghavi M. Relation of Religious Coping and Depression Levels in Infertile Women. IRANIAN JOURNAL OF PSYCHIATRY 2020; 15:134-142. [PMID: 32426009 PMCID: PMC7215248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Objective: Religious coping is known as one of the successful manners to cure depressed infertile women; however, research findings show that demographic factors (e.g., education level) have played an important role on the relationship between depression and religious coping scores. The goal of this study is to measure the influence of age, job status, and education level on both scores within Iranian infertile women. Method : In this cross sectional study, 1000 women (mean age, 35.96; range, 26-45), who are recruited from different hospitals of Shiraz (Iran), are selected via multistage cluster sampling method. The reliability and validity of the translated versions of the questionnaires have been confirmed. The correlation coefficient (Spearman method), adjusted linear regression coefficient, and ordinal regression coefficient of demographic features with the depression scores/levels (minimal, mild, moderate, and severe) and religious coping scores are determined. Results: A significant negative correlation is found between depression and religious compatibility scores in 1000 infertile women (ρ = -0.318, P = 0.000). In addition, the results have implied the existence of a significant correlation and linear relationship between religious coping and age and job status (P < 0.05). Furthermore, both correlation and ordinal regression of depression intensity with both job status and education level are found to be statistically meaningful (P < 0.05). Conclusion: The negative correlation between religious coping and depression scores has implied the positive role of religious coping in protecting infertile women from depression, especially among employed women. Nevertheless, the correlation of religious coping with education level is not strong enough due to the nonuniform distribution of variables through their range.
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Affiliation(s)
| | - Mahsa Taghavi
- Corresponding Author: Address: Medical School, Islamic Azad University, Kazeroon Branch, Kazeroon, Iran, Postal Code: 7319846451. Tel: 98-71-42243930, Fax: 98-71-42230508.
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Zarif Golbar Yazdi H, Aghamohammadian Sharbaf H, Kareshki H, Amirian M. Psychosocial Consequences of Female Infertility in Iran: A Meta-Analysis. Front Psychiatry 2020; 11:518961. [PMID: 33250787 PMCID: PMC7674496 DOI: 10.3389/fpsyt.2020.518961] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 09/16/2020] [Indexed: 12/29/2022] Open
Abstract
Background: Although not a life-threatening condition, infertility does influence various aspects of life. Based on a meta-analysis of the relevant literature, the aim of this study is to identify the psychosocial consequences of infertility in Iranian women. Methods: Comprehensive Portal of Human Sciences, Magiran, Scientific Information Database, Noormags, MEDLIB, ScienceDirect, Google Scholar, Medline, and ProQuest were the databases searched from inception (1999) to 2018. To maximize the comprehensiveness of the search, the reference lists of all the relevant papers identified were manually examined. The evaluation of the content was based on PRISMA guidelines, and Comprehensive Meta-Analysis software was used for data analysis. Results: Based on the analysis of 124 quantitative papers, the psychosocial consequences of infertility in women in Iran can be classified into 14 categories: psychological well-being (effect size = 3.10), adaptation to infertility (effect size = 2.71), quality of life (effect size = 1.83), depression (effect size = 1.80), anxiety (effect size = 1.72), marital relationships (effect size = 1.37), personality disorders (effect size = 1.37), violence (effect size = 1.31), social support (effect size = 0.90), self-efficacy (effect size = 0.90), coping strategies (effect size = 0.84), irrational thoughts (effect size = 0.77), somatization disorders (effect size = 0.65), and sexual dysfunction (effect size = 0.55). Conclusion: Considering the wide-ranging psychosocial consequences of infertility in women, it is necessary for treatment to account for psychological factors.
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Affiliation(s)
| | | | - Hossein Kareshki
- Department of Psychology, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Malihe Amirian
- Department of Reproductive Medicine and Gynecology, Milad (Mashhad) Infertility Center, Mashhad, Iran
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Zarif Golbar Yazdi H, Aghamohammadian Sharbaf H, Kareshki H, Amirian M. Infertility and Psychological and Social Health of Iranian Infertile Women: A Systematic Review. IRANIAN JOURNAL OF PSYCHIATRY 2020; 15:67-79. [PMID: 32377216 PMCID: PMC7193241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Revised: 12/14/2019] [Accepted: 12/25/2019] [Indexed: 12/02/2022]
Abstract
Objective: Infertility influences various emotional, psychological, social, and relational aspects of women's lives. By employing a systematic review on the papers published in this field, this study aimed to identify the consequences of infertility on psychological and social health of women in Iran. Method : This was a descriptive study, conducted through a systematic review according to the directions denoted by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) in 2018. To investigate the entirety of the published studies on the sociopsychological consequences of women's infertility in Iran, various databases, including Comprehensive Human Science Portal, Scientific Information Databases (SID), Magiran, National Library and Archives of I. R. IRAN, Noormags, MEDLIB, Science Direct, Google Scholar, Medline, and ProQuest, were explored for the studies published between 1991 and 2018. The selected papers were evaluated according to the content analysis method. Results: Out of the 53 papers investigated, 27 were published in domestic journals (51%), while the remaining 26 papers were published in international journals and were in English (49%). The results revealed that sociopsychological consequences of women's infertility are categorized in 6 main categories: (1) quality of life, (2) depression, (3) anxiety, (4) social support, (5) violence, and (6) sexual function. Conclusion: The results of this study can be used to design psychocognitive interventions and assist women in decreasing the emerging psychological pain and pressure.
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Affiliation(s)
- Haniye Zarif Golbar Yazdi
- Department of Psychology, School of Education and Psychology, Ferdowsi University of Mashhad, Mashhad, Iran
| | | | - Hossein Kareshki
- Department of Psychology, School of Education and Psychology, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Malihe Amirian
- Department of Reproductive Medicine and Gynecology, Milad (Mashhad) Infertility Center, Mashhad, Iran
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Ebrahimzadeh Zagami S, Latifnejad Roudsari R, Janghorban R, Mousavi Bazaz SM, Amirian M, Allan HT. Iranian infertile couples' strategies to manage social interactions after unsuccessful treatment with assisted reproductive technologies. HUM FERTIL 2019; 24:341-352. [PMID: 31621448 DOI: 10.1080/14647273.2019.1677950] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Many infertile couples feel vulnerable after failed treatment cycles and find insensitive remarks or inappropriate support distressing. They fear that the stress of failed treatment cycles may affect their marriage and lead to marriage breakdown. This study explored the strategies a sample of infertile couples used to manage social interactions after unsuccessful treatment with assisted reproductive technologies. A descriptive qualitative study was conducted with 34 participants including nine infertile couples, nine infertile women and two infertile men with primary infertility, two relatives, and three fertility clinic staff. The participants were selected through purposive sampling at an infertility centre in Iran, between 2016 and 2017. Data were collected using semi-structured face-to-face interviews and analysed by qualitative content analysis approach. Participants found some social interactions after failed assisted reproductive treatment cycles to be distressing and painful. They described tolerating painful emotions which cause them sadness and sorrow as well as feeling embarrassed. As a result, they found they needed to maintain their adopting concealment strategies with their families through not permitting speculation, selective disclosure, not giving details and hiding the truth. This study showed that social interactions following failed assisted reproductive cycles can be upsetting for infertile couples. Couples use different strategies to manage potentially distressing social interactions. Healthcare providers and psychologists may provide a space for safe social interactions in order to help couples to use appropriate strategies in these circumstances.
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Affiliation(s)
| | | | - Roksana Janghorban
- Maternal-Fetal Medicine Research Centre, Shiraz University of Medical Sciences , Shiraz , Iran
| | | | - Maliheh Amirian
- Department of Obstetrics and Gynecology, School of Medicine, Mashhad University of Medical Sciences , Mashhad , Iran
| | - Helen T Allan
- Department of Adult Child and Midwifery, School of Health and Education, Middlesex University , London , UK
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Çapık A, Aksoy M, Yılmaz E, Yılmaz F. Infertility Stigma Scale: A psychometric study in a Turkish sample. Perspect Psychiatr Care 2019; 55:328-335. [PMID: 30680737 DOI: 10.1111/ppc.12360] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 12/27/2018] [Accepted: 01/15/2019] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The purpose of the present study is to conduct the Turkish validity and reliability study of the Infertility Stigma Scale (ISS). DESIGN AND METHODS This methodological study was conducted in an infertility polyclinic in Turkey. The sample consisted of 178 infertile women. FINDINGS The validity of the four-factor structure of the scale and the appropriateness of its fit indices were confirmed. The analyses of internal consistency indicated that the total score correlations of items were sufficient; test-retest, r = 0.948;P < 0.001; Cronbach's α = 0.93. PRACTICE IMPLICATIONS ISS could be used as a useful assessment instrument in investigating the stigma concerning infertility and making efficient related interventions.
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Affiliation(s)
- Ayla Çapık
- Department of Midwifery, Faculty of Health Science, Ataturk University, Erzurum, Turkey
| | - Meyreme Aksoy
- Department of Nursing, Faculty of Nursing, Ataturk University, Erzurum, Turkey
| | - Emine Yılmaz
- Department of Nursing, Faculty of Health Science, Bingöl University, Bingöl, Turkey
| | - Filiz Yılmaz
- Erzurum Regional Training and Research Hospital, Ministry of Health, Erzurum, Turkey
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Banihani SA, Khabour OF, Alzoubi KH. Fertility testing for men before marriage: Is it acceptable? Andrologia 2018; 51:e13212. [PMID: 30523631 DOI: 10.1111/and.13212] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 11/05/2018] [Accepted: 11/06/2018] [Indexed: 02/01/2023] Open
Abstract
Addressing male infertility issue before marriage, at least to the mate and her family, seems reasonable to avoid several psychosocial, economic and biological consequences. Here, we intended to comprehend whether fertility testing (i.e. semen analysis) for men before marriage is acceptable and can be applied in Jordanian society. To achieve this contribution, we designed a questionnaire that shows the opinion of a sample of the Jordanian population in applying fertility testing for men before marriage. A total of 740 adult individuals (>18 years old, 364 males, 382 females) were selected randomly from different martial, economic, social, ethnic, religious and education statuses to fill the questionnaire. A total of 523 (70.11%) participants had a positive attitude towards applying fertility testing for men before marriage. This opinion was found not to be affected by gender (p = 0.305), age (p = 0.329), body mass index (p = 0.061), smoking (p = 0.059), monthly income (p = 0.094), education level (p = 0.131) and family members with infertility (p = 0.074); while, it is found to be affected by the social status of the participant (p = 0.004). In conclusion, applying fertility testing for men before marriage appears to be acceptable in Jordanian society.
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Affiliation(s)
- Saleem Ali Banihani
- Department of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Omar F Khabour
- Department of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Karem H Alzoubi
- Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
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