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Tulić L, Tulić I, Stojnić J, Bila J, Vuković Ž, Kotlica B. Different doses of recombinant FSH and determining parameters of oxidative stress. J Med Biochem 2024; 43:219-225. [PMID: 38699703 PMCID: PMC11062336 DOI: 10.5937/jomb0-46156] [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: 08/15/2023] [Accepted: 09/01/2023] [Indexed: 05/05/2024] Open
Abstract
Background This study aimed to examine if there is a connection between recombinant FSH dose and OS parameters in serum and the impact on IVF outcome. Methods This study consisted of 101 participants that went through IVF procedures. Parameter that were tested are SOD, SH groups and MDA. Serum samples were drawn before stimulation and on the last day of ovarian stimulation. Results Two groups were formed according to the dose of gonadotropins (rFSH). In both groups there were no significant differences in live-birth rate and miscarriage. In both groups mean serum MDA and SH-groups were significantly higher after ovarian stimulation, but mean serum SOD was significantly lower when compared to values before stimulation. There were less patients without OS before stimulation. Conclusions Our results suggest that there is a difference in serum concentration in groups SOD, SH groups and MDA at the beginning and at the end ovarian stimulation. On the other hand, dose of rFSH is not related with change of parameters for oxidative stress, quality of oocytes, embryos, fertilization, pregnancies, and miscarriage rate. Patients without oxidative stress before the IVF procedure needed lower doses of gonadotropins during stimulation.
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Affiliation(s)
- Lidija Tulić
- University of Belgrade, School of Medicine, Clinical Center of Serbia, Clinic for Gynecology and Obstetrics, Department of In Vitro Fertilization, Belgrade
| | - Ivan Tulić
- University of Belgrade, School of Medicine, Clinical Center of Serbia, Clinic for Gynecology and Obstetrics, Department of In Vitro Fertilization, Belgrade
| | - Jelena Stojnić
- University of Belgrade, School of Medicine, Clinical Center of Serbia, Clinic for Gynecology and Obstetrics, Department of In Vitro Fertilization, Belgrade
| | - Jovan Bila
- University of Belgrade, School of Medicine, Clinical Center of Serbia, Clinic for Gynecology and Obstetrics, Department of In Vitro Fertilization, Belgrade
| | - Željka Vuković
- Clinical Center of Serbia, Clinic for Gynecology and Obstetrics, Belgrade
| | - Boba Kotlica
- University of Belgrade, School of Medicine, Belgrade
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Bokek-Cohen Y. The impact of relationship status on IVF patients' quality of life. Women Health 2024; 64:14-22. [PMID: 37919948 DOI: 10.1080/03630242.2023.2277890] [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: 03/18/2023] [Accepted: 10/26/2023] [Indexed: 11/04/2023]
Abstract
Infertility treatments are emotionally taxing and include invasive and time-consuming procedures over extended periods of time. In light of the growing numbers of single mothers by choice, the objective of this study was to apply the Conservation of Resources Theory in the context of infertility care and examine whether relationship status constitutes a psychological resource that buffers the decline in quality of life during IVF treatments. We used the FertiQol questionnaire to compare the quality of life of IVF patients between 422 patients who are involved in a couple relationship ("attached") and 117 patients who are not ("unattached"). Results show that the total FertiQol was significantly higher among the attached participants; the Core FertiQol and the Treatment FertiQol were rated higher by the "attached." No significant differences were found between the attached and unattached for the Emotional and Social subscales. "unattached" participants report significantly lower levels of quality of life in the "mind-body" and "treatment tolerability" subscales than the "attached" participants. It is concluded that being involved in a long-term couple relationship is to be seen as a resource that buffers the decline in quality of life of infertile women undergoing IVF treatments.
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Chamorro PP, Herruzo J, Pino MJ, Casas-Rosal JC. Coping, social support and medical factors on psychosocial impact in couples experiencing infertility. JOURNAL OF SEX & MARITAL THERAPY 2023; 50:197-215. [PMID: 37867461 DOI: 10.1080/0092623x.2023.2269983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2023]
Abstract
This study assessed dyadically the relationship between psychosocial impact of infertility experienced by 87 couples and individual coping strategies, perceived social support and some medical factors. Although problem-focused strategies emerged as positive, certain side effects on partner were revealed. Social support was related to psychosocial outcomes in a positive way, cognitive component of coping strategies resulted as a prominent factor on individual's adjustment as well as the partner's role. Findings suggest the convenience of promoting the awareness about the effects of each partner's feelings, behaviors and beliefs on his/her individual's well-being in this field due to the interdependent context in which they are. Infertility counselors may foster this process by evaluating and educating to them about the functionality of these factors.
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Affiliation(s)
| | - J Herruzo
- Psychology Department, University of Cordoba, Córdoba, Spain
| | - María J Pino
- Psychology Department, University of Cordoba, Córdoba, Spain
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Colombo C, Pistoljevic-Kristiansen N, Saupstad M, Bergenheim SJ, Spangmose AL, Klajnbard A, la Cour Freiesleben N, Løkkegaard EC, Englund AL, Husth M, Breth Knudsen U, Alsbjerg B, Prætorius L, Løssl K, Schmidt L, Pinborg A. Does luteal phase progesterone supplementation affect physical and psychosocial well-being among women undergoing modified natural cycle-FET? A sub-study of a randomized controlled trial. Hum Reprod 2023; 38:1970-1980. [PMID: 37634089 DOI: 10.1093/humrep/dead171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 07/27/2023] [Indexed: 08/28/2023] Open
Abstract
STUDY QUESTION Are there any differences in physical and psychosocial well-being among women undergoing modified natural cycle frozen embryo transfer (mNC-FET) with or without vaginal progesterone as luteal phase support (LPS)? SUMMARY ANSWER Women undergoing mNC-FET with vaginal progesterone supplementation were more likely to experience physical discomfort but there was no difference in psychosocial well-being between the two groups. WHAT IS KNOWN ALREADY mNC-FET can be carried out with or without vaginal progesterone as LPS, which has several side-effects. It is commonly known that fertility treatment can cause stress and psychosocial strain, however, most studies on this subject are conducted in fresh cycle regimes, which differ from NC-FET and results may not be comparable. STUDY DESIGN, SIZE, DURATION This is a sub-study of an ongoing RCT investigating whether progesterone supplementation has a positive effect on live birth rate in mNC-FET. The RCT is conducted at eight fertility clinics in Denmark from 2019 and is planned to end primo 2024. The sub-study is based on two questionnaires on physical and psychosocial well-being added to the RCT in August 2019. On the time of data extraction 286 women had answered both questionnaires. PARTICIPANTS/MATERIALS, SETTING, METHODS Women who had answered both questionnaires were included in the sub-study. Participants were equally distributed, with 143 in each of the two groups. Participants in both groups received the same questionnaires at two time-points: on cycle day 2-5 (baseline) and after blastocyst transfer. Participants in the progesterone group had administered progesterone for 7 days upon answering the second questionnaire. All items in the questionnaires were validated. Items on psychosocial well-being originate from the Copenhagen Multi-Centre Psychosocial Infertility-Fertility Problem Stress Scale (COMPI-FPSS) and from the Mental Health Inventory-5. MAIN RESULTS AND THE ROLE OF CHANCE Women receiving progesterone experienced more vaginal itching and/or burning than women in the non-progesterone group (P < 0.001). Women in the progesterone group also experienced more self-reported vaginal yeast infection, this was, however, not significant after adjustment for multiple testing (P/adjusted P = 0.049/0.881). No differences regarding psychosocial well-being were found between the two groups. Within the progesterone group, a shift toward feeling less 'downhearted and blue' was found when comparing response distribution at baseline and after blastocyst transfer (P < 0.001). LIMITATIONS, REASONS FOR CAUTION All items on physical symptoms were self-reported. The item on vaginal yeast infection was therefore not diagnosed by a doctor. Inclusion in the study required a few extra visits to the clinic, participants who felt more burdened by fertility treatment might have been more likely to decline participation. Women who experienced a lot of side-effects to progesterone prior to this FET cycle, might be less likely to participate. WIDER IMPLICATIONS OF THE FINDINGS Our results are in line with previous known side-effects to progesterone. Physical side-effects of progesterone should be considered before administration. STUDY FUNDING/COMPETING INTEREST(S) The RCT is fully supported by Rigshospitalet's Research Foundation and a grant from Gedeon Richter. Gedeon Richter were not involved in the design of protocol nor in the conduction of the study or analysis of results. A.P., L.P., and N.I.-C.F. report grants from Gedeon Richter, Ferring and Merck with no relations to this study. N.I.-C.F. has received travel support from Ferring, Merck A/S, & Gideon Richter, and is the head of the steering committee for the Danish Fertility Guidelines made by the members of from the Danish Fertility Society. A.P. reports consulting fees from Preglem, Novo Nordisk, Ferring, Gedeon Richter, Cryos, & Merck A/S, honoraria from Gedeon Richter, Ferring, Merck A/S, Theramex, and Organon, has received travel support from Gedeon Richter (payment to institution), participated on an advisory board for Preglem and was loaned an embryoscope from Gedeon Richter to their institution. A.L.S. has stock options for Novo Nordisk B A/S. B.A. have received unrestricted grant from Gedeon Richter Nordic and Merck and honoraria for lectures from Gedeon Richter, Merck, IBSA, and Marckyrl Pharma. TRIAL REGISTRATION NUMBER The RCT is registered on ClinicalTrials. gov (NCT03795220) and in EudraCT (2018-002207-34).
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Affiliation(s)
- Clara Colombo
- Faculty of Health and Medicine, The Fertility Department, Section 4071, The Juliane Marie Centre for Women, Children and Reproduction, University Hospital of Copenhagen, University of Copenhagen, Rigshospitalet, Copenhagen N, Denmark
| | - Nina Pistoljevic-Kristiansen
- Faculty of Health and Medicine, The Fertility Department, Section 4071, The Juliane Marie Centre for Women, Children and Reproduction, University Hospital of Copenhagen, University of Copenhagen, Rigshospitalet, Copenhagen N, Denmark
| | - Marte Saupstad
- Faculty of Health and Medicine, The Fertility Department, Section 4071, The Juliane Marie Centre for Women, Children and Reproduction, University Hospital of Copenhagen, University of Copenhagen, Rigshospitalet, Copenhagen N, Denmark
| | - Sara Johanna Bergenheim
- Faculty of Health and Medicine, The Fertility Department, Section 4071, The Juliane Marie Centre for Women, Children and Reproduction, University Hospital of Copenhagen, University of Copenhagen, Rigshospitalet, Copenhagen N, Denmark
| | - Anne Lærke Spangmose
- Faculty of Health and Medicine, The Fertility Department, Section 4071, The Juliane Marie Centre for Women, Children and Reproduction, University Hospital of Copenhagen, University of Copenhagen, Rigshospitalet, Copenhagen N, Denmark
| | - Anna Klajnbard
- Fertility Clinic, Copenhagen University Hospital-Herlev and Gentofte Hospital, Herlev, Denmark
| | - Nina la Cour Freiesleben
- Fertility Clinic, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Ellen Christine Løkkegaard
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Fertility Clinic, Copenhagen University Hospital-North Zealand, Hillerød, Denmark
| | | | - Merete Husth
- Fertility Unit and Centre for Preimplantation Genetic Test, Aalborg University Hospital, Aalborg, Denmark
| | - Ulla Breth Knudsen
- Fertility Clinic, Horsens Regional Hospital and Institute of Clinical Medicine, Aarhus University, Horsens, Denmark
| | | | - Lisbeth Prætorius
- Fertility Clinic, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Kristine Løssl
- Faculty of Health and Medicine, The Fertility Department, Section 4071, The Juliane Marie Centre for Women, Children and Reproduction, University Hospital of Copenhagen, University of Copenhagen, Rigshospitalet, Copenhagen N, Denmark
| | - Lone Schmidt
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Anja Pinborg
- Faculty of Health and Medicine, The Fertility Department, Section 4071, The Juliane Marie Centre for Women, Children and Reproduction, University Hospital of Copenhagen, University of Copenhagen, Rigshospitalet, Copenhagen N, Denmark
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Amiel A, Tarabeih M. Prenatal Tests Undertaken by Muslim Women Who Underwent IVF Treatment, Secular Versus Religious: An Israeli Study. JOURNAL OF RELIGION AND HEALTH 2023; 62:3204-3214. [PMID: 36890359 DOI: 10.1007/s10943-023-01786-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
Our goal was to determine if differences exist in the attitudes of religious Muslim women living in Israel toward prenatal testing and pregnancy termination after undergoing in vitro fertilization (IVF) compared to the secular Muslim women who had undergone IVF. Six hundred and ninety-nine Muslim women from cities and villages participated, 47% city-dwellers; 53% village-dwellers; 50%-secular; 50%-religious. Secular women who had undergone IVF performed more invasive tests and terminated more pregnancies due to an abnormal fetus than religious women. More genetic counseling must be provided explaining the different prenatal tests and the problems in raising an abnormal child.
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Affiliation(s)
- Aliza Amiel
- School of Nursing Sciences, The Academic College of Tel-Aviv-Yaffa, 2 Rabenu Yerucham St., P.O.B 8401, 61083, Tel-Aviv, Israel.
| | - Mahdi Tarabeih
- School of Nursing Sciences, The Academic College of Tel-Aviv-Yaffa, 2 Rabenu Yerucham St., P.O.B 8401, 61083, Tel-Aviv, Israel
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Kooli R, Sallem A, Chebil D, Boussabbeh M, Mohamed BB, Ajina T, Boughzela I, Mougou S, Mehdi M. Factors associated with anxiety and depression in men undergoing fertility investigations: a cross-sectional study. BMC Psychol 2023; 11:299. [PMID: 37777800 PMCID: PMC10543840 DOI: 10.1186/s40359-023-01330-z] [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: 01/12/2023] [Accepted: 09/14/2023] [Indexed: 10/02/2023] Open
Abstract
BACKGROUND Infertility is a real public health issue because of its medical, socio-cultural, and financial impact. It does also have heavy psychological consequences on both partners. This study aimed to assess levels of anxiety and depression among men undergoing infertility investigation and to identify their associated factors. METHODS We conducted a cross-sectional study in the Laboratory of Cytogenetics and Reproductive Biology of Fattouma Bourguiba University Teaching Hospital (Monastir, Tunisia) between August 30th, 2020, and March 16th, 2021. Anxiety and depression levels were assessed using the valid Arab version of the Hospital Anxiety and Depression scale (HAD). Semen parameters were analyzed and interpreted according to 2021 World Health Organization (WHO) guidelines. RESULTS A total of 282 men were included in the current study. The mean HAD-D (depression) and HAD-A (anxiety) scores were of 6.56 ± 3.07 (IQR [4-8]) and 7.94 ± 3.73 (IQR[5-10]) respectively. Univariate analysis showed that patients having two or more comorbidities were nearly five times more likely to be anxious than those without or with only one comorbidity (ORc = 4.71; p = 0.007). Furthermore, single patients were about four times more anxious than those in couple having primary or secondary infertility (ORc = 3.85; p = 0.027). With regards to semen parameters, patients having hypospermia were more than two times anxious compared with those with normal semen volume (ORc = 2.33; p = 0.034). As for depression, we observed that patients with an infertility history lasting for a year or more have a nine times greater risk of depression (ORc = 9.848; p = 0.007). With regards to semen parameters, patients exhibiting two or more semen abnormalities, teratozoospermia and increased MAI were more depressed (ORc = 2.478; p = 0.036; ORc = 2.549: p = 0.023; ORc = 2.762; p = 0.036). Furthermore, we found a negative correlation between HAD-A scores and patient's age. CONCLUSIONS We pointed out through the current study the associated factors with anxiety and depression in patients under fertility management to precociously identify those who need psychological counseling and hence to better manage infertility issues.
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Affiliation(s)
- Rim Kooli
- Laboratory of Cytogenetics and Reproductive Biology, Maternity and Neonatology Center, Fattouma Bourguiba University Teaching Hospital, Monastir, Tunisia
| | - Amira Sallem
- Laboratory of Cytogenetics and Reproductive Biology, Maternity and Neonatology Center, Fattouma Bourguiba University Teaching Hospital, Monastir, Tunisia.
- Laboratory of Histology-Embryology and Cytogenetics (LR 18 ES 40), Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia.
| | - Dhekra Chebil
- Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Manel Boussabbeh
- Laboratory of Cytogenetics and Reproductive Biology, Maternity and Neonatology Center, Fattouma Bourguiba University Teaching Hospital, Monastir, Tunisia
- Laboratory for Research On Biologically Compatible Substances, Faculty of Dentistry of Monastir, University of Monastir, Monastir, Tunisia
| | - Bochra Ben Mohamed
- Psychiatry Service, Fattouma Bourguiba University Teaching Hospital, Monastir, Tunisia
| | - Tesnim Ajina
- Laboratory of Cytogenetics and Reproductive Biology, Maternity and Neonatology Center, Fattouma Bourguiba University Teaching Hospital, Monastir, Tunisia
| | - Ines Boughzela
- Laboratory of Cytogenetics and Reproductive Biology, Maternity and Neonatology Center, Fattouma Bourguiba University Teaching Hospital, Monastir, Tunisia
| | - Soumaya Mougou
- Laboratory of Human Cytogenetics and Reproductive Biology, Farhat Hached Univesity Teaching Hospital, Sousse, Tunisia
| | - Meriem Mehdi
- Laboratory of Cytogenetics and Reproductive Biology, Maternity and Neonatology Center, Fattouma Bourguiba University Teaching Hospital, Monastir, Tunisia
- Laboratory of Histology-Embryology and Cytogenetics (LR 18 ES 40), Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
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7
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Tippett A. Reproductive rights where conditions apply: an analysis of discriminatory practice in funding criteria against would-be parents seeking funded fertility treatment in England. HUM FERTIL 2023; 26:483-493. [PMID: 36628623 DOI: 10.1080/14647273.2022.2164746] [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: 06/03/2021] [Accepted: 10/17/2022] [Indexed: 01/12/2023]
Abstract
Access to in vitro fertilisation (IVF) funding in England is limited by a range of local criteria set out historically by Clinical Commissioning Groups (CCGs) (now superseded by Integrated Care Boards (ICBs)). Many of these criteria discriminate on the grounds of sexual orientation, relationship status and existing family structure. Contrary to increasing rates of IVF treatment across the UK, NHS funding for IVF treatment has decreased, in some cases rapidly, across most areas of England. This article reviews the eligibility criteria previously developed by CCGs and critically examines three major discrepancies in entitlement to funding: (i) the postcode lottery; (ii) restrictions placed upon lesbians and single women; and (iii) existing family structures as less deserving of funding. Inconsistencies in IVF funding are framed within broader discussions of discrimination and inequality within fertility funding. Recommendations for social and political change are made, alongside areas for future research engagement.
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Affiliation(s)
- Anna Tippett
- Hertfordshire Law School, University of Hertfordshire, Hatfield, UK
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Njogu A, Kaburu F, Njogu J, Barasa E, Mutisya A, Luo Y. The effect of self-compassion-based programs for infertility (SCPI) on anxiety and depression among women pursuing fertility treatment: a three-armed, randomised controlled trial. J Assist Reprod Genet 2023; 40:911-927. [PMID: 36930358 PMCID: PMC10224906 DOI: 10.1007/s10815-023-02771-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 03/06/2023] [Indexed: 03/18/2023] Open
Abstract
PURPOSE To examine the effects of self-compassion training using videos (SCV) versus self-compassion training using digital stories (SC-DS) as compared to a control group (CG) on reducing anxiety and depression symptoms among women pursuing fertility treatment. METHODS A three-armed, randomised controlled trial randomly assigned 200 eligible women to SCV(n = 65), SC-DS (n = 67), and CG (n = 68). All three randomised groups completed questionnaires immediately after randomisation (T1), after completing the interventions (T2), and 10 weeks after the interventions (T3). A generalised estimation equation was used with the intention-to-treat analysis. The primary outcomes were anxiety and depression, and secondary outcomes were self-compassion, infertility self-efficacy, and pregnancy rates. RESULTS SCV and SC-DS participants experienced a significant reduction in anxiety and depression from T1 to T2 and from T1 to T3 (p < 0.001; d > 0.8). SCV and SC-DS participants experienced a significant increase in self-compassion and infertility self-efficacy from T1 to T2 and from T1 to T3 (p < 0.001; d > 0.8). SC-DS seemed to be superior to SCV and CG. No significant differences were found among the three groups in pregnancy rates. SCV and SC-DS participants rated self-compassion training programs positively and said they would highly recommend them to others. CONCLUSION These findings suggest that SCV and SC-DS were effective in reducing anxiety and depression and increasing self-compassion and infertility self-efficacy. Online flexible self-compassion interventions could make psychological support more accessible for women undergoing fertility treatment in resource-poor settings. TRIAL REGISTRATION (ChiCTR2100046065) [12/04/2021].
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Affiliation(s)
- Anne Njogu
- Xiangya School of Nursing, Central South University, Changsha, 410013, Hunan, China
| | - Francis Kaburu
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Julius Njogu
- Jomo Kenyatta University of Agriculture and Technology (JKUAT)/Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Emmanuel Barasa
- Masinde Muliro University of Science and Technology (MMUST), Kakamega, Kenya
| | - Albanus Mutisya
- Jomo Kenyatta University of Agriculture and Technology (JKUAT), Juja, Kenya
| | - Yang Luo
- Xiangya School of Nursing, Central South University, Changsha, 410013, Hunan, China.
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9
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Kawamura E, Asano M. Changes, differences, and factors of parenthood in high-risk pregnant women and their partners in Japan. BMC Pregnancy Childbirth 2023; 23:205. [PMID: 36964602 PMCID: PMC10037369 DOI: 10.1186/s12884-023-05519-3] [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: 11/29/2022] [Accepted: 03/14/2023] [Indexed: 03/26/2023] Open
Abstract
Background Various stressors exists for pregnant women worldwide, especially negative social and environmental influences that can increase the number of high-risk pregnant women. These may cause a difficult transition to parenthood for women and their partners. However, limited studies have focused on and examined parenthood. Therefore, this study aimed to identify the changes in parenthood from pregnancy to post-discharge after childbirth among high-risk pregnant women and their partners, as well as the presence or absence of gender differences and the factors associated with parenthood. Methods This longitudinal quantitative study used a self-administered anonymous questionnaire distributed among 127 pregnant women and their partners who visited a high-risk pregnant outpatient clinic. The Scale of Early Childrearing Parenthood (SECP; three subareas, 33 items) was administered thrice: during pregnancy (T1), after childbirth (T2), and after discharge (T3). Results The analysis included 85 T1 (37 fathers and 48 mothers), 36 T2 (13 fathers and 23 mothers), and 31 T3 (11 fathers and 20 mothers) responses. There was a significant increase in the SECP scores for both parents from T1 to T3. Mothers had a greater increase in the SECP scores from T1 to T2 than fathers. In addition, fathers’ mean SECP scores at T1 and T2 were higher compared with those of the mothers. Mothers’ and fathers’ SECP scores at each time point showed no significant differences. At all time points, the SECP scores were commonly and significantly associated with infertility treatment, physical and mental condition, postpartum depression at T2, and parenting stress at T3. Conclusions Because parenthood in the infertility treatment group was significantly higher throughout the series, we need to support such couples so that childbirth does not become their main goal. We suggest interventions for factors that impede parenthood development, understand the various backgrounds of the parents, and support the couple individually while also considering them as a unit. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-023-05519-3.
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Affiliation(s)
- Eriko Kawamura
- grid.27476.300000 0001 0943 978XNagoya University Graduate School of Medicine, 1-1-20 Daiko Minami, Higashi-Ku, Nagoya, Aichi 461-8673 Japan
| | - Midori Asano
- grid.27476.300000 0001 0943 978XNagoya University Graduate School of Medicine, 1-1-20 Daiko Minami, Higashi-Ku, Nagoya, Aichi 461-8673 Japan
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10
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de Miguel Beriain I, Payán Ellacuria E, Sanz B. Germline Gene Editing: The Gender Issues. Camb Q Healthc Ethics 2023; 32:1-7. [PMID: 36847191 DOI: 10.1017/s0963180122000639] [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: 03/01/2023]
Abstract
Human germline gene editing constitutes an extremely promising technology; at the same time, however, it raises remarkable ethical, legal, and social issues. Although many of these issues have been largely explored by the academic literature, there are gender issues embedded in the process that have not received the attention they deserve. This paper examines ways in which this new tool necessarily affects males and females differently-both in rewards and perils. The authors conclude that there is an urgent need to include these gender issues in the current debate, before giving a green light to this new technology.
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Affiliation(s)
| | - Ekain Payán Ellacuria
- Department of Public Law, University of the Basque Country-Bizkaia Campus, Leioa, Spain
| | - Begoña Sanz
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country, Leioa, Spain
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11
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Gregersen PA, Funding M, Alsner J, Olsen MH, Overgaard J, Urbak SF, Staffieri SE, Lou S. Danish heritable retinoblastoma survivors' perspectives on reproductive choices: "It's important for me, not to pass on this condition". J Genet Couns 2023; 32:31-42. [PMID: 35876835 PMCID: PMC10087262 DOI: 10.1002/jgc4.1618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 05/13/2022] [Accepted: 06/24/2022] [Indexed: 11/11/2022]
Abstract
Despite reporting an overall normal life, survivors of heritable retinoblastoma face numerous physical and psychosocial issues. In particular, reproductive decision-making is often complex and difficult. This study aims to examine survivors' reflections on passing on heritable retinoblastoma to their children, how survivors approach their reproductive choices, and how the healthcare system can optimize counseling and support. Semi-structured interviews with Danish adult survivors of heritable retinoblastoma were qualitatively analyzed to explore their experiences. Participants were recruited from the Retinoblastoma Survivorship Clinic, Aarhus University Hospital, Denmark. Thematic data analysis was conducted followed by a condensing process specifically for the subthemes relating to reproductive choices. A common subtheme for all participants was a strong wish to avoid passing on retinoblastoma to their children. The participants emphasized the various medical, practical, emotional, and moral issues impacting their final reproductive choice in the process of family planning to conceive a child unaffected by retinoblastoma. Some had no option other than to conceive naturally and hope for an unaffected baby; while others weighed the pros and cons of choosing natural conception with prenatal testing and then considering termination of pregnancy (in case of an affected fetus) versus choosing fertility treatment with preimplantation genetic testing to achieve an unaffected pregnancy. Several participants underlined the complexity of their decisions, and also expressed feelings of guilt, both toward their affected child, and guilt for putting their partner through many difficult decisions and obstacles due to their genetic condition. Our findings demonstrate how one family-planning decision is not unequivocally "better" or easier than another. Healthcare professionals must provide the necessary information and tools to support the individual's unique decision-making process. Survivors' autonomy and individual needs, as well as the numerous and diverse aspects of heritable retinoblastoma, should be carefully considered.
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Affiliation(s)
- Pernille A Gregersen
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Genetics, Aarhus University Hospital, Aarhus, Denmark.,Centre for Rare Diseases, Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Mikkel Funding
- Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark
| | - Jan Alsner
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Maja H Olsen
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Jens Overgaard
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Steen F Urbak
- Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark
| | - Sandra E Staffieri
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia.,Department of Ophthalmology, Royal Children's Hospital, Parkville, Australia.,Ophthalmology, University of Melbourne, Department of Surgery, Melbourne, Australia
| | - Stina Lou
- Defactum - Public Health & Health Services Research, Central Denmark Region, Aarhus, Denmark.,Centre for Fetal Diagnostics, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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12
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Mackay A, Taylor S, Glass B. Inequity of Access: Scoping the Barriers to Assisted Reproductive Technologies. PHARMACY 2023; 11:pharmacy11010017. [PMID: 36649027 PMCID: PMC9887590 DOI: 10.3390/pharmacy11010017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/12/2023] [Accepted: 01/12/2023] [Indexed: 01/18/2023] Open
Abstract
Infertility impacts millions of people of reproductive age worldwide, with approximately 10-15% of couples affected. When infertility is present, there are many potential barriers to treatment, leading to inequity of access. Assisted reproductive technologies (ART) are the mainstay of medical treatment for infertility and include procedures such as in vitro fertilisation. This scoping review aims to explore the barriers to accessing assisted reproductive technologies to highlight a potential role for the pharmacist in addressing these barriers. Five databases, including CINAHL, Emcare, Medline, Scopus, and Web of Science, were searched using keywords that resulted in 19 studies that explored barriers to initially accessing or continuing ART. Studies identified more than one barrier to accessing ART, with the most mentioned barrier being the geographic location of the patient, with others themed as psychological, financial, minority groups, educational level, and the age of the patient. Recommendations were made to address barriers to accessing ART, which included changes to government regulations to increase health education and promotion of infertility. Pharmacists' accessibility, even in geographically remote locations, places them in an ideal position to address many of the challenges experienced by people accessing infertility treatment to improve outcomes for these people.
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Affiliation(s)
- Amanda Mackay
- Pharmacy, College of Medicine and Dentistry, James Cook University, Douglas, Townsville, QLD 4811, Australia
- Correspondence:
| | - Selina Taylor
- Centre for Rural and Remote Health, James Cook University, Mount Isa, QLD 4825, Australia
| | - Beverley Glass
- Pharmacy, College of Medicine and Dentistry, James Cook University, Douglas, Townsville, QLD 4811, Australia
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13
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Ogden J, Syder A. Making sense of the stories we are told about our own conception and birth: a qualitative analysis. COGENT PSYCHOLOGY 2022. [DOI: 10.1080/23311908.2022.2105877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
Affiliation(s)
- Jane Ogden
- School of Psychology, University of Surrey, Guildford, UK
| | - Amy Syder
- School of Psychology, University of Surrey, Guildford, UK
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14
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Experiences of infertile women pursuing treatment in Kenya: a qualitative study. BMC Womens Health 2022; 22:364. [PMID: 36056344 PMCID: PMC9440532 DOI: 10.1186/s12905-022-01950-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 08/25/2022] [Indexed: 11/15/2022] Open
Abstract
Background The infertility treatment process is associated with various psychological, physical, social, moral, and financial challenges, especially for women. The women are likely to report low marital satisfaction and emotional distress due to fertility treatment demands. This study explored how infertile women described their treatment experience and how they coped with treatment demands as they underwent treatment at three gynecology outpatient clinics in Kenya. Methods A qualitative phenomenological research design was used to analyze and describe women’s fertility treatment experiences. The data were collected through semi-structured in-depth interviews with 33 infertile women selected purposively. Trustworthiness of the findings was ensured using Guba and Lincoln’s criteria. The recorded interviews were transcribed verbatim and then analyzed using reflective thematic analysis, developed by Braun and Clarkes. Results Three themes and 13 sub-themes related to women’s fertility treatment experiences and coping strategies were identified. The theme challenges encountered during fertility treatment have three sub-themes: emotional distressing, physical pain, and financial constraining. Theme impacts of fertility treatment on relationships have three sub-themes: relationship with their husband, relationship with their family, and relationship with their friends. Finally, coping with fertility treatment has six sub-themes: religious practices and personal faith, giving in to feelings, shifting focus, taking a break, staying with their relative’s children, and receiving support from others. Conclusion The experiences of women undergoing treatment are multi-dimensional. Therefore, incorporating psychosocial interventions or counseling into the fertility treatment routine with National Health Insurance Fund cards may reduce the treatment burden, improving women’s psychological well-being and relationships with their husbands, family, and friends.
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15
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Zhu H, Shi L, Wang R, Cui L, Wang J, Tang M, Qian H, Wei M, Wang L, Zhou H, Xu W. Global Research Trends on Infertility and Psychology From the Past Two Decades: A Bibliometric and Visualized Study. Front Endocrinol (Lausanne) 2022; 13:889845. [PMID: 35903282 PMCID: PMC9317298 DOI: 10.3389/fendo.2022.889845] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 06/13/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives The aim of this study was to evaluate the global scientific output of research on infertility and psychology; explore the current status and trends in this field through the cooperation of authors, countries, and institutions; shed light on the direction of clinical infertility research in the future, and provide inspiration for targeted diagnosis and treatment of infertility. Methods Research publications on infertility and psychology from the past two decades were retrieved from the Web of Science Core Collection (WoSCC). Bibliometric analyses were performed using VOSviewer software and the bibliometrix R package. Network maps were generated to evaluate the collaborations between different authors, countries, institutions, and keywords. Results A total of 151 articles related to the study of infertility and psychology were identified. We observed a gradual increase in the number of publications from 2001 to 2021, and the trend has been relatively stable in the past eight years. Human Reproduction (England), as the leading journal publishing the most papers (29 articles), was cited in the most journals (1208 times). Boivin J was the most prolific author (16 articles), with the largest number of citations (890 times) and the highest h-index (14) during the past decades. Boivin J was also the leader with the highest publication frequency and more active cooperation with other top authors. The United Kingdom (34 papers) and Cardiff University (25 articles) contributed the most publications and were the leading contributors in this field. Active cooperation between countries and between institutions was observed, and analyses of articles and references were also shown. The main hot topics included matters related to women (39 times), in-vitro salt (31 times), infertility (30 times), couples (25 times), and impact (24 times). Conclusion Our study results provide a comprehensive overview of the development of scientific literature, allowing relevant authors and research teams to recognize the current research status in this field. At the same time, infertility and psychology may soon become hotspots and should be closely monitored.
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Affiliation(s)
- Hongkun Zhu
- Nanjing University of Chinese Medicine, Nanjing, China
| | - Lingli Shi
- Department of Reproduction, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Rong Wang
- Department of Laboratory Medicine, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Lijuan Cui
- Department of Pathology, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Jiahui Wang
- Department of Reproduction, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Mengyu Tang
- Department of Reproduction, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Haiqing Qian
- Department of Reproduction, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Minggang Wei
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Lihong Wang
- Department of Reproduction, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Huifang Zhou
- Department of Gynaecology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Wenting Xu
- Nanjing University of Chinese Medicine, Nanjing, China
- Department of Reproduction, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
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Ebrahimzadeh Zagami S, Latifnejad Roudsari R, Janghorban R, Allan HT. Trying for a second chance: Iranian infertile couples' experiences after failed ART. J Psychosom Obstet Gynaecol 2022; 43:165-170. [PMID: 34388051 DOI: 10.1080/0167482x.2021.1961733] [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] [Indexed: 10/20/2022] Open
Abstract
INTRODUCTION Despite significant advances, only 35% infertile couples conceive after ART. If IVF is unsuccessful, couples will need to decide whether to proceed again with assisted conception. The aim of this study was to explore Iranian infertile couples' experiences after failed ART to continue treatment. METHODS In this qualitative study participants were selected using purposeful sampling method. Data were collected using 29 semi-structured face-to-face in-depth interviews at a regional Infertility Center from April 2016 to June 2017. All interviews were recorded, transcribed verbatim, and analyzed with conventional content analysis method using MAXQDA software. RESULTS Our findings suggest that couples' decisions to continue treatment after unsuccessful ART is shaped by their social, emotional and financial circumstances. We have constructed two themes to describe their experiences: support to continue and trying for a second chance. CONCLUSION Our findings suggest that good marital and family support networks can support infertile couples during this period of decision making. Considering the depression and anxiety caused by failed ARTs, which itself could affect the success rate of any further ARTs, the clinical team should effectively assess psychological readiness of couples who decide to continue with another ART after unsuccessful treatment.
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Affiliation(s)
| | | | - Roksana Janghorban
- Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Helen T Allan
- Department of Adult Child and Midwifery, School of Health and Education, Middlesex University, London, UK
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Tyler B, Walford H, Tamblyn J, Keay SD, Mavrelos D, Yasmin E, Al Wattar BH. Interventions to optimize embryo transfer in women undergoing assisted conception: a comprehensive systematic review and meta-analyses. Hum Reprod Update 2022; 28:480-500. [PMID: 35325124 PMCID: PMC9631462 DOI: 10.1093/humupd/dmac009] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 02/02/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Several interventions and techniques are suggested to improve the outcome of embryo transfer (ET) in assisted conception. However, there remains no consensus on the optimal practice, with high variations among fertility specialists. OBJECTIVE AND RATIONALE We conducted a comprehensive systematic review and meta-analyses of randomized controlled trials (RCTs) aiming to identify effective interventions that could be introduced around the time of ET to improve reproductive outcomes. SEARCH METHODS We searched the electronic databases (MEDLINE, EMBASE and Cochrane CENTRAL) from inception until March 2021 using a multi-stage search strategy of MeSH terms and keywords, and included all RCTs that evaluated an intervention in the 24-h period before/after ET in women undergoing IVF/ICSI. Our primary outcome was clinical pregnancy rate post-ET confirmed as viable pregnancy on ultrasound scan. We assessed the risk of bias in included trials and extracted data in duplicate. We pooled data using a random-effect meta-analysis and reported using risk ratio (RR) with 95% CI. We explored publication bias and effect modifiers using subgroup analyses. OUTCOMES Our search yielded 3685 citations of which we included 188 RCTs (38 interventions, 59 530 participants) with a median sample size of 200 (range 26-1761). The quality of included RCTs was moderate with most showing a low risk of bias for randomization (118/188, 62.8%) and attrition (105/188, 55.8%) but there was a significant risk of publication bias (Egger's test P = 0.001). Performing ET with ultrasound guidance versus clinical touch (n = 24, RR 1.265, 95% CI 1.151-1.391, I2 = 38.53%), hyaluronic acid versus routine care (n = 9, RR 1.457, 95% CI 1.197-1.261, I2 = 46.48%) and the use of a soft versus hard catheter (n = 27, RR 1.122, 95% CI 1.028-1.224, I2 = 57.66%) led to higher clinical pregnancy rates. Other pharmacological add-ons also showed a beneficial effect including granulocyte colony-stimulating factor (G-CSF: n = 4, RR 1.774, 95% CI 1.252-2.512, I2 = 0), Atosiban (n = 7, RR 1.493, 95% CI 1.184-1.882, I2 = 68.27%) and hCG (n = 17, RR 1.232, 95% CI 1.099-1.382, I2 = 57.76%). Bed rest following ET was associated with a reduction in clinical pregnancy (n = 6, RR 0.857, 95% CI 0.741-0.991, I2 = 0.01%). Other commonly used interventions, such as non-steroidal anti-inflammatory drugs, prophylactic antibiotics, acupuncture and cervical mucus removal, did not show a significant benefit on reproductive outcomes. Our effect estimates for other important outcomes, including miscarriage and live birth, were limited by the varied reporting across included RCTs. WIDER IMPLICATIONS Using ultrasound guidance, soft catheters and hyaluronic acid at the time of ET appears to increase clinical pregnancy rates. The use of Atosiban, G-CSF and hCG showed a trend towards increased clinical pregnancy rate, but larger trials are required before adopting these interventions in clinical practice. Bed rest post-ET was associated with a reduction in clinical pregnancy and should not be recommended.
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Affiliation(s)
- Bede Tyler
- UCL Institute for Women's Health, University College London, London, UK
| | - Hugo Walford
- UCL Institute for Women's Health, University College London, London, UK
| | - Jennifer Tamblyn
- Institute of Metabolism and Systems Research (IMSR), University of Birmingham, Birmingham, UK
| | - Stephen D Keay
- Centre for Reproductive Medicine, University Hospital of Coventry & Warwickshire, Coventry, UK
| | - Dimitrios Mavrelos
- UCL Institute for Women's Health, University College London, London, UK,Reproductive Medicine Unit, Elizabeth Garrett Anderson Wing, University College London Hospitals, London, UK
| | - Ephia Yasmin
- UCL Institute for Women's Health, University College London, London, UK,Reproductive Medicine Unit, Elizabeth Garrett Anderson Wing, University College London Hospitals, London, UK
| | - Bassel H Al Wattar
- Correspondence address. Reproductive Medicine Unit, Elizabeth Garrett Anderson Wing, University College London Hospitals, London, UK, WC1E 6DB. E-mail:
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18
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Early detection of pregnancy after IVF and embryo transfer with hyperglycosylated HCG versus Elecsys HCG+β assay. Reprod Biomed Online 2021; 44:349-356. [PMID: 34924288 DOI: 10.1016/j.rbmo.2021.10.007] [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: 05/10/2021] [Revised: 09/29/2021] [Accepted: 10/11/2021] [Indexed: 11/22/2022]
Abstract
RESEARCH QUESTION Is measurement of hyperglycosylated HCG (hHCG) superior to beta-HCG (HCG+β) for early pregnancy detection after IVF and embryo transfer? DESIGN Blood samples were collected on day 4 (+1), 7 (+1) and 11 (+2) after embryo transfer from women aged 18-45 years undergoing first or second fresh or frozen IVF embryo transfer cycles. Biochemical pregnancy was assessed on-site by HCG determination on day 11; clinical pregnancy was assessed by ultrasound on day 21 (+4/-3). Serum hHCG (immunochemiluminometric assay) and HCG+β (Elecsys® HCG+β assay) concentrations were measured. Performance of hHCG and HCG+β for predicting pregnancy was evaluated and cut-offs selected. RESULTS In total, 155 women were enrolled and underwent IVF and embryo transfer. Area under the curve (AUC) (95% CI) on day 4 was not significantly different for hHCG (AUC 0.88; 95% CI 0.83 to 0.94) and HCG+β (AUC 0.90; 95% CI 0.84 to 0.95), as was predictive performance on day 7 and 11, with higher AUC estimates compared with day 4. Applying cut-offs derived according to Youden's index on day 4 (hHCG, 100 pg/ml; HCG+β, 1.30 mIU/ml), both biomarkers demonstrated high negative predictive values for ruling out pregnancy (hHCG, 83.8%; HCG+β, 82.8%) and high positive predictive values for ruling in pregnancy (hHCG, 89.0%; HCG+β, 84.9%) on day 21. Diagnostic performance improved from day 4 to day 11. CONCLUSIONS Predictive performance for early pregnancy post-IVF embryo transfer of day-5 blastocysts was not significantly different for hHCG and HCG+β; hHCG superiority over HCG+β was not shown.
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Butts CD, Bloom MS, McGough A, Lenhart N, Wong R, Mok-Lin E, Parsons PJ, Galusha AL, Browne RW, Yucel RM, Feingold BJ, Fujimoto VY. Toxic elements in follicular fluid adversely influence the likelihood of pregnancy and live birth in women undergoing IVF. Hum Reprod Open 2021; 2021:hoab023. [PMID: 34337160 PMCID: PMC8318822 DOI: 10.1093/hropen/hoab023] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 05/19/2021] [Indexed: 01/24/2023] Open
Abstract
STUDY QUESTION Are follicular fluid (FF), arsenic (As), mercury (Hg), cadmium (Cd) and lead (Pb) concentrations associated with IVF outcomes among women undergoing IVF? SUMMARY ANSWER There was a non-linear association between higher FF Hg concentration and a lower likelihood of biochemical pregnancy and live birth. Higher FF Pb concentration was also associated with a lower probability of live birth. WHAT IS KNOWN ALREADY Previous research suggests that toxic elements may affect fertility among couples conceiving with and without assistance. However, the results have been inconsistent, possibly related in part to exposure misclassification. Very few studies have used ovarian FF to measure toxic elements, as it requires an invasive collection procedure, yet it may offer a more accurate estimate of a biologically effective dose than blood or urine. STUDY DESIGN SIZE DURATION This is a prospective study of 56 women undergoing IVF, from October 2015 to June 2017. FF was collected for analysis on the day of oocyte retrieval. PARTICIPANTS/MATERIALS SETTING METHODS As, Cd, Hg and Pb were determined in 197 FF specimens, using inductively coupled plasma tandem mass spectrometry. FF glutathione peroxidase, glutathione reductase, total glutathione-S-transferase, superoxide dismutase, arylesterase and paraoxonase (PON1p) activities were measured using kinetic enzyme assays. MAIN RESULTS AND THE ROLE OF CHANCE Non-linear associations were detected, in which the probabilities of biochemical pregnancy (P = 0.05) and live birth (P = 0.05) were lower in association with FF Hg greater than ∼0.51 µg/l Hg, adjusted for age, race, cigarette smoking and recent seafood consumption. Higher FF Pb was also associated with a lower likelihood of live birth (relative risk (RR) = 0.68, 95% CI: 0.46, 1.00; P = 0.05). We also found a suggestive, although imprecise, antagonizing mediating effect of PON1p activity on the association between FF Pb and live birth (-28.3%; 95% CI: -358%, 270%). LIMITATIONS REASONS FOR CAUTION The results should be interpreted judiciously given the limited sample size and difficulty accounting for correlated data in generalized additive models and mediation analyses. Additionally, women undergoing IVF are highly selected with respect to age and socioeconomic status, and so the generalizability of the results may be limited. WIDER IMPLICATIONS OF THE FINDINGS Overall, the results suggest that FF Hg was associated with a lower likelihood of biochemical pregnancy and live birth, with a potential threshold effect, and that higher FF Pb was associated with a lower probability of live birth. These results may help to guide clinical recommendations for limiting the exposure of patients to Hg and Pb and ultimately improve IVF success rates. STUDY FUNDING/COMPETING INTERESTS This work was funded in part by the National Institute of Environmental Health Sciences (NIEHS), grant number 1R56ES023886-01, to the University at Albany (M.S.B.), and in part by the National Institute of Environmental Health Sciences (NIEHS), grant number 1U2CES026542-01, to the Wadsworth Center (P.J.P.). The authors declare no competing interests. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Celeste D Butts
- Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, NY, USA
| | - Michael S Bloom
- Department of Global and Community Health, George Mason University, Fairfax, VA, USA
| | - Alexandra McGough
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California at San Francisco, San Francisco, CA, USA
| | - Nikolaus Lenhart
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California at San Francisco, San Francisco, CA, USA
| | - Rebecca Wong
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California at San Francisco, San Francisco, CA, USA
| | - Evelyn Mok-Lin
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California at San Francisco, San Francisco, CA, USA
| | - Patrick J Parsons
- Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, NY, USA
- Laboratory of Inorganic & Nuclear Chemistry, Wadsworth Center, New York State Department of Health, Albany, NY, USA
| | - Aubrey L Galusha
- Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, NY, USA
- Laboratory of Inorganic & Nuclear Chemistry, Wadsworth Center, New York State Department of Health, Albany, NY, USA
| | - Richard W Browne
- Department of Biotechnical and Clinical Laboratory Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Recai M Yucel
- Department of Epidemiology and Biostatistics, Temple University, Philadelphia, PA, USA
| | - Beth J Feingold
- Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, NY, USA
| | - Victor Y Fujimoto
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California at San Francisco, San Francisco, CA, USA
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Casale M, Carlqvist A. Is social support related to better mental health, treatment continuation and success rates among individuals undergoing in-vitro fertilization? Systematic review and meta-analysis protocol. PLoS One 2021; 16:e0252492. [PMID: 34061903 PMCID: PMC8168841 DOI: 10.1371/journal.pone.0252492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 05/15/2021] [Indexed: 11/19/2022] Open
Abstract
Infertility and its treatment via in-vitro fertilization (IVF) represent a global health area of increasing importance. However, the physical and psychological burden of IVF can negatively impact psychological wellbeing, as well as treatment retention and success. Social support has been found to have positive health effects among populations facing health-related stressors worldwide, and its potential protective role for IVF patients merits further attention. We present a protocol for a systematic review of peer-reviewed published studies quantitatively investigating associations between social support and i) mental health; ii) the decision to (dis)continue with IVF treatment cycles and; iii) IVF success (pregnancy and birth rates); among individuals who are undertaking or have undertaken IVF cycles. Studies will be included if they work with human subjects, provide correlation coefficients between measures of social support and at least one of the outcomes of interest, and are in the English language. Social support may derive from both naturally occurring networks and more formalized sources or interventions. The protocol for this systematic review was developed according to the PRISMA-P guidelines. Ten health-, psychology- and sociology-related databases will be searched using composite search terms that include keywords for ‘IVF’ and ‘social support’. To assess methodological quality, the authors will use a modified version of the Newcastle-Ottawa Scale. Should three or more moderate or good quality studies be identified for any one outcome of interest, correlation meta-analyses, using the Hedges-Olkin method, will be conducted to pool effect sizes and heterogeneity will be assessed. Should the number, quality and characteristics of eligible studies not allow for reliable quantitative synthesis, the authors will limit the analysis to qualitative synthesis, with a focus on implications of findings for future research and programming.
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Affiliation(s)
- Marisa Casale
- Department of Social Policy and Intervention, University of Oxford, Barnett House, Oxford, United Kingdom
- School of Public Health, University of the Western Cape, Bellville, South Africa
- * E-mail: ,
| | - Anna Carlqvist
- Department of Social Policy and Intervention, University of Oxford, Barnett House, Oxford, United Kingdom
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21
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Malina A, Roczniewska M, Pooley JA. Contact, moral foundations or knowledge? What predicts attitudes towards women who undergo IVF. BMC Pregnancy Childbirth 2021; 21:346. [PMID: 33933010 PMCID: PMC8088622 DOI: 10.1186/s12884-021-03810-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 04/19/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The willingness to try in vitro fertilization (IVF) as an infertility treatment, as well as its psychosocial consequences for couples, may be influenced by how they perceive the attitudes of general public towards this procedure. The focus of the current study was to identify predictors of attitudes towards mothers who underwent IVF to conceive a child. Three predictors were derived from attitude components: contact with someone who had undergone IVF (behavior), moral foundations (emotions), and the level of knowledge (cognition) about IVF. METHOD In total, 817 participants (118 male and 692 female, 7 unreported) from Poland took part in the study. Participants were asked whether they knew a person who underwent IVF, completed a Moral Foundation Questionnaire, and answered a pre-piloted IVF knowledge test. Attitudes towards women who utilised IVF were measured with a modified Bogardus Social Distance Scale. Data were analysed using hierarchical and logistic regression analyses. RESULTS The results showed that there was a weak link between previous contact with a person who underwent IVF and a positive attitude toward a woman who underwent IVF. The attitudes was also predicted by moral foundations: positively by care/harm and fairness/cheating foundations, and negatively by sanctity/degradation. Importantly, more knowledge about IVF was linked with a more positive attitude towards IVF, and this effect explained additional variance over and above moral foundations. CONCLUSIONS Our study implies the need of psychoeducation to prevent stigmatization of individuals who try IVF due to infertility.
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Affiliation(s)
- Alicja Malina
- Faculty of Psychology, Kazimierz Wielki University, Bydgoszcz, Poland
| | - Marta Roczniewska
- Faculty of Psychology in Sopot, SWPS University of Social Sciences and Humanities, Warszawa, Poland
- Department of Learning, Informatics, Management and Ethics, Karolinska Institute, Stockholm, Sweden
| | - Julie Ann Pooley
- School of Arts and Humanities, Edith Cowan University, Perth, Western Australia
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22
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Tippett A. Life on pause: An analysis of UK fertility patients’ coping mechanisms after the cancellation of fertility treatment due to COVID-19. J Health Psychol 2021; 27:1583-1600. [PMID: 33685265 PMCID: PMC9092918 DOI: 10.1177/1359105321999711] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
In March 2020, fertility clinics across the UK began cancelling all assisted
reproductive technology (ART) treatment, with the Human Fertilisation and
Embryology Authority (HFEA) stopping all ART treatment from going ahead beyond
the 15th April 2020 due to the COVID-19 pandemic. This article examines the
coping mechanisms adopted by fertility patients during this time, focussing on
the emotional support received from online fertility forums and fertility
clinics during the indeterminate wait for treatment to resume. The study draws
upon an online survey which assessed the mental health and wellbeing of 124
female fertility patients whose ART treatment was cancelled due to the
Coronavirus pandemic. The findings indicate a potential for improved
communication between fertility clinics and patients in order to reduce
psychological stress and isolation during the postponement of ART treatment,
alongside better utilisation of online platforms as mechanisms for support. This
article adds to the growing body of knowledge concerned with the implications of
denying reproductive rights to the infertility community during a global
pandemic. It also contributes to sociological discussions on the support
mechanisms available to those navigating infertility and the wider social
management of uncertainty.
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Maia Bezerra NK, de Menezes Galvão AC, Martins Leite NE, Leão Barbalho Sant'anna A, de Medeiros Garcia Torres M, Galvão Pinto Coelho MC, Kenji Medeiros Shiramizu V, de Sousa MBC, Leite Galvão-Coelho N. Success of in vitro fertilization and its association with the levels of psychophysiological stress before and during the treatment. Health Care Women Int 2020; 42:420-445. [PMID: 32866071 DOI: 10.1080/07399332.2020.1787415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Despite the advance of assisted reproduction, high rates of failure in treatment are still observed. Herein, we investigated how the psychophysiological stress profiles of patients can modulate the in vitro fertilization treatment (IVF) outcome. The women who had failure in IVF (n = 13; 65%) had higher baseline salivary cortisol awakening response and anxiety-state during treatment than patients who became pregnant (n = 7; 35%). Patients with major stress levels and religious coping style showed lower social support, which was correlated with higher anxiety. Therefore, we appointed stress modulators that negatively affect IVF and should be improved aiming to increase its success.
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Affiliation(s)
- Nathália Karen Maia Bezerra
- Laboratory of Hormone Measurement, Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, RN, Brazil.,Postgraduate Program in Psychobiology and Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Ana Cecília de Menezes Galvão
- Laboratory of Hormone Measurement, Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, RN, Brazil.,Postgraduate Program in Psychobiology and Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Nathalia Evelyn Martins Leite
- Laboratory of Hormone Measurement, Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, RN, Brazil.,Postgraduate Program in Psychobiology and Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Adriana Leão Barbalho Sant'anna
- Center of Assisted Reproduction, Januário Cicco Maternity School Hospital of Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Mychelle de Medeiros Garcia Torres
- Center of Assisted Reproduction, Januário Cicco Maternity School Hospital of Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Maria Cecília Galvão Pinto Coelho
- Center of Assisted Reproduction, Januário Cicco Maternity School Hospital of Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | | | - Maria Bernardete Cordeiro de Sousa
- Laboratory of Hormone Measurement, Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, RN, Brazil.,Postgraduate Program in Psychobiology and Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, RN, Brazil.,Brain Institute, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Nicole Leite Galvão-Coelho
- Laboratory of Hormone Measurement, Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, RN, Brazil.,Postgraduate Program in Psychobiology and Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, RN, Brazil.,National Institute of Science and Technology in Translational Medicine, Brazil
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24
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Schofield D, Zeppel M, Staffieri S, Shrestha R, Jelovic D, Lee E, Jamieson R. Preimplantation genetic diagnosis for retinoblastoma survivors: a cost-effectiveness study. REPRODUCTIVE BIOMEDICINE & SOCIETY ONLINE 2020; 10:37-45. [PMID: 32577540 PMCID: PMC7301166 DOI: 10.1016/j.rbms.2020.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 02/17/2020] [Accepted: 03/16/2020] [Indexed: 06/11/2023]
Abstract
This study aimed to investigate the cost-effectiveness of preimplantation genetic diagnosis (PGD) for the reproductive choices of patients with heritable retinoblastoma. The study modelled the costs of three cycles of in-vitro fertilization (IVF) and PGD across all uptake rates of PGD, number of children affected with retinoblastoma at each uptake rate and the estimated quality-adjusted life years (QALYs) gained. Cost-effectiveness analysis was conducted from the Australian public healthcare perspective. The intervention was the use of three cycles (one fresh and two frozen) of IVF and PGD with the aim of live births unaffected by the retinoblastoma phenotype. Compared with the standard care pathway (i.e. natural pregnancy), IVF and PGD resulted in a cost-saving to 18 years of age of AUD$2,747,294 for a base case of 100 couples with an uptake rate of 50%. IVF and PGD resulted in fewer affected (n = 56) and unaffected (n = 78) live births compared with standard care (71 affected and 83 unaffected live births), and an additional 0.03 QALYs per live birth. This modelling suggests that the use of IVF and PGD to achieve an unaffected child for patients with heritable retinoblastoma resulted in an overall cost-saving. There was an increase in QALYs per baby across all uptake rates. However, in total, fewer babies were born following the IVF and PGD pathway.
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Affiliation(s)
- D. Schofield
- GenIMPACT, Centre for Economic Impacts of Genomic Medicine, Faculty of Business and Economics, Macquarie University, Sydney, Australia
| | - M.J.B. Zeppel
- GenIMPACT, Centre for Economic Impacts of Genomic Medicine, Faculty of Business and Economics, Macquarie University, Sydney, Australia
| | - S. Staffieri
- Department of Ophthalmology, Royal Children's Hospital, Parkville, Australia
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia
- Ophthalmology, University of Melbourne, Department of Surgery, East Melbourne, Australia
| | - R.N. Shrestha
- GenIMPACT, Centre for Economic Impacts of Genomic Medicine, Faculty of Business and Economics, Macquarie University, Sydney, Australia
| | - D. Jelovic
- Eye Genetics Research Unit, The Children’s Hospital at Westmead, Children’s Medical Research Institute, Save Sight Institute, University of Sydney, Sydney, Australia
- Discipline of Genomic Medicine, The Children’s Hospital at Westmead Clinical School, University of Sydney, Sydney, Australia
- Department of Clinical Genetics, Western Sydney Genetics Program, The Children’s Hospital at Westmead, Sydney Children’s Hospitals Network, Sydney, Australia
| | - E. Lee
- GenIMPACT, Centre for Economic Impacts of Genomic Medicine, Faculty of Business and Economics, Macquarie University, Sydney, Australia
| | - R.V. Jamieson
- Eye Genetics Research Unit, The Children’s Hospital at Westmead, Children’s Medical Research Institute, Save Sight Institute, University of Sydney, Sydney, Australia
- Discipline of Genomic Medicine, The Children’s Hospital at Westmead Clinical School, University of Sydney, Sydney, Australia
- Department of Clinical Genetics, Western Sydney Genetics Program, The Children’s Hospital at Westmead, Sydney Children’s Hospitals Network, Sydney, Australia
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Gonen LD, Bokek-Cohen Y. The experience of being an in vitro fertilization (IVF) patient in a pro-natalist society - a form of emotional labor. SOCIAL WORK IN HEALTH CARE 2020; 59:273-299. [PMID: 32369421 DOI: 10.1080/00981389.2020.1749214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 02/24/2020] [Accepted: 03/23/2020] [Indexed: 06/11/2023]
Abstract
Israel is known as a highly pronatalist society. We conceptualize the pro-natalist state as the employer of in vitro fertilization (IVF) patients in the labor of procreation. We characterize the unique Israeli religio-cultural environment regarding infertility using the concepts of emotional labor, surface acting, deep acting, emotional dissonance, and burnout. One hundred and forty-two women and 62 men undergoing IVF in eight public IVF units were asked to describe their emotions on the Positive and Negative Affect Schedule (PANAS). We discuss the patients' emotional responses in light of the religio-cultural and the emotional labor context. Evidence was found for gender differences whereby women suffer more negative emotional outcomes than male partners of IVF patients. The pro-natalist state poses greater emotional stress for female IVF patients in comparison with that experienced by the male spouses of IVF patients. Consulting professionals should offer psycho-social care if necessary, focusing on strategies taken from emotional labor theory.
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Affiliation(s)
- Limor Dina Gonen
- Department of Economics and Business Administration, Ariel University , Ariel, Israel
| | - Ya'Arit Bokek-Cohen
- School of Nursing, Efrata Academic College , Tel Aviv, Israel
- School of Nursing, Tel Aviv Yaffo Academic College , Tel Aviv, Israel
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26
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Zaake D, Kayiira A, Namagembe I. Perceptions, expectations and challenges among men during in vitro fertilization treatment in a low resource setting: a qualitative study. FERTILITY RESEARCH AND PRACTICE 2019; 5:6. [PMID: 31312510 PMCID: PMC6609388 DOI: 10.1186/s40738-019-0058-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 06/27/2019] [Indexed: 11/15/2022]
Abstract
Introduction Partner support is very important in alleviating the burden of infertility related stress and although understudied, partner coping patterns also play a key role in the other partner’s ability to cope with the infertility experience which eventually affects treatment outcomes. Very few studies more so in a low to middle income setting, explore the psychological and social aspects of infertility in men. There is a need for a deeper understanding into men’s perceptions, expectations and challenges of fertility treatment in our low resource setting. Objective To explore men’s perceptions, expectations, challenges and experiences during IVF treatment among men in a low resource setting. Methods A qualitative research design was utilised. The study was conducted at life sure fertility and gynaecology centre. The study participants were men participating in the IVF cycles. They were selected purposefully by maximum variation sampling. All the interviews took place on the day of enrolment for treatment and inductive content analysis was used to draw meaning from the transcripts. Ethical approval for the study will be sought from Nsambya Hospital IRB/REC. Results Seven major themes arose, and these included: (1) Societal influence on IVF treatment experience; (2) Social support during IVF treatment; (3) Feeling insignificant; (4) Financial burden; (5) IVF as an emotional bridge; (6) Inadequate sensitization; (7) Fear of treatment failure. Conclusion Men’s experiences during IVF treatment were negatively affected by the society’s perceptions of IVF treatment and infertility, cost of treatment, perceived men’s involvement and insufficient knowledge about the IVF process. However, spouse and friends’ support helped with coping and the IVF treatment experience strengthened emotional bonds. Electronic supplementary material The online version of this article (10.1186/s40738-019-0058-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Daniel Zaake
- Life Sure Fertility and Gynaecology Centre, Kampala, Uganda.,2Uganda Martyr's University Postgraduate Medical School, Kampala, Uganda.,3St. Francis Hospital Nsambya, Kampala, Uganda
| | - Anthony Kayiira
- Life Sure Fertility and Gynaecology Centre, Kampala, Uganda.,2Uganda Martyr's University Postgraduate Medical School, Kampala, Uganda.,3St. Francis Hospital Nsambya, Kampala, Uganda
| | - Imelda Namagembe
- 4Makerere University College of Health Sciences, Kampala, Uganda
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Philpott LF, Savage E, FitzGerald S, Leahy-Warren P. Anxiety in fathers in the perinatal period: A systematic review. Midwifery 2019; 76:54-101. [PMID: 31176080 DOI: 10.1016/j.midw.2019.05.013] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 03/13/2019] [Accepted: 05/25/2019] [Indexed: 02/03/2023]
Abstract
BACKGROUND fatherhood in the perinatal period can be a time of great excitement, happiness and joy. However, a growing body of literature indicates that fathers are at risk for elevated levels of anxiety symptoms during the perinatal period. PURPOSE the purpose of this systematic review is to determine the prevalence and levels of anxiety in fathers during the perinatal period, identify the risk factors and impact of anxiety, and establish if there are effective interventions that reduce father's anxiety. DESIGN Systematic review. METHODS A systematic review protocol was developed and registered with PROSPERO (reference number: CRD42017073760). The review was guided by the PRISMA reporting process. Electronic databases Medline, CINAHL, Embase, the Cochrane Library, PsycARTICLES, PsycINFO, and Psychology were searched to identify eligible studies. Studies that researched fathers during the perinatal period were included if anxiety was the primary focus of the research or was an outcome or dependent variable. Data were extracted and presented in narrative form including tables and figures. FINDINGS Thirty-four studies met the inclusion criteria. Findings from these studies indicate that fathers experience anxiety in the perinatal period, particularly at the time of birth. Anxiety increased from the antenatal period to the time of birth, with a decrease in anxiety from the time of birth to the later postnatal period. The prevalence of anxiety ranged between 3.4% and 25.0% during the antenatal period and 2.4% and 51.0% during the postnatal period. Factors contributing to anxiety included lower education levels, lower income levels, lower co-parenting support, lower social support, work-family conflict, a partner' anxiety and depression, and being present during a previous birth. Anxiety had a negative impact on fathers' mental health, physical health, social relationships and parenting skills. Anxiety contributed to stress, depression, fatigue and lower paternal self-efficacy. Five studies reported on interventions to reduce anxiety and all the studies found that anxiety significantly decreased following the intervention. KEY CONCLUSION Fathers experience increased anxiety from the antenatal period to the time of birth, with a decrease in anxiety from the time of birth to the later postnatal period. Anxiety during the perinatal period that can impact negatively on fathers physical and mental health, and social relationships.
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Affiliation(s)
- Lloyd Frank Philpott
- School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork T12AK54, Ireland.
| | - Eileen Savage
- School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork T12AK54, Ireland.
| | - Serena FitzGerald
- School of Nursing and, Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork T12AK54, Ireland.
| | - Patricia Leahy-Warren
- School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork T12AK54, Ireland.
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28
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Ghaebi M, Abdolmohammadi-Vahid S, Ahmadi M, Eghbal-Fard S, Dolati S, Nouri M, Talebi M, Hamdi K, Marofi F, Aghebati-Maleki L, Jadidi-Niaragh F, Dopour M, Yousefi M. T cell Subsets in Peripheral Blood of Women with Recurrent Implantation Failure. J Reprod Immunol 2018; 131:21-29. [PMID: 30471511 DOI: 10.1016/j.jri.2018.11.002] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 11/05/2018] [Accepted: 11/08/2018] [Indexed: 12/11/2022]
Abstract
The objective of this study was to determine whether there are any differences in the T cell composition and the expression of specific factors (i.e., IRF4, TBX21, GATA3, and GITR) of T cells between women with Repeated Implantation Failure (RIF) and fertile women. We observed a decrease in circulating Tregs and exhausted CD8 + T cells in RIF patients when compared to the controls whereas exhausted Treg and Th17 cells were more frequent. Using real-time PCR, we determined that the expression of IRF-4 and TBX21 was significantly elevated in the cases. In contrast, mRNAs encoding GATA3 and GITR were reduced. Furthermore, the expression of some miRNAs involved in T cell differentiation and their target gene candidates were examined in T cells from women with RIF and fertile control women. The patients showed significant up-regulation of miR-25, miR-93, and miR-326. miR-155 and miR-146a demonstrated significant down-regulation in RIF patients. The results revealed that the expression pattern of target genes was in line with data for miRNAs expression from purified Treg and Th17 cells. The findings of real-time PCR analysis provided insights into the genetic pathways underlying this aberration in the proportions of T cell subsets. Our data suggest that a combination of higher pro-inflammatory Th17 and exhausted Treg cells, and lower Treg and exhausted CD8 + T cells may co-exist in the peripheral blood of women with RIF. Moreover, the expression level of transcription factors and miRNAs controlling T cell differentiation may differ in women with RIF influencing pregnancy outcomes in these women.
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Affiliation(s)
- Mahnaz Ghaebi
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Student's Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran; Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Samaneh Abdolmohammadi-Vahid
- Student's Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Immunology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Majid Ahmadi
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Immunology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shadi Eghbal-Fard
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Immunology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sanam Dolati
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Immunology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Nouri
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mehdi Talebi
- Hematology & Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Kobra Hamdi
- Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Faroogh Marofi
- Hematology & Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Farhad Jadidi-Niaragh
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Immunology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Masoume Dopour
- Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mehdi Yousefi
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Immunology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
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