Fertility Problem Inventory Research Articles

Male infertile couples: an actor-partner interdependence model of attachment styles and fertility pressure

BackgroundCouples undergoing artificial insemination by donor semen(AID) represent a unique group of infertility patients, the relationship between fertility pressure and attachment styles remains unclear. To investigate the fertility pressure and attachment dimensions in artificial insemination by donor semen(AID) couples, and develop an Actor-Partner Interdependence Model (APIM) for patient care.MethodsThis study is a cross-sectional study. From June to September 2021, couples who were about to receive AID treatment in our hospital were assessed using the Fertility Problem Inventory, and the Experiences in Close Relationships(ECR). Dyadic analysis applying the APIM was used.ResultsA total of 448 valid questionnaires were recovered, the effective response rate was 94.9%. The average score of men’s fertility pressure was higher than that of women’s(P = 0.021). The score of male attachment anxiety was higher than that of females(P = 0.038). Attachment avoidance(β = 0.46) and attachment anxiety(β = 0.33) in wives significantly impacted their fertility pressure. Attachment avoidance(β = 0.17) and attachment anxiety(β = 0.52) in husbands significantly impacted their fertility pressure. The attachment avoidance of wives’ had a significant impact on the husbands’ fertility pressure(β = 0.11).ConclusionOverall, the study revealed that in the couples who use donor sperm to expect pregnancy, the male has higher fertility pressure. Insecure attachment can cause more severe fertility pressure, fertility pressure is also affected by one’s partner.

Fertility Stress, Psychological Resilience, and Depressive Symptoms in Women With Polycystic Ovary Syndrome.

Infertility is a common problem for patients with polycystic ovary syndrome (PCOS), which is closely related to stress and raises the risk of depression, while psychological resilience has been revealed to be protective for mental health. However, the associations of fertility stress, psychological resilience, and depressive symptoms in individuals with PCOS are not thoroughly explored. Our study aims to examine the associations of fertility stress and psychological resilience with depressive symptoms among patients with PCOS, as well as the mediating role of psychological resilience. A cross-sectional study was conducted in a reproductive clinic. The participants completed structured questionnaires on fertility stress (Fertility Problem Inventory (FPI)), psychological resilience (10-Item Connor-Davidson Resilience Scale (CD-RISC 10)), and depressive symptoms (Beck Depression Inventory-II (BDI-II)). Hierarchical regression was utilized to explore the relationship between fertility stress, psychological resilience, and depressive symptoms in PCOS patients after controlling for covariates. Psychological resilience was included in the final layer of the regression model to determine its potential mediating roles by comparing changes in the effect sizes between models. The percentage of mediating effect was then determined using structural equation modeling (SEM). A total of 192 women with PCOS were included. Of them, 50 (26%) presented depressive symptoms, 18% of which were severe. Hierarchical regression showed that after adjusting for sociodemographic and health-related characteristics, both fertility stress (β=0.361; p<0.001) and resilience (β=-0.453; p<0.001) were significantly correlated with depressive symptoms. SEM demonstrated that fertility stress was directly linked to depressive symptoms in women with PCOS (β=0.050; 95% CI (0.028, 0.084); p<0.001). Psychological resilience mediated 21.9% of the relationship between fertility stress and depressive symptoms (β=0.014; 95% CI (0.005, 0.034); p=0.001). This study demonstrated that among women with PCOS, fertility stress was, directly and indirectly through psychological resilience, associated with depressive symptoms. However, this study was cross-sectional, and the participants were recruited from a single clinical hospital. If replicated in longitudinal studies, the findings provide fertility stress and psychological resilience as potential intervention targets for better mental health in this population.

Infertility-related stress is associated with quality of life through negative emotions among infertile outpatients

Infertility is not a fatal disease but it really produces infertility-related stress and affects individuals’ quality of life to a great extent. This study aims to investigate the relations among infertility-related stress, negative emotions and quality of life in infertile outpatients, and suppose gender difference as well as Dark Triad, which contained three dark personality traits: Machiavellianism, narcissism, and psychopathy, would moderate the relations. 105 infertile outpatients age range 20–49 completed a cross-sectional questionnaire on the Fertility Quality of Life scale, the Fertility Problem Inventory, the Hospital Anxiety and Depression Scale a the Chinese version of Dirty Dozen. Results showed that negative emotions mediated the relations between infertility-related stress and quality of life. Dark Triad could not moderate the relations between infertility-related stress, negative emotions, and quality of life, but gender can moderate the associations between infertility-related stress and negative emotions. Specifically, the association between infertility-related stress and negative emotions was stronger in men than in women. Infertility-related stress has direct and indirect effects on infertile outpatients’ quality of life. It is important to consider the important roles of emotions and gender difference between patients, and delivering targeted intervention programs.

The effectiveness of expressive art therapy on infertile women undergoing surgery: study protocol for a randomized controlled trial

BackgroundInfertility produces infertility-related stress in both members of infertile couples, especially for infertile women. Some studies verified the negative relationship between infertility-related stress and outcomes of infertility treatments. Effective mental health care during fertility treatment is urgently needed, but there has been a lack of efficient support services. To reduce the infertility-related stress of infertile women, expressive art therapeutic schemes will be organized and implemented by certified international expressive art therapists.MethodsThis study is a randomized controlled trial. Participants in the intervention group will receive expressive art therapies after the baseline investigation. Expressive art therapies will be led by the certified international expressive art therapist. The interventions include progressive muscle relaxation training, music meditation and drawing therapy. Participants in the control group will receive routine care. The Hospital Anxiety and Depression Scale (HADS) and Fertility Problem Inventory (FPI) will be used to investigate the anxiety, depression, and infertility-related stress of all participants at admission and at discharge.DiscussionThis study will verify the effectiveness and efficiency of expressive art therapies for infertile women. The results will provide new knowledge on mental health care strategies for infertile women.Trial registrationChiCTR, ChiCTR2300070618. Registered 14 April 2023.

The Stigma and Infertility-Related Stress of Chinese Infertile Women: A Cross-Sectional Study.

This study was conducted to investigate the stigma status of infertile women in China and to determine the influencing factors. 366 infertile women from the gynecological and reproductive departments of two tertiary hospitals completed socio-demographic questionnaires, the Infertility Stigma Scale (ISS) and the Mandarin Fertility Problem Inventory (M-FPI). The scores of stigma and infertility-related stress in infertile women were (52.51 ± 17.74) and (150.03 ± 17.51), respectively. Multiple regression analysis found that location of residence, regarding children as the most important thing in life, talking to others about infertility and infertility-related stress were the main influencing factors of stigma in infertile women, which explained 17.3% of the total variance. In the current study, the level of stigma in women with infertility was at the middle range. Location of residence, regarding children as the most important thing in life, whether to talk with others about infertility and infertility-related stress were the four main influencing factors of stigma.

Examining the association between coping strategies and perceived social support among Vietnamese infertile women undergoing IVF treatment

ABSTRACT The purpose of the study was to examine the association between coping strategies and perceived social support among women diagnosed with infertility and undergoing IVF treatment. A total of 383 Vietnamese women were invited to participate in this study. Participants completed a questionnaire consisting of The Multidimensional Scale of Perceived Social Support, the Copenhagen Multi-centre Psychosocial Infertility coping scales and the Fertility Problem Inventory, and other relevant questions. The results reveal that coping strategies significantly predict some specific types of perceived social supports among women undergoing IVF treatment. Specifically, passive-avoidance coping (PAC) and active-avoidance coping (AAC) predicts a decrease in receiving support from family and friends, whereas active-confronting coping (ACC) predicts an increase in receiving support from these two sources of support. Women who demonstrate increased meaning-based coping (MBC) received all three sources of support including family, friends, and significant others support. Despite some limitations, this study is useful in understanding how coping strategies among women undergoing IVF treatment affects the social support received in the Vietnamese social context. It also emphasizes the importance of psychological support for women facing IVF treatment distress.

Impact of primary care posttraumatic stress disorder (PC-PTSD) on fertility problem of Iranian women with infertility during the COVID-19 pandemic

BackgroundInfertility continued to be a major stressor among women with infertility during COVID-19pandemic. This study aimed to evaluate the impact of primary care posttraumatic stress disorder (PC-PTSD) on fertility problem of Iranian women with infertility during COVID-19 pandemic.MethodIn this cross-sectional study, 386 women with infertility completed the questionnaires of PC-PTSD-5 and Fertility Problem Inventory (FPI) at an infertility center between 2020 and 2022.ResultsThe mean of fertility problems was 145.20 (± 32.31). In terms of FPI subscales, the means were as follows: Sexual concern 21.80 (± 7.58), social concern 26.53 (± 8.94), relationship concern 26.02 (± 9.18), need for parenthood concern 40.88 (± 8.98), and rejection of childfree lifestyle 29.96 (± 7.69). The highest mean of FPI subscales was related to the need for parenthood concern in women with infertility. The strongest correlation was found between the subscales of sexual concern and social concern followed by sexual concern and relationship concern. The variables of PC-PTSD were a predictor of fertility problems (β = 0.203, P < .0001). Additionally, the variables of PC-PTSDwere a predictor of sexual concern (β = 0.248, P < .0001), social concern (β = 0.237, P < .0001), relationship concern (β = 0.143, P < .020), and need for parenthood concern (β = 0.101, P < .010). After adjusting for demographic characteristics, there was a significant relationship between FPI with job (β=-0.118, P < .031), education (β=-0.130, P < .023), living place (β = 0.115, P < .035), smoking (β = 0.113, P < .036), relationship with husband (β = 0.118, P < .027), and PC-PTSD symptom (β = 0.158, P < .0001). In addition, the multivariate linear regression showed a significant association between sexual concern and education (β=-0.152, P < .008), smoking (β = 0.129, P < .018), PC-PTSD symptom (β = 0.207, P < .0001); social concern and job (β=-0.119, P < .033), PC-PTSD symptom (β = 0.205, P < .0001); relationship concern and education (β=-0.121, P < .033), living place (β = 0.183, P < .001), relationship with husband (β = 0.219, P < .0001); and rejection of childfree lifestyle and job (β=-0.154, P < .007).ConclusionSystematic PTSD screening during COVID-19 pandemic by healthcare providers can be uniquely used to identify, evaluate, and treat trauma-related health conditions in infertility settings, which can link women with infertility to mental health services. This can be novel and useful for future policymakers and practitioners in the infertility field.

Relationship between stigma and infertility-related stress among couples undergoing AID: The mediating role of communication patterns.

Infertility can be stressful for infertile couples. This study aims to examine the intra-dyadic associations between stigma, communication patterns, and infertility-related stress in couples undergoing artificial insemination by donor semen (AID). This cross-sectional study was conducted from January to April 2021. Two hundred and three couples undergoing AID were recruited from a reproductive centre in China. All of the couples completed a two-item stigma questionnaire, Communication Pattern Questionnaire, and Fertility Problem Inventory. The actor-partner interdependence mediation analysis was performed using AMOS 23.0. The analysis demonstrated significant actor-actor effects for couples undergoing AID. More specifically, higher levels of stigma among wives and husbands were associated with more negative communication patterns, thereby increasing their own infertility-related stress. Simultaneously, there was a significant partner-actor effect among infertile wives, demonstrating that the husband's stigma can affect his wife's infertility-related stress by influencing her communication patterns. Couples undergoing AID experience increased infertility-related stress when they have high levels of stigma and negative communication patterns, and husbands' stigma is correlated to wives' communication patterns. Therefore, dyadic interventions aiming to improving stigma and enhancing positive communication may be conducive to reducing infertility-related stress.

The Effect of Chewing Gum on Stress in Women with Unexplained Infertility

Introduction: Infertile women may have difficulty coping with the stress caused by assisted reproductive methods. Aim: It was aimed to investigate the effect of chewing gum on stress levels in women with unexplained infertility. Method: Sixty - one women receiving in - vitro fertilization treatment in the tertiary care center were included in the study. A randomized controlled experimental design was established in the study. The group chewing gum for five minutes at least two times a day was called "Experimental Group - 1", the group chewing gum for 20 minutes at least two times a day was called "Experimental Group - 2", and the group not chewing gum was called "Control Group". Reproductive information and stress level data of infertile women were collected with the Descriptive Information Form and Fertility Problem Inventory. Results: No statistically significant difference was found in comparing Fertility Problem Inventory total scores between the groups (p &amp;gt; 0.005). However, a statistically signifiant difference was found between the mean values of the denial of life without children, which was a subscale of the Fertility Problem Inventory score according to time in the Experimental Group - 2 group (p &amp;lt;0.005). Conclusion: We believe that the positive effect of chewing gum on coping with stress may be an alternative intervention that may contribute positively to coping with the infertility treatment process and should be supported by other interventions.

(107) “Can Sexual Dysfunction and Stress in Couples Attempting Conception Be Explained by the Ovulation Calculator?” An Evaluation Study

Abstract Introduction Stress and sexual dysfunction affect a significant portion of couples seeking conception, leading to emotional strain. We hypothesized that ovulation calculators, widely used as a tool to predict fertile days, may play a role in the stress experienced by couples undergoing fertility treatments. We evaluated the impact of ovulation calculators on stress levels in couples seeking fertility treatment and explored the associations with sexual dysfunction and mental health implications due to the stress of infertility. Objective The objective of this study is to evaluate the impact of ovulation calculators on stress levels in couples seeking fertility treatment and to explore the associations with sexual dysfunction and mental health implications due to the stress of infertility. Methods Participants were recruited from the University of Miami Health System Clinics. Fifty couples consulting for infertility were included in the study. Both partners were asked to complete anonymous self-reported surveys consisting of validated questions related to stress levels, sexual function, and the use of ovulation calculators. The surveys included the Female Sexual Function Index (FSFI) for females and the International Index of Erectile Function (IIEF) for males to assess sexual function. Additionally, the Fertility Problem Inventory (FPI) was used to measure fertility-related stress and distress. The data collected included age, duration of attempts to conceive, and responses to stress-related questions. Results A total of 50 couples who we reattempting conception completed the cross-sectional study with all the questionnaires were included in the study. Whether or not they were using ovulation calculators, women scored similarly in the 4 variables of the FSFI, including Arousal, Orgasm, Satisfaction, and Lubrication. When evaluating IIEF scores for Male Erectile Function, the average score of men tracking ovulation was 12.0 ± 4.8, compared to 11.5 ± 5.4 in male patients who were not (P-Value: 0.81). The results showed no statistically significant difference in stress levels between couples who used ovulation calculators and those who did not. However, both male and female participants reported higher levels of sexual dysfunction in couples experiencing higher stress levels due to infertility. Fertility-related stress was also found to be significantly associated with mental health implications, with increased anxiety and depression reported by couples undergoing fertility treatments. Conclusions The findings suggest that the use of ovulation calculators did not significantly influence the stress experienced by couples seeking fertility treatment. However, the study highlights the significant impact of infertility-related stress on sexual function and mental health in both male and female partners. These results emphasize the importance of addressing the psychological aspects of infertility and providing comprehensive support to couples undergoing fertility treatments. Further research is warranted to explore the complex interplay between ovulation calculator usage, infertility-related stress, sexual dysfunction, and mental health implications in couples seeking to conceive. Healthcare providers should consider incorporating mental health support into fertility treatment programs to optimize patient outcomes and overall well-being. Disclosure No.

Infertility-Related Stress, and Dyadic Coping as Predictors of Quality of Life: Gender Differences Among Couples with Infertility Issues.

The purpose of this study was to explore the relationship between infertility-related stress and dyadic coping with quality of life (QoL) in couples with infertility issues, and verify gender differences and dyadic interactions in the associations between them. This cross-sectional study included 340 couples who were recruited from the First Affiliated Hospital of Lanzhou University between March 2022 and November 2022. The Fertility Problem Inventory, Dyadic Coping Inventory and FertiQoL were used to measure infertility-related stress, dyadic coping and QoL. The Actor-Partner Interdependence Model was used to analyze the effects of infertility-related stress and dyadic coping on the couple's own QoL (actor effect) as well as on their partner's QoL (partner effect). Female patients perceived significantly lower levels of QoL and dyadic coping than those of husbands. There was no statistically significant difference in the infertility-related stress between wives and husbands. Husbands' infertility-related stress had actor and partner effects on their own and their wives' QoL, while wives' infertility-related stress only had an actor effect on their own QoL. Husbands' dyadic coping had both actor effect and partner effects on their own and their wives' QoL, meanwhile wives' dyadic coping had both actor effect and partner effects on their own and their husbands' QoL. Husbands' QoL was impacted by their own infertility-related stress, dyadic coping and their wives' dyadic coping. Whereas wives' QoL was influenced by infertility-related stress and dyadic coping from both their own and their spouses. Therefore, elevating the level of dyadic coping may contribute to improving QoL for both husbands and wives. Moreover, enhancing the ability to cope with infertility-related stress might be useful for husbands and indirectly contribute to wives' QoL.

Correlation among irrational parenthood cognitions, fertility stress, and social support in patients with repeated implantation failure and the mediating effect of fertility stress: a cross-sectional survey

PurposeThis study investigated the relationships among irrational conceptions of parenthood, fertility stress, and social support, as well as the mediating effect of fertility stress, in patients with repeated implantation failure.MethodsPatients who underwent assisted reproductive technology due to repeated implantation failure at the Reproductive Centre at Women's Hospital between January 2020 and August 2022 were selected using cross-sectional research and convenience sampling. A total of 129 patients with recurrent implantation failure were investigated using the Irrational Parenthood Cognitions Questionnaire (IPCQ), Fertility Problem Inventory (FPI), and Social Support Rating Scale (SSRS).ResultsThe differences in irrational parenthood cognitions, fertility, stress, and social support among patients with repeated implantation failure in the education and yearly household income subgroups were statistically significant (P<0.001). Pearson correlation analysis revealed that irrational parenthood cognitions were favorably correlated with all measures of reproductive stress (r=0.384 to 0.664, all P<0.01) and negatively correlated with social support (r=-0.310, p<0.01). The fertility stress of patients with repeated implantation failure fit the structural equation model of irrational parenthood cognitions and social support well [X2/df=2.04, Comparative Fit Index (CFI)=0.944, Tucker–Lewis (TLI)=0.905, Root Mean Squared Error of Approximation (RMSEA)=0.090]. The bootstrap test results revealed that the mediating effect of the 95% CI ranged between -0.506 and -0.109, and the interval did not contain 0. Fertility stress had a strong mediating effect on the relationship between irrational parenthood cognitions and social support.ConclusionsThe mediating effect of reproductive stress on the relationship between irrational parenthood cognitions and social support in patients with repeated implantation failure was significant. It is important for medical and nursing staff to address physical and psychological illnesses and develop effective intervention strategies from the perspectives of fertility stress, social support, and cultural background, with the ultimate goal of improving mental health.

Infertility-related stress and its relationship with emotional divorce among Iranian infertile people

BackgroundInfertility affects different aspects of couples’ lives, so it may cause problems in couples’ emotional relationships by increasing marital conflicts. This study aimed to determine Infertility-related stress and its relationship with emotional divorce among Iranian infertile people.MethodsWe conducted a cross-sectional observational study on 200 infertile people. The research environment was one of the well-equipped infertility centers in Tehran, Iran. Continuous sampling was employed. The data collection tools included a general information form, the Fertility Problem Inventory (FPI), and the Emotional Divorce Scale (EDS).ResultsThe findings revealed a significant direct relationship between infertility-related stress and all its subscales with emotional divorce in both infertile women and men. In infertile women, the most concern was the need for parenthood, while the lowest concerns were the relationship and sexual concerns. Multiple linear regression analysis indicated that social and relationship concerns predicted 44% of emotional divorce, with social concern being the more influential factor. In infertile men, the need for parenthood was the most significant concern, while relationship and social concerns were less prominent. Multiple linear regression analysis showed that relationship concern predicted 50% of emotional divorce in infertile men. In both infertile men and women, social and relationship concerns explained 45% of the variance in emotional divorce. Among these two variables, relationship concern had a more impact in predicting emotional divorce. Also, there was no statistically significant difference between women and men regarding infertility-related stress and its subscales, except for sexual concern.ConclusionThe study highlights the importance of the need for parenthood as a main concern among infertile individuals. Increased infertility-related stress and its subscales contribute to higher levels of emotional divorce among this population. Additionally, relationship concern was the lowest concern in infertile people. But it significantly predicts emotional divorce among infertile individuals.

IMPACT OF INFERTILITY-RELATED STRESS AND FAMILY AND SOCIAL SUPPORT ON MARITAL SATISFACTION OF INFERTILE INDIVIDUALS

Although infertility is a medical problem, however, the phenomenon is widely researched. With each passing day, infertile individuals undergo various personal and social challenges. Particularly, family pressure to carry on the progeny creates an unmounted pressure which ultimately affects their marital union. These factors altogether create an unprecedented scenario for their marital life. Considering this, the present research aimed to assess how family and social support could help in reducing the mounting infertility-related stress. Infertile individuals were approached at their offices, homes, as well as at infertility centres in Rawalpindi, Islamabad, and Attock using snowball and purposive sampling techniques. The participants were invited to complete a set of questionnaires including Fertility Problem Inventory, ENRICH Marital Satisfaction Scale, and Multidimensional Scale of Perceived Social Support. Hypotheses testing revealed non-significant association of family and social support with both infertility-related stress and marital satisfaction. However, family support (subscale) had positive association with infertility-related stress and negative association with marital satisfaction. Similarly, marital union of married individuals was negatively affected by stress due to infertility. However, infertility-related stress accounted for 7% variance in marital satisfaction. The study further found non-significant moderating role of family and social support between infertility-related stress and marital satisfaction. These results provided a baseline for future studies in Pakistan, in exploration of indigenous protective factors against marital dissatisfaction among infertile individuals. The present study further highlighted the importance and appropriateness of family support for childless individual. From the current study, the conclusion can be drawn that the family members (specifically in collectivistic cultures) should be consciously careful regarding their involvement in the intimate affairs (such as infertility) of the married individuals which otherwise could have detrimental effects instead of positive impacts on infertile individuals.

IMPACT OF INFERTILITY-RELATED STRESS AND FAMILY AND SOCIAL SUPPORT ON MARITAL SATISFACTION OF INFERTILE INDIVIDUALS

Although infertility is a medical problem, however, the phenomenon is widely researched. With each passing day, infertile individuals undergo various personal and social challenges. Particularly, family pressure to carry on the progeny creates an unmounted pressure which ultimately affects their marital union. These factors altogether create an unprecedented scenario for their marital life. Considering this, the present research aimed to assess how family and social support could help in reducing the mounting infertility-related stress. Infertile individuals were approached at their offices, homes, as well as at infertility centres in Rawalpindi, Islamabad, and Attock using snowball and purposive sampling techniques. The participants were invited to complete a set of questionnaires including Fertility Problem Inventory, ENRICH Marital Satisfaction Scale, and Multidimensional Scale of Perceived Social Support. Hypotheses testing revealed non-significant association of family and social support with both infertility-related stress and marital satisfaction. However, family support (subscale) had positive association with infertility-related stress and negative association with marital satisfaction. Similarly, marital union of married individuals was negatively affected by stress due to infertility. However, infertility-related stress accounted for 7% variance in marital satisfaction. The study further found non-significant moderating role of family and social support between infertility-related stress and marital satisfaction. These results provided a baseline for future studies in Pakistan, in exploration of indigenous protective factors against marital dissatisfaction among infertile individuals. The present study further highlighted the importance and appropriateness of family support for childless individual. From the current study, the conclusion can be drawn that the family members (specifically in collectivistic cultures) should be consciously careful regarding their involvement in the intimate affairs (such as infertility) of the married individuals which otherwise could have detrimental effects instead of positive impacts on infertile individuals.

IMPACT OF INFERTILITY-RELATED STRESS AND FAMILY AND SOCIAL SUPPORT ON MARITAL SATISFACTION OF INFERTILE INDIVIDUALS

Although infertility is a medical problem, however, the phenomenon is widely researched. With each passing day, infertile individuals undergo various personal and social challenges. Particularly, family pressure to carry on the progeny creates an unmounted pressure which ultimately affects their marital union. These factors altogether create an unprecedented scenario for their marital life. Considering this, the present research aimed to assess how family and social support could help in reducing the mounting infertility-related stress. Infertile individuals were approached at their offices, homes, as well as at infertility centres in Rawalpindi, Islamabad, and Attock using snowball and purposive sampling techniques. The participants were invited to complete a set of questionnaires including Fertility Problem Inventory, ENRICH Marital Satisfaction Scale, and Multidimensional Scale of Perceived Social Support. Hypotheses testing revealed non-significant association of family and social support with both infertility-related stress and marital satisfaction. However, family support (subscale) had positive association with infertility-related stress and negative association with marital satisfaction. Similarly, marital union of married individuals was negatively affected by stress due to infertility. However, infertility-related stress accounted for 7% variance in marital satisfaction. The study further found non-significant moderating role of family and social support between infertility-related stress and marital satisfaction. These results provided a baseline for future studies in Pakistan, in exploration of indigenous protective factors against marital dissatisfaction among infertile individuals. The present study further highlighted the importance and appropriateness of family support for childless individual. From the current study, the conclusion can be drawn that the family members (specifically in collectivistic cultures) should be consciously careful regarding their involvement in the intimate affairs (such as infertility) of the married individuals which otherwise could have detrimental effects instead of positive impacts on infertile individuals.

Illness anxiety, infertility stress, resilience and thyroid-stimulating hormone among infertile people undergoing ART treatment in China

Objective Infertile people undergoing assisted reproductive technology (ART) treatment in China may experience severe infertility-related stress and illness anxiety (IA). However, little relevant research has been conducted until now. Design This study investigated the IA of 340 infertile people undergoing ART treatment, including 43 males, 292 females and 5 who preferred not to answer, in 2 tertiary general public hospitals in Wen Zhou, China. Main Outcome Measures Blood samples for thyroid-stimulating hormone (TSH) levels were obtained from 107 women to explore the relationship between IA and TSH. The questionnaire contained the Mandarin version of the Fertility Problem Inventory, the Resilient Trait Scale for Chinese Adults and the Whiteley Index, measuring infertility stress, resilience and IA, respectively. Results An incidence rate of 44.1% of IA among infertile people undergoing ART treatment in China was determined, and 30.2% of men and 46.6% of women had severe IA (χ 2 = 4.05, p < 0.05). The risk of severe IA in women was around twice that in men (OR = 2.01, 95% CI: 1.01–4.01). Women’s IA level was significantly associated with their TSH level (β = 0.27, p < 0.01). Resilience played a moderating role in the relationship between parenthood importance and illness anxiety. Conclusion This study highlighted the importance and urgency of providing holistic care for illness anxiety of infertile people undergoing ART treatment in China, especially women. The findings of this study indicated that mind-body therapies and resilience empowerment workshops could be conducive to infertile people’s holistic health.

The prevalence of adjustment disorder and predisposing factors in infertile women

BackgroundInfertility is a stressful life event that increases the risk of developing mental disorders, particularly adjustment disorder (AD). Given the paucity of data on the prevalence of AD symptoms in infertility, the purpose of this study was to ascertain the prevalence, clinical presentation, and risk factors for AD symptoms in infertile women.MethodIn a cross-sectional study, 386 infertile women completed questionnaires including the Adjustment Disorder New Module-20 (ADNM), the Fertility Problem Inventory (FPI), the Coronavirus Anxiety Scale (CAS), and the Primary Care Posttraumatic Stress Disorder (PC-PTSD-5) at an infertility center between September 2020 and January 2022.ResultThe results indicated that 60.1% of infertile women exhibited AD symptoms (based on ADNM > 47.5). In terms of clinical presentation, impulsive behavior was more common. No significant relationship was observed between prevalence and women's age or duration of infertility. Infertility stress (β = 0.27, p < 0.001), coronavirus anxiety (β = 0.59, p = 0.13), and a history of unsuccessful assisted reproductive therapies (β = 2.72, p = 0.008) were several predisposing factors for AD symptoms in infertile women.ConclusionsThe findings suggest that all infertile women be screened from the start of infertility treatment. Additionally, the study suggests that infertility specialists should focus on combining medical and psychological treatments for individuals predisposed to AD, particularly infertile women who exhibit impulsive behaviors.

Preliminary examination of acceptability, feasibility, and effectiveness of internet-based cognitive behavioral therapy for treatment of depression and anxiety in infertile women

BackgroundDespite a large body of evidence supporting the effectiveness of internet-based cognitive behavior therapy (ICBT) for the treatment of depression and anxiety, there is no report of the efficacy of ICBT program in the Iranian population. The present study aimed to test the acceptability, feasibility, and effectiveness of ICBT program for the treatment of depression or anxiety in infertile women. MethodThis study consisted of two phases. In the first phase, we designed “Peaceful Mind”, an eight-session therapist-guided ICBT program. In the second phase, we tested the efficacy of the program by conducting 2-arm parallel group, non-inferiority randomized control trial, between October 2020 and July 2021.60 infertile women diagnosed with depression or anxiety disorders were divided randomly to ICBT treatment (n = 30) and face-to face CBT (n = 30). The participants received individual CBT sessions (60 min, over 8 weeks) and completed the questionnaires at the beginning, in mid-trial, and 8 weeks after the trial. The outcomes comprised Beck Depression Inventory (BDI-II), Beck Anxiety Inventory (BAI, Fertility problem inventory (FPI), Client Satisfaction Questionnaire (CSQ-8), and System usability scale (SUS). ResultsThe usability scores of the “Peaceful Mind” ICBT (M = 67.07, SD = 17.23, range = 1–100) and satisfaction with the treatment (M = 25.06, SD = 4.18, range = 1–32) were high. Patient adherence to the treatment in the ICBT group (86.6%) was the same as that in the CBT (73.3%). The between-group mean differences at the post-trial were −4.79 (CI 95% = −10.81 to 1.23) for depression scores and −4.15 (CI 95% = −9.52 to 1.22) for anxiety scores; both differences were within the non-inferiority margin points for the lower 95%CI. Conclusion“Peaceful mind” ICBT was found to be feasible and accessible for delivering the treatment to the patients. The study confirmed that both ICBT face-to face CBT were equally effective in reducing depression and anxiety of the patients.

The Role of Psychological Distress in the Relationship between Personality Dimensions and Pregnancy Outcome of Women Undergoing Assisted Reproductive Treatment (IVF/ICSI).

Objective: The aim of this study was to determine the role played by psychological distress in the relation between personality dimensions and pregnancy outcome of women undergoing in vitro fertilization/Intra-Cytoplasmic Injections (IVF/ICSI) treatment. Method : This prospective cohort study was conducted for 12 months on 154 infertile women who were receiving IVF/ICSI assisted reproductive treatment for the first time. Research instruments for measuring psychological distress included the Fertility Problem Inventory (FPI) and the Depression, Anxiety, and Stress Scale (DASS-21). One of these was completed prior to ovarian stimulation and the other during the embryo transfer stage. The temperament and Character Inventory-Revised (TCI-R 125) was employed once to assess personality dimensions prior to the ovarian stimulation stage. Independent t-test, Mann Whitney test, Repeated Measures and path analysis were performed for statistical analysis of data. Results: The results of this study showed no significant difference between the pregnant and non-pregnant groups in personality traits (Harm avoidance and self-directness) and psychological distress (FPI and DASS scores). Repeated measures showed a significant difference in stress, anxiety, and depression levels between the two stages of ovarian stimulation and embryo transfer (P < 0.01). Path analysis showed no significant direct and indirect effect for harm avoidance on the pregnancy outcome when psychological distress was mediated. Conclusion: The effect of psychological factors on IVF outcomes is more complicated than is generally assumed and more studies are mandatory to clarify the relationship between personality traits and infertility treatments.