Undergoing Infertility Treatment Research Articles

The profile of steroid hormones in human fetal and adult ovaries.

Reproduction in women is at risk due to exposure to chemicals that can disrupt the endocrine system during different windows of sensitivity throughout life. Steroid hormone levels are fundamental for the normal development and function of the human reproductive system, including the ovary. This study aims to elucidate steroidogenesis at different life-stages in human ovaries. We have developed a sensitive and specific LC-MS/MS method for 21 important steroid hormones and measured them at different life stages: in media from cultures of human fetal ovaries collected from elective terminations of normally progressing pregnancy and in media from adult ovaries from Caesarean section patients, and follicular fluid from women undergoing infertility treatment. Statistically significant differences in steroid hormone levels and their ratios were calculated with parametric tests. Principal component analysis (PCA) was applied to explore clustering of the ovarian-derived steroidogenic profiles. Comparison of the 21 steroid hormones revealed clear differences between the various ovarian-derived steroid profiles. Interestingly, we found biosynthesis of both canonical and "backdoor" pathway steroid hormones and corticosteroids in first and second trimester fetal and adult ovarian tissue cultures. 17α-estradiol, a less potent naturally occurring isomer of 17β-estradiol, was detected only in follicular fluid. PCA of the ovarian-derived profiles revealed clusters from: adult ovarian tissue cultures with relatively high levels of androgens; first trimester and second trimester fetal ovarian tissue cultures with relatively low estrogen levels; follicular fluid with the lowest androgens, but highest corticosteroid, progestogen and estradiol levels. Furthermore, ratios of specific steroid hormones showed higher estradiol/ testosterone and estrone/androstenedione (indicating higher CYP19A1 activity, p < 0.01) and higher 17-hydroxyprogesterone/progesterone and dehydroepiandrosterone /androstenedione (indicating higher CYP17A1 activity, p < 0.01) in fetal compared to adult ovarian tissue cultures. Human ovaries demonstrate de novo synthesis of non-canonical and "backdoor" pathway steroid hormones and corticosteroids. Elucidating the steroid profiles in human ovaries improves our understanding of physiological, life-stage dependent, steroidogenic capacity of ovaries and will inform mechanistic studies to identify endocrine disrupting chemicals that affect female reproduction.

Exploring Infertility Treatment Among Economically Active Married Women

Purpose: This study aimed to assess the current landscape of infertility treatment among married women engaged in economic activities and analyze the associated factors.Methods: Using data from the 2021 National Family and Fertility Survey in Korea, this study included 1,772 married women aged 20–44 who participated in economic activities. General characteristics were compared based on participants’ experiences with infertility and the use of infertility treatments (assisted reproductive technology). Logistic regression analysis was used to identify the factors associated with infertility and infertility treatment.Results: Among the study participants, 325 had experienced infertility and 122 had undergone infertility treatment. The likelihood of infertility was higher in women aged ≥35 years and those with gynecological problems. Infertility treatment was more probable among infertile women over 40 years of age, with higher levels of education and household income, cohabiting with their spouse for 4–9 years, working less than 40 hours per week, and holding office jobs as opposed to service or sales workers. Respondents who underwent infertility treatment highlighted the following challenges: mental and social prejudice, physical discomfort, pain, financial burden, workplace factors, and time constraints.Conclusion: This study shows that biological factors are important in infertility and underscores the significance of workplace factors and socioeconomic characteristics in the decision to treat infertility. This emphasizes the need for research that supports women pursuing a career or education who encounter the challenges of infertility.

Эффективность психокоррекционного воздействия методами имагинативной психотерапии при идиопатическом бесплодии

&lt;p&gt;The article provides results of research into the impact of psychosomatic factors on successful conception in patients with idiopathic infertility who undergo treatment in the department of infertile marriage and ART of the Ural Research Institute of Maternity and Child Care. Infertility-related psychological targets and their correction by imaginative psychosomatic psychotherapeutic techniques can be a way to provide a solution to the infertility problem. A method to reduce the effect of distress hormones on the target reproductive function body organs was developed and tested. This method is rooted in the knowledge of neuroendocrine regulation of reproductive processes. The psychotherapeutic correction was based on the approaches of emotional-figurative therapy as a way to reduce the extremeness of living conditions while undergoing infertility treatment. Psychodynamic indicators of socio-psychological maladaptation, volitional tension, behavior constructiveness in distress situations, psychovegetative coefficient of ergicity were selected as the effectiveness criteria.&lt;/p&gt;

Influence of medical and social factors on patients’ satisfaction at the center for reproduction and family planning with medical care

BACKGROUND: The constant increase in the number of commercial medical organisations providing medical care using assisted reproductive technology (ART) and compulsory medical insurance funds necessitates the need to control the quality of medical services in this area. An important tool for this control is conducting sociological surveys of women undergoing infertility treatment using in vitro fertilisation (IVF) both in paid and free forms.&#x0D; MATERIALS AND METHODS: Using a random sampling method, an anonymous survey was conducted on 398 patients of the Center for Reproduction and Family Planning in St. Petersburg, which provided medical care for infertility treatment using ART both at the expense of compulsory medical insurance and in paid form. The significance of differences in indicators was assessed using Student’s t-test for quantitative indicators. The significance of differences between qualitative characteristics was checked using contingency tables and Pearson’s chi-square test (χ2). Differences were considered significant at р 0.05.&#x0D; RESULTS: Despite the high level of patient satisfaction with the provision of medical care using ART, 9.0% of women were partially or completely dissatisfied. Compulsory medical insurance funds were paid for infertility treatment using IVF for 12.1% of patients. The majority of patients paid for medical care themselves (87.9%), of which 13.1% of women believed that the cost of medical services in the center was excessive (χ2=29.08; р=0.000), and 10.9% thought that the cost does not correspond to the level of medical services provided (χ2=25.74; р=0.000). There was no significant influence of age (χ2=4.78; р=0.311), place of residence (χ2=1.79; р=0.409), presence of children (χ2=2.21; р=0.331), employment (χ2=2.91; р=0.233) and forms of payment for treatment (χ2=4.69; р=0.096) on the distribution of patients according to the degree of satisfaction with medical care. At the same time, it was determined that marital status (χ2=6.88; р=0.032) and income level (χ2=60.01; р=0.000) are factors that influence the degree of satisfaction of women with infertility treatment using ART.&#x0D; CONCLUSION: Many medical and social factors have been identified to significantly affect satisfaction with medical care, such as the patient’s marital status and income level. Simultaneously, the economic form of payment for treatment did not have a significant effect on the degree of satisfaction.

Depression in women undergoing infertility treatment: A clinic-based study in Kerala, India.

Depression in women undergoing infertility treatment: A clinic-based study in Kerala, India.

Anxiety, Depression, and Quality of Life Among Infertile Women: A Case-Control Study.

Introduction Pregnancy holds significant cultural and social value for women. However, women facing challenges in conceiving often grapple with emotional distress, including depression and anxiety. The connection between psychological elements (stress, anxiety, and depression) and infertility is complex, influenced by multiple factors, and bidirectional. Infertile women are more likely to develop mental illnesses, marital dissatisfaction, and impaired quality of life compared to the individuals of the fertile group. Thus, the study aimed to assess levels of anxiety, depression, and quality of life among infertile women compared to fertile women. Methods This case-control study conducted at a tertiary care center recruited 100 nulliparous women between the age group of 20 and 38 years with primary or secondary infertility, while those with male factor infertility were excluded. The control group (N=100) comprised normal parous women who had at least one child. The primary objective of the study was to assess the impact of infertility on the mental health and quality of life of women seeking infertility treatment. Outcome measures included standardized tools such as the WHOQOL-BREF questionnaire to assess the quality of life across multiple domains (e.g., physical, psychological, social, and environmental) as well as the Depression Anxiety and Stress Scale (DASS-21) to measure levels of anxiety, depression, and stress. Cronbach's alpha was used to measure the tool's reliability. A P value of <0.05 was considered statistically significant. Results Baseline sociodemographic parameters were comparable between the two groups. The mean age of infertile women was 30.6±3.9 years compared to 31.5±3.2 years in fertile women (P=0.076). Using the WHOQOL-BREF scale, we found that the quality of life was better in the fertile group compared to the infertile group through all the physical, psychological, social, and environmental domains (P<0.001). The infertile group had a significantly higher number of women with anxiety, depression, and stress. The questionnaires showed high internal reliability. Conclusion Infertile women experienced a lower quality of life in various domains, higher levels of anxiety, and increased rates of depression compared to fertile counterparts. The study findings underscore the multidimensional impact of infertility, emphasizing the need for comprehensive healthcare approaches to address the psychosocial challenges faced by women undergoing infertility treatment.

Depressive symptoms among women undergoing infertility treatment by in vitro fertilization and some associated factors at the National Hospital of Obstetrics and Gynecology in 2023

Depressive symptoms among women undergoing infertility treatment by in vitro fertilization and some associated factors at the National Hospital of Obstetrics and Gynecology in 2023

(205) The Psychological, Sexual, and Financial Impact of Infertility on Couples: An Urological Approach

Abstract Introduction Infertility is a public health issue with socioeconomic and demographic impact. Understanding the psychological, sexual, and financial repercussions on couples is crucial for comprehensive treatment. Objective Infertility can evoke complex emotions and disrupt the couple's sexual relationship. The aim of this study is to examine the psychological, sexual, and financial aspects of this condition on infertile couples. Methods A retrospective study was conducted on 50 couples undergoing infertility treatment at a military hospital. Data, including medical records, questionnaires, and follow-up information, were collected. Results 1. Psychological Impact: Infertility represents a failure of the parental project, leading to negative emotions. Women are more likely to report the psychological impact and seek help. Family pressure and potential divorce due to societal expectations were observed. 2. Sexual Impact: Infertility can significantly affect sexual life, causing decreased satisfaction, stress, and anxiety. Communication and emotional intimacy may suffer. Contrary to literature, men reported more sexual disorders due to socio-cultural factors and female partners' discomfort discussing sexuality. 3. Financial Impact: Infertility treatments incur substantial costs, adding to emotional and physical burdens. Financial implications vary by country, and lack of national funding policies lead to debt or abandonment of conception plans. In the study, half of the couples spent over $1000. Conclusions Infertility has a significant psychological, sexual, and financial impact on couples. A comprehensive approach involving healthcare practitioners and policymakers is necessary for significant improvement in the well-being of infertile couples. Disclosure No.

Anxiety, depression, and body image among infertile women with and without polycystic ovary syndrome.

In women undergoing fertility treatment, do those with polycystic ovary syndrome (PCOS) have a higher prevalence of symptoms of anxiety and depression and lower body appreciation than women without PCOS? Having PCOS was not associated with symptoms of anxiety and depression but was associated with somewhat lower body appreciation. PCOS has been associated with a higher chance to develop mental health problems, like anxiety, and body image concerns. The International Guidelines on PCOS recommend that all women with PCOS should routinely be screened for anxiety and depressive disorders. In most studies in this field, the comparison group included healthy women without fertility problems. We conducted a cross-sectional survey study between May 2021 and July 2023, using an online questionnaire. We informed women about this study at fertility clinics in the Netherlands through posters and leaflets and on the websites of the Dutch patient organizations Freya and Stichting PCOS. This study included women with infertility, with and without PCOS, who were undergoing fertility treatment. Women completed two assessment tools: the Hospital Anxiety and Depression Scale (HADS) and the Body Appreciation Scale-2 (BAS-2). Primary outcomes were clinically relevant symptoms of anxiety (score ≥ 11) and depression (score ≥ 11), and BAS-2 scores. Secondary outcomes were mean anxiety and depression scores and anxiety and depression scores of 8 and higher. Dichotomous outcomes and continuous outcomes were analysed using logistic and linear regression analyses adjusted for age, BMI, and duration of infertility. A total of 1025 women currently undergoing infertility treatment participated, of whom 502 (49.0%) had PCOS and 523 (51.0%) had other infertility diagnoses. We found self-reported clinically relevant symptoms of anxiety in 33.1% of women with PCOS and in 31.0% of women with other infertility diagnoses (adjusted OR: 0.99, 95% CI 0.74-1.31). Clinically relevant symptoms of depression were reported in 15.5% of women with PCOS versus 14.5% of women with other infertility diagnoses (adjusted OR: 1.04, 95% CI 0.71-1.50). Women with PCOS reported slightly less body appreciation (adjusted mean difference: -1.34, 95% CI -2.32 to -0.36). Results are based on self-report and may have been affected by sampling bias. Although guidelines recommend screening women with PCOS, feelings of anxiety and depression can be present in any woman undergoing fertility treatments. We advise fertility clinics to be aware of women's mental health issues and to offer support accordingly, as a part of routine care. This study did not receive specific funding. All authors report no conflict of interest related to the current research. This study was pre-registered at OSF: https://osf.io/qbeav.

A Qualitative Exploration of Psychosocial Support Strategies for Reducing Psychological Distress among Clients Attending an Assisted Reproductive Center in South-West Nigeria

Clients undergoing infertility treatment usually face a multitude of psychosocial challenges as well as the stigma associated with childlessness. In order to alleviate these issues, psychosocial support strategies are put in place. The strategies target emotional, social, mental, and spiritual needs, with studies confirming the importance of psychosocial support in assisted reproductive technology management. This study explored psychosocial support strategies for reducing psychological distress among clients attending an assisted reproductive center in South West, Nigeria. A purposive sampling technique was used to select 10 participants who met the inclusion criteria. In-depth interview was conducted to gather qualitative data which was analyzed using themes and subthemes. The themes identified are: family support, spiritual support, avoidance strategies and professionalism of healthcare workers. It was therefore concluded that psychosocial support strategies are necessary to reduce the psychological distress that usually accompanies infertility and assisted reproductive technology. It may also improve the outcome of the treatment.

(200) The Fertility and Childbearing Experiences of US Male Physicians

Abstract Introduction Recent attention has been brought to physician fertility in the last decade, most notably amongst female physicians who suffer an increased risk of infertility compared to the general population. Various factors related to a career in medicine play a role, such as a delay in pursuit of childbearing, a demanding work schedule, shift work, and stress associated with the profession. However, risk of infertility in the male physician population has yet to be studied. Objective Therefore, we sought to evaluate the experiences and childbearing patterns of a sample of American male physicians with special attention to timing of conception and childbearing, reflections upon professional and personal decision-making, and general knowledge regarding fertility. The primary objective of this study was to determine the incidence of infertility among American male physicians. Methods Utilizing a third party to access the American Medical Association (AMA) database, licensed US physicians registered as male and between the ages of 18-65 were identified. Within this cohort, 690 men were randomly selected and contacted via paper mail (340) or email (350) and asked to participate in the survey study. Surveys were administered electronically via REDCap (obtained through a QR code) and included questions regarding the physicians’ demographics, medical specialty, and whether they have attempted to conceive. Those who have attempted to conceive were also surveyed on their work experience at the time of their first attempt at conception and their experience and partner’s experience with fertility and childbearing. Internal Review Board approval was obtained for this study (STUDY 20211036). Results Fifty-three men responded to the survey (7.7%). All respondents were cisgender males with cisgender female partners. The majority (94.3%) had attempted to conceive and occurred most during residency (46.0%). The average age when first attempting conception was 31.6 years, and this was most commonly during residency (46.0%) or after training (30.0%). During this time, many (72.0%) were responsible for night shifts, overnight call duties, or both. In addition, as many as 34 men (68.0%) had no access to paid parental leave during this time. Of 50 men who attempted conception, 14 (28.0%) of their partners experienced a miscarriage. Eight men (17.0%) underwent a fertility workup, and 6 underwent infertility treatment(s). Only 4 respondents had insurance partially covering their infertility treatments, while the other two had no insurance coverage. Conclusions Male physicians are often exposed to long work hours, nighttime duties, and sparse paid parental leave during the time of their first attempt at conception, most commonly in residency. Our cohort shows a high rate of miscarriage (28.0%) and infertility assessment (16.0%) among this population. Future studies are needed to continue characterizing fertility amongst physicians. Disclosure No.

(343) The Psychological, Sexual, and Financial Impact of Infertility on Couples: An Urological Approach

Abstract Introduction Infertility is a public health issue with socioeconomic and demographic impact. Understanding the psychological, sexual, and financial repercussions on couples is crucial for comprehensive treatment. Objective Infertility can evoke complex emotions and disrupt the couple's sexual relationship. The aim of this study is to examine the psychological, sexual, and financial aspects of this condition on infertile couples. Methods A retrospective study was conducted on 50 couples undergoing infertility treatment at a military hospital. Data, including medical records, questionnaires, and follow-up information, were collected. Results 1. Psychological Impact: Infertility represents a failure of the parental project, leading to negative emotions. Women are more likely to report the psychological impact and seek help. Family pressure and potential divorce due to societal expectations were observed. 2. Sexual Impact: Infertility can significantly affect sexual life, causing decreased satisfaction, stress, and anxiety. Communication and emotional intimacy may suffer. Contrary to literature, men reported more sexual disorders due to socio-cultural factors and female partners' discomfort discussing sexuality. 3. Financial Impact: Infertility treatments incur substantial costs, adding to emotional and physical burdens. Financial implications vary by country, and lack of national funding policies lead to debt or abandonment of conception plans. In the study, half of the couples spent over $1000. Conclusions Infertility has a significant psychological, sexual, and financial impact on couples. A comprehensive approach involving healthcare practitioners and policymakers is necessary for significant improvement in the well-being of infertile couples. Disclosure No.

Cryopreservation of Limited Sperm Using A Combination of Sucrose and Taurine, Loaded on Two Different Devices, and Thawed at Two Different Temperatures.

Cryopreservation of sperm is essential for patients with low sperm counts and couples undergoing infertility treatment. The aim of this study was to compare the effects of Taurine (T) and Sucrose (S) in individual sperm cryopreservation utilizing cryotop and petri dish and thawing at 37 and 42°C. In this experimental study, 17 normospermic semen samples were processed using the "Swim-up" procedure and progressively motile sperm were then isolated from these samples using an inverted microscope. Sperm were added to droplets of "sucrose medium" with 25 mM Taurine antioxidant (S+T) and the commercial cryoprotectant "Sperm Freeze" (CPA), loaded on a petri dish and cryotop. After rapid freezing of the samples, they were thawed at two different temperatures (37°C and 42°C), and the sperm classical parameters, viability, and DNA fragmentation were assessed. Statistical analysis displayed a significant increase in total and progressive motility in individual sperm freezing on cryotop with CPA and thawing at 42°C (P<0.05). Other parameters did not show any differences between the CPA and S+T groups and two thawing temperatures in either of the cryopreservation methods. Although, both cryoprotectants (CPA and S+T) may preserve individual sperm effectively using cryotop, the CPA and thawing at 42°C showed a better effect on the motility percentage of the small number of sperm.

Proposal for a system to identify the causes and triggers of stress in infertility patients

This paper aims to classify the types of stress experienced by women undergoing infertility treatment in Japan and to clarify the causes of such stress. To achieve this, tweets posted by infertility patients were used to identify the causes of stress through a learning model, followed by dependency analysis. A system is proposed to extract causal relations using dependency analysis, where the dependents are the causes and the leaders are the effects. The study focuses on the stress experienced by infertility patients and limits the analysis to "family issues" and "work." Consequently, the incentives for the causes were clarified.

Affective temperaments show stronger association with infertility treatment success compared to somatic factors, highlighting the role of personality focused interventions

Infertility has a multifactorial background, where, besides somatic factors, psychological contributors also play a role in development and outcome. While affective temperaments have been associated with development, course, and outcome as well as treatment success in various somatic conditions, their association with infertility and its treatment has not been investigated so far. The purpose of our retrospective cohort study was to evaluate the influence of affective temperaments on fertility treatment outcomes. Among 578 women who underwent infertility treatment in an Assisted Reproduction Centre in Budapest, Hungary, treatment success, detailed medical history, and demographic parameters were recorded, and the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Auto-questionnaire (TEMPS-A) was administered. Possible predictors of assisted reproduction outcome were analyzed using multivariate logistic regression models, followed by a receiver operating curve (ROC) analysis in order to define ideal affective temperament cut-off values for clinical applicability. Aside from age, BMI, and previous miscarriage, cyclothymic scores > 4 (OR = 0.51 CI 0.35–0.74, p < 0.001), depressive scores > 9 (OR = 0.59 CI 0.4–0.87, p = 0.009) and anxious scores > 9 (OR = 0.45 CI 0.31–0.66, p < 0.001) significantly decreased the odds of clinical pregnancy by 49%, 41% and 55%, respectively. Irritable and hyperthymic temperaments, as well as other somatic and socio-economic factors had no effect on infertility treatment outcomes. The results suggest that affective temperaments may be related to the outcome of infertility treatments. Thus, screening for affective temperaments may help identify high-risk patient groups and offer patient-tailored treatment, which may increase the chances of a successful pregnancy and live birth for women undergoing IVF treatment.

#102 : The Impact of Guided Meditation [Mindfulness Based Intervention] on the Stress Levels in Patients Undergoing Infertility Treatment

BACKGROUND: 1 in 8 couples have difficulty in conception. The majority of them are prone to psychological vunerability, ranging from anxiety to depression leading to shame, guilt, low self-esteem all of which lead to a poor quality of life. Mindfulness meditation improves parasympathetic functions and is a powerful modulator of the sympathetic nervous system. AIMS &amp; OBJECTIVES: To conduct a prospective, randomized, comparative trial at Private reproductive medicine clinic. To investigate the impact of ‘Guided Meditation’ on stress and anxiety level of infertile women during the infertility treatment. Via a questionnaires series and evaluation of autonomic function tests of patients before the intervention and after intervention Patient(s): All enrolled women undergoing infertility (n=75), were asked to practice guided meditation daily for three months, post which they were reevaluated. MATERIALS &amp; METHODS: Inclusion Criteria Women with Primary infertility Age - 21 to 50 years Exclusion Criteria Known case of any psychological/psychiatric illness Already taking antipsychotics, any medicine related to mood disorders, anxiety, depression, interfering with the serotonin pathway Method/Design: Standardized scales of infertility-related coping strategies and fertility quality of life (FertiQoL), Becks Anxiety scale, Becks Depression scale, Patient Health Questionnaire (PHQ 10) were endorsed pre and post-MBI at the end of three months. RESULT: The outcome measure is to evaluate if women post intervention revealed a significant increase in mindfulness, self-compassion, meaning-based coping strategies and changes in their FertiQoL, Beck’s anxiety scale and PHQ 10 domains. Inversely, if they presented a significant decrease in emotional regulation difficulties, active- and passive-avoidance coping strategies. CONCLUSION: The impact of Guided Meditation or MBI by practice and its effective symptomatic reduction in their Anxiety &amp; Depression scores [Stress levels]

Gestational diabetes mellitus in pregnancies conceived after infertility treatment: a population-based study in the United States, 2015–2020

To evaluate the risk of gestational diabetes mellitus (GDM) in singleton pregnancies conceived using infertility treatment and examine the influence of race and ethnicity as well as prepregnancy body mass index (BMI). Cross-sectional study using the US vital records data of women that delivered singleton births. United States, 2015-2020. Any infertility treatment was divided into two groups: those that used fertility-enhancing drugs, artificial insemination, or intrauterine insemination, and those that used assisted reproductive technology (ART). Gestational diabetes mellitus, defined as a diagnosis of diabetes mellitus during pregnancy, includes both diet-controlled GDM and medication-controlled GDM in singleton pregnancies conceived with infertility treatment or spontaneously and delivered between 20- and 44-weeks' gestation. We also examined whether the infertility treatment-GDM association was modified by maternal race and ethnicity as well as prepregnancy BMI. Associations were expressed as a rate ratio (RR) and 95% confidence interval (CI), derived from log-linear models after adjustment for potential confounders. A total of 21,943,384 singleton births were included, with 1.5% (n = 318,086) undergoing infertility treatment. Rates of GDM among women undergoing infertility treatment and those who conceived spontaneously were 11.0% (n = 34,946) and 6.5% (n = 1,398,613), respectively (adjusted RR 1.24, 95% CI 1.23, 1.26). The RRs were adjusted for maternal age, parity, education, race and ethnicity, smoking, BMI, chronic hypertension, and year of delivery. The risk of GDM was modestly increased for those using fertility-enhancing drugs (adjusted RR 1.28, 95% CI 1.27, 1.30) compared with ART (adjusted RR 1.18, 95% CI 1.17, 1.20), and this risk was especially apparent for non-Hispanic White women (adjusted RR 1.29, 95% CI 1.26, 1.31) and Hispanic women (adjusted RR 1.35, 95% CI 1.29, 1.41). The number of women who needed to be exposed to infertility treatment to diagnose one case of GDM was 46. Prepregnancy BMI did not modify the infertility treatment-GDM association overall and within strata of race and ethnicity. These general patterns were stronger after potential corrections for misclassification of infertility treatment and unmeasured confounding. Infertility treatment, among those who received fertility-enhancing drugs, is associated with an increased GDM risk. The persistently higher risk of GDM among women who seek infertility treatment, irrespective of prepregnancy weight classification, deserves attention. Infertility specialists must be vigilant with preconception counseling and ensure that all patients, regardless ofrace and ethnicity or BMI, are adequately tested for GDM early in pregnancy using a fasting blood glucose level or a traditional 50-g oral glucose tolerance test. Testing may be completed by the infertility specialist or deferred to the primary prenatal care provider at the first prenatal visit.

ASSESSING THE EFFICACY OF LONG-PROTOCOL OVULATION STIMULATION USING GONADOTROPIN-RELEASING HORMONE AGONIST IN WOMEN EXPERIENCING INFERTILITY AND COMORBIDITY OF LEIOMYOMA AND CHRONIC ENDOMETRITIS

Introduction. Nowadays infertility is one of the global medical and social issues worldwide. Assisted reproductive technologies, including in vitro fertilization, is one of the main techniques for restoring fertility. Among the main stages of IVF are controlled ovarian stimulation (COS), the optimal method of which is chosen depending on a numerous factor, such as the patient's age, the ovarian reserve, and the presence of concomitant gynecological or extragenital pathology. The prevalence of various combinations of gynecological pathologies, for example, the comorbidity of uterine leiomyoma and chronic endometritis, can affect the results of IVF in different ways, so scientists around the world are increasingly studying the management of such patients. The aim of the study is to compare controlled ovarian stimulation long-protocol parameters and its effectiveness in the therapy of infertile patients with the comorbidity of uterine leiomyoma and chronic endometritis. Methods and participants. We performed retrospective comparative analysis of anamnestic data of 130 women with infertility who underwent infertility treatment with assisted reproductive technologies. The patients were divided into three groups. In all groups, stimulation of superovulation was carried out following a long protocol with a GnRH agonist; p&lt;0.05 was considered statistically significant during the statistical data processing. Results. The study has revealed that higher starting dose of gonadotropins, as well as higher total gonadotropin consumptions are required for the patients of the second study group with uterine leiomyoma and chronic endometritis, compared to the first study group and the control group. The number of retrieved oocytes, including mature ones, were the lowest as well as the number of immature, deeply immature and degenerative oocytes were the highest in the second study group. The lowest rate of normal fertilization (2pn) and, as a result, a lower blastocyst yield is recorded in the same group. The highest frequency of aborted pregnancies among achieved clinical pregnancies is observed in the group of infertile women with uterine leiomyoma and chronic endometritis. Conclusions. The presence of the uterine cavity pathology combined with persistent chronic inflammation of the uterine mucosa, as well as the absence of proper preparation for IVF-ET cycles are the main reasons for the negative infertility treatment outcomes in such patients. This justifies the need for appropriate optimal preparation and elimination of the identified negative factors before or during the infertility treatment.

PSYCHOSEXUAL CARE COULD PROTECT and PROMOTE SEXUAL WELL-BEING in WOMEN UNDERGOING INFERTILITY TREATMENT: a RANDOMIZED CONTROLLED TRIAL

ABSTRACT Sexual well-being plays a central role in promoting the health and well-being of women undergoing infertility treatment. However, because of the predominance of the biomedical approach, most studies focus on women’s sexual function levels and how to improve them. There is little knowledge about how sexual well-being could be promoted in infertile women by using a health-oriented approach, as presented in the Model. This study aimed to examine the effectiveness of psychosexual care using the conceptual framework of the Salutogenic Model in promoting sexual well-being in women undergoing infertility treatment. This was a two-armed parallel randomised controlled trial. Seventy women with primary infertility undergoing infertility treatment were randomly assigned to receive either psychosexual care (intervention group, n = 35) or routine care (control group, n = 35). The psychosexual care program lasted 4 weeks and was aimed at delivering knowledge, support, and skills that may provide resources to women for the promotion of their sexual well-being. The primary outcome was sexual well-being; secondary outcomes included depression and sense of coherence. The effects of psychosexual care were estimated by the t-test with the intention-to-treat principle. Sexual function was improved in the intervention group and significantly reduced in the control group. Sexual satisfaction was preserved in the intervention group and significantly reduced in the control group. Sexual esteem and self-efficacy significantly improved in women after psychosexual care compared with routine care. Although depression levels were improved in the intervention group, the difference in depression levels was not statistically significant between the intervention and the control groups. However, sense of coherence was significantly improved in the intervention group compared with the control group. Psychosexual care protected and promoted sexual well-being in women undergoing infertility treatment. Application of the health-oriented Salutogenesis Model may be useful to develop care interventions that enable women to reach a state of sexual well-being.

The social infertility cycle model

Infertility poses an immense challenge to contemporary society. Around one in six people worldwide trying to conceive a child are facing infertility. This situation exists in an age of great technological developments where advances in medicine have made infertility treatment widely available and increasingly effective. In this article, a model will be presented that aims to explain the individual and social functioning of individuals and couples undergoing infertility treatment using assist-ed reproductive methods. The model was developed on the basis of a series of studies carried out by the author and col-leagues during 2015-2021. The social infertility cycle model was proposed as the outcome of further research steps that were taken. The model takes into consideration the factors and behaviours of couples with infertility that determine the quality of their everyday functioning as well as the effectiveness of infertility treatment. The successive steps of the research process will be outlined in the article along with a presentation of the developed model.