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The psychological and psychiatric aspects of infertility
Abstract
Infertility can be defined as a crisis with cultural, religious, and class related aspects, which coexists with medical, psychiatric, psychological, and social problems. Relation between psychiatric and psychological factors stem from a mutual interaction of both. Consequences of infertility arise from short and long-term devastating effects on both individual's physical and mental health, and marital system. Many studies focus on infertility related psychological and psychiatric disorders (depression, anxiety, grief, marital conflict), gender differences, relation between the causes of infertility and psychopathology, the effects of psychiatric evaluation and intervention -when necessary- on the course of infertility treatment, pregnancy rates, and childbirth. The aim of this paper is to review the infertility related psychiatric isssues studied in different countries. Articles concerning this aim were reached via internet using the key words, 'infertility', 'psychiatry', 'depression', 'anxiety' through 'PubMed', 'Proquest', and 'Turkish Medline' medical search motors. According to the contemporary consultation-liasion psychiatry, infertile couples would benefit from biopsychosocial and multidiciplinary approach during the treatment process of infertility, pregnancy and parenting periods, eventually achieving a plausible consensus in the marital relation. As to our knowledge, because of the scarcity of the studies emphasizing our own sociocultural features, especially prospective studies with this special patient population are needed.
... 3,4 İnfertilite, kadınlığın annelik ve erkeğin üretkenlik ile eş değer görüldüğü toplumlarda, çiftlerin ruhsal sağlığını ve yaşam kalitesini olumsuz etkileyerek, depresyon, kaygı, cinsel istekte azalma ile evlilik ilişkilerinde bozulmaya neden olabilen beklenmedik bir deneyimdir. 2,5 İnsan neslinin sürekliliğinin devam etmesinde ve toplumun beklentilerine uyan kişiler yetiştirilmesinde aile çok önemli yer tutmaktadır. Ailenin üyesi olan ebeveynler bu rolü, üreme ve doğurganlık işlevleriyle yerine getirmektedirler. ...
... Ailenin üyesi olan ebeveynler bu rolü, üreme ve doğurganlık işlevleriyle yerine getirmektedirler. 5 Üreme ve doğurganlık işlevlerinde meydana gelen bir sorun, çiftler üzerinde baskı oluşturarak psikolojik ve sosyal sorunlar yaşamalarına neden olmaktadır. İnfertil birey, toplumun aileden beklediği bebek sahibi olma ve topluma uygun birey yetiştirme beklentisini karşılayamayarak, bundan dolayı anksiyete, kendini olumsuz algılama, toplumdan soyutlanma ve toplum tarafından doğru algılanamama gibi olumsuz duygular yaşamaktadır. ...
... Uygulanan soru formu, araştırmacılar tarafından konuya ilişkin literatür taraması sonucunda hazırlandı. [1][2][3][4][5][6][7][8] Soru formu 2 farklı bölümden oluşmaktadır. İlk bölümde ebe ve hemşirelerin sosyodemografik özelliklerine (yaş, öğrenim durumu, aile tipi vb.) ilişkin 5 soru, 2. bölümde infertiliteye yönelik 5 soru olmak üzere toplam 10 soru yer almaktadır. ...
... Reaction of the family and environment is an additional emotional burden. Many mothers blame the syndrome on their behaviour during pregnancy, even though extensive research does not confi rm it, and that signifi cantly affects the atmosphere in which a girl grows up and impacts her relationship with mother (Bidzan, 2006). Female infertility itself, as well as the necessary long-term treatment, are not only a physical diffi culty for a woman but most of all a huge emotional burden for the woman affected by this problem and for her partner and family as well. ...
... The elements that make up neuroticism are anger, aggressive hostility, depressive mood, impulsivity, oversensitivity and excessive self-criticism (Costa & McCrae, 1992a;Zawadzki, Strelau, Szczepaniak & Śliwińska, 2007). The results of research conducted so far show that infertile women score higher on all fear measuring scales, moreover they are more emotionally unsteady (Bidzan, 2006). In addition, research results show that blaming oneself and avoidance coping are the tools used most frequently by those women in diffi cult situations (Cwikel, Gidron & Sheiner, 2004;Jarmołowska, 2007). ...
... The coping style is defi ned as "a set of coping strategies characteristic for a given individual" i.e. a set of cognitive and behavioral efforts, some of which may be made in a specifi c diffi cult situation (Heszen-Niejodek, 2000, p. 484). The research conducted by Bidzan andJózefi ak (2006, after: Bidzan, 2006) showed that women who felt that they did not fulfi ll their role of a mother did indeed use escapism as a method of fi ghting stress. The research also showed that there is a signifi cant difference in the avoidance subscale arising from the fact that women who found procreation diffi cult were indeed more eager to divert attention from the cause of stress than healthy women. ...
Objectives: Study participants are 46 women (age 23.48 ± 4.88 years) with Mayer-Rokitansky-Küster-Hauser
(M-R-K-H) syndrome. Occurrence of the M-R-K-H syndrome is one in 4000-5000 female children. It was investigated (a) whether coping styles mediate the effect of neuroticism (N) on positive (PA) and negative (NA) affect, and (b) whether this mediation is moderated by the level of N as well as (c) whether this moderated mediation is moderated by length of awareness of illness. Methods: Neuroticism, coping style as well as positive and negative emotions were assessed using the Polish version of NOE-FFI, CISS and Scale of Emotional State. Results: Emotion coping style fully (for PA) or partly (for NA) mediated the relationship between neuroticism and emotions and these mediations were moderated by the level
of N. Additionally, direct effect of neuroticism on NA was moderated by the time for which a patient has been aware of the disease. Conclusions: The level of neuroticism and the length of illness are important factors for the psychological functioning of women with M-R-K-H Syndrome. In women with medium and high neuroticism, (positive) effect of N on NA was indirect and also direct – but only in those who have been aware of the diagnosis for 6 years or more. Relations with positive emotions were different: the indirect effect (negative) was observed only in women with a moderate and low neuroticism.
Key words: Mayer-Rokitansky-Küster-Hauser Syndrome, neuroticism, coping style, affect, mediation, moderated mediation
... Although not classified as a life-threatening disease, infertility is a social problem affecting the individual, family, and society. Since infertility causes personal, familial, and social problems, it is a devastating therefore serious health problem [1,2]. An abundance of studies have evidenced the physical, psychological, ethical, sociocultural, emotional, and financial effects of infertility. ...
... Among the main objectives of infertility psychological counseling are providing some coping strategies to the individual and couples diagnosed with infertility, 1 Helping the couple uncover their ambivalent emotions toward being infertile emotional readiness to the treatment process, discovering the options, assisting in making a choice, and determining the effects of infertility on the individual and his/ her immediate surroundings. Having recently renowned as a domain calling for professional expertise and skills, psychological counseling for infertility gives a chance to infertile individuals to seek the ways for enhancing, exploring, and clarifying their life quality and satisfaction. ...
... tıbbi, psikiyatrik, psikolojik ve sosyal sorunları beraberinde getiren, kültürel, dinsel ve sınıfsal yönleri olan, bireye özel, beklenmeyen stresörlerle karşılaştıran, toplumsal etiketlenmeyle sonuçlanan, cinsellikle ilgili başarısızlık, yetersizlik duyguları yaşanmasına neden olan, yaşamı değiştiren bir deneyimdir.[7,8]Tüm bu nedenlerden dolayı infertilite tanısı çiftlerde nasıl başa çıkacaklarını bilmedikleri bir kriz meydana getirmektedir.[9]Ayrıca çiftler infertilite tedavisi sürecinde, negatif gebelik testi sonucu ve yeni tedavilerde yorgunluk ve başarısızlık gibi bir çok beklenmedik durumla daha karşılaşıp birbiri ardına yeni krizler yaşayabilmektedirler.[10]Her bireyin beklenmedik bir olay karşısında gösterdiği tepki farklıdır.[11]İnfertil ...
... kendi kültürü ve değerler sistemi içinde kendisinden beklenen psikolojik, fiziksel ve sosyal işlevlerini yerine getirememesi durumunda buna bağlı olumsuz sonuçları en aza indirmek ya da tamamen ortadan kaldırmak için başa çıkma yöntemlerini kullanması gerekmektedir.[33]Çiftler, infertilite tanı ve tedavi sürecinde kullandıkları başa çıkma yöntemleri ile infertilite krizini yönetebilmektedirler.[8,13]Bu yüzden infertil çiftlerin psikososyal değerlendirmesinde çiftlerin yaşadıkları güçlükler ve kullandıkları başa çıkma yöntemleri değerlendirilmelidir.[9]Literatürde infertilite stresi ile başa çıkma yöntemleri ile ilgili farklı sınıflandırmalara rastlanmaktadır. İnfertilite stresi ile başa çıkma yöntemlerini Peterson ve arkadaşları (2006) meydan okuyarak başa çıkma, uzaklaştırma, kendini kontrol etme, sosyal destek arama, sorumluluğu kabul etme, kaçış/uzak durma, planlı problem çözme ve pozitif yeniden değerlendirme olarak sekiz alt boyutta toplamışlardır.[8]Lechner ...
... The effects of infertility on individuals' emotions are complicated and these effects vary based on the duration of infertility, individuals' capacities for adaptation, reasons and prognosis of infertility, and emotional and social supports (14)(15)(16). Infertility not just a situation about the function of reproduction it also appears as a potential crisis causing social and psychological exposure (17)(18)(19)(20). It is estimated that almost 86.8% of infertile women have anxiety and 40.8% have depression. ...
... Likewise, infertility treatment is expensive in terms of economy, stressful in terms of emotions and a physically painful process, all of which require adjustment within the couple. Infertile couples might subsequently develop guilt, a sense of worthlessness and depression (2,19,20). ...
Background:
Studies conducted on infertile women in the literature investigated some features such as depression, anxiety, loneliness, and social support. However, there has been no study examining the relationship between levels of perceived social support and depression in infertile women. Considering this deficiency, the study was conducted to determine the relationship between perceived social support and depression in infertile women. The purpose of this study is to determine the relationship between perceived social support and depression in infertile women.
Materials and methods:
This descriptive and sectional study was conducted between 16 April and 31 October 2012 in in vitro fertilisation (IVF) Centre of Fırat University Re- search Hospital. Sampling formula was used in cases when the number of elements in the population was not known to calculate minimum sample size required to be included in the study. A total of 238 women who applied to the relevant centre between the specified dates constituted the sample group of the study. A Questionnaire Form, Beck Depression Inventory (BDI) and the Multidimensional Scale of Perceived Social Support (MSPSS) were used to collect the data. A pilot study was carried out on nine infertile women. As a result of the pilot study, we formed the final version of the Questionnaire Form. The data of these nine women were not involved in the research. The data obtained from the study was assessed using Statistical Package for the Social Sciences (SPSS; SPSS Inc., Chicago, IL, USA) version 15.0. Percentage distribution, mean, t test, one-way analysis of variance (One-Way ANOVA), and Pearson correlation analysis were used to evaluate the data.
Results:
The women's total mean score on the BDI was 12.55 ± 8.07. Scores obtained by women on the MSPSS was 15.75 ± 8.53 for the subscale of friend, 21.52 ± 8.20 for the subscale of family, and 15.62 ± 8.45 for the subscale of significant others. The women's total MSPSS score was 52.89 ± 21.75.
Conclusion:
A significant, negative relationship was found between total BDI score with subscale and total mean scores of MSPSS (r= -0.596, p<0.01). Symptoms of depression decreased as the women's perceived social support increased.
... Infertility is a life crisis because of its uncertain and individual outcomes [1]. Infertility affects 10-15% of all couples in the United States [2][3][4][5][6]. With its emotionally threatening and stressful nature and high cost, infertility is a life crisis for both men and women. ...
... When looked through the clinical aspect, it is reported that there is an association between the "level of distress" and the "rate of conception" [2,4,7]. Hence, psychosocial evaluation is as important as medical evaluation. ...
To develop a scale to evaluate violence experienced among infertile women.
Three steps were followed in the development of the scale: Literature review and deep interviews to generate item pool, content validity testing, and administration of draft. Content validity was evaluated by experts. The draft scale was pilot-tested with a convenience sample of 30 women during their treatment. After the pilot-test, 166 infertile females filled the scale in the infertility clinic of a university hospital in Istanbul.
For evaluation of construct validity, Kaiser-Mayer Olkin was 0.91. Bartlett test was statistically significant (p = 0.00). According to the results of analysis, 5 domains were determined: "domestic violence", "social pressure", "punishment", "exposure to traditional practices" and "exclusion". The values of correlation of item were between 0.50 and 0.82. Item-total and subscale-total correlation varied between 0.57-0.91.The scale had good internal reliability, with Cronbach's Alpha coefficient of 0.96. The other coefficients of subscales varied between 0.80-0.94.
The scale called "Infertile Women's Exposure to Violence Determination Scale" indicates high reliability, good content and construct validity. Routine screening for domestic violence in infertility clinics is necessary to give affected women an opportunity to access appropriate health care and support services. On the other hand, common use of Infertile Women's Exposure to Violence Determination Scale in infertility clinics provides increased sensitivity and awareness by caregivers.
... Regardless of the fact that infertility may or may not be due to the female in a couple, it is expected that she will be more negatively affected by infertility than the man ( Repokari et al. 2007), as she will undergo complicated in vitro treatments even when the man has the infertility problem ( Özçelik et al. 2007). Research shows that women in infertile couples have more psychiatric symptoms than men ( Christie et al. 1998;Lee et al. 2000;Wischmann et al. 2001;Özçelik et al. 2007). ...
... The results of the present study show that men in the infertile group reported more problems related to sexual dysfunction. The results of the present study support others that suggest 51% of infertility is due to the men in infertile couples and that 80% of those men have sexual dysfunction (Eliot 1998;Özçelik et al. 2007); however, similar results were also reported in the control group, which suggests that there isn't a significant relationship between infertility and the results. ...
The aim of this study was to determine the effects of infertility on sexual functions and dyadic adjustment in infertile couples that seek infertility treatment.
The Beck Depression Inventory (BDI), Golombok-Rust Inventory of Sexual Satisfaction (GRISS), and Dyadic Adjustment Scale (DAS) were administered to the infertility group (n = 220) and control group (n = 110). None of the study participants had an Axis I psychiatric disorder.
There wasn't a significant difference in BDI score between the 2 groups. None of the study participants had clinical depression. Men in both groups reported more problems according to GRISS total scale and subscale scores (except the avoidance subscale) than the women. Women in both groups reported more problems according to GRISS avoidance subscale score than did the men. Men in the control group reported more problems on the GRISS frequency subscale, as compared men in the infertile group. Women in the control group reported more problems based on GRISS total score, and GRISS frequency, satisfaction, touch, and avoidance subscale scores, as compared to the women in the infertile group. The men in the infertile group were more satisfied with dyadic adjustment than the women in the infertile group. The men and women in the control group had higher DAS total score, and DAS consensus and emotional expression subscale scores.
The differences in sexual functions between the infertile and control groups were not significant. Both women and men in the infertility group reported more dyadic adjustment problems than those in the control group.
... Infertility can be defined as a crisis, which coexists with medical, psychiatric, psychological, and social problems. Consequences of infertility arise from short and long-term devastating effects on both individual"s physical and mental health, and marital system (36). Then, infertilty and its psychosocial outcomes were investigated with many studies. ...
Title: The status of depression and anxiety in infertile Turkish couples Key words: Depression, Anxiety, Infertility.
... It has also been established that African women with infertility have been subjected to domestic violence due to their inability to conceive [2]. Consequently, couples with infertility live in fear and anxiety, especially if they have been diagnosed medically and are undergoing treatment [3]. This feeling of fear and anxiety may cause conflict between the spouses, a decrease in selfesteem, a decrease in frequency of sexual intercourse, and the development of feelings of inadequacy. ...
Introduction
Women with infertility have different experiences that determine the quality of their psychosocial health. Cultural constructions of infertility in Africa have made the experience of infertility among African women more burdensome. Yet, little is known about the psychosocial experiences of women with infertility in Zamfara State of Nigeria. The purpose of this study was to explore the psychosocial experiences of women with infertility in Zamfara.
Materials and methods
An exploratory qualitative design was used for this exploration. Individual in-depth interviews were conducted using a semi-structured interview guide. Ethical approval was received from the Institutional Review Board of the Nogouchi Memorial Institute for Medical Research in the University of Ghana. Women who were married and seeking treatment for infertility from a public hospital were recruited and interviewed. A total of 12 women were interviewed with each interview lasting 45 minutes. The interviews were audiotaped with permission from the participants, transcribed verbatim, and content analysed.
Results
The findings revealed that psychologically, majority of the women had experienced anxiety, stress and depression as a result of their inability to get pregnant. Socially, the women suffered self and social isolation, social stigma, social pressure and marital problems.
Conclusion
These women have psychosocial health problems that need the attention of health professionals to enhance their wellbeing.
... [6,7] Couples live in fear and anxiety about infertility as well as the infertility diagnosis, treatment process, and treatment outcome. [8] Each individual blames himself/herself and reflects his/her anger toward the other. This situation may cause conflict between the spouses, decrease in self-esteem, decrease infrequency of sexual intercourse, and the development of feelings of inadequacy. ...
Background and Aim
In Asian countries, child bearing is a social obligation. Experience of infertility profoundly affects the personal well-being of women. Women with infertility are at a higher risk of anxiety, depression, and Intimate partner violence (IPV). In this background the present study was carried out to determine IPV and psychiatric comorbidity in women with infertility.
Methods
Hundred consecutive women with primary infertility in the age group of 18 years to 45 years were included in the study. Psychiatric diagnosis was made according to DSM-5. Hamilton Anxiety Rating Scale (HAM-A) and Hamilton Depression Rating Scale (HAM-D) were used to assess the severity of the anxiety and depressive symptoms. IPV was assessed using WHO violence against women instrument.
Results
The mean age of the 100 women was 26.73 ± 4.23 years, duration of marriage was 7.11 ± 4.177 years and duration of infertility treatment in years was 5.56 ± 3.89. The prevalence of IPV among patients was 50% and psychiatric comorbidity was 46%. When we compared the women who experienced IPV and who did not, the prevalence of anxiety disorder and depressive disorder was high among IPV group. Anxiety, depressive scores in HAM A, HAM D were higher in IPV group compared to the other group and was statistically significant.
Conclusion
A significant number of women who had infertility reported IPV. This emphasizes the importance of screening for IPV in these women. It is observed that women with IPV had higher psychiatric comorbidity and may require psychotherapeutic intervention.
... Individuals who transform these behaviours into a lifestyle can improve and maintain their health status 20 . All these behaviours play an important role during pregnancy, which is a pivotal time in a woman's life 21 . ...
This study investigated effects of a healthy lifestyle and anxiety levels on in vitro fertilization (IVF) outcomes. This follow-up study on 102 infertile women and 66 infertile men (total: 168) was carried out at a infertility clinic in university hospital in Instanbul, Turkey. Health-Promoting-Lifestyle-Profile-II (HPLP II) and State-Trait Anxiety Inventory (STAI) instruments were used. Female participants were called following their IVF treatment to determine whether they were pregnant or not. The mean age for female respondents was 31.38±4.66; for men it was 34.22±4.34 (t:-3.96; p:0.00). Their subjects’ infertility types were unexplained 23.8%, male factor 41.1% and female factor 24.4%. Their total HPLP-II scores were 129.21±22.33 (a range of 63-204). Their rate of pregnancy following IVF was 19%. The HPLP-II scores were upper-intermediate. Despite the State anxiety levels being moderate, the Trait anxiety levels were high. Comparison of the scales by gender was not significant. In addition, on HPLP-II and STAI scores, there were no differences between pregnant and non-pregnant women following IVF. © 2015, Women's Health and Action Research Centre, All rights reserved.
... life, emotional status, future plans, self-esteem, and the body image of women. Infertility diagnosis, treatment process, and treatment outcome causes anxiety and fear in infertile couples (5) . After failure of artificial reproductive treatment, the prevalence of distress was reported to have increased from 33 to 43%; in some (8%), depression remained permanent. ...
Objective
To evaluate the effect of infertility on sexual distress in women attending the infertility clinic.
Materials and Methods
In a cross-sectional study we evaluated sexual distress among 88 women who attended the infertility clinic in our institute between January and June 2015. All women who were experiencing primary or secondary infertility during the study sampling were included in the sudy. Sexual distress was measured using the Female sexual distress scale-revised (FSDS-R), a cross-validated patient-reported outcomes measure. Correlations of FSDS-R with patient characteristics and laboratory measurements were calculated using Spearman’s rank correlation tests.
Results
With the exceptions of the age of couples and serum anti-mullerian hormone (AMH) levels, no predictor of high sexual distress was found in the univariate analysis when comparing groups with regard to the FSDS-R cut-off score. The mean age of the sexually distressed women (33.6±5.8 years vs. 29.3±5.1 years) and their partners (35.4±4.8 years vs. 31.6±4.2 years) was significantly higher than those of the non distressed women, according to a FSDS-R score over 11 (p<0.05). The serum level of AMH was significantly lower in infertile women with high total sexual distress scores (1.4 vs. 7.6 ng/mL (p<0.001)).
Conclusion
In infertile women, age of woman, age of partner, and serum AMH levels are related with the hope of women to have a child despite an association with sexual distress. Serum AMH, which is perceived as necessary for fertility, had a significant inverse correlation with levels of sexual stress.
... In particular, women are expected to be fertile. Otherwise, infertility in women may result in divorce in some regions of Turkey (37). In the present study, anxiety symptoms were higher among females than males. ...
Objective: Evaluation of infertile couples' emotional symptoms and perceived social supports according to gender differences. Method: Hospital Anxiety and Depression Scale (HADS) and Multidimensional Scale of Perceived Social Support (MSPSS) were administered to 66 primarily infertile couples that did not have psychiatric Axis-I disorders according to DSM-IV. Results: According to the scale's average points, the samples' depressive symptom levels did not indicate clinical depression; rather, anxiety levels were in normal ranges. Comparing participants' anxiety according to gender, female participants were more anxious than male participants. Couples reported less anxiety and depression as long as they perceived higher social support. It was found that the combined infertility group, in which both women and men have problems to conceive, had more perceived social support from significant other and friends than in the female-originated infertility group. Also, results revealed that the male-originated infertility group reported more perceived social support from significant other compared to the female-originated infertility group. Conclusion: Social support and emotional stress of females in infertile couples are more than males', and perceived sufficient social support decreases couples' emotional symptoms.
... Представља животну кризу за парове која се одражава на све аспекте живота; сматра се неуспехом на личном, емотивном и социјалном нивоу 9 . Парови пролазе кроз психолошки стрес који се карактерише бесом, тугом, осећајем кривице, смањеним самопоштовањем, анксиозношћу и депресијом, али и брачну/ патрнерску кризу која подразумева лошу ко-муникацију међу партнерима, незадовољство браком и нарушен сексуални однос 9,10,11 . Поред тога, инфертилне особе се често осећају изоловано и запостављено у окружењу које високо цени родитељство 12 . ...
Background: Infertility is the inability of a sexually active couple, which is not using contraception, to achieve pregnancy in one year. Aim: The aim of this study was to develop and test the reliability of the scale for measuring the intensity of the fear from infertility among students. Material: Creation of the questionnaire went through several phases: literature review, formation of item pool, construction of the final version of the questionnaire, testing it on a sample and statistical analysis. The questionnaire contains 21 questions, with answers in the form of seven-point Likert scale. It was tested on a sample of 310 respondents, students of the Faculty of Medical Sciences, University of Kragujevac, Serbia. The results were used for testing the questionnaire reliability and for exploratory factor analysis. Results: The scale has good internal reliability, with Cronbach’s alpha coefficient of 0.911. The values of Cronbach's alpha, after splitting the questionnaire into two parts, were 0.885 and 0.815. There was moderate correlation between these two parts (0704). Exploratory factor analysis revealed the existence of three factors which explained 56.19% of variance. The values of Cronbach's alpha coefficients of these three factors were: 0.834, 0.867 and 0.807. Conclusion: Results of our study showed that the scale "Fear from infertility" has good reliability with high Cronbach’s alpha coefficient and appropriate factorial structure.
... İnfer ti li te tıb bi, psi ki yat rik, psi ko lo jik ve sos yal so run la rı be ra be rin de ge ti ren kül tü rel, dinsel ve sı nıf sal yön le ri olan bir kriz du ru mu dur. 15 Ars lan ve ark.nın in fer ti li te so ru nu ya şa yan çift lerde yap tık la rı ça lış ma da, ka dın la rın ya şam ka li tesi er kek le re oran la da ha dü şük bu lun muş tur. 16 Ka dın lar da ya şam ka li te si ne et ki eden sağ lık so run la rın dan bi ri de hir su tizm dir. ...
Technological improvements provided people a longer life but, nonetheless, the quality of life was started to be interrogated. The World Health Organization defines quality of life as 'an individual's perception of their position in life in the context of the culture and value systems in which they live, and in relation to their goals, expectations, standards and concerns' The status of woman in the society is one of the most important factors that determine her quality of life. Woman's social status plays a determining role in getting and reaching health services. In addition to woman's social status, her physical and mental health also determines her quality of life. Reasons related to physical health that decrease quality of life are mostly health problems in different life periods and methods of diagnosis and treatment related to these problems. Dismenore, starting from the adolescence and continuing during the reproductive period, pregnancy and health problems related to pregnancy, symptoms related to menopausal period, breast cancer, gynaecological cancers, osteoporosis and urinary incontinence can all be assumed as reasons related to physical health that decrease the quality of life of women. Besides mental and social problems which are caused by these health problems, mental health problems also cause a decrease in the quality of life. Mental health problems such as depressive disorders, obsessive compulsive disorders, panic disorder and agoraphobia can cause a decrease in the quality of life of women. First of all, the individual must be healthy in order to improve his/her quality of life. All attempts to protect and improve health and strengthening woman in the social area may contribute an increase in her quality of life.
... Robust evidence indicates that infertility leads to distress among women more so for those suffering from primary infertility (Boivin, Griffiths, and Venetis 2011;Greil 1997;McQuillan et al. 2003). The relationship between gender and infertility distress is not affected by which partner has the reproductive impairment (Chachamovich et al. 2010;Ozcelik et al. 2007;Repokari et al. 2007;Wischmann et al. 2009). This is particularly true for primary infertile couples (Epstein and Rosenberg 2005). ...
This study aimed to identify prevalence rates of psychological distress among Pakistani women seeking help for primary infertility. The associations of social support, marital adjustment, and socio-demographic factors with psychological distress were also examined.
A total of 177 women with primary infertility were interviewed from one hospital in Islamabad using a Self-Reporting Questionnaire, the Multidimensional Scale of Perceived Social Support and the Locke-Wallace Marital Adjustment Test. The data were collected between November, 2012 and March, 2013.
The prevalence of psychological distress was 37.3 percent. The results of the logistic regression suggested that marital adjustment and social support were significantly negatively associated with psychological distress in this sample. These associations were not confounded by any of the demographic variables controlled in the multivariable regression models.
The role of perceived social support and adjustment in marriage among women experiencing primary infertility are important factors in understanding their psychological distress. The results of this small-scale effort highlight the need for social and familial awareness to help tackle the psychological distress related to infertility. Future research needs to focus on the way the experience of infertility is conditioned by social structural realities. New ways need to be developed to take into account better the process and nature of the infertility experience.
... Infertility can be defined as a crisis, which coexists with medical, psychiatric, psychological, and social problems. Consequences of infertility arise from short and long-term devastating effects on both individual"s physical and mental health, and marital system (36). Then, infertilty and its psychosocial outcomes were investigated with many studies. ...
Infertility is a major psychosocial crisis as well as being a medical problem. The factors that predict psychosocial consequences of infertility may vary in different gender and different infertile populations.
The primary purpose of this study was to investigate whether Turkish infertile couples had higher levels of depression and anxiety when compared to non-infertile couples. Our secondary aim was to evaluate the relationship between sociodemographic characteristics and levels of depression and anxiety in Turkish infertile couples.
We designed a descriptive cross sectional study of 248 infertile women and 96 infertile men with no psychiatric disturbance and 51 women and 40 men who have children to evaluate the depression and anxiety levels between infertile couples and fertile couples. A gynecologist evaluated participants for demographic data and then they were visited by a psychologist to perform questionnaire scales which were The Beck Depression Inventory and the State-Trait Anxiety Inventory for the evaluation of the degree of psychopathology. The data were statistically analyzed, with p<0.05 as the level of statistical significance.
We observed significant differences between the infertile couples and fertile couples with respect to state and trait anxiety (p<0.0001) while no difference was regarding with depression, both of women and men. Anxiety and depression were observed as independent from gender when infertile women and men were compared (p=0.213).
We believed that the psychological management at infertile couples must be individualized with cultural, religious, and class related aspects.
... Couples live in fear and anxiety about infertility as well as the infertility diagnosis, treatment process, and treatment outcome (7). Each individual blames himself/herself and reflects his/ her anger to the other. ...
The aim of this study was to determine the relationship between marital violence and distress level among women with a diagnosis of infertility.
This cross-sectional study consisted of 139 married women diagnosed as primary infertile who applied to an in vitro fertilization (IVF) center in Turkey, between September and December 2009. A descriptive information questionnaire developed by the researcher was used for data collection. In addition, an infertility distress scale (IDS) for determining the severity effect of infertility and the scale for marital violence against women (SDVW) for determining level of marital violence against the women were used.
The total IDS score of the study sample was 37.76 ± 10.53. There was no significant relationship between the age and education level of the women and the total IDS score. The total IDS score was higher in women who did not work and those being treated for infertility for more than three years. The total SDVW score of the study sample was 67.0 ± 8.26. The total SDVW score was higher in women who had been trying to have a child for more than six years and had received infertility treatment for longer than three years. The employment status of the women and physical, emotional, and sexual violence scores had a statistically significant relationship with the IDS scores. The emotional violence score was found to have the highest significance among the variables affecting total IDS score.
Marital violence is a factor increasing the distress of infertile women. Healthcare staff serving infertile couples should consider the possibility of domestic violence against women as a factor affecting the psychological infertility distress level.
Background: Infertility is a common gynecological problem that is associated with social stigma, social neglect, economic deprivation, emotional stress, unhappiness and marital instability. Violence against women is a global major health and human right concerns as this affects millions of women all over the world across ethnicity, culture, socioeconomic and educational classes. Infertile women have been deemed particularly vulnerable to domestic abuse in several studies. Aim: highlight and compare the prevalence and trends of domestic violence among infertile women receiving treatment for infertility in Upper verses Lower Egypt. Methods: A cross-sectional comparative study on 200 infertile women. The study was carried out at Beni-Suef University's Center for Diagnosis and Treatment of Delayed Reproduction and Gynecological Outpatient Clinic Beni-Suef University Hospital and gynecological outpatient clinic, Port Said University Hospital. Results: Women either upper Egyptian or lower Egyptian infertile women experienced and exposed all forms of domestic violence. The Upper & Lower studied Egyptian women experienced physical violence in about 70.0% & 68.0% and verbal violence in about 69.0% & 62.0% and financial violence in about 48.0% &46.0% and violence in about sexual violence in about 45.0% & 28.0%, since not been able to have a baby successfully and in the past years. Relationships between physical and verbal aggression that are statistically significant include age, different types of infertility, the gender of children (p<0.05). Conclusion: However, is no statistically significant deference between geographical area (upper or lower) and types of violence experienced by infertile women, all form of violence were more prevalent among upper Egyptian infertile women. Recommendations: (1) It is recommended that additional research be done with a larger sample from other provinces of Upper Egypt with regard to infertility and its psychological effects. (2) The relationship between violence and reproductive results requires more study, as do effective psychosocial interventions. Research on emotions and coping mechanisms within the context of treatment is particularly important.
Introduction: Management of benign positional vertigo (BPV) in the emergency department (ED) includes performing specific maneuvers at the bedside which relieve symptoms in a large proportion of cases. The aim of this study was to evaluate the effectiveness of therapeutic maneuvers in relieving BPV symptoms in the ED.
Materials and Methods: A convenience sample of patients who presented to our ED with vertiginous symptoms during an 80-day period were evaluated for the study. Patients were examined by a single physician using Dix-Hallpike and lateral canal testing to determine the character of each patient’s nystagmus, if present. Those with chronic disease or already taking anti-vertigo medications were excluded. According to their test findings, patients were subjected to one of the following maneuvers: the modified Epley, the modified Semont, or the Brandt-Daroff maneuver. Before the maneuver, and 15 and 30 minutes after the maneuver, patients rated their vertigo symptoms on a 0-10 verbal rating scale. Using SPSS 12 for Windows®, before and after ratings were compared using chi-squared and Kruskal Wallis testing.
Results: During the study period, 72 patients presented with vertiginous symptoms, and 40 were enrolled in the study. In the modified Epley (n=26) and modified Semont (n=11) maneuver groups, mean patient symptom scores decreased significantly between baseline and 15 minutes (p=0.0001 for both groups), and between baseline and 30 minutes (p=0.0001 and p=0.001, respectively). The number of patients (n=3) in the group subjected to the Brandt-Daroff maneuver was not sufficient for statistical testing.
Conclusions: All three performed therapeutic maneuvers are effective for the treatment of patients with BPV in the ED.
Key words: Benign positional vertigo, maneu vers, emergency department.
Objective: This study aims to determine the nursing students knowledge levels, attitudes and related factors about infertility. Methods: The research sample consisted of 550 nursing students studying at a state university in the south of Turkey between December 2019 -March 2020. The Introductory Information Form of the students, "Infertility Knowledge Test" and "Attitude Scale Towards Infertility" were collected in connection with the research. The obtained data were evaluated using percentage values, Student's t-test, Tukey and ANOVA tests. Results: The mean age of the students was 21.15±1.99. It was determined that 28.4% of the students were educated in the third grade, 58.4% were women and 67.8% were born in the Southern Anatolia Region. In the study, it was determined that the total mean scores of the Infertility Knowledge Test of the nursing students were "19.23±6.48"(min=0- max=31), and the total mean score of the Attitude Scale towards Infertility was 46.00±7.5 (min=16- max=60), The difference between the mean scores of the Infertility Knowledge Test was found to be statistically significant according to the class of the students, their region of birth, being an infertile individual in the family and having children in the future (p
This study aims to investigate the effects of psychodrama on feelings of depression, anxiety, and hopelessness, as well as the level of self-esteem in female patients with infertility. The study sample consisted of 30 female patients with infertility, who applied to the In Vitro Fertilisation Unit of a university hospital in Ankara. Initially, Beck’s Depression Inventory, Beck’s Anxiety Inventory, Beck’s Hopelessness Scale, and the Rosenberg Self-Esteem Scale were administered to recruited patients twice, before and after the start of the psychodrama practice. 8 weeks of psychodrama were practised with the sample group for 3 h per week. In each group session, the aim was for women to acknowledge their emotions and share their challenges during the infertility treatment process through psychodrama games. The IBM SPSS Statistics 21.0 program (Istanbul, Turkey), Shapiro–Wilk test, Mann–Whitney U test, and Wilcoxon test were used for statistical analysis and calculation. The results showed significant differences between participants’ pre and post-test scores on Beck’s Depression, Beck’s Anxiety, Beck’s Hopelessness, and the Rosenberg Self-Esteem Scale. However, there was no significant difference between participants’ pre and post-test scores on Beck’s Anxiety Inventory; post-test scores were lower than pre-test scores. It was shown that group therapy for female patients with infertility. This result shows that psychodrama may enhance self-esteem, despair, anxiety and depression.
Objective:
To investigate the effect of a previous IVF failure on the quality of life and emotional distress, in couples undergoing IVF treatment. Experiencing IVF failure might cause differences on the anxiety-depression and quality of life scores of the couples, compared to the ones who were undergoing IVF treatment for the first time.
Study design:
This study included 64 couples who had previously experienced at least one IVF failure (Group 1) and 56 couples without history of IVF failure (Group 2) in a private Assisted Reproductive Center, Istanbul, Turkey. A sociodemographic data form, the FertiQoL International and Hospital Anxiety (HAD-A) and Depression scale (HAD-D) for evaluating the status of distress, were administered for the study.
Result(s):
FertiQoL scores were compared between the groups, the environment scale of the quality of life in treatment section was found to be significantly higher in Group 1 compared with Group 2 (p=0.009). The HAD-A and HAD-D scores did not differ significantly between the groups. Group-variables were investigated using multilevel analysis, the infertility duration and income level were found to have an effect on the subscales of quality of life (p=0.009 and p=0.001 respectively) in Group 2. Depression scores were higher in couples with infertility duration of below five years in Group 1 and Group 2 compared to couples with infertility duration of five years or above (MANOVA analysis). The level of education was found to affect the scores of HAD-D in Group 2, but not in Group 1 (p=0.011). The score of HAD-D was significantly affected by the family type only in Group 2 (p=0.009); the depression score of the couples living with a nuclear family was found to be higher compared with the couples living in a traditional family (p=0.021).
Conclusion(s):
Fertility-specific quality of life scores reveals better results regarding the orientation to the treatment environment in the couples with a previous IVF failure, compared to first IVF cycle couples. Treatment failure does not elevate the level of anxiety, while the effect on depression scores changes according to duration of infertility.
Purpose: The aim of this study was to determine hopelessness and the influencing factors in infertile individuals. Method: The sample of this sectional study consisted of 609 individuals chosen by random sampling from those presenting at two IVF centers, one at a branch hospital and one at a university hospital, between March and September 2008 and who volunteered to participate in the study. The data were collected using the information form mostly containing questions on socio-demographic characteristics and the Beck Hopelessness Scale (BHS). Findings: The mean BHS score was 5.6±4.2 for females and 6.1±4.6 for males. The hopelessness level was found to be related positively to age and the duration of trying for a child in females and only with the duration of trying for a child in males. Males and females with no social security, low income and those with only primary school education suffered more hopelessness . Discussion and Conclusion: We found some socio-demographic characteristics to influence hopelessness in infertile individuals in this study. We believe it is important for treatment success to take these influencing factors into account for individuals presenting at infertility treatment centers.
Objective: This study was made to investigate affecting factors and hopelessness level of infertile women and men. Material and Methods: Sample of study as the descriptive type was constitued 47 women and 28 men. Data of the research were gathered using a questionnaire form and Beck Hopelessness Scale (BHS). Results: 62.7% of the participant were women. The average point of women' hopelessness was found as 6.87 ± 3.84, men's hopelessness was found as 6.21 ± 2.74 and statistically difference was not significant (p= 0.616). Statistically, correlation between their income level (p= 0.041) and their the number of consulting to a doctor (p= 0.021) with BHS was significant. BHS scores of women, who have graduated from secondary school, who were housewife, who don't have health insurance, who don't have natural pregnancy, who don't have pregnancy with treatment were higher than other BHS scores of women, but statistically difference was not significant. BHS scores of men, who have graduated from primary school, who were farmer, who don't have health insurance, who don't have natural pregnancy, who don't have pregnancy with treatment were higher than other BHS scores of men, but statistically difference was not significant. Conclusion: In this study was found that the hopelessnes level of infertile women and men was lower than average. However, lower income, higher of applying number to doctor, uneasiness between supouses because they no have child was effect on hopelessness level of infertile women. Affecting factors on hopelessnes of infertile women should be evaluate in diagnosis and treatment practices by health persons and it is advised to give support to women.
Objective: This study of has been performed in order to investigate effects of the infertility in couples suffering infertility problem on their sexual activities and life quality. Material and Methods: The samples have been gathered with random sampling method among the 52 women and 55 men who had applied to Adnan Menderes University Faculty of Medicine, Department of Obstetrics and Gynecology, Urology Policlinic. Data is based on the answers obtanied by the questionnaire which is prepared considering the related literature survey, Arizona Sexual Experiences Scale and WHOQOL-BREF quality of life scale. Statistical characteristics of data have been done by under consideration of Pearson correlation test, t-test. Results: When the sexual activities and the quality of life in infertile women and men are take in the consideration, it can be seen that 82.7% of infertile women and 49.1% of infertile men are suffering from sexual activity dysfunctions. Sexual activities of the women having infertility problem are less than the men suffering for the same problem. The difference between the ratings (p<0.05) of sexual activities of infertile women and men has been found statistically correlated, while the difference between ratings (p>0.05) of quality of life in infertile women and men not. Quality of life rating in infertile women is lower than that of men. Conclusion: It has been seen that it is a problem that affects couples sexual activities and quality of lives. Infertility affects women's sexual life and quality of life has been negative. Therefore, quality of life and sexuality of women supporting studies should be performed in clinics.
This study was carried out illustratively in order to examine the effects of infertility on sexual life of couples presenting with infertility. The study was carried out IVF unit of a university hospital between January and April 2009. The sample constituted total 150 voluntary couples who were diagnosed with infertility as a result of specialists' gynecologic evaluation, had an infertility history at least for 6 months, were married, were at least primary school graduates, did not have a life-threatening chronic disease history and did not have a psychiatric diagnose before infertility treatment. Data were obtained by questionnaire, Arizona Sexual Experiences Scale (ASEX) and Beck Depression Inventory (BDI). Mean ages of the women and men in the study were determined as 30.85±5.02 (min:20-max:43) and 33.82±5.49 (min:23-max:55), respectively and mean marriage duration was 6.64±4.33 (min 1-max 21) years. It was detected that mean ASEX points of the women and men were 13.20±3.96 (min:5-max:24) and 9.28±2.97(min:5-max:17), respectively; mean BDI points of the women and men were 9.93±6.45 (min:0-max:33) and 6.97±6.54 (min:0-max:40), respectively. It was found that 77% of the women and 23% of the men had sexual dysfunctions and there was a statistically significant difference (p=0.000) in terms of sexual dysfunction between infertile couples. In terms of depression state, it was detected that women get into depression more in comparison with men, and statistically significant difference (p=0.042) was found between them. In our study it was found that infertile women get into sexual dysfunctions and depressive symptoms more in comparison with men.
The study was conducted due to the fact that there is not enough data on the topic in Turkey, where having a child brings status to women, and the related literature includes no qualitative studies about the effects of infertility on marital relationship (MR) and Quality of Life (QoL). Qualitative research in which 16 people who received successful infertility treatment received in-depth interviews, and data collected retrospectively. Infertility has negative effects on MR and QoL. In the marital relation category, four themes emerged from the answers given: (1) Separation-divorce; (2) Treatment phase and husband’s reaction, support after unsuccessful treatment; (3) MR after the delivery; (4) significance of child in marriage. It was identified that infertility, regardless of which gender experiences it, brought along many problems such as unhappiness, stress, sorrow, insomnia, increase/decrease in appetite, increase in the smoking habit, social stigmatization, being exposed to curious questions about having a child, avoiding being in places with children, losing privacy of sexual life, having sexual intercourse in a planned way solely for the purpose of reproduction not of pleasure, deterioration in family relations, interruption in work life, and high cost of treatment expenses. Infertility and its treatment have effects on MR and QoL. These effects varied depending on the stage of infertility process, gender, and the quality of the relationship.
Psychological reactions of childless couples applying to an adoption agency are examined. Infertility can be a developmental life crisis and may be experienced as a narcissistic trauma, resolution of which depends upon individual character structure. Intrapsychic tasks include acceptance and working though of grief for the loss of the self-ideal, restitution of body-image deficiency, and assessment of the importance of parenthood as a developmental phase. An adaptive resolution is seen as a necessary condition for successful adoptive parenting.
To test whether there is a relationship between anxiety levels and conception rates, 116 married women entering an artificial donor insemination treatment were pro-spectively studied with psychometric tests. All pregnancy groups (pregnancy in first, second, … seventh insemination cycle) were comparable in duration of infertility, age of the woman, female fertility status and the husband's infertile status.
A statistically significant relation was found between initial trait anxiety level and the number of treatment cycles necessary for conception. Women having early spontaneous abortions were initially more stressed than the other pregnant women.
Triphasic oral contraceptive (Logynon) induced a significant increase (36%) in the maximal binding capacity of platelet membranes for [3H]imipramine. The increase was achieved in the second Logynon cycle as compared to pretreatment and first Logynon cycle binding values. The pill contains a combination of ethinyl estradiol and levonorgestrel, and it is as yet unclear which of the two hormones is responsible for the up-regulatory effect. The increase in the density of platelet imipramine binding sites may reflect a similar alteration in brain. The increase in imipramine binding did not correlate with alteration in mood as assessed by Beck Depression Inventory scores.
PIP
As an indicator of analogous brain serotonin metabolism, and by extension of depression tendency, platelet imipramine receptors were measured in women taking the triphasic oral contraceptive Logynon. Logynon (Schering AG Berlin/Bergkamen, Germany) contains levonorgestrel 50 mcg for 6 days, 75 mcg for 5 days and 125 mcg for 10 days, followed by 7 days pill-free; ethinyl estradiol doses are 30, 40 and 30 mcg for the same periods of time. The mean imipramine binding values (Bmax), calculated from Scatchard plots of tritiated uptake by platelets, was 429 in the control cycle, 396 on Day 14 of the 1st treatment cycle, and 582 in the 2nd treatment cycle (p0.02 vs pretreatment). Control means were 412 and 411. No significant differences were seen in affinity (Kd). There were no significant differences in mean Beck Depression Inventory tests, although 1 woman became clinically depressed, with BDI scores of 22 and 33 compared to 2 before taking Logynon. Her Bmax values were 626, 630 and 796 in the pretreatment, 1st and 2nd cycles respectively. Overall, the increase in imipramine binding did not correlate with Beck depression inventory scores.
The purpose of this pilot study was to evaluate the impact of a 6-month cognitive-behavioral therapy for infertile couples.
Seventeen idiopathic infertile couples participated in a therapy program comprised of modules to behaviorally optimize the chance of conception, improve sexual functioning and satisfaction, reduce thoughts of helplessness and, if necessary, improve marital communication skills. Pre- to posttreatment changes in the therapy group were compared to changes in two control groups.
The therapy group showed an improvement in sperm concentration, a reduction in thoughts of helplessness and a decrease in marital distress. By the end of therapy participants practiced timed intercourse more reliably and reported unchanged sexual pleasure and satisfaction during the nonfertile period of the menstrual cycle. At the 6-month follow-up, problem-focused thoughts had decreased. The live birth rate was higher in the therapy group than in epidemiological samples.
Preliminary data suggest that cognitive-behavioral treatment may be an effective approach for the treatment of infertility.
The experience of infertility can be devastating for the couple desiring a child. For women, pregnancy and motherhood are developmental milestones that are highly emphasized by our culture. This paper will explain psychological issues in infertility, including evaluation and intervention. Specific issues such as privacy and disclosure, and deciding when to end infertility treatment, will also be discussed. A psychologist, or other mental health professional on the health care team, is essential to treatment of the biopsychosocial nature of infertility.
Infertility arises from a complex pathogenic process in which it is often difficult to identify etiology. Psychological and behavioral factors may play a role in some cases of infertility. The extent to which eating behaviors and attitudes contribute to infertility is unknown.
In this study, 120 subjects with infertility, 80 fertile women, and 90 patients suffering from anorexia nervosa, restricting subtype (AN-R), were assessed with the Eating Disorder Inventory (EDI-2).
The EDI-2 highlights differences among patients with AN-R and fertile and infertile subjects. Infertile patients had higher scores on the Interpersonal Distrust, Interoceptive Awareness, and Maturity Fears EDI-2 subscales than fertile subjects. Logistic regression identifies the independent variables of interpersonal distrust, interoceptive awareness, maturity fears, and asceticism as predictors of infertility.
Infertile patients without eating disorders share some psychological features of women with AN. These features do not include disturbed eating attitudes and behaviors, but rather feelings of inadequacy, insecurity, and maturity fears.