Quality of life and sexual functioning of Polish infertile couples

Objectives To evaluate the influence of infertility on the quality of life (QoL) and sexual functioning of infertile couples.

Methods The research group consisted of 206 infertile couples and the control group of 190 fertile couples. A specific questionnaire was used as a research tool. It gathered information about socio-demographic features and infertility status, and included validated scales: Short Form-36 Health Survey, Female Sexual Function Index and International Index of Erectile Function.

Results The QoL parameters in all categories were generally lower for infertile women than for those of the control group. Clinical sexual dysfunctions were not significantly more common among infertile than fertile women (17.5% versus 12.1%, p = 0.13). Clinically relevant erectile dysfunctions were diagnosed in 23.9% of infertile men and in 13.7% of the controls. Male infertility had the most significant negative effect on men's sexual functioning.

Conclusions The risk groups for decreased QoL are infertile women and older subjects with lower education and occupationally inactive. Clinically relevant sexual disorders in the infertile population most frequently affect older men, with a lower educational level and with previously diagnosed male infertility.     

Spontaneous pregnancies in couples who discontinued intracytoplasmic sperm injection treatment: a 5-year follow-up study

OBJECTIVE: To analyze the occurrence of deliveries after spontaneous conception in patients who have discontinued unsuccessful intracytoplasmic sperm injection (ICSI) treatment.DESIGN: Cohort follow-up study.SETTING: Tertiary referral center.PATIENT(S): Between July 1992 and December 1993, 200 Belgian women younger than 37 years underwent 433 consecutive unsuccessful ICSI cycles with freshly ejaculated sperm and eventually discontinued their treatment.INTERVENTION(S): Ultrasound-guided oocyte retrieval and ICSI.MAIN OUTCOME MEASURE(S): Delivery after 25 weeks following a spontaneous pregnancy.RESULT(S): The mean age at the time of the last oocyte pick-up was 31.0 +/- 3.9 years. The mean time interval between the last ICSI and the end of the follow-up period was 47.7 +/- 12.1 months. Twenty-three spontaneous pregnancies ending in delivery after 25 weeks were observed (11.5%). The cumulative delivery rate reached a plateau of 10% after 36 months of follow-up. The mean time interval (from last oocyte retrieval) for spontaneous pregnancy to occur after discontinuing ICSI treatment was 20.2 +/- 13.7 months. Proportional hazards analysis showed that delivery rate was reduced by 2.0% per year of infertility.CONCLUSION(S): This study suggests that duration of infertility appears to be predictive of the likelihood of live delivery after spontaneous conception following an unsuccessful ICSI treatment.     

Follow-up of infertile couples who dropped out of a specialist fertility clinic

Lack of commitment to infertility investigations and treatment was not the reason for patient dropout.     

Evaluation, therapy, and outcome in 493 infertile couples

From 1973 through 1979, 493 infertile couples were evaluated for their infertility problem, allowing for a minimum follow-up of 1 year and a maximum follow-up of 7 years. Accurate records were kept on margin-punched cards for easy review and updating. Ovulation defects; male factor problems, and tubal disease accounted for 60% of the diagnosed causes of infertility. No diagnosis was made in 25% of the patients studied. Therapy began as soon as indicated and continued concurrently as the diagnostic evaluation progressed. Among the 493 infertile couples, 257 (52%) patients had a successful outcome; 90% of this group conceived by 1 year after the initial visit. One hundred thirty-seven patients underwent both hysterosalpingography and laparoscopy during their diagnostic evaluation. The interpretation of the hysterosalpingogram was wrong in about one third of the cases. Of 37 (7.5%) undiagnosed patients who underwent complete evaluation, including visualization of the pelvis by either laparoscopy or laparotomy, only 12 eventually conceived, 11 by the end of 1 year from the initial visit.     

Menstrual cycle pattern and fertility: a prospective follow-up study of pregnancy and early embryonal loss in 295 couples who were planning their first pregnancy

OBJECTIVE: To characterize how the menstrual cycle pattern relates to fertility regardless of potential biases caused by inappropriate coital timing during the menstrual cycle or early embryonal loss. DESIGN: Prospective follow-up study. SETTING: Healthy couples recruited throughout Denmark. PATIENT(S): Two hundred ninety-five couples who were planning their first pregnancy were followed up from the discontinuation of birth control until a pregnancy was recognized within six menstrual cycles. Early embryonal losses were detected by changes in urinary hCG levels. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): The probability of pregnancy occurring within one menstrual cycle (fecundity). RESULT(S): In women who had a cycle length that differed by >10 days from the usual cycle length, fecundity was approximately 25% that of women who had no variation (odds ratio 0.25, 95% confidence interval 0.09-0.68). When the combined effect of cycle variation and cycle length was assessed, cycle variation was a persistent strong predictor of fecundity. CONCLUSION(S): The mechanisms of the present findings probably are female functional disturbances in ovulation, conception, implantation, or sustained pregnancy, linked with variable menstrual cycle length. Thus, identification of medical and environmental causes of abnormal menstrual cycle patterns may provide clues to the causes of infertility. Moreover, the menstrual cycle pattern also should be taken into consideration in the clinical decision-making process.     

Effect of counseling on quality of marital relationship of infertile couples: a randomized, controlled trial (RCT) study

Background

Infertility is a major cause of marital problems and sexual dissatisfaction. This study was conducted to determine the effects of counseling on infertile couple’s marital relationship and sexual satisfaction.

Materials and methods

This study was performed as a randomized controlled trial (RCT) in which 100 infertile couples (200 participants) who visited Reproductive Health Research Center Tehran, Iran were randomly assigned into two groups: intervention (n = 50 couples, 50 wives and 50 husbands) and control (n = 50 couples, 50 wives and 50 husbands). Intervention was defined as three counseling sessions per week, each lasting 60–90 min. Counseling in the intervention group was conducted separately for each couple. Demographic characteristics and marital and sexual satisfaction were investigated using three questionnaires through interviews. The outcomes, including changes in marital satisfaction and sexual satisfaction, were compared between the two groups 3 months later.

Results

Based on the data collected 3 months after the intervention period, the mean scores of marital and sexual satisfaction in intervention and control groups for wives were 49.62 ± 11.09 versus 54.97 ± 12.64 (P = 0.036) and 36.00 ± 8.37 versus 40.04 ± 7.69 (P = 0.019), respectively. Respective scores for husbands were 45.48 ± 9.55 versus 50.08 ± 11.43 (P = 0.042) and 33.37 ± 7.09 versus 36.63 ± 6.52 (P = 0.025), respectively. It should be noted that higher scores in questionnaires inspecting marital and sexual satisfaction indicate lower satisfaction.

Conclusions

Infertility counseling improves marital and sexual satisfaction in infertile couples.     

Ectopic pregnancy and infertility following treatment of infertile couples: a follow-up of 929 cases.

A follow-up analysis was made of 929 infertile couples, with special attention paid to ectopic pregnancy. The conception rate was 46%, and 9% of the pregnancies were ectopic. Previous ectopic pregnancy, an industrial occupation and smoking reduced the fecundity and increased the risk of ectopic pregnancy. Tubal damage as a verified reason for infertility and its treatment also increased the risk of ectopic pregnancy. Stepwise logistic regression analysis showed the strongest association with ectopic pregnancy to exist in the case of women with a previous ectopic pregnancy (9.9-fold risk) rather than women with primary infertility. Treatment of tubal damage by salpingostomy entailed a 6.0-fold risk and treatment by other methods a 2.8-fold risk. Women working in industry had a 3.5-fold risk of ectopic pregnancy compared with those in other professions.     

Predictors of sexual and relationship functioning in couples with Chronic Prostatitis/Chronic Pelvic Pain Syndrome

IntroductionBoth partners in a relationship are typically affected when one experiences sexual dysfunction and/or pain. However, couple functioning has rarely been investigated in Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS), a common condition in men involving pelvic pain and sexual dysfunction.AimTo identify potential predictors of sexual and relationship function among couples with CP/CPPS, and to examine associations among pain, sexual, and relationship variables in patients and their women partners.MethodsThirty-eight patients with CP/CPPS and their women partners completed questionnaires assessing sexual and relationship function via mail.Main Outcome MeasuresPatients completed a subscale from the Multidimensional Pain Inventory and the International Index of Erectile Function. Partners completed the Female Sexual Function Index. All participants completed the Golombok–Rust Inventory of Sexual Satisfaction and the Dyadic Adjustment Scale.ResultsCouples' sexual function, sexual satisfaction, and relationship adjustment were all significantly associated. Pain severity significantly predicted sexual and relationship functioning among couples. However, multiple regression models revealed that sexual and relationship variables were the strongest predictors of patient and partner functioning, over and above pain severity. Patient sexual function was predicted by patient sexual satisfaction and female sexual function, whereas female sexual function was predicted by female sexual satisfaction and patient relationship adjustment. With regard to sexual satisfaction, patient sexual function and relationship adjustment and female relationship adjustment predicted patient sexual satisfaction. Female sexual function predicted female sexual satisfaction. Among both patients and partners, relationship adjustment was significantly predicted by that of one's partner. The only partner variable that was significantly predicted by patient pain severity was female sexual function.ConclusionsSignificant links exist among the sexual and relationship functioning of patients with CP/CPPS and their partners. These results emphasize the importance of the interpersonal context on couples' functioning, and highlight the need to adopt a biopsychosocial approach when investigating CP/CPPS. Smith KB, Tripp D, Pukall C, and Nickel JC. Predictors of sexual and relationship functioning in couples with Chronic Prostatitis/Chronic Pelvic Pain Syndrome.     

Four-year follow-up of women who were diagnosed to have postpartum urinary retention

OBJECTIVE: The purpose of this study was to evaluate the long-term prevalence of urinary incontinence in women with postpartum urinary retention. STUDY DESIGN: A telephone interview was conducted by contacting a cohort of 691 women who delivered vaginally 4 years ago, of which 101 women had been diagnosed as having postpartum urinary retention. A structured telephone interview consisted of 9 questions on the possible outcomes of postpartum urinary retention. RESULTS: Of the original cohort of 691 women, 394 women were contacted. Seventy-three women had had postpartum urinary retention, and 321 women had not. In women who had had postpartum urinary retention, the prevalence of the outcome variables were urinary stress incontinence (28.8%), fecal incontinence (2.7%), frequency (39.1%), nocturia (65.2%), urgency (26.1%), urge incontinence (26.1%), and coital incontinence (13%). Analyses showed that there was no significant difference between women with and without urinary retention. CONCLUSION: Women who had had postpartum urinary retention did not have a higher prevalence of urinary stress incontinence.     

A longitudinal study of sexual functioning in women referred for colposcopy: a 2-year follow up

Objective  To elucidate psychosexual problems in women referred for colposcopy after an abnormal cervical smear and a 6-month and 2-year follow up.
Design  Prospective study.
Setting  Department of Gynaecology, Malmö University Hospital, Sweden.
Population  One hundred consecutive women referred for colposcopy for the first time subsequent to receiving notification of an abnormal cervical smear.
Methods  The women completed the State-Trait Anxiety Inventory, a psychosexual questionnaire and had one psychosocial interview prior to colposcopy at all three visits.
Main outcome measures  Depending upon the result of the cervical biopsy, women had either a loop electrosurgical excision procedure (LEEP) or not. Psychosexual variables, anxiety measures, and psychosocial variables were used to estimate sexual functioning at the beginning of the study and at follow up. Differences in sexual functioning between LEEP and non-LEEP groups were estimated.
Results  'Spontaneous interest in sex', 'frequency of intercourse', and 'sexual arousal' were reported to be statistically significant lower at 6 months compared with the first visit, and at 2 years, 'spontaneous interest in sex' and 'frequency of intercourse' still remained low. There was no difference in sexual functioning between the LEEP and non-LEEP groups at follow up.
Conclusions  Two years after referral for colposcopy, women still had an effect on sexual functioning, that is, lesser 'spontaneous interest' and decreased 'frequency of intercourse'. We found no support for a relationship between treatment of cervical intraepithelial neoplasia by LEEP and deterioration in sexual functioning.     

Modern and traditional practices of Turkish infertile couples

Objective?This investigation was carried out to determine modern and traditional practices of infertile couples in Kayseri, Turkey.

Methods?Two hundred and fifty-two infertile couples were selected from the study area. Modern and traditional practices of the infertile women and their husbands were investigated through a questionnaire. The effects of some factors on the utilization of traditional methods were analysed through the logistic regression method.

Results?It was found out that 92.5% of the infertile women and 71.8% of their husbands had consulted a physician for infertility and 92.1% of the women and 32.6% of their husbands had applied for medical or surgical intervention. However, only 11.1% of the couples had attempted in vitro fertilization. In contrast, 61.5% of the infertile couples admitted to carrying out traditional practices. All traditional practices were more prevalent among the women than the men.

Conclusion?It was concluded that traditional practices were more prevalent in the rural areas and among the older couples.     

Ambulatory evaluation and treatment of infertile couples.

With the exception of major surgical procedures, all investigative and therapeutic regimes regarding infertility can be instituted and carried to completion via the ambulatory office and hospital route if a foundation for understanding and cooperation between the physician and the couple is established during the initial stages.