Quality of life of infertile Tunisian couples and differences according to gender

Objective

To compare quality-of-life gender differences within infertile couples from Tunisia and between infertile couples and controls.

Methods

The present case–control study included 100 couples with primary infertility who, during 2009, underwent assisted reproductive technology at Farhat Hached Hospital in Sousse, Tunisia, and 100 control couples. The 36-item Short-Form Health Survey (SF-36) was administered to assess quality of life.

Results

Compared with male controls, men in the infertility group had lower scores in the mental dimension (P = 0.020), social functioning (P = 0.007), and role–emotional (P < 0.001) categories of the SF-36. Women in the infertility group had lower mental and physical dimension scores (P < 0.001) and lower vitality (P = 0.022), social functioning (P < 0.001), role–emotional (P < 0.001), and mental health (P < 0.001) scores than female controls. Within infertile couples, female partners had lower total (P = 0.01) and mental dimension (P < 0.001) scores than their spouses. Delay of the first consultation was correlated with bodily pain, vitality, and mental health among women in the infertility group.

Conclusion

Women in infertile couples had a lower quality of life than their spouses, and infertile couples had a lower quality of life than controls. These findings confirm the need for psychological support for infertile couples.     

Characteristics of infertile women in the United States and their use of infertility services

National estimates of demographic characteristics are shown for infertile women compared with those who were fecund, women with primary versus secondary infertility, and infertile women who had, and had not, sought infertility services. Overall, 30% of infertile women had primary infertility, and 70% had secondary infertility. Women with primary infertility were twice as likely to seek services as women with secondary infertility. Many demographic characteristics of women with secondary infertility who sought services differed from those of women who had not sought services. There were fewer differences among women with primary infertility. These findings have implications for the generalizability of results from clinic-based studies and suggest that more research is needed on the barriers to service among infertile couples.     

Primary infertility and health-related quality of life in Upper Egypt

Objective

To assess the effect of infertility on the health-related quality of life and sexual function of infertile women in Upper Egypt.

Method

The Quality-of-Life Questionnaire (QLQ) C30, version 2, and a visual analog scale were used to assess the quality of life and sexual satisfaction of 116 women with primary infertility and 116 fertile women with similar sociodemographic characteristics. We also looked for associations between the results and infertility duration.

Results

Compared with the fertile women, the women with primary infertility had significantly lower scores for both health-related quality of life and sexual function, and their sexual function was the most disturbed during the fourth, fifth, and sixth years of their marriage.

Conclusion

Women with primary infertility need to be treated medically and psychologically to improve their quality of life and sexual function.     

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.     

女性不孕症患者焦虑、抑郁状况和生活质量调查

目的调查女性不孕症患者焦虑、抑郁状况和生活质量,以探讨影响不孕症患者生活质量的因素。方法对182例女性不孕症患者进行焦虑、抑郁和生活质量测评,分析患者不同精神状况的特征,确定对其生活质量的影响因素。结果 182例不孕症患者中,有焦虑者46例(25.3%),有抑郁者20例(11.0%)。焦虑患者伴肥胖症、中等及以下教育程度、单纯女方不孕分别为15例(32.6%)、32例(69.6%)和26例(56.5%),高于无焦虑者的13例(9.6%)、70例(51.5%)和50例(36.8%),两组各因素比较,差异有统计学意义(P均0.05)。抑郁患者伴肥胖症、单纯女方不孕分别为11例(55.0%)和13例(65.0%),高于无抑郁患者的17例(10.5%)和63例(38.9%),两组各因素比较,差异有统计学意义(P均0.05)。焦虑或抑郁患者的躯体健康评分分别为(88±15)分和(89±12)分,精神状况正常者为(90±15)分和(89±15)分,差异无统计学意义(P0.05);而评价生活质量的其他评分比较,差异有统计学意义(P0.05)。多元回归分析显示,焦虑是影响生活质量危险因素(t=-5.665,P0.001)。结论女性不孕症患者的精神障碍发病率高,精神障碍影响患者生活质量。     

Effects of a psychological intervention on depression in infertile couples

OBJECTIVE: To determine factors affecting depression in infertile couples and the impact of a psychological intervention before or during infertility treatment. METHODS: In a cross-sectional study with 638 infertile couples assessed for depression, 140 couples with a member who had a Beck Depression Inventory (BDI) score of 17 or higher were randomized to receive psychological treatment either before or during infertility treatment. Logistic regression was performed to eliminate confounding factors. RESULTS: Depression was initially found in 48% of women and 23.8% of men. The mean+/-SD Beck scores fell from 18.7+/-9.7 to 10.7+/-5.8 (P<0.001) in the group psychologically treated before they received infertility treatment. CONCLUSION: The psychological intervention was found useful in alleviating depression in infertile couples before they received infertility treatment.     

General psychopathology,anxiety, depression and self-esteem in couples undergoing infertility treatment: a comparative study between men and women

Objective

To compare measures of psychological distress between men and women undergoing ART in the Unit of Reproductive Medicine “UMR” in the Department of Obstetrics and Gynecology at “Farhat Hached” Hospital in Sousse, Tunisia.

Study design

We conducted a gender comparative study of psychological profile in infertile couples. Recruitment was done during period from January to May 2009. 100 infertile couples with primary infertility were recruited. Scores of general psychopathology, depression, anxiety and self-esteem were evaluated. We administrated questionnaires on psychological factors among infertile couples before starting a new infertility treatment cycle. Psychological factors included the symptom check-list (SCL-90-R), the hospital anxiety and depression scale (HAD-S) and the Rosenberg self-esteem scale (RSE).

Result(s)

Infertile women had higher scores than their spouses in the three global scores of the SCL-90-R and in several items such as somatisation, obsessive symptoms, interpersonal sensitivity and phobias. Scores of HADS were higher among women for both depression and anxiety. Scores of self-esteem were lower among women.

Conclusion(s)

Women endorsed higher psychological distress than men across multiple symptoms domains: general psychopathology, anxiety, depression and self esteem.     

Coping with male infertility. Gender differences

Infertility is a stressor that affects the infertile couple. Coping of infertile couples with the unfulfilled desire for a child is affected by numerous variables. Depending on the diagnose is the patients were assigned to four groups: Group 1: female infertility (infertile women of fertile men), Group 2: infertility of the men, Group 3: infertility of both partners, Group 4: idiopathic sterility). One hundred and ten infertile couples were investigated with the Freiburg questionnaire of Coping with Illness. Compared to their partners, the women of infertile couples report a higher feature rating in the cales ”depressional coping” and ”self-distraction and self-stabilisation”. Women of infertile couples show lower feature ratings compared to the standardised collective of patients with chronic somatic disease only on the scale ”religiousness and search for meaning”. Involuntarily childless men activate all coping strategies to a smaller extent than the reference sample. The experience of infertility is greatly affected by gender and the associated role expectations. Received: 12 March 2001 / Accepted: 16 March 2001     

Factors influencing the quality of life of infertile women in United Arab Emirates.

OBJECTIVES: To measure the quality of life in a representative sample of infertile women and evaluate their sociocultural attitude to this condition. METHODS: Two hundred sixty-nine infertile women attending the Assisted Reproduction clinic, Tawam Hospital were consecutively selected. They were interviewed about the effect of infertility on their quality of life using a structured, measurement-specific and pre-tested questionnaire. RESULTS: Parameters mostly affected were mood-related mainly in women above 30 years, with primary and female factor infertility and those in polygamous marriages. Quality of life did not affect sexual performance and was not affected by duration of infertility or cost of treatment. CONCLUSION: The results highlight the importance of bearing children and the stresses exerted on infertile women in Eastern societies. Thorough counseling and continuing support of infertile women is therefore indicated to improve their quality of life.     

Subjective well-being in infertile couples

The subjective well-being of infertile couples is affected by numerous variables. One hundred and ten infertile couples were investigated using the von Zerssen symptom checklist. With the exception of sterile women of fertile men (group 1: female infertility), women and men in the overall randomized sample and the diagnostic groups (group 2: subfertility of the man; group 3: sterility of both partners; group 4: idiopathic sterility) report fewer general symptoms than the overall population of patients with somatic and psychiatric diseases. Subfertile men show lower rating in the symptom checklist than the norm. Involuntarily childless women express more symptoms than their partners.     

Subjective well-being in infertile couples

The subjective well-being of infertile couples is affected by numerous variables. One hundred and ten infertile couples were investigated using the von Zerssen symptom checklist. With the exception of sterile women of fertile men (group 1: female infertility), women and men in the overall randomized sample and the diagnostic groups (group 2: subfertility of the man; group 3: sterility of both partners; group 4: idiopathic sterility) report fewer general symptoms than the overall population of patients with somatic and psychiatric diseases. Subfertile men show lower rating in the symptom checklist than the norm. Involuntarily childless women express more symptoms than their partners.     

Quality of life during the transition to parenthood in Hong Kong: a longitudinal study

Abstract

Objective: Quality of life has emerged as an important health outcome in the care of perinatal families. This study was designed to examine the changes in quality of life among Chinese couples during the transition to parenthood.

Methods: A longitudinal design was used. Participants comprised a convenience sample of 203 Chinese-childbearing couples attending the antenatal clinics, who completed data collection during pregnancy and at six weeks and six months postpartum. At each point, couples completed the Medical Outcomes Study Short Form 12-Item Health Survey.

Results: The results showed that women experienced substantial changes in their quality of life during pregnancy and postpartum, whereas the changes in their partners’ quality of life were less noteworthy. Women had a poorer quality of life than their partners during the early postpartum period. The mental health component of women’s quality of life was closely related to their partners’ across the perinatal period.

Conclusions: The findings of the present study highlight the need for more attention to a couple’s quality of life during the transition to parenthood. Couple-based and culturally relevant interventions should be developed to assist both parents to cope with the new challenges and demands of parenthood, and thus achieve a better quality of life.     

Effects of infertility on gender differences in marital relationship and quality of life: a case-control study of Turkish couples

Objectives

Although there are many studies trying to evaluate the effect of infertility on marital relations (MR) and quality of life (QoL) in developed counties, there have been no studies in Turkey. As in many societies around the world, lack of pregnancy and the resulting childlessness are often highly stigmatized, leading to profound social suffering for infertile couples in Turkey.

Study Design

This study was planned as a case–control study in order to investigate the effects of infertility on MR and QoL. It was conducted among 58 primary infertile and 51 fertile couples. The Dyadic Adjustment Scale (DAS) and the World Health Organization QoL Scale (WHOQOL-BREF) were applied at the infertility department of the Istanbul University's faculty of medicine. The t-test, Mann–Whitney U, ANOVA and Pearson's correlation coefficient were used.

Results

The socio-demographic properties were similar for both groups. The QoL average score was higher for the infertile group. There were no gender differences in QoL for infertile couples. The total DAS score was higher than the cut-off score for both groups (114.44 ± 18.53 for infertile, 110.29 ± 18.28 for fertile couples; p > 0.05). Infertile women's DAS and QoL scores were higher than the fertile women's (p < 0.05). Other than in the social domain, all QoL scores were higher for infertile men than fertile men (p < 0.05). There was a positive correlation between the DAS and QoL scores.

Conclusions

It was determined that infertility did not have a negative impact on MR and QoL measurements. There were no gender differences.     

Temperament and character in couples with fertility disorders: a double-blind,controlled study

Objective: To evaluate the personality features of infertile patients.

Design: A double-blind, controlled study.

Setting: An outpatient facility for diagnosis and care of infertility.

Patient(s): We assessed 142 infertile couples with obstetric-gynecologic clinical and instrumental examinations. The couples were divided into three groups: organic infertility, functional infertility, and infertility of uncertain origin. The third group was excluded.

Intervention(s): Organic infertility and functional infertility were ascertained with gynecologic and andrologic clinical examinations, seminal liquid examination, postcoital testing, progesterone assay, hysterosalpingography, biopsy of endometrium, and laparoscopy. Personality traits were assessed with the Temperament and Character Inventory (TCI).

Main Outcome Measure(s): Results of the Temperament and Character Inventory.

Result(s): Infertile women showed lower Cooperativeness than control women. Women with functional infertility had lower scores in Cooperativeness and Self-Directedness than women with organic infertility. Men belonging to the functional infertility group had a lower Novelty Seeking score than did those of the organic infertility group. Men and women in the functional infertility group showed higher Harm Avoidance than those in the organic infertility and control groups.

Conclusion(s): The results emphasize that the study of personality in the diagnostic and therapeutic assessment of infertility might provide useful predictive elements for functional infertility.     

Increased infertility with age in men and women

OBJECTIVE: To estimate the effects of aging on the percentage of outwardly healthy couples who are sterile (completely unable to conceive without assisted reproduction) or infertile (unable to conceive within a year of unprotected intercourse). METHODS: A prospective fecundability study was conducted in a sample of 782 couples recruited from 7 European centers for natural family planning. Women aged 18-40 years were eligible. Daily intercourse records were used to adjust for timing and frequency of intercourse when estimating the per-menstrual-cycle probability of conception. The number of menstrual cycles required to conceive a clinical pregnancy and the probability of sterility and infertility were derived from the estimated fecundability distributions for men and women of different ages. RESULTS: Sterility was estimated at about 1%; this percent did not change with age. The percentage infertility was estimated at 8% for women aged 19-26 years, 13-14% for women aged 27-34 years and 18% for women aged 35-39 years. Starting in the late 30s, male age was an important factor, with the percentage failing to conceive within 12 cycles increasing from an estimated 18-28% between ages 35 and 40 years. The estimated percentage of infertile couples that would be able to conceive after an additional 12 cycles of trying varied from 43-63% depending on age. CONCLUSION: Increased infertility in older couples is attributable primarily to declines in fertility rates rather than to absolute sterility. Many infertile couples will conceive if they try for an additional year.     

Quality of life in Indian women with fertility problems as assessed by the FertiQoL questionnaire: a single center cross sectional study

Purpose: Infertility and its treatment can significantly impact an individual's physical and psychological health; however, this has not been well-studied in the Indian population. This study aimed to assess the quality of life in women with infertility at a teaching hospital in Hyderabad, India.

Methods: In this cross sectional study of women with infertility, the quality of life was measured using the ‘FertiQoL International’ questionnaire (English/Hindi).

Results: The age ranged from 20 to 38?years and polycystic ovary syndrome was the most common cause of infertility. Core FertiQoL scores were analyzed in 215 women and Treatment FertiQoL in 156. The mean Total FertiQoL score in the study population was 66.1 (SD 13.0) and this overall score was not influenced by socio-demographic or infertility-specific factors. However, on subscale analysis, women who had living children and were university-educated had significantly better emotional scores while obese (≥35?kg/m²) women and those on ovulation induction treatment had poorer mind body and relational scores, respectively. Women with associated co-morbidities had worse quality of life on the Treatment Environment scale than those without.

Conclusions: The results provide a baseline quality of life score in these women. Infertility had the greatest impact on the emotional domain.     

Carrier of numerical chromosome abnormalities in infertile married couples

OBJECTIVES: Genetic anomalies are one of many conditions causing infertility. DESIGN: The aim of the study was to define the frequency of numerical chromosome aberrations in infertile married couples. MATERIALS AND METHODS: Metaphasal chromosomes were analysed by G-T-G stration in 650 patients, i.e. 325 married couples. Chromosomes for testing had been obtained from peripheral blood lymphocytes. RESULTS: Of all women and men, numerical chromosome anomalies were found in 14 married couples (4.1%). The aberrations were connected with female factors in 8 couples (2.3%), and with male factors in 6 (1.8%). CONCLUSIONS: Results of the study indicate that diagnostic procedure for infertility should preferably include cytogenetic examinations as well.     

Poor Health‐related Quality of Life After Severe Preeclampsia

Abstract: Background: Preeclampsia is a major complication of pregnancy associated with increased maternal morbidity and mortality, and adverse birth outcomes. The objective of this study was to describe changes in all domains of health‐related quality of life between 6 and 12 weeks postpartum after mild and severe preeclampsia; to assess the extent to which it differs after mild and severe preeclampsia; and to assess which factors contribute to such differences. Methods: We conducted a prospective multicenter cohort study of 174 postpartum women who experienced preeclampsia, and who gave birth between February 2007 and June 2009. Health‐related quality of life was measured at 6 and 12 weeks postpartum by the RAND 36‐item Short‐Form Health Survey (SF‐36). The population for analysis comprised women (74%) who obtained scores on the questionnaire at both time points. Results: Women who experienced severe preeclampsia had a lower postpartum health‐related quality of life than those who had mild preeclampsia (all p < 0.05 at 6 wk postpartum). Quality of life improved on almost all SF‐36 scales from 6 to 12 weeks postpartum (p < 0.05). Compared with women who had mild preeclampsia, those who experienced severe preeclampsia had a poorer mental quality of life at 12 weeks postpartum (p < 0.05). Neonatal intensive care unit admission and perinatal death were contributing factors to this poorer mental quality of life. Conclusions: Obstetric caregivers should be aware of poor health‐related quality of life, particularly mental health quality of life in women who have experienced severe preeclampsia (especially those confronted with perinatal death or their child’s admission to a neonatal intensive care unit), and should consider referral for postpartum psychological care. (BIRTH 38:3 September 2011)