The dimensions of the transition to parenthood in fathers after assisted reproductive technology

Perinatality represents a major life transition period for future parents for the activation of the caregiving system and the development of early parenting skills. This transition may be influenced by specific contexts of parenthood, such as infertility and the need to undergo Assisted Reproductive Technologies (ART), which are known as highly stressful events. Nevertheless, literature on parenthood after ART has focused on mothers and less on fathers’ experience. This study aimed to investigate the transition to parenthood in fathers after ART treatments, analysing the quality of both parental mental representations and father-infant interactive styles according to modality of conception (ART vs Spontaneous Conception, SC). Forty-two fathers (17 ART, 25 SC) and their partners were recruited at Santa Maria Nuova Hospital (Reggio Emilia, Italy) during the antenatal period. The quality of parental representations was assessed at 32 gestational weeks and 3 months after childbirth, by the Semantic Differential of the IRMAG. Father-infant interactive patterns were also evaluated after birth during 5 minute-free interactions, coded by the CARE-Index. Results showed similar mental representations between ART and SC fathers in individual (Child, Self-as-man, Partner) and parental (Self-as-parent, Own parent) characteristics. Nevertheless, ART fathers showed higher scores in Emotional Tendencies, suggesting a more intense involvement in the parenting role. Father-infant interactions showed a similar level of sensitivity between ART and SC fathers and infants were cooperative in both groups. Anyway, considering the influence of the type of ART, infants whose fathers underwent ICSI procedure showed to be more passive. Findings suggest the need to further investigate paternal experience during transition to parenthood after ART, to improve the understanding of fathers’ difficulties and resources in developing their parental role and possibly to target specific parenting support

Psychological adjustment of infertile couples in the postpartum period: the characteristics of parental mental representations and early parent-infant interactions

Clinical and empirical literature has recognized Assisted Reproductive Technology (ART) as a stressful condition that may impact on psychological transition to parenthood during pregnancy. However, poor attention has been paid to investigate parental adjustment in the postpartum period, a crucial moment for the parent-infant relationship. We therefore aimed to investigate transition to motherhood and fatherhood in the postnatal period, discussing an overview of recent studies on postnatal outcomes (parental representations and parent-infant interactions) of infertile couples after a successful ART treatment. The first study included a sample of 17 ART conceiving and 25 spontaneous conception (SC) couples; at 3 months postpartum all parents completed the Semantic Differential of IRMAG/IRPAG (Interview of Maternal/Paternal Representations During Pregnancy; Ammaniti et al., 1992, 1995, 2006), a self-report tool to evaluate domains of mental representations according to individual (Child, Self-as-womanman, and Partner) and parental (Self-as-parent, Own parent) characteristics. The second study aimed to assess the quality of a 5-minute free parent–infant interaction on 25 ART and 31 SC couples and their 3-month-old baby. Fathers, mothers and babies’ interactive patterns were coded using CARE-Index (Crittenden, 1994). Results on mental representations showed that both ART mothers and fathers had significantly higher positive representations of the Child than SC ones. The type of ART treatment (IVF/ICSI) showed a significant influence on the representation of Self-as-woman/man, with higher positive scores in IVF parents compared to ICSI ones. Regarding parent-infant interactions, both ART mothers and fathers showed more frequently “inept” and “at-risk” interactive patterns, compared to SC ones. ART variables significantly influenced interactive behaviours: infants conceived at first ART cycle showed lower scores at Difficulty scale than those conceived after more attempts; ICSI babies got lower scores at Compulsivity and higher at Passivity compared to IVF ones. These findings support the clinical relevance of exploring parents’ psychological adjustment after successful ART treatments, to improve the understanding of the transition to parenthood in infertile couples and to target more specific interventions when needed

Assisted reproductive technology treatments and quality of life: a longitudinal study among subfertile women and men

Purpose: Quality of life (QoL) may represent a comprehensive indicator for the assessment of the psychological impact of complex clinical conditions, such as infertility. Infertile women have a worse QoL compared to both infertile men and non-infertile controls. However, the initial phases of infertility treatments have been frequently investigated using cross-sectional study designs. This prospective longitudinal study aimed at assessing the health-related QoL change across different phases of assisted reproductive technology (ART) treatments in subfertile women and men. Methods: Eighty-five subfertile women and men undergoing ART cycles were assessed at the beginning of the ovarian stimulation, during oocyte retrieval before discharging, and around 14\uc2\ua0days after the embryo transfer. QoL was assessed through the Short Form 36. Results: Irrespective of the cause of infertility, work status, and age, QoL levels decreased from the first to the third assessment, and women scored significantly lower than men to each QoL indicator. Additionally, a higher number of previous ART failures had a negative impact on QoL, irrespective of gender and the phase of treatment. ART outcome marginally affected women\ue2\u80\u99s QoL across time. Conclusion: Infertile women have a worse QoL throughout all phases of ARTs compared to men, and this difference increases in infertile patients with more than one previous ART failure

Effect of the previous reproductive outcomes in subfertile women after in vitro fertilization (IVF) and/or intracytoplasmic sperm injection (ICSI) treatments on perinatal anxious and depressive symptomatology

Introduction: The present study aims to investigate the effects of previous reproductive outcomes on the levels of depression, anxiety and perceived social support in subfertile women who conceived after in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) treatment. Methods: A prospective cohort study was developed. Data were collected on subfertile patients who conceived after IVF/ICSI treatment. All demographic and clinical data were recorded. The Edinburgh Postnatal Depression Scale, the State-Trait Anxiety Inventory-Y and the Multidimensional Scale of Perceived Social Support at 22 and 32 weeks of gestation and 15 days after delivery were completed. Data were analyzed comparing patients who conceived at their first IVF/ICSI cycle, after one unsuccessful ARTs cycle, and after multiple unsuccessful IVF/ICSI cycles. Results: A significant increase in state anxiety and depression scores from 22 gestational weeks of gestation to 15 days after delivery was observed in patients who received multiple unsuccessful IVF/ICSI cycles compared with other groups. No significant difference in perceived social support was detected among groups. The differences in depression and anxiety scores remained consistent after controlling for perceived social support. Discussion: A history of unsuccessful IVF/ICSI treatments seems to leave women more vulnerable in facing the duties of the new parental role. Such possibility underlies the importance of the availability of a psychological support for these women, even after a successful medical treatment for infertility

Anxiety symptoms during late pregnancy and early parenthood following assisted reproductive technology

Objective: To evaluate the relationship between assisted reproduction technology (ART) and anxiety symptoms during late pregnancy and early parenthood. Method: Women with ART pregnancies were prospectively compared to their partners and to women with spontaneous pregnancies. The sample of 87 subjects, 48 ART (25 mothers and 23 fathers) and 39 non-ART mothers were given the ASQ-IPAT Anxiety Scale at 30-32 weeks of gestation, and at one week and three months after delivery. Results: The main socio-demographic and obstetrical characteristics were similar between groups. ART women showed higher scores for latent anxiety than non-ART women at three months after birth and showed no difference from ART men in all assessments. Manifest anxiety scores in ART women were higher, compared to non-ART women during the third trimester of pregnancy and one week after birth and were higher in all assessments when compared to ART men. Overall level of anxiety was higher in ART women in all assessments when compared to non-ART women and higher than in ART men during the two postnatal assessments. Conclusion: We confirm the higher level of anxiety that characterizes the pregnancy-birth process in ART pregnancies. In addition, the higher manifest anxiety present before delivery and one week post-partum can be explained by the special nature of these pregnancies. Psychological support should be offered to ART patients because anxiety is an important risk factor for maternal post-partum depression and can lead to negative effects on the neonate and on child emotional and behavioral development. \ua9 2008 by Walter de Gruyter

Emotions, Stress and Coping among Healthcare Workers in a Reproductive Medicine Unit during the First and Second COVID-19 Lockdowns

The impact of the COVID-19 pandemic on global healthcare workers’ (HCWs) mental health has been well documented in the last two years; however, little is known regarding HCWs working in specific healthcare fields. During two subsequent periods of national lockdown in Italy (June–July 2020, T1, and November–December 2020, T2), a total sample of 47 HCWs working in a reproductive medicine hospital unit completed an ad hoc questionnaire for assessing emotional reactions to the pandemic, stress symptoms, and ways of coping. Moderate–high levels of anger and sadness were experienced by 65.9% and 68.1% of the HCWs, respectively, while moderate–high levels of anxiety and fear were experienced by 51.1% and 56.8%, respectively. Higher stress symptoms experienced by HCWs were hypervigilance, avoidance of thoughts and memories, and tiredness/low energy. At T2, levels of hypervigilance, irritability, intrusive thoughts, and detachment were higher than at T1, while avoidance of external triggers decreased. Moderate–high levels of anxiety resulted significantly associated with several symptoms of stress: irritability/fearfulness, depression/hopelessness, tiredness/low energy, problems with concentration, and intrusive thoughts. Regarding coping strategies, HCWs tended to adopt more problem-focused coping (e.g., contributing to improving a situation) and this tendency was higher at T2. Overall findings suggest a risk for the persistence of stress symptoms and, therefore, a risk for a chronic course, which might interfere with the global quality of mental health at work and the care provided to patients. Clinical implications highlight the relevance of implementing support programs for this category of HCWs focused on the elaboration of negative emotions and on fostering adaptive coping strategies

Characteristics of Early Mother\u2013Infant and Father\u2013Infant Interactions: A Comparison between Assisted Reproductive Technology and Spontaneous Conceiving Parents

Abstract: This study aims to describe parents\u2019 and infant\u2019s interactive styles after assisted reproduction treatments (ART), to compare them with parent\u2013infant interactions after spontaneous conception (SC), and to assess the effect of specific ART variables (cause of infertility, treatment type, and previous ART attempts) on interaction quality. The sample included 25 ART conceiving couples and 31 SC couples with their 3-months-old babies. Free parent\u2013infant interactions (3\u20135 min) were coded using the CARE-Index, a video-based assessment scale that gives both dimensional (e.g., sensitivity, control, passivity) and categorical scores (sensitive, inept, at-risk) for parents and infants. Results showed a global similarity between groups in CARE-Index dimensions. Nevertheless, differences emerged in categorical scores, as the interactive patterns of ART parents were more frequently classified as \u201cinept\u201d and \u201cat-risk\u201d compared to SC parents. With regards to ART dyads only, infants conceived through intracytoplasmic sperm injection scored significantly lower to the dimension compulsivity and higher to passivity, compared to infants conceived through in vitro fertilization. Yet, infants conceived at the first ART cycle had significantly lower levels of difficulty than infants conceived after one ART attempt. These results speak about the existence of important parent\u2013infant interactive differences related to conception modality and ART technique and suggest the need to implement support programs to promote more sensitive parenting styles

Effects of assisted reproductive technology and of women's quality of life on depressive symptoms in the early postpartum period: a prospective case-control study

This study explored the influence of both assisted reproductive technology (ART) and reduced quality of life (QoL) during pregnancy on postpartum blues (PPB). Sixty-three sub-fertile patients who conceived through ART and 72 women who naturally conceived were enrolled in this prospective study. At 22nd and 32nd gestational weeks, women completed the Edinburgh Postnatal Depression Scale (EPDS) and the Short-Form 36 (SF-36), to investigate depressive symptoms and QoL, respectively; EPDS was again used at 15 days after birth to assess PPB. At both time points, higher EPDS scores and lower mental well-being scores (SF-36) significantly predicted PPB. The number of previous ART cycles emerged as the strongest predictor, whereas no significant effect was observed for the conceiving method. The results suggest the usefulness of assessing QoL during pregnancy and considering previous ART failures in preventing PPB

Rac1 activation links tau hyperphosphorylation and Aβ dysmetabolism in Alzheimer’s disease

Abstract One of the earliest pathological features characterizing Alzheimer’s disease (AD) is the loss of dendritic spines. Among the many factors potentially mediating this loss of neuronal connectivity, the contribution of Rho-GTPases is of particular interest. This family of proteins has been known for years as a key regulator of actin cytoskeleton remodeling. More recent insights have indicated how its complex signaling might be triggered also in pathological conditions. Here, we showed that the Rho-GTPase family member Rac1 levels decreased in the frontal cortex of AD patients compared to non-demented controls. Also, Rac1 increased in plasma samples of AD patients with Mini-Mental State Examination < 18 compared to age-matched non demented controls. The use of different constitutively active peptides allowed us to investigate in vitro Rac1 specific signaling. Its activation increased the processing of amyloid precursor protein and induced the translocation of SET from the nucleus to the cytoplasm, resulting in tau hyperphosphorylation at residue pT181. Notably, Rac1 was abnormally activated in the hippocampus of 6-week-old 3xTg-AD mice. However, the total protein levels decreased at 7-months. A rescue strategy based on the intranasal administration of Rac1 active peptide at 6.5 months prevented dendritic spine loss. This data suggests the intriguing possibility of a dual role of Rac1 according to the different stages of the pathology. In an initial stage, Rac1 deregulation might represent a triggering co-factor due to the direct effect on Aβ and tau. However, at a later stage of the pathology, it might represent a potential therapeutic target due to the beneficial effect on spine dynamics