Health-related quality of life in infertile couples receiving IVF or ICSI treatment

<p>Abstract</p> <p>Background</p> <p>Infertile couples might experience psychological distress and suffer from impaired health-related quality of life. This study aimed to examine health-related quality of life in infertile couples receiving either in-vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) treatment.</p> <p>Methods</p> <p>This was a cross-sectional study of quality of life in infertile couples attending to Vali-e-Asr Reproductive Health Research Center or Royan Institute for either IVF or ICSI treatment in Tehran, Iran. Health-related quality of life was assessed using the Short Form Health Survey (SF-36). Patients' demographic and clinical characteristics were also recorded. Data were analyzed to compare quality of life in infertile women and men and to indicate what variables predict quality of life in infertile couples.</p> <p>Results</p> <p>In all 514 women and 514 men (n = 1028) were studied. There were significant differences between women and men indicating that male patients had a better health-related quality of life. Also health-related quality of life was found to be better in infertility due to male factor. Performing logistic regression analysis it was found that female gender, and lower educational level were significant predictors of poorer physical health-related quality of life. For mental health-related quality of life in addition to female gender and lower educational level, younger age also was found to be a significant predictor of poorer condition. No significant results were observed for infertility duration or causes of infertility either for physical or mental health-related quality of life.</p> <p>Conclusion</p> <p>The findings suggest that infertility duration or causes of infertility do not have significant effects on health-related quality of life in infertile couples. However, infertile couples, especially less educated younger women, are at risk of a sub-optimal health-related quality of life and they should be provided help and support in order to improve their health-related quality of life.</p

A survey of relationship between anxiety, depression and duration of infertility

BACKGROUND: A cross sectional study was designed to survey the relationship between anxiety/depression and duration/cause of infertility, in Vali-e-Asr Reproductive Health Research Center, Tehran, Iran. METHODS: After obtaining their consents, 370 female patients with different infertility causes participated in, and data gathered by Beck Depression Inventory(BDI) and Cattle questionnaires for surveying anxiety and depression due to the duration of infertility. This was studied in relation to patients' age, educational level, socio-economic status and job (patients and their husbands). RESULTS: Age range was 17–45 years and duration and cause of infertility was 1–20 years. This survey showed that 151 women (40.8%) had depression and 321 women (86.8%) had anxiety. Depression had a significant relation with cause of infertility, duration of infertility, educational level, and job of women. Anxiety had a significant relationship with duration of infertility and educational level, but not with cause of infertility, or job. Findings showed that anxiety and depression were most common after 4–6 years of infertility and especially severe depression could be found in those who had infertility for 7–9 years. CONCLUSIONS: Adequate attention to these patients psychologically and treating them properly, is of great importance for their mental health and will improve quality of their lives

The Effect of Psychological Intervention on Mother-Infant Bonding and Breastfeeding

ABSTRACT Background: The emotional bond that a mother feels towards her infant is critical to their social, emotional, and cognitive development. This concept has a major influence on an infant’s future health, and growth, so the assessment of parental-fetal attachment and related factors is of great importance. This study aimed to examine the effect of psychological intervention on attachment and persistency of lactation.Methods: This clinical trial was carried out on 71 pregnant women who visited Milad and Vali-Asr hospitals in Tehran, Iran. The subjects were selected by convenience sampling method and randomly divided into control (n=36) and intervention (n=35) groups. In the intervention group, the subjects received three sessions of supportive group psychotherapy supplemented by training packages. Avant’s mother-infant attachment behavior questionnaire, Maternal Attachment Inventory, 28-item General Health Questionnaire, and the short form of the Coopersmith Self-Esteem Inventory were used to evaluate attachment behaviors and related factors. Attachment of mothers was examined at six different times. Statistical data was analyzed using independent t-test, Fisher’s exact test.Results: The findings indicated that the intervention group had increased attachment and breastfeeding persistency (P˂0.001). Regression test also showed that maternal attachment was significantly influenced by psychological interventions, self-esteem, and depression (P˂0.001).Conclusion: According to the results, psychological interventions are suggested during pregnancy to increase attachment and breastfeeding persistency, and thereby, improve mental health of both mother and newborn

Effects of a psychological intervention on Quality of life in infertile couples

Objective: This study aimed to determine factors affecting depression in infertile couples and effect of psychological intervention on pregnancy rate of infertile couples. Materials and Methods: In this study, 638 infertile patients referring to a university infertility clinic were evaluated. Among them, 140 couples with different levels of depression in at least one of the spouses were found and the study was continued by dividing them randomly into two groups, entering a randomized clinical trial. Patients in the case group received 6-8 sessions of psychotherapy before infertility treatment and were given daily Fluoxetin 20- 60 mg at the same period, and the control group did not receive any intervention. Three questionnaires including Beck Depression Inventory (BDI), Stress Scale (Holmes-Rahe) and a sociodemographic questionnaire were applied for all patients. Pregnancy rate was compared between two groups. 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 in the group psychologically treated before receiving infertility treatment (P<0.001). Pregnancy rate was 47.1% in case group and 7.1% in control group. Pregnancy rate showed a significant relation with duration and cause of infertility and the level of stress in both groups (P< 0.001). Pregnancy rate was shown to be higher in couples with a second level of education in men (P< 0.001). Conclusion: The psychological intervention was found useful in alleviating depression and promoting pregnancy rate, it is crucial to mandate psychology counseling in all fertility centers

Increase Concentration of Transforming Growth Factor Beta (TGF-β) in Breast Milk of Mothers With Psychological Disorders

Several studies have shown an imbalance between proinflammatory and anti-inflammatory cytokines in depression and anxiety disorders. However, less attention has been paid to the role of cytokines in psychological disorder in mothers who breastfeed. This study looks at whether concentration levels of TGF-β2 are altered in anxious and depressive breastfeeding mothers. This study checked the concentration level of TGF-B2 in relation with psychological symptoms on 110 breastfeeding mothers; based on random sampling method with using of Beck Depression Inventory (BDI), General Health Questionnaire (GHQ) and Spielberger Stress Scale (STAI) in 2015 also TGF-β2 was measured in breast milk using ELISA. We used of Pearson Correlation Method, independent t-test and one-way analysis of variance (ANOVA) to analyze the data. Psychological symptoms (Anxiety and depression) showed positive correlation with TGF-Beta level in which relationships were significant (P=0.01). Psychological problems may be uniquely associated with the level of TGF-β in breast milk. More attention should be paid to the mental health of mothers during breastfeeding, and more research needs to be done in this subject to clarify the relationship between psychological variables with the level of TGF-β in breast milk

Effect of anxiety and depression on ART outcome

Background: There is increasing evidence that psychological factors like anxiety and depression can affect IVF/ICSI treatment results. Objective: This study aimed to clarify the role of women’s anxiety and depression on the outcome of ART cycles using Intra Cytoplasmic Sperm Injection (ICSI). Materials and Methods: This was a prospective pilot study. One hundred six (106) consecutive women undergoing ICSI cycles were enrolled between January 2006 and 2007. Age, duration and cause of infertility, number and score of transferred embryos were recorded for each patient. Data regarding the state of anxiety and depression of each volunteer were collected using the translated and validated Iranian Cattle Anxiety and Beck Depression Inventories. Results: Among 106 women enrolled in the study, 25 cases (23.5%) of clinical pregnancies occurred. In univariate analysis, there was no significant difference regarding age and cause and duration of infertility between groups. Number of transferred embryos was significantly associated with higher pregnancy rates (3.4± 1.15 vs. 2.5±1.38 in pregnant and nonpregnant group respectively). Among the 106 participants, 73.58% had anxiety and 30.18% showed various degrees of depression. Out of 28 patients with no anxiety, 21(75%) and out of 74 patients with no depression, 24(32%) became pregnant. There was significant association between depression/anxiety and pregnancy rate (p=0.034 and p=0.00 respectively). Logistic regression model showed that anxiety/depression affect the outcome of ART significantly. Conclusion: It is crucial to identify infertile patients at greater demand for psychological support before starting ART cycles

Comparison of Predisposing and Effective Factors on Divorce Application between Men and Women

Objective: with regard to his human and social nature, sympathy is required that men and women live together in peace and rest. Since that family is manifestation and expression of life and love, divorce is a critical that consequences and undesirable effects on individuals, families and society. The present study based on gender People requesting a divorce in the family courts in Tehran has paid during the years 2006-2007. Materials and methods: The sample included 300 people referred from the courts, and cross-sectional study approach, with structured interview was conducted. Causes and reasons for divorce after the interview and identified as economic factors, psychological, cultural - social, sexual problems, physical, addiction, violence and marriage with this classification and statistical methods chi-square, Fisher and Mann - Whitney two groups were compared. Results: Results showed that although most divorce because both gender (84.4% of women and 90% of men) lack of understanding and compromise has been divorce for women, but more influenced by socioeconomic status (P< 0.001), violence (P< 0.001) sexual problems (P= 0.048) and addiction (P= 0.001), while men were more due to cultural problems - social (P= 0.023) had been demanded divorce. Conclusion: The results also suggested the counseling of premarital and to aware in the field of professional advice at the time of the divorce that it can prevent the occurrence divorce

Effect of Ramadan Fasting on Stress Neurohormones in Women with Polycystic Ovary Syndrome.

Objective:To determine the effects of Ramadan fasting on serum levels of stress neurohormones in Iranian women with polycystic ovary syndrome (PCOS). Materials and methods:This study was a clinical trial and was performed during July 2011 (month of Ramadan) in Royan institute, Tehran. A total of 40 women who were aged 20-40 years and known cases of PCOS and had no other medical diseases were included in the study. They were divided into two groups as follows: (i) study group (n = 20) who participated in Ramadan fasting and (ii) control group (n = 20) who did not participate in fasting. For evaluating Ramadan's effect on the level of neurohormones serum level of the following variables were evaluated before and after Ramadan: cortisol, adrenaline (A), noradrenalin (NA), beta-endorphin (β-End), insulin, as well as sex hormones including follicle-stimulating hormone (FSH), luteinizing hormone (LH), and testosterone.In the study group after Ramadan serum cortisol and nor-adrenaline levels were significantly lower than the initial levels obtained at beginning of Ramadan (p < 0.05) as compared to control group. Conclusion:This study indicates that Ramadan fasting decreases stress neurohormones in women with PCOS

Psychological Signs in Patients with Polycystic Ovary Syndrome

Objective: PCOS is a multifaceted disorder with multiple potential risk factors (e.g. infertility, diabetes,cardiovascular disease and metabolic syndrome). PCOS affects quality of life and can worsen anxiety and depression either due to the features of PCOS or due to the diagnosis of a chronic disease. This study aimed to determine the risk factors of PCOS in a group of patients. Materials and methods: In this descriptive-analytic study, 81 patients with PCOS were studied in Vali-e-Asr Reproductive Health Research Center, Tehran, Iran. A questionnaire with items related to stress information was used for data collection. Stress  symptoms were assessed using the Understanding Yourself standard questionnaire. Statistical analyses were performed using SPSS 13.0 (SPSS Inc., Chicago, ILL, USA). Data are presented as mean ± SD or as frequency with percentages. P-value less than 0.05 were considered as statistically significant. Results: The evaluation of psychological signs in 81 PCO patients and descriptive results showed that 8 (9.9%) had not any stress problem, 32 (39.5%) had neurotic stress, 29 (35.8%) had high level and 12 (14.8%) had extremely high level of stress. The age range of 26 years and more (P=0.023), touchy personality (P = 0.028) and acne (P = 0.015) related with high stress level. The odds of high level of anxiety in women with hirsutism was 3.1 (95%CI 1.00 to 9.59). The odds of high level of obsession in overweight patients was 3.2 (95%CI 1.12 to 9.234). The odds of high level of worrisome in patients with touchy personality was 3.4 (95%CI 1.10 to 11.19). Obsession score had a correlation with illness duration (r = -0.268, P = 0.038). Conclusion: These data showed that clinical signs of PCOS are the most closely associated with psychological distress and this  has important implications for the diagnosis and treatment of  disorders

Breastfeeding Self-Efficacy as a Predictor of Exclusive Breastfeeding: A Clinical Trial

Background: "Exclusive breastfeeding (EBF) is globally promoted as the ideal method of infant feeding during the first six months of life due to its health benefits to both the mother and child" (1). The aim of this study was to examine the effect of the interventions leading to increased awareness, knowledge, and self-efficacy regarding exclusive breastfeeding and duration of breastfeeding. Methods: This clinical trial was conducted on 129 pregnant women before the gestational age of 21 weeks and 6 days referring to Vali-e-Asr Hospital in Tehran, Iran. The study population was selected using the convenience sampling method. The participants were randomly assigned into two groups of intervention (n=64) and control (n=65). The mothers in the intervention group received one training session on breastfeeding self-efficacy, as well as training and audio packages regarding postpartum care and relationship with neonates. In addition, the women who suffered from anxiety, stress, or depression were provided with psychotherapies. The data collection instruments included the Self-Efficacy Scale, Edinburgh Postnatal Depression Scale, and Spielberger's State-Trait Anxiety Inventory. Results: Exclusive breastfeeding was higher in the intervention group than in the control group during the first six months postpartum (P=0.015). The follow-up study showed that there were higher rates of breastfeeding for the two-year-old children in the intervention group (