The Complex Relationship Between Celebrity-Driven Magazines and Depictions of Fertility at Advanced Reproductive Ages

In this issue of the Journal of Women’s Health, Willson and colleagues explore how age and fertility are portrayed in celebrity-driven magazines.1 Specifically, they examine if popular media depictions of celebrity pregnancies present accurate information related to age and fertility, the use of assisted reproductive technology (ARTs), and pregnancy-related risks associated with advanced maternal age (AMA \u3e35 years). Their study provides an important viewpoint related to the impact of media on reproductive perceptions, and its potential intersection with delayed childbearing, fertility awareness, and reproductive decision making

Fertility Counseling for Couples

The purpose of this chapter is to provide fertility counselors with the tools necessary to effectively assess and treat couples experiencing fertility problems so that these couples can improve their relationships, reduce psychological and infertility related distress, and regain control and direction in their lives. The chapter will outline the challenges unique to couples experiencing infertility, and will integrate several case vignettes which portray common profiles of couples who fertility counselors may encounter. Gender differences in how couples communicate and cope with infertility distress will be presented. The chapter will also examine the impact of infertility on a couple’s sexual relationship, strategies to help couples best share infertility related treatment information with others and the importance of working through grief and loss. The challenges unique to couples experiencing age-related fertility decline will also be presented, as will the usefulness of mindful meditation as a method for approaching fertility related thoughts and feelings.https://digitalcommons.chapman.edu/mft_books/1001/thumbnail.jp

Posttraumatic Growth in Women With a Long-Standing Experience of Involuntary Childlessness in the Czech Republic

This qualitative research study aimed to examine aspects of posttraumatic growth (PTG) in women with a long-standing experience of involuntary childlessness. In-depth semi-structured interviews, lasting an average of 53 min, were conducted in the Czech Republic. Twenty-four women, averaging 38.8 years old with an average of 6.2 years of infertility experience, participated. They were asked how involuntary childlessness affected/changed their partnerships, sexual life, job, future plans, attitude to children/values/faith, and leisure time. Participants shared both positive and negative aspects of the infertility experience. Data were analyzed using thematic analysis. Five main themes of PTG were identified: strengthening of partnership, greater humility, deeper self-appreciation, reassessment of relationships, and changes in the philosophy of life. These findings could be useful to mental health providers to facilitate the PTG process in patients

A Typology of Coping in Couples Undergoing Fertility Treatment

Poster presentation about the use of cluster analysis to identify clinically meaningful groups of infertile couples, and how such profiles can be used by medical and mental health professionals

Understanding and Treating the Psychosocial Consequences of Infertility

Psychological distress and infertility are linked in a complex pattern, such that distress may be a cause of infertility and reduce the probability of achieving a pregnancy at the same time that infertility may be a cause of psychological distress. Although infertile women are not more likely to be characterized by psychopathology, they are more likely to experience higher levels of distress than comparison groups. Infertile men also experience psychological distress, but women experience more infertility distress than men. Both infertility and its treatment are stressors putting a heavy psychological strain on couple relationships. Whereas there is general agreement about the need for psychological interventions to treat infertility distress, little is known about the efficacy and effectiveness of psychosocial intervention. Given the prevalence of infertility and the fact that the numbers of individuals and couples seeking infertility treatments are increasing, it is essential that mental health professionals understand the emotional challenges faced by this population.https://digitalcommons.chapman.edu/mft_books/1002/thumbnail.jp

Severe Depressive Symptoms Predict Individual and Partner Infertility-Related Distress at One-Year Follow-up

Poster presentation on whether severe depressive symptoms at baseline are a predictor of individual and partner infertility-related distress after one-year of unsuccessful fertility treatments

Gender Differences in How Men and Women Referred with In Vitro Fertilization (IVF) Cope with Infertility Stress

Men and women use a variety of coping strategies to manage stress associated with infertility. While previous research has helped us understand these coping processes, questions remain about gender differences in coping and the nature of the relationship between coping and specific types of infertility stress. Methods: This study examined the coping behaviors of 1,026 (520 women, 506 men) consecutively referred patients at a Universityaffiliated teaching hospital. Participants completed the Ways of Coping Questionnaire, Fertility Problem Inventory, and the Dyadic Adjustment Scale. Results: Women used proportionately greater amounts of confrontive coping, accepting responsibility, seeking social support, and escape/avoidance when compared to men, while men used proportionately greater amounts of distancing, self-controlling, and planful problem-solving. For men and women, infertility stress was positively related to escape/avoidance and accepting responsibility, and negatively related to seeking social support, planful problem-solving, and distancing. Conclusions: By analyzing relative coping scores, this study identified key gender differences in how men and women cope with infertility. This was particularly true for men’s coping processes that had previously remained hidden because of less frequent use of coping strategies when compared to women

Initiating Patient Discussions about Oocyte Cryopreservation: Attitudes of Obstetrics and Gynaecology Resident Physicians

This study examined the attitudes of obstetrics and gynaecology (OB/GYN) resident physicians to initiating patient discussions regarding medical and elective oocyte cryopreservation (OC). The study used a cross-sectional online survey of OB/GYN medical residents in the USA, sampled from residency programmes approved by the American Council for Graduate Medical Education. In total, 208 medical residents, distributed evenly between postgraduate years 1–4, participated in the study. Residents\u27 fertility knowledge and attitudes to initiating discussions about OC were gathered. Forty percent (n = 83) believed that OB/GYN residents should initiate discussions about OC with patients (initiators), while 60% (n = 125) did not (non-initiators). Initiators were less likely to overestimate the age at which a woman\u27s fertility begins to decline, and were more likely to believe that discussions about OC and age-related fertility decline should take place during a well-woman annual examination. Initiators and non-initiators did not differ in their attitudes towards discussing OC with patients undergoing cancer treatments; however, initiators were significantly more likely to discuss elective OC with patients who were currently unpartnered or who wished to delay childbearing to pursue a career. Given the increasing age of childbearing among women, and the fact that women prefer to receive reproductive information from their healthcare providers, it is critical that such topics are discussed in consultations to assist patients in making more informed reproductive decisions. Further research is needed to assess the existing barriers to these discussions from both physician and patient perspectives

Knowledge, Attitudes, and Intentions Toward Fertility Awareness and Oocyte Cryopreservation Among Obstetrics and Gynecology Resident Physicians

STUDY QUESTION What knowledge, attitudes and intentions do US obstetrics and gynecology (OB/GYN) residents have toward discussing age-related fertility decline and oocyte cryopreservation with their patients? SUMMARY ANSWER Most OB/GYN residents believe that age-related fertility decline, but not oocyte cryopreservation, should be discussed during well-woman annual exams; furthermore, nearly half of residents overestimated the age at which female fertility markedly declines. WHAT IS KNOWN ALREADY Oocyte cryopreservation can be utilized to preserve fertility potential. Currently, no studies of US OB/GYN residents exist that question their knowledge, attitudes, and intentions toward discussing age-related fertility decline and oocyte cryopreservation with patients. STUDY DESIGN, SIZE, DURATION A cross-sectional online survey was conducted during the fall of 2014 among residents in American Council for Graduate (ACOG) Medical Education-approved OB/GYN residency programs. Program directors were emailed via the ACOG Council on Resident Education in Obstetrics and Gynecology server listing and asked to solicit resident participation. PARTICIPANTS/MATERIALS, SETTING, METHODS Participants included 238 residents evenly distributed between post-graduate years 1–4 with varied post-residency plans; 90% of residents were women and 75% were 26–30 years old. The survey was divided into three sections: demographics, fertility awareness, and attitudes toward discussing fertility preservation options with patients. Descriptive and inferential statistics were conducted. MAIN RESULTS AND THE ROLE OF CHANCE A strong majority of residents (83%) believed an OB/GYN should initiate discussions about age-related fertility decline with patients (mean patient age 31.8), and 73% percent believed these discussions should be part of an annual exam. One third of residents overestimated the age at which there is a slight decline in female fertility, while nearly half of residents overestimated the age at which female fertility markedly declines. Over three-quarters of residents (78.4%) also overestimated the likelihood of success using assisted reproductive treatments (ARTs). Residents were likely to support oocyte cryopreservation in cancer patients irrespective of the woman\u27s age, but much less likely to support elective oocyte cryopreservation. For elective oocyte cryopreservation, 40% believed OB/GYNs should initiate discussions with patients (mean age 31.1), while only 20% believed this topic should be part of an annual exam. LIMITATIONS, REASONS FOR CAUTION Because the study invitation was sent through US OB/GYN residency program directors rather than directly to residents, it is possible that some residents did not receive the invitation to participate. This limits the generalizability of the findings. WIDER IMPLICATIONS OF THE FINDINGS Within the USA, there appears to be a critical need for improved education on fertility decline in OB/GYN residency programs. To promote informed reproductive decision-making among patients, efforts should be made to help OB/GYNs provide comprehensive fertility education to all women, while also respecting patient choices

Intentions and Attitudes Towards Parenthood and Fertility Awareness Among Chinese University Students in Hong Kong: A Comparison with Western Samples

STUDY QUESTION What are the levels of awareness regarding female fertility and the intentions and attitudes towards parenthood among Chinese university students in Hong Kong compared with their counterparts in the West? SUMMARY ANSWER Chinese university students in Hong Kong were similarly over-optimistic about the age-related fertility decline, although they were less inclined to have children and undergo fertility treatment compared with their Western counterparts. WHAT IS KNOWN ALREADY Past studies of highly educated young adults in Europe and the USA have found that they are not sufficiently aware of the age-related decline in female fertility, and falsely believe that advanced reproductive treatments such as IVF will overcome fertility problems associated with age. Little is known about the perceptions of Chinese students in Hong Kong, a modernized Chinese city where the fertility rate is among the lowest in the world. STUDY DESIGN, SIZE, DURATION An online cross-sectional survey of Chinese university students in Hong Kong was conducted in 2013. Results were compared with two similar studies in Sweden and the USA. PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 367 university students in Hong Kong (275 female, 92 male; mean age 23) responded to an e-mail invitation to participate in an online survey. Intentions and attitudes towards parenthood and awareness regarding female fertility were assessed using the Swedish Fertility Awareness Questionnaire. MAIN RESULTS AND THE ROLE OF CHANCE Like their Western counterparts, a large proportion of Chinese university students underestimated the age-related fertility decline (92%) and overestimated the fertility treatment success rate (66%). However, they were less inclined to have children, were more aware of and less concerned with infertility and were less motivated to seek solutions in the event of a fertility problem. These comparisons were significant at P \u3c 0.05. LIMITATIONS, REASONS FOR CAUTION Self-selection bias was inevitable in the questionnaire survey, and the anonymous nature of the survey did not permit the collection of characteristics of non-responders. International comparisons warrant caution because the Hong Kong sample was older than the US sample (mean age 20), but not older than the Sweden sample (mean age 24). WIDER IMPLICATION OF FINDINGS While this study was consistent with past Western studies on the lack of fertility awareness among highly educated young people, the findings reveal significant cultural differences in family planning and responses to infertility between Asia and the West