The effect of the collaborative infertility counseling model on coping strategies in infertile women undergoing in vitro fertilization: A randomized controlled trial

Objectives: Infertility is a stressful condition influencing interpersonal and social relationships among infertile couples. Various strategies have been suggested for coping with infertility. This study examined the effect of the collaborative infertility counseling model on coping strategies in infertile women undergoing in vitro fertilization (IVF) in an urban area of Iran. Materials and Methods: This clinical controlled trial was conducted on 60 women with primary infertility selected from Milad Infertility Center in Mashhad, Iran. They were randomly allocated to the intervention and control groups with 29 and 31 samples in each group. The intervention group received individual counseling based on the collaborative reproductive healthcare model. The counseling was provided with the collaboration of a midwife, a gynecologist and a clinical psychologist in 5 sessions during a 2-month period. The control group received only routine care. The fertility problem inventory (FPI) and general health questionnaire were used to measure perceived fertility-related stress and general health, respectively. Moreover, the ways of coping-revised questionnaire was used to collect data regarding the women’s coping strategies at the beginning of the study and at the day of the embryo transfer. The student t test, Fisher exact test, Mann-Whitney U test and analysis of variance (ANOVA) were used for data analysis. Results: A statistically significant difference was reported between the two groups in terms of problem-focused coping strategies (P = 0.037). However, no statistically significant difference was reported between the groups with regard to emotion-focused coping strategies (P = 0.947). There were statistically significant differences between the 2 groups in the mean scores of seeking social support (P = 0.022) and planful problem-solving strategies (P = 0.045) as the subscales of problem-focused coping strategies. Conclusion: The collaborative reproductive healthcare model promoted the use of problem-focused coping strategies. Therefore, the use of collaborative counseling approaches by healthcare professionals is suggested for assisting infertile women to cope with infertility. © 2018 The Author (s)

Trying for a second chance: Iranian infertile couples’ experiences after failed ART

Introduction: Despite significant advances, only 35% infertile couples conceive after ART. If IVF is unsuccessful, couples will need to decide whether to proceed again with assisted conception. The aim of this study was to explore Iranian infertile couples’ experiences after failed ART to continue treatment. Methods: In this qualitative study participants were selected using purposeful sampling method. Data were collected using 29 semi-structured face-to-face in-depth interviews at a regional Infertility Center from April 2016 to June 2017. All interviews were recorded, transcribed verbatim, and analyzed with conventional content analysis method using MAXQDA software. Results: Our findings suggest that couples’ decisions to continue treatment after unsuccessful ART is shaped by their social, emotional and financial circumstances. We have constructed two themes to describe their experiences: support to continue and trying for a second chance. Conclusion: Our findings suggest that good marital and family support networks can support infertile couples during this period of decision making. Considering the depression and anxiety caused by failed ARTs, which itself could affect the success rate of any further ARTs, the clinical team should effectively assess psychological readiness of couples who decide to continue with another ART after unsuccessful treatment

A qualitative study of the experiences of Iranian infertile couples after unsuccessful assisted reproductive technologies

Objectives: Assisted reproductive technologies (ARTs) give hope to some infertile couples; however, in vitro fertilization (IVF) is expensive and not subsidized by the Iranian state. More than 75% of IVF cycles in Iranian couples are unsuccessful. The aim of this paper is to describe the experiences of Iranian infertile couples after unsuccessful treatment. Materials and Methods: In this descriptive qualitative study, 36 participants including 29 Iranian infertile couples recruited after unsuccessful ART treatments, five infertility treatment team members and 2 relatives of infertile couples were interviewed at an Infertility Center in Northeastern Iran from April 2016 to June 2017. Data were collected using semi-structured, face-to-face interviews. Data analysis was carried out following Sandelowski. Results: Iranian infertile couples’ experiences following failed ART cycles are described. The findings presented here show that Iranian infertile couples experience stressors during treatment cycles and systemic challenges which may be unique to the Iranian cultural context. Conclusions: Iranian infertile couples face particular challenges related to the cultural context in which ARTs are delivered. Further exploration of the effects of culture on the experiences of failed ARTs needs to be considered by infertility clinics in Ira

Infertile couples' perceived needs after unsuccessful fertility treatment: A qualitative study

Introduction: Infertility is a major medical issue. Investigations and treatment of infertility are the beginning of a complex, time-consuming and stressful process for couples that may fail well. The present study explored the needs of infertile couples following treatment failure with Assisted Reproductive Technologies (ARTs). Methods: A descriptive qualitative study was conducted in an Iranian infertility center, in the Northeast of the country between April 2016 and June 2017. The researchers recruited 29 individuals including 9 couples, 9 women and two men with primary infertility through purposive sampling. The data were collected using semi-structured interviews and analyzed iteratively, using conventional content analysis with MAXQDA software. Results: The main concepts obtained from the data were classified into one theme titled: ""The need for support"" and four main categories along with their subcategories, and included the need for psychological support, the need for more useful information, the need for social support and the need to access to supplementary services. Conclusion: The findings show that following treatment failure, the infertile patients’ expressed needs and preferences were not met. Identifying and meeting their needs may help the infertile couples to deal with ARTs failure and to reach a decision about future treatment

A simple method for serving Web hypermaps with dynamic database drill-down

BACKGROUND: HealthCyberMap aims at mapping parts of health information cyberspace in novel ways to deliver a semantically superior user experience. This is achieved through "intelligent" categorisation and interactive hypermedia visualisation of health resources using metadata, clinical codes and GIS. HealthCyberMap is an ArcView 3.1 project. WebView, the Internet extension to ArcView, publishes HealthCyberMap ArcView Views as Web client-side imagemaps. The basic WebView set-up does not support any GIS database connection, and published Web maps become disconnected from the original project. A dedicated Internet map server would be the best way to serve HealthCyberMap database-driven interactive Web maps, but is an expensive and complex solution to acquire, run and maintain. This paper describes HealthCyberMap simple, low-cost method for "patching" WebView to serve hypermaps with dynamic database drill-down functionality on the Web. RESULTS: The proposed solution is currently used for publishing HealthCyberMap GIS-generated navigational information maps on the Web while maintaining their links with the underlying resource metadata base. CONCLUSION: The authors believe their map serving approach as adopted in HealthCyberMap has been very successful, especially in cases when only map attribute data change without a corresponding effect on map appearance. It should be also possible to use the same solution to publish other interactive GIS-driven maps on the Web, e.g., maps of real world health problems

Iranian infertile couples' strategies to manage social interactions after unsuccessful treatments with assisted reproductive technologies

Many infertile couples feel vulnerable after failed treatment cycles and find insensitive remarks or inappropriate support distressing. They fear that the stress of failed treatment cycles may affect their marriage and lead to marriage breakdown. This study explored the strategies a sample of infertile couples used to manage social interactions after unsuccessful treatment with assisted reproductive technologies. A descriptive qualitative study was conducted with 34 participants including nine infertile couples, nine infertile women and two infertile men with primary infertility, two relatives, and three fertility clinic staff. The participants were selected through purposive sampling at an infertility centre in Iran, between 2016 and 2017. Data were collected using semi-structured face-to-face interviews and analysed by qualitative content analysis approach. Participants found some social interactions after failed assisted reproductive treatment cycles to be distressing and painful. They described tolerating painful emotions which cause them sadness and sorrow as well as feeling embarrassed. As a result, they found they needed to maintain their adopting concealment strategies with their families through not permitting speculation, selective disclosure, not giving details and hiding the truth. This study showed that social interactions following failed assisted reproductive cycles can be upsetting for infertile couples. Couples use different strategies to manage potentially distressing social interactions. Healthcare providers and psychologists may provide a space for safe social interactions in order to help couples to use appropriate strategies in these circumstances

MicroRNA-129-1 acts as tumour suppressor and induces cell cycle arrest of GBM cancer cells through targeting IGF2BP3 and MAPK1

Background MicroRNA-129-1 (miR-129-1) seems to behave as a tumour suppressor since its decreased expression is associated with different tumours such as glioblastoma multiforme (GBM). GBM is the most common form of brain tumours originating from glial cells. The impact of miR-129-1 downregulation on GBM pathogenesis has yet to be elucidated. Methods MiR-129-1 was overexpressed in GBM cells, and its effect on proliferation was investigated by cell cycle assay. MiR-129-1 predicted targets (CDK6, IGF1, HDAC2, IGF2BP3 and MAPK1) were also evaluated by western blot and luciferase assay. Results Restoration of miR-129-1 reduced cell proliferation and induced G1 accumulation, significantly. Several functional assays confirmed IGF2BP3, MAPK1 and CDK6 as targets of miR-129-1. Despite the fact that IGF1 expression can be suppressed by miR-129-1, through 30-untranslated region complementary sequence, we could not find any association between IGF1 expression and GBM. MiR-129-1 expression inversely correlates with CDK6, IGF2BP3 and MAPK1 in primary clinical samples. Conclusion This is the first study to propose miR129-1 as a negative regulator of IGF2BP3 and MAPK1 and also a cell cycle arrest inducer in GBM cells. Our data suggests miR-129-1 as a potential tumour suppressor and presents a rationale for the use of miR-129-1 as a novel strategy to improve treatment response in GBM

The prevalence of Human Papilloma Virus (HPV) infection in the oligospermic and azoospermic men

Background: Human papilloma virus (HPV) infection is one of the most common sexually transmitted diseases that affects men like women and infected cutaneous and mucosal squamous epithelium. The aim of the present study was to determine the prevalence of HPV in the semen of oligospermic, azoospermic and normal patients. Methods: From June 2012 to June 2013, a total of 90 individuals were enrolled in this cross sectional comparative study. The participants were classified into three groups (oligospermia, azoosprmia and normal). This classification was based on a new WHO reference values for human semen characteristics published on 2010. After extraction of DNA from specimens L1 gene of HPV was amplified by nested polymerase chain reaction (Nested-PCR) and the PCR products of positive specimens were genotyped using INNO-LiPA HPV Genotyping Extra assay. Results: Among 50 confirmed oligospermic male, 15 were HPV DNA positive (30). In azoospemic group we had 8 HPV DNA positive (40) and in normal group just 3 of 20(15) samples were positive. Statistical assessment was done with SPSS v.15. Chi-square test showed no significant relationship between 3 groups results. Based on independent samples t-test, we found statistical significant relationship for sperm count (p<0.05) and sperm motility (slow) (p<0.05) in oligospermic group positive samples compared with negative. In the present study, 13 HPV genotypes were detected among positive samples. HPV genotypes 16, 45 in the high risk group and 6,11,42 in the low risk group were more frequent than the others. Conclusion: The current study shows that HPV infection can affect on sperm count and motility and decrease count of sperm cell and decrease motility capability of these cells

The relationship between body image and marital adjustment in infertile women

Introduction: Body image is one of the most important issues in women's mental health and due to its relationship with physical, cognitive and emotional aspects of women’s life; it can predict their healthy or unhealthy behaviors. According to some research reports, women’s negative or positive body image can affect their marital relationships. Considering the impact of infertility on both body image and marital adjustment and the lack of evidence regarding the relationship of these two variables in infertility, this study aimed to investigate the relationship of body image with marital adjustment in infertile women in 2010 in Mashhad. Methods: This correlational study was carried out on 130 infertile women referred to Montaserie Infertility Research Center in Mashhad who were selected through convenient sampling. Research tools were consisted of valid and reliable demographic questionnaire including personal and infertility-related information, modified Younesi Body Image Questionnaire and Spanier marital adjustment scale (DAS) which were completed by subjects. Data analysis was carried out by SPSS software (version 15/5) using t-tests, one way ANOVA, and Spearman and Pearson correlation test. Results: 93/1% of women reported positive body image and 76/9% had high marital adjustment. There was a direct correlation between the overall score of body image with marital adjustment (P<0/001). There was also a direct correlation between the scores of body image subscales including body in loneliness (P= 0/001), real body (P=0/014), public image of body (P=0/016), spouse image of body (P<0/001) and spouse family image of body (P<0/001) with marital adjustment. However, this relationship was not observed between the subscale of ideal body and marital adjustment. Conclusion: The presence of a direct correlation between body image and marital adjustment could guide developing educational or counseling programs particularly for infertile women who suffer from marital disputes. Keywords: Body image, Marital adjustment, Infertilit