Fertility quality of life tool: update on research and practice considerations

The 36-item Fertility Quality of Life (FertiQoL) tool is increasingly used in research and practice. It measures quality of life in four personal domains (emotional, social, relational, mind/body) and two treatment domains (tolerability, environment). A literature review of published empirical research using FertiQoL was undertaken to provide an overview of this research base. Five databases were searched using ‘FertiQoL’ and its variant. In total, 41 published articles from 35 independent samples in 23 countries involving 16,315 participants, mainly in clinical settings, were reviewed. FertiQoL was used for three main purposes: (i) to assess quality of life and FertiQoL measurement properties (especially Core FertiQoL) using cross-sectional designs; (ii) to identify correlates, predictors, and consequences of fertility quality of life (some of which included international comparisons); (iii) to assess the effect of psychological interventions on fertility quality of life. The range of median FertiQoL Core, Treatment and subscale (scaled) scores in 31 samples was between 60 and 75. Poorer fertility quality of life was consistently associated with being a woman, longer duration of infertility, poorer psychological functioning and lower patient–centred care. Some FertiQoL subscale scores improved after psychological interventions. Future research should address measurement issues and examine reported associations with fertility quality of life

The fertility quality of life (FertiQoL) tool: development and general psychometric properties

BACKGROUND To develop the first international instrument to measure fertility quality of life (FertiQoL) in men and women experiencing fertility problems, to evaluate the preliminary psychometric properties of this new tool and to translate FertiQoL into multiple languages. METHOD We conducted a survey, both online and in fertility clinics in USA, Australia/New Zealand, Canada and UK. A total of 1414 people with fertility problems participated. The main outcome measure was the FertiQoL tool. RESULTS FertiQoL consists of 36 items that assess core (24 items) and treatment-related quality of life (QoL) (10 items) and overall life and physical health (2 items). Cronbach reliability statistics for the Core and Treatment FertiQoL (and subscales) were satisfactory and in the range of 0.72 and 0.92. Sensitivity analyses showed that FertiQoL detected expected relations between QoL and gender, parity and support-seeking. FertiQoL was translated into 20 languages by the same translation team with each translation verified by local bilingual fertility experts. CONCLUSIONS FertiQoL is a reliable measure of the impact of fertility problems and its treatment on QoL. Future research should establish its use in cross-cultural research and clinical work

Impact of the in-vitro fertilization process on emotional, physical and relational variables

The purpose of the study was to examine the stress associated with in-vitro fertilization (IVF) concurrently with other physical and relational variables, and to compare these reactions with those reported during a menstrual cycle without treatment. Women (n = 20) completed a daily symptom checklist for one complete menstrual cycle without treatment and one complete IVF cycle. The checklist included items related to stress, optimism, physical discomfort and marital and social relationships. Daily ratings during IVF were compared with those obtained during the no-treatment menstrual cycle. IVF was associated with more stress, optimism and physical discomfort than a menstrual cycle without treatment, and with greater changes to marital and social relationships. The pattern of results shows that the stress associated with IVF is less salient when examined in the context of reactions in other areas of functioning. The findings suggest that the emotional impact of IVF might be less pronounced during the actual treatment process than is generally assumed from studies focusing on the impact of treatment failure. Variables such as optimism and physical discomfort which have previously received less attention in the literature were significantly affected by IVF treatment

Stress level across stages of in vitro fertilization in subsequently pregnant and nonpregnant women

OBJECTIVE: To examine the relationship between stress and IVF outcome in women and to compare prospective ratings of IVF stress to retrospective ratings. DESIGN: Women completed daily stress ratings for one complete IVF cycle. Three days after the pregnancy test women completed a questionnaire that asked them to recall the stress of IVF. Based on the results of treatment, women were assigned to the nonpregnant (n = 23) or pregnant (n = 17) group and their daily stress ratings were compared. In addition, prospective and retrospective ratings were compared. RESULTS: The nonpregnant group reported more stress during specific stages of IVF and had a poorer biologic response to treatment than the pregnant group. It also was found that women recalled the stress of the waiting period as greater than their ongoing experience of it as measured by their daily ratings. CONCLUSIONS: The pattern of differences between the nonpregnant and pregnant group on stress and biologic factors indicates that stress is related to IVF outcome. Certain data suggest that negative feedback about the progress of treatment communicated to patients responding poorly to IVF (nonpregnant group) may have increased their stress level. However, the direction of causality between stress and IVF outcome remains speculative. Differences between prospective and retrospective stress ratings may reflect women's attempt to cope with the strain of the waiting period