Cross-cultural comparison of fertility specific quality of life in German, Hungarian and Jordanian couples attending a fertility center

Background: Only a few studies have reported cross-cultural comparisons regarding psychosocial consequences of infertility. Differences between societies with different cultural backgrounds were revealed and seemed to be based on the importance of pronatalism. Our aim was to measure cross-cultural differences in fertility specific quality of life of infertile couples in Germany, Hungary and Jordan who attend a fertility center in a cross-sectional study. Methods: A cross-sectional study was conducted in one fertility clinic in Germany, in five fertility clinics in Hungary and in one fertility clinic in Jordan. Overall 750 couples (252 couples in Jordan, 246 couples in Germany and 252 couples in Hungary) attending the first medical infertility consultation were asked to fill out our questionnaire set. Fertility specific quality of life (FertiQoL) and sociodemographic differences were measured between couples from three countries. Results: Jordanian couples had the shortest relationship (5.8 ± 4.3 yrs.), though they reported the longest duration of child wish (4.2 ± 3.6 yrs.) and fertility treatments (3.0 ± 3.3 yrs.). The proportion of high education was considerably higher in Jordanian women and men (60 % and 66 %, respectively) compared to the other two samples. First, marked cross-country differences were obtained on Emotional, Mind/Body and Relational subscales of the FertiQoL, indicating that Jordanian couples reported poorer fertility-related quality of life than Germans and Hungarians (p < 0.001). After controlling for the sociodemographic and medical variables, a significant difference only in the Emotional domain was observed (p < 0.001). Conclusions: The study revealed only a few cultural based differences in fertility specific quality of life between the couples of the three countries. Thus, infertility counselors should pay attention to psychosocial problems rooted in individual sociocultural aspects of the infertile couple regardless of cultural stereotypes. Further studies should identify sociocultural factors within different subgroups of infertile patients instead of focusing different societies as a whole because intra-cultural psychosocial differences in experiencing infertility seem to be more important for the individual patient than intercultural differences

Setting the global research agenda in psychosocial aspects of women’s health – outcomes from ISPOG world conference at The Hague

The World Conference of the International Society of Psychosomatic Obstetrics and Gynecology held in The Hague, Netherlands in October 2019 ran a dedicated session debating the global research priorities for psychological and social aspects of women’s health. Member countries of ISPOG and individual members were invited to lodge abstracts arguing for topics that required, or would benefit from, a global effort to seek answers to important issues in clinical care. Using a deliberative decision-making approach, a debate was held after presentations, and the audience voted for the top-ranked topics (Table 1). The six identified topics, being three in gynecology and obstetrics respectively, reflected areas of common clinical concern and where gaps in knowledge were identified

Psychometric characteristics of the FertiQoL questionnaire in a German sample of infertile individuals and couples.

Background: FertiQoL is a questionnaire internationally developed to measure fertility-specific quality of life. It has been validated with infertile populations in many countries and used in several studies focusing on the psychosocial consequences of infertility in Europe, Asia, and North America. Methods: Over a period of two years, 596 infertile women and men took part in the study conducted at three German fertility clinics. Psychometric properties of FertiQoL were tested by performing confirmatory factor analyses, calculating average variance extracted values, reliability and correlation coefficients. Hierarchical regression analyses were conducted to determine the relations between FertiQoL subscales and both sociodemographic and medical variables. Individual and cross-partner effects were tested for. Results: The confirmatory factor analyses conducted on our FertiQoL data supported the original four-factor solution for both women and men but, resulted in some unsatisfactory indices. Family and friends’ support items loaded weakly on the Social subscale of FertiQoL (.27 and .34 in women, .32 and .19 in men). The Emotional and Mind/Body subscales revealed a strong intercorrelation (r = .77, p &lt; .001 in women, r = .74, p &lt; .001 in men). Women scored lower than men on the Emotional and Mind/Body subscales only, and they reported better fertility-specific relational QoL. In women, the perceived cause of infertility and already mothering a child related significantly to individual FertiQoL scores, while in men, age, educational level, and the duration of their wish for a child had an impact on the FertiQoL subscales (all p &lt; .05). The men’s educational level, the women’s educational level, and the subjective perceived medical cause of fertility problems exerted cross-partner effects on QoL (all p &lt; .05). Conclusions: Our study results represent a contribution both to research and clinical practice. The findings suggest the importance of considering the personal experience of infertility in different cultural and gender specific settings and that the strong connections between the emotional, physical, and cognitive aspects of an individual’s fertility-specific quality of life should be regarded as a more coherent system. Trial registration DRKS: DRKS00014707. Registered: 1 May 2018 (retrospectively registered)

Effectiveness of psychosocial interventions for infertile women: A systematic review and meta-analysis with a focus on a method-critical evaluation.

BackgroundApproximately seven to nine percent of couples of reproductive age do not get pregnant despite regular and unprotected sexual intercourse. Various psychosocial interventions for women and men with fertility disorders are repeatedly found in the literature. The effects of these interventions on outcomes such as anxiety and depression, as well as on the probability of pregnancy, do not currently allow for reliable generalisable statements. This review includes studies published since 2015 performing a method-critical evaluation of the studies. Furthermore, we suggest how interventions could be implemented in the future to improve anxiety, depression, and pregnancy rates.MethodThe project was registered with Prospero (CRD42021242683 13 April 2021). The literature search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Six databases were searched and 479 potential studies were discovered. After reviewing the full texts, ten studies were included for the synthesis. Not all studies reported the three outcomes: four studies each for depression, three for anxiety and nine studies for pregnancy rates were included in the meta-analysis, which was conducted using the Comprehensive meta-analysis (CMA) software.ResultsPsychosocial interventions do not significantly change women's anxiety (Hedges' g -0,006; CI: -0,667 to 0,655; p = 0,985), but they have a significant impact on depression in infertile women (Hedges' g -0,893; CI: -1,644 to -0,145; p = 0,026). Implementations of psychosocial interventions during assisted reproductive technology (ART) treatment do not increase pregnancy rates (odds ratio 1,337; 95% CI 0,983 to 1,820; p = 0,064). The methodological critical evaluation indicates heterogeneous study design and samples. The results of the studies were determined with different methods and make comparability difficult. All these factors do not allow for a uniform conclusion.Methodological critical evaluationStudy design (duration and timing of intervention, type of intervention, type of data collection) and samples (age of women, reason for infertility, duration of infertility) are very heterogeneous. The results of the studies were determined with different methods and make comparability difficult. All these factors do not allow for a uniform conclusion.ConclusionIn order to be able to better compare psychosocial interventions and their influence on ART treatment and thus also to achieve valid results, a standardised procedure to the mentioned factors is necessary

Cross-border reproductive services – suggestions for ethically based minimum standards of care in Europe

Cross-border reproductive services (CBRS) is a phenomenon discussed worldwide. The major challenges associated with CBRS are the lack of data on the number of patients travelling for treatment and lack of transparency regarding the quality and safety of treatment procedures, especially in countries that have not yet introduced legislation or binding professional guidelines. This has given rise to practices that range from dubious to irresponsible treatment. Given that pan-European (let alone globally encompassing) legislation or guidelines are unlikely to appear quickly if at all, the authors suggest the implementation of ethically based minimum standards of care to which clinics and service providers can adhere on a voluntary basis. Such minimum standards of care can result in providing infertility treatment that is transparent, accountable and carried out responsibly for all parties involved Read More: http://informahealthcare.com/doi/abs/10.3109/0167482X.2011.64634

CBRC and psychosocial counselling: assessing needs and developing an ethical framework for practice

Encountering infertility and involuntary childlessness and undergoing infertility treatment are acknowledged as stressful experiences that impact on individuals’ psychological and emotional health – and for which access to psychosocial counselling by a skilled mental health professional may be beneficial. Evidence of patients’, gamete donors’ and surrogates’ experiences indicates that utilization of infertility treatment in another country may not only exacerbate these psychosocial adversities, but may also pose additional risks to the psychological or physical health of participants, thus further emphasizing the need for competent psychosocial counselling services in cross-border reproductive care. However, this is a largely neglected topic in recent discussions of both CBRC itself and of infertility counselling practice. This paper extends the previous work undertaken by two of the authors to begin to map out practice issues within an ethical framework for counsellors when working with clients, donors, surrogates, individuals conceived following infertility treatment and existing children in clients’, donor’s and surrogates’ families where cross-border reproductive treatment is considered or undertaken

Psychosoziale Kinderwunschberatung aus Sicht reproduktionsmedizinischer Fachkräfte. Implementierungsempfehlungen zur psychosozialen Kinderwunschberatung

Diese im Jahr 2017 durchgeführte Studie untersuchte zum einen, welchen Stellenwert die nicht-ärztliche psychosoziale Beratung bei Kinderwunsch in der Reproduktionsmedizin aktuell einnimmt. Zum anderen erfasste sie Implementierungs-empfehlungen der reproduktions-medizinischen Fachkräfte für eine behandlungsunabhängige psychosoziale Beratung bei Kinderwunsch. Dabei wurde festgestellt, dass der psychosozialen Kinderwunschberatung unter den Fachkräften der Reproduktionsmedizin eine besondere Relevanz beigemessen wird, aber auch Unsicherheiten hinsichtlich ihrer Inhalte und Abläufe bestehen. Entlang der Studienergebnisse werden in dem Beitrag die Ein-stellungen und Empfehlungen der reproduktionsmedizinischen Fachkräfte beschrieben und entsprechende Handlungsempfehlungen daraus abgeleitet.Psychosocial infertility counselling from the perspective of specialists working in reproductive medicine – Recommendations for further action. This study, which was conducted in 2017, had two objectives. Firstly, it sought to find out what status the non-medical psychosocial counselling for persons with an unfulfilled wish for a child had at that time from the perspective of the specialists working in reproductive medicine. Secondly, it attempted to gauge the recommendations of these medical specialists in this regard. It was found that the specialists working in reproductive medicine attributed great relevance to the psychosocial counselling for persons with a wish for a child. However, it was also discovered that uncertainties existed regarding the content and procedures of psychosocial counselling. In addition to presenting the study results, this report will also not only characterise the attitudes and recommendations of the specialists working in reproductive medicine, but also derive recommendations for further action from this