The fertility quality of life questionnaire (FertiQoL) relational subscale: Psychometric properties and discriminant validity across gender

Studyquestion: Is the Fertility Quality of LifeQuestionnaire (FertiQoL)-Relational Scale a valid measure to assess the relational domain regarding quality of life in women and men undergoing infertility treatment? summaryanswer: The FertiQoL-Relational scale (FertiQoL-REL) showed good psychometric properties and captured core aspects of couple relationships. what is known already: FertiQoL has become a gold standard for the assessment of infertility-related quality of life in patients undergoing assisted reproduction treatment (ART). Despite its growing importance, no previous studies have examined the convergent validity of the FertiQoL-REL and its discriminant validity across gender. study design, size, duration: Baseline cross-sectional data as part of a longitudinal study of infertile couples undergoing an ART between February 2013 and January 2015. participants/materials, setting, methods: Five hundred and eighty-nine patients (301 females and 288 males), prior to starting an ART in a private clinic, filled in the Fertility Quality of Life Questionnaire (FertiQoL) and several measures of the marital relationship (Dyadic Adjustment Scale, MaritalCommitment InventoryandENRICHMarital Satisfaction Scale) and infertility-related distress (Fertility Problem Inventory). main results and the role of chance: Confirmatory factor analysis showed that the FertiQoL four-factor solution provided a good fit for the observed data. Reliability of the FertiQoL-RELwas higher forwomenthan men. Significant correlations between the FertiQoL-REL scores and all the other measures of marital relationship were found for both women and men. FertiQoL-REL scores did not differ significantly in women and men. The FertiQoL-REL was able to differentiate subjects as regards the Dyadic Adjustment Scale and ENRICH Marital Satisfaction Scale threshold. limitations, reasons for caution: Findings are limited because the data were obtained from only one Italian private clinic. wider implications of the findings: FertiQoL-REL threshold scores are useful for identifying those patients undergoing ART who are more likely to report poor or good relationship quality. Clinicians should tailor their counselling strategies to the positive qualities in a couple's relationship, so as to reinforce the overall quality of life, especially among women, and to support patients in tackling the psychological burden, so that they can either continue treatment or choose discontinuation. study funding/competing interest(s): This research wassupported by funds provided byCentroAndrosS.r.l., Palermo, Italy. The authors declare no financial or commercial conflicts of interest in this study. trial registration number: Not necessary

Infertility-related stress, anxiety and ovarian stimulation: can couples be reassured about the effects of psychological factors on biological responses to assisted reproductive technology?

The aim of this prospective, longitudinal study was to examine the association between couples’ pre-treatment psychological characteristics (state anxiety and infertility-related stress levels of both partners) and ovarian response during assisted reproductive technology treatment in a well-controlled sample. A total of 217 heterosexual couples (434 patients), suffering from primary infertility and undergoing their first assisted reproductive technology treatment at the Reproductive Medicine Unit of ANDROS Day Surgery Clinic in Palermo (Italy), were recruited. Psychological variables were assessed using the State Scale of State-Trait Anxiety Inventory (STAI-S) and the Fertility Problem Inventory (FPI). The number of follicles ≥ 16 mm in diameter, evaluated by transvaginal ultrasound scan on the eleventh day of the workup, was chosen as the outcome measure. No association between women's level of anxiety and infertility-related stress, and the number of follicles ≥ 16 mm in diameter was found. Moreover, the male partner's infertility stress and anxiety did not influence the relationship between the woman's infertility-related stress, anxiety level and ovarian response. Fertility staff should reassure couples that the woman's biological response to ovarian stimulation is not influenced by either partner's level of psychological distress

How do individual attachment patterns of both members of couples affect their perceived infertility stress? An actor–partner interdependence analysis

There exists a lack of dyadic research examining how the attachment characteristics of infertile individuals influ- ence their experience of infertility-related distress. The actor partner interdependence model was used to test a theoretical model by examining whether both infertile wives and husbands, who display high levels of attach- ment avoidance and/or attachment anxiety, will experience infertility-related distress. Seven hundred and sev- enty individuals (385 couples) completed the experience in close relationships, the fertility problem inventory, and the state-trait anxiety inventory prior to infertility treatment. Wives' distress was predicted by their own and by their husbands' attachment avoidance. Husbands' distress was predicted by wives' attachment anxiety. Moreover, interaction effects between two partners were observed when predicting husbands' distress. The results of the current study support the reciprocal nature of couple's attachment relationships

Are attachment dimensions associated with infertility-related stress in couples undergoing their first IVF treatment? A study on the individual and cross-partner effect

study question: Are attachment anxiety and avoidance dimensions in female and male partners in couples seeking infertility treat- ment associated with her and his infertility-related stress? summary answer: Attachment dimensions are significantly associated with several aspects of infertility stress in couples undergoing IVF treatment. what is known and what this paper adds: Attachment dimensions of anxiety and avoidance (where highly anxious individuals fear rejection and are preoccupied with maintaining proximity to their partner and highly avoidant individuals are uncomfortable with intimacy and prefer to maintain distance from their partner) may influence the well being of individuals undergoing IVF/ICSI treatment. This study showed that one partner’s attachment dimensions had a direct effect on the infertility-related stress of the other partner. design: Cross-sectional study of consecutive couples before starting their first IVF/ICSI treatment in 2009–2011 at the ANDROS clinic in Palermo, Italy. participants and setting: Three hundred and fifty-nine couples undergoing fertility treatments were invited to participate in the research. The final sample comprised 316 females and 316 males who filled out the psychological questionnaires (Experiences in Close Rela- tionships; Fertility Problem Inventory; State scale of State-Trait Anxiety Inventory). The participants included patients who had a primary infertility diagnosis and were about to undergo their first IVF or ICSI treatment. data analysis method: Paired t-tests were used to examine gender differences on the study variables (attachment anxiety, attach- ment avoidance, infertility stress, state anxiety, etc.). Associations between infertility-related stress and the study variables were explored using hierarchical stepwise multivariate linear regression analyses. main results and the role of chance: Attachment anxiety and attachment avoidance were significantly associated with global infertility stress in both women (b 1⁄4 0.24, P , 0.01 and b 1⁄4 0.27, P , 0.01) and men (b 1⁄4 0.23, P , 0.01 and b 1⁄4 0.37, P , 0.01). Regarding the cross-partner effects, men’s infertility stress and relationship concerns were associated with their partners’ attachment avoidance (b 1⁄4 0.10 P , 0.05 and b 1⁄4 0.12, P , 0.05); and the infertility stress of women and the scores for need of parenthood were associated with their partners’ attachment anxiety (b 1⁄4 0.14 P , 0.05 and b 1⁄4 0.16, P , 0.05). bias, confounding and other reasons for caution: The study data are cross sectional, and specifically focus on associations between adult attachment style and infertility stress. Treating the data from couples as independent observations may be a limi- tation of the analysis. Potential moderators of such relationships (e.g. coping strategies, stress appraisal) are not included in this study

Assessing infertility-related stress: The factor structure of the Fertility Problem Inventory in Italian couples undergoing infertility treatment

The factor structure of the Fertility Problem Inventory (FPI) and its invariance across gender were examined in Italian couples undergoing infertility treatment. About 1000 subjects (both partners of 500 couples) completed two questionnaires prior to commencing infertility treatment at a private Clinic in Palermo, Italy. Confirmatory Factor Analysis demonstrated that the original factor structure of the FPI was partially confirmed. Two correlated factors (Infertility Life Domains and Importance of Parenthood) were obtained via a post hoc Exploratory Factor Analysis. Finally, the invariance of this factor structure across gender was confirmed. The study supported the relevance of two interrelated factors specific to infertility stress which could help clinicians to focus on the core infertility-related stress domains of infertile couples

The gender gap in the diagnostic-therapeutic journey of the infertile couple

Medical procreation impairs both the biological and psychological lives of couples. How-ever, male and female attitudes to infertility are different and require a different approach during the IVF journey. Thus, the gender impact assessment (GIA) method was used to analyse original studies present in the literature. We found some gender-related differences and, subsequently, possible outcomes of intervention to improve healthy reproduction management and prevent infertility. In particular, it became apparent that there was the need for an in-depth male infertility assessment and a gender-specific follow-up