The Sexual Impact of Infertility Among Women Seeking Fertility Care.

IntroductionInfertility affects approximately 6.7 million women in the United States. Couples with infertility have significantly more anxiety, depression, and stress. This is compounded by the fact that almost 40% of couples undergoing assisted reproduction technology still cannot conceive, which can have an ongoing effect on quality of life, marital adjustment, and sexual impact.AimTo assess the sexual impact of infertility in women undergoing fertility treatment.MethodsThis study is a cross-sectional analysis of women in infertile couples seeking treatment at academic or private infertility clinics. Basic demographic information was collected. Respondents were surveyed regarding sexual impact and perception of their infertility etiology. Multivariate regression analyses were used to identify factors independently associated with increased sexual impact.Main outcome measureSexual impact of perceived fertility diagnosis.ResultsIn total, 809 women met the inclusion criteria, of whom 437 (54%) agreed to participate and 382 completed the sexual impact items. Most of the infertility was female factor only (58.8%), whereas 30.4% of infertility was a combination of male and female factors, 7.3% was male factor only, and 3.5% was unexplained infertility. In bivariate and multivariate analyses, women who perceived they had female factor only infertility reported greater sexual impact compared with woman with male factor infertility (P = .01). Respondents who were younger than 40 years experienced a significantly higher sexual impact than respondents older than 40 years (P < .01). When stratified by primary and secondary infertility, respondents with primary infertility overall reported higher sexual impact scores.ConclusionIn women seeking fertility treatment, younger age and female factor infertility were associated with increased sexual impact and thus these women are potentially at higher risk of sexual dysfunction. Providers should consider the role young age and an infertility diagnosis plays in a women's sexual well-being

The position of diagnostic laparoscopy in current fertility practice

In everyday clinical practice, it is not always clear if and when exactly in the fertility work-up a diagnostic laparoscopy should be offered. The aim of this review is to analyse the available evidence with respect to alternative diagnostic methods for detecting tuboperitoneal infertility and with respect to the position of diagnostic laparoscopy in women with infertility. A literature search of the National Library of Medicine and the National Institutes of Health (PubMed) was performed using the key words 'diagnostic laparoscopy and infertility'. The study methodology was carefully considered in an effort to present conclusions preferably based on randomized controlled trials (RCTs). The routine use of diagnostic laparoscopy for the evaluation of all cases of female infertility is currently under debate. According to data published in retrospective non-controlled studies, diagnostic laparoscopy after several failed cycles of ovulation induction enables the detection of a significant proportion of pelvic pathology amenable to treatment. A Cochrane review has shown that laparoscopic ovarian diathermy in clomiphene-resistant polycystic ovarian syndrome is at least as effective as gonadotrophin treatment, and results in a lower multiple pregnancy rate. The role of laparoscopy before the start of treatment with intrauterine insemination is controversial, according to one RCT. In women with bilateral ultrasonically visible hydrosalpinges, two RCTs have demonstrated increased implantation and pregnancy rates in IVF cycles after salpingectomy. Although RCTs which have studied the benefit of laparoscopic surgery in moderate or severe endometriosis are still lacking, its value has generally been accepted. In conclusion, some specific clinical settings, solid evidence is available to recommend the use of diagnostic laparoscopy in current fertility practice. There is however a need for more RCTs to answer remaining questions regarding its value in the diagnosis and treatment of some patients with infertility

The Use of Plasmapheresis in Treatment of Patients with Infertility, Peritoneal Endometriosis and Nat2 Gene Polymorphism

It is known that 30–40 % of patients with peritoneal endometriosis suffer from infertility. Half of the patients with endometriosis are identified point mutation in NAT2 – gene, which plays an important role in the acetylation of aromatic and heterocyclic amines, in the accumulation of endotoxins, activation of free radical oxidation, impaired microcirculation. These factors involve the use of methods of gemapheresis which have detoxification, the blood rheology corrective and immune corrective effects. The purpose of this study was to evaluate the efficacy of therapeutic plasma exchange in treatment of patients with peritoneal form of endometriosis, infertility and point mutations in the gene NAT2. The study included 140 patients with infertility, peritoneal form of endometriosis and point mutations in the gene NAT2. All patients are performed laparoscopy, coagulation foci of endometriosis. In the following 93 (66.4 %) patients were treated with a the course of therapeutic plasmapheresis using the apparatus «PCS-2» with the removal of 20–25 % the volume of circulating plasma with replacement plasma of crystalloid and colloid solutions. Before treatment were shown the signs of endotoxemia, activation of oxidative stress. After treatment with the use of plasmapheresis was revealed the significant reduction of endogenous intoxication parameters and oxidative stress. Also is noted the increase in the pregnancy rate, both independently and in IVF programs, especially during the first 3 months after treatment. The findings suggest that the efficiency of the proposed comprehensive treatment techniques (laparoscopy and subsequent course of therapeutic plasmapheresis) of patients with peritoneal endometriosis and infertility and with point mutations in the gene NAT2. The use of plasmapheresis is pathogenetically justified in patients of the studied group

Health disparities and infertility: impacts of state-level insurance mandates

Infertility is more common for non-Hispanic black women, non-Hispanic other race women, and Hispanic women than for non-Hispanic white women, and both infertility and impaired fecundity are more common for high school dropouts and high school graduates with no college than for 4-year college graduates, and for older women compared with women 29 and younger. Older women, non-Hispanic white women, and women who are more educated (with at least some college) are more likely to have ever received treatment. No evidence has been found that the racial, ethnic, or education disparities are ameliorated by the health insurance mandates.Infertility treatment, infertility, impaired fecundity, health disparities, health insurance mandates

Infertility treatment in the health status of tourism

Introduction: health tourism ((health tourism, which of late there have to travel back to health or treat various diseases is referred to. Tourism and health care today to Rshdtryn world tourism sectors are among the causes organizations involved in the countries interested in tourism development according to this section of the tourism industry to attract and to plan for it. One type of health tourism, tourism with the aim of infertility treatment is aimed at individuals who completed treatment or treatment infertility in a country other than their own country shall. The purpose of this review and analyze the reasons and motivation to create this type of tourism industry, health promotion strategies in the field of infertility treatment is. Method: Article aimed at investigating the causes and motivations in creating this type of tourism industry (the field of infertility) and the promotion of tourism strategies in the health field is that treatment of infertile couples to achieve the goals of scientific sites to use the world and a key terms of health tourism, medical health, Reproductiove tourism articles search were evaluated. Article 24, which had a direct relation with this issue, and from 2006 to 2011, the Academic sites were recorded and were translated . After reading the above review articles and research solutions and causes this type of tourism development and summarized in the article was brought results. Results: The literature showed that among the causes and motives of the tourism industry can lead to infertility suitability life beliefs and customs in the host country, affordable, high quality service, respect for clients expectations, long waiting lists in the country treat your ... Mentioned. In the meantime the most suitable solutions for this industry can be developed to equip hospitals and centers for infertility treatment and recruiting experienced and committed and prepared for the Center's website and ... Mentioned in the article is available. Conclusion: The results and findings about the potential of Iran in the creation and investment in this branch of tourism is healthy and has the ambition and the persistence and planning can be of this type in Iran Tourism development in social, cultural and economical utilization

Mandated Health Insurance Benefits and the Utilization and Outcomes of Infertility Treatments

During the last two decades, the treatment of infertility has improved dramatically. These treatments, however, are expensive and rarely covered by insurance, leading many states to adopt regulations mandating that health insurers cover them. In this paper, we explore the effects of benefit mandates on the utilization and outcomes of infertility treatments. We find that use of infertility treatments is significantly greater in states adopting comprehensive versions of these mandates. While greater utilization had little impact on the number of deliveries, mandated coverage was associated with a relatively large increase in the probability of a multiple birth. For relatively low fertility patients who responded to the expanded insurance coverage, treatment was often unsuccessful and did not result in a live birth. For relatively high fertility patients, in contrast, treatment often led to a multiple, rather than a singleton, birth. We also find evidence that the beneficial effects on the intensive treatment margin that have been proposed in other studies are relatively small. We conclude that, while benefit mandates potentially solve a problem of adverse selection in this market, these benefits must be weighed against the costs of the significant moral hazard in utilization they induce.

Social Anxiety, Quality of Life, and Healthy Lifestyle Behaviors of Women With Infertility Problems

Not having a child has significant psychosocial effects on women experiencing infertility problems. There is a gap in research on social anxiety, quality of life, and healthy lifestyle behaviors of women during infertility, fertility treatment, and subsequent pregnancy. The purpose of this quantitative comparative study was to investigate the social anxiety, quality of life, and healthy lifestyle behaviors of Turkish women with infertility issues and Turkish women who conceived after infertility treatment, as measured by the Liebowitz Social Anxiety Scale, the Fertility Quality of Life Questionnaire, and the Healthy Lifestyle Behavior Scale II. The social support and stress buffering theory and the health promotion model provided the framework for the study. Mann-Whitney U tests were used to evaluate 200 women undergoing infertility treatment and women who conceived after infertility treatment on social anxiety, quality of life, and healthy lifestyle behaviors. The results indicated that women undergoing infertility treatment had higher social anxiety and avoidance and higher nutritive healthy lifestyle behaviors than women who conceived after infertility treatment. There was no difference in quality of life between the groups. Findings may promote a better understanding of social anxiety, quality of life, and healthy lifestyle behaviors of women undergoing infertility treatment. This heightened awareness may be used to increase psychosocial well-being of women and may increase the success rate of infertility treatment

DOES EXPERIENCING FERTILITY PROBLEMS AND HAVING INFERTILITY TREATMENT AFFECT THE WOMEN STRESS AND WORKING LIFE? THE TURKISH EXPERIENCE

Background: Infertility processis a stresfull period that effect\u27s of couple\u27s life, especially their working life.It can be difficult for women with fertility problems to fulfill work responsibilities during infertility treatment. The current study aimed to explore effects of infertility treatment on women\u27s stress and hence working life.There is limited literature related to effect of this of this treatment on women working life so this is important issue worldwide. Subjects and methods: This was a cross-sectional descriptive study and 200 women undergoing infertility treatment participated. Our participants were primary infertile working women who had received at least one-cycle of infertility treatment before being invited to be part of study. An Introductory Data and Fertility History Form, Infertility Treatment and Working Performance Questionnaire and Visual Analogue Stress Scale were administered over-3 month period. Results: More than half of women (53%) reported that they experienced problems related to ask the manager for the leave because of some procedure during the infertility treatment. Fear of administrator, not being able to focuse on work , not being understood by collegues,a negative impact on career, increase in work stress were problems reported by women. Also participants reported adversity in sharing infertility treatment with male administrators. Conclusions: The study found that infertility treatment process affect women\u27s working life negatively. Therefore health professionales should improve employers awareness about impact of infertility treatment on working life for purposs of improving professional support needed during this treatment time. Women should be encouraged to share feelings/problems they experience with employers/colleagues

DOES EXPERIENCING FERTILITY PROBLEMS AND HAVING INFERTILITY TREATMENT AFFECT THE WOMEN STRESS AND WORKING LIFE? THE TURKISH EXPERIENCE

Background: Infertility processis a stresfull period that effect\u27s of couple\u27s life, especially their working life.It can be difficult for women with fertility problems to fulfill work responsibilities during infertility treatment. The current study aimed to explore effects of infertility treatment on women\u27s stress and hence working life.There is limited literature related to effect of this of this treatment on women working life so this is important issue worldwide. Subjects and methods: This was a cross-sectional descriptive study and 200 women undergoing infertility treatment participated. Our participants were primary infertile working women who had received at least one-cycle of infertility treatment before being invited to be part of study. An Introductory Data and Fertility History Form, Infertility Treatment and Working Performance Questionnaire and Visual Analogue Stress Scale were administered over-3 month period. Results: More than half of women (53%) reported that they experienced problems related to ask the manager for the leave because of some procedure during the infertility treatment. Fear of administrator, not being able to focuse on work , not being understood by collegues,a negative impact on career, increase in work stress were problems reported by women. Also participants reported adversity in sharing infertility treatment with male administrators. Conclusions: The study found that infertility treatment process affect women\u27s working life negatively. Therefore health professionales should improve employers awareness about impact of infertility treatment on working life for purposs of improving professional support needed during this treatment time. Women should be encouraged to share feelings/problems they experience with employers/colleagues

Uterus transplantation:An update and the Middle East perspective

Uterus transplantation (UTx) is the only available treatment for absolute uterine factor infertility (AUFI), which is caused by either absence (congenital or after hysterectomy) or presence of a non-functioning uterus. Uterus transplantation became a clinical reality after more than 10 years of structured animal-based research. Aside from gestational surrogacy, this procedure is the only alternative for women with AUFI to attain genetic motherhood. In the Middle East, North Africa and Turkey (MENAT) region, out of a population of around 470 million, more than 100,000 women of fertile age are estimated to suffer from AUFI. Introduction of UTx as an infertility treatment in this region will certainly differ in specific countries from ethical, religious and legal standpoints depending on culture and religion. The MENAT region is the cradle of three religions and the geographic area encompasses a variety of cultures and religions with different views on assisted reproduction. In light of these issues, the aim of this article is to give an overview of the research-based development of UTx and its clinical results up until today as well as to explore how UTx would fit into current infertility treatments in the MENAT region, with its existing multifaceted religious perspectives