Relationships between attachment, appraisal, coping and adjustment in men and women experiencing infertility concerns.

BACKGROUND: Attachment style may influence distress and relationship satisfaction in infertile couples. Appraisal and coping have also been linked to adjustment to infertility and may be related to attachment patterns. The study examined these associations in men and women around the time of attending initial appointments at fertility clinics. METHODS: Attachment, appraisal, coping, general well-being, infertility-related stress and relationship satisfaction questionnaires were completed by 98 women and 64 men. Data were analysed by gender comparisons, correlations and path analysis. RESULTS: Attachment anxiety was associated with well-being in women via appraisal of infertility as a loss and use of self-blame and avoidance (SBA) coping. Attachment anxiety was also linked with infertility-related stress through SBA. In men, attachment anxiety was associated with well-being and infertility-related stress again via SBA coping. Attachment anxiety and avoidance were related to lower relationship satisfaction in women, whereas only the former was important for men. CONCLUSIONS: Attachment patterns link to couples' relationship satisfaction and are associated with adjustment via appraisal and coping. Identification of such patterns may assist in identifying need and tailoring cognitive interventions to individuals. Participants were mainly white and well-educated, and wider generalization cannot automatically be assumed.

Influence of formula versus breast milk on cholesterol synthesis rates in four-month-old infants.

We investigated whether supplementation of regular formula (RF) with cholesterol (Ch) (RF+Ch) influenced circulating Ch levels and de novo synthesis compared with their breast-fed (BF) counterparts in 4-mo-old infants. The incorporation rate of deuterium in body water into erythrocyte membrane-free Ch over 48 h was used as an index of cholesterogenesis. Plasma total-Ch and LDL-Ch concentrations were highest (p < 0.02) in BF infants, compared with infants in the RF-fed groups. Infants in the RF+Ch groups showed an intermediate response; their plasma total-Ch and LDL-Ch concentrations were not significantly different from the BF or the RF-fed groups. Plasma total/HDL-Ch and LDL/HDL-Ch ratios were higher (p < 0.05) in BF, and higher in RF+Ch-fed infants, compared with those fed RF, whereas not different between BF and RF+Ch-fed infants. At 4 mo of age, Ch FSR was 4-fold lower (p < 0.0001) in BF versus other groups, but not significantly different between RF- and RF+Ch-fed infants. Thus, despite addition of Ch to the concentration found in breast milk, FSR remained elevated compared with that of the group fed breast milk, with an intermediate response in circulating Ch levels. It is speculated that factors other than Ch intake account for the differential Ch metabolism between formula-fed and BF infants.