Emotional disorders, marital adaptation and the moderating role of social support for couples under treatment for infertility.

OBJECTIVES: Over the last few years, the impact of infertility on the psychological well-being of couples has been well recognised. Men and women with infertility experience stress, anxiety and depression and their relationship might be under pressure. MATERIAL AND METHODS: We conducted a non-experimental correlational descriptive study where transversal analysis using questionnaires and quantitative data was performed for 76 couples with diagnosed infertility under the care of various reproductive medicine clinics in Romania between 2018 to 2019. Participants were asked to fill, via internet or in person, a set of tests including data on socio-demographic and infertility characteristics along with five psychological tests: The Fertility Problem Inventory (FPI), State-Trait Anxiety Inventory, Beck's Depression Inventory (BDI), Dyadic Adjustment Scale and Interpersonal Support Evaluation List-12. The aim of the study was to explore how couples with infertility respond and adapt to this diagnosis and to assess the relationship between emotional disorders, marital adjustment and social support. RESULTS: Mean age of females was 34.2 and of males 36.7 and 38.2% of the couples were experiencing infertility for > 6 years. Women had worse scores on infertility-related distress (FPI) (t = -4.35, p = 0.01), on the BDI depression scale (t = -5.43, p = 0.01) and on anxiety scales (t = -5.48, p = 0.01). Participants with a longer duration of infertility scored significantly higher on infertility-related distress than those with more recent difficulties. Marital adjustment scores correlated negatively with emotional disorders. Both appraisal social support and belonging support moderated the relationship between state-anxiety and marital adjustment. CONCLUSIONS: Infertility carries a significant psychological burden for the couple and the longer its duration, the higher the distress level. Women seem to be more vulnerable to its psychological consequences. Marital adjustment correlates negatively with the degree of emotional disorders. In couples with high levels of social support, the relationship between state-anxiety and marital adjustment was negatively correlated.

Cytomegalovirus Infection in Pregnancy - Counselling Challenges in the Setting of Generalised Testing.

Cytomegalovirus (CMV) is the most common cause of perinatal viral infection, affecting 0.2-2.2% of all neonates, with variation among different study populations. It can cause serious long-term neurological sequelae, being the leading cause of non-genetic congenital hearing loss. The risk of congenital infection is highest after primary maternal infection, varying between 30-70% and depending on the gestational age at the time of infection. Although CMV can have serious neurodevelopmental consequences, in most developed countries current guidelines do not recommend routine screening for CMV in pregnancy, since current tests have a low predictive value for cases with serious adverse outcome and efficient therapeutic options are not standardized yet. In Romania there is a routine clinical practice to offer screening for most common causes of infections, including CMV, in the first trimester of pregnancy In these settings, this review summarizes the current methods of diagnosis and management of CMV infection in pregnancy.

Managing Crohn's Disease during Pregnancy.

Crohn's disease (CD) is a chronic infl ammatory bowel disease with onset during reproductive age. Advancement in medical therapies and treatment strategies have made pregnancy following a diagnosis of CD a viable and safe option for more women with this disease. In this review we discuss the evidence based management of Crohn's disease during pregnancy.