RESUMEN
Solo motherhood is a family constellation that is becoming increasingly common in high income countries. The demographic characteristics of solo women entering treatment with donated sperm or embryo have been shown to be different from that of cohabiting women. The general importance of perceived social support is frequently amplified when health and quality of life are concerned, and positively affects mental health status, experienced stress, perceived self-efficacy during the transition to parenthood and during parenthood itself. The objective of the present study was to compare demographic characteristics, social network and perceived social support among solo women and cohabiting women awaiting fertility treatment. This objective was explored with a study-specific demographic and background questionnaire as well as through questions on access to practical support and the Multidimensional Scale of Perceived Social Support (MSPSS) assessing different sources of support. This study is a part of a longitudinal prospective multicenter study of solo women who awaited donation treatment in six Swedish public and private fertility clinics and a comparison group of women who were cohabiting/married to male partner and awaited in vitro fertilization (IVF) treatment with the couple's own gametes. A total of 670 women were invited and 463 accepted participation (69% response rate); 207 solo women (study group) and 256 cohabiting women (comparison group). The results show significant differences in age, education, and employment between the groups. Solo women were on average 3.6 years older, had a higher level of education, a higher-income profession, and were more frequently working full time. Solo women perceived an equally high degree of social support from their families, significantly higher levels of support from friends and significantly lower support from a significant other compared to cohabiting women. Solo women expected their mother to be the most supportive person in future parenthood, while cohabiting women most often stated their cohabiting partner to fill that role. The study adds to the body of knowledge of solo women as a sociodemographic distinct group going at motherhood alone, stating a high degree of currently perceived and expected social support. The previously studied negative impact that lack of a co-parent might have, may be attenuated by the expected and perceived social support from family and friends.
Asunto(s)
Heterosexualidad , Calidad de Vida , Humanos , Masculino , Femenino , Estudios Prospectivos , Semen , Apoyo Social , Fertilización In Vitro/psicología , EspermatozoidesRESUMEN
A majority of infertile women experience emotional problems, such as anxiety and depression. Nurses need nonpharmacological methods rather than drugs to address women's emotional distress during the in vitro fertilization (IVF) process. The purpose of this study was to examine the effect of progressive muscle relaxation exercises and laughter therapy on the mental health and treatment outcomes of women receiving IVF treatment. This parallel-group, randomized controlled trial was conducted in a private IVF center. Participants were randomly assigned to the intervention group (IG; n = 71) and control group (CG; n = 70). The IG received progressive muscle relaxation and laughter therapy for 40 min in each session for 3-4 sessions, whereas the CG received routine care. Data were obtained from the patient information form, State-Trait Anxiety Inventory, Beck Depression Inventory, and medical records. The questionnaire was completed at recruitment (T1) and oocyte pick-up day (T2). In the evaluation performed on the day of the oocyte pick-up, depression and trait anxiety scores of the IG were found to be lower than those in the CG, and the effect size was small. Group × time interaction was significant for depression (large effect size) and trait anxiety (small effect size). The estradiol levels, the number of oocytes, transfer status, and pregnancy rates (according to a blood test) were similar between groups. Women receiving IVF treatment who received progressive muscle relaxation and laughter therapy demonstrated psychological changes; however, the treatment did not affect medical outcomes.
Asunto(s)
Fertilización In Vitro/psicología , Infertilidad Femenina/psicología , Risoterapia , Terapia por Relajación , Estrés Psicológico/prevención & control , Adulto , Femenino , Humanos , Embarazo , Índice de Embarazo , Estudios Prospectivos , Escalas de Valoración Psiquiátrica , Estrés Psicológico/psicología , TurquíaRESUMEN
OBJECTIVE: To investigate the effect of acupuncture on pregnancy success rates applied before and after embryo transfer (ET) among women undergoing in vitro fertilization (IVF). MATERIALS AND METHODS: In this randomized controlled trial, 72 infertile women undergoing IVF were randomized to acupuncture (AG; n = 36) and control group (CG; n = 36). Three sessions of acupuncture were applied to AG, the first was one week before ET, the second was 30 min before ET, and the third was 30 min after ET. CG received no acupuncture. The primary outcome was pregnancy success rate (Beta-HCG level, clinical pregnancy, ongoing pregnancy, live birth). Secondary outcome was anxiety level (STAI-1 state anxiety scale). Beta-HCG levels were assessed for conception 12 days after ET. Additionally, STAI-1 state anxiety scale was administered 30 min before and after ET to measure anxiety levels in both groups. RESULTS: The mean age was 30.9 ± 3.7 years. Positive Beta HCG was detected in 63.9% (n = 23) of the AG and 33.3% (n = 12) of CG (p = 0.009). Clinical pregnancy, ongoing pregnancy, and live birth rates were higher in AG (p < 0.05). There was no difference between the groups concerning anxiety scores before ET (p > 0.05). The mean STAI-1 score was decreasing from 57.3 ± 9.8 to 28.8 ± 3.3 in AG, while it was decreasing from 57.0 ± 8.0 to 41,1 ± 6,8 in CG after ET (p < 0.000). CONCLUSIONS: It was observed that three sessions of acupuncture before and after ET significantly increased the pregnancy rates in women with unexplained infertility. It was also found that acupuncture significantly reduced anxiety levels that occurred before ET.
Asunto(s)
Terapia por Acupuntura/métodos , Ansiedad/terapia , Fertilización In Vitro/métodos , Infertilidad Femenina/terapia , Adulto , Ansiedad/etiología , Transferencia de Embrión/métodos , Transferencia de Embrión/psicología , Femenino , Fertilización In Vitro/psicología , Humanos , Infertilidad Femenina/psicología , Nacimiento Vivo , Embarazo , Índice de Embarazo , Resultado del TratamientoRESUMEN
Compassionate transfer is a procedure wherein in vitro-created embryos are placed in a patient's cervix, vagina or uterus at an infertile period in the menstrual cycle where they are expected to perish. Patients report that they feel this procedure is a more natural means of disposition and provides them with the opportunity to grieve the loss of a potential child. However, some have argued that the procedure is an unnecessary, and illogical, addition to fertility treatment and that it detracts resources from medical care. Here, we introduce compassionate transfer as an alternative disposition option and argue that, for certain patients, it may constitute an ethical extension of fertility care that respects patient autonomy and psychosocial health.
Asunto(s)
Destinación del Embrión/ética , Transferencia de Embrión/métodos , Fertilización In Vitro/métodos , Infertilidad/psicología , Destinación del Embrión/psicología , Transferencia de Embrión/ética , Transferencia de Embrión/psicología , Femenino , Fertilización In Vitro/ética , Fertilización In Vitro/psicología , Salud Holística/ética , Humanos , Infertilidad/terapia , Autonomía PersonalRESUMEN
Objectives: There is growing evidence that psychosocial factors play an important role in the success of in-vitro fertilisation (IVF). The current study explored the impact of coping style, social support, self-compassion, parenthood motivation and relationship attachment as predictors of IVF success. Design: A follow-up survey of 305 women undergoing IVF who had initially been assessed one year earlier. Methods: Participants were assessed on measures of coping style, social support, self-compassion, parenthood motivation, relationship attachment and psychological distress and reassessed one year later in terms of the outcome of IVF. Results: Of these, 156 reported successful births while 149 had been unsuccessful. Of the 149 who had been unsuccessful, 66 were undertaking another cycle of IVF and 83 were not, although whether they had completely given up is not known. The significant positive predictors were problem-focused coping, mindfulness, nurturance motivation, secure attachment, support from friends and self-kindness. In addition, social pressure motivation, and avoidance coping were negative predictors. Conclusions: The findings point to potential psychological interventions in terms of stress management, couple counselling and mindfulness therapy in increasing the likelihood of success from IVF.
Asunto(s)
Fertilización In Vitro/psicología , Infertilidad/psicología , Adaptación Psicológica , Adulto , Consejo , Femenino , Estudios de Seguimiento , Humanos , Atención Plena/métodos , Irlanda del Norte , Embarazo , Índice de Embarazo , Psicometría , Apoyo Social , Estrés Psicológico/terapia , Encuestas y CuestionariosRESUMEN
AIM: This review evaluates the impact of complementary therapies on psychosocial factors in women undergoing IVF. BACKGROUND: According to the CDC, nearly 7% of married women in the United States face infertility. Approximately 1.5% of all infants born in the U.S. annually are conceived through assisted reproductive technologies (ART), such as IVF. Women undergoing ART report distress, anxiety, and depression related to their treatment. Stress has been cited as the top reason why women terminate treatment. Complementary therapies, such as mind-body techniques, have been associated with decreasing stress and anxiety. METHODS: CINAHL and PubMED databases were searched for studies 1) published from January 2010 to 2017, 2) written in English, 3) that examined the effect of an complementary therapy on the psychological well-being of women undergoing, or about to be undergoing a cycle of IVF. RESULTS: The search revealed 11 studies published between 2010 and 2015 from a variety of countries. The most common research design was a randomized controlled trial (n=7). The psychosocial factor most frequently measured was anxiety (n=8). The forms of complementary therapy varied, with the most common being Hatha yoga, cognitive behavioral interventions, and mind-body therapies (n=2 each). CONCLUSIONS: Utilizing complementary therapies appears to be a positive way to decrease women's anxiety, depression, distress, and stress, and to increase fertility quality of life. This review informs providers that incorporating complementary therapies into the plan of care can lead to improved psychosocial health outcomes for women undergoing IVF.
Asunto(s)
Ansiedad/terapia , Terapias Complementarias/métodos , Fertilización In Vitro/psicología , Infertilidad Femenina/psicología , Técnicas Reproductivas Asistidas/psicología , Adulto , Femenino , Humanos , Embarazo , Estados UnidosRESUMEN
BACKGROUND: Acupuncture is a common adjuvant treatment to support patients undergoing in vitro fertilisation (IVF). However, the impact of acupuncture and the different roles it can play in IVF remain unclear. OBJECTIVE: In this paper, we present an overview and critique of the current evidence on acupuncture's impact on IVF-related stress, describe harms, and propose future directions for investigation. CONCLUSION: Two to three acupuncture sessions performed on or around the day of embryo transfer are insufficient interventions to improve IVF birth outcomes but provide significant IVF-related stress reduction. Research investigating acupuncture to support IVF is heterogeneous and confounded by the lack of an appropriate comparator. However, evidence suggests several acupuncture sessions improve endometrial thickness, reduce stress, and improve patient satisfaction. Observational studies suggest more sessions are associated with increases in clinical pregnancy and live birth rates. An optimised acupuncture intervention with a reasonable comparator is necessary for future studies, with evidence-based guidance on technique and number of sessions. Acupuncture should not be rejected as an adjuvant therapy for IVF, but more studies are needed to clarify acupuncture's role in supporting IVF cycles.
Asunto(s)
Terapia por Acupuntura , Fertilización In Vitro , Infertilidad Femenina/terapia , Animales , Terapia Combinada , Femenino , Fertilización In Vitro/psicología , Humanos , Infertilidad Femenina/psicología , Masculino , Estudios Observacionales como AsuntoRESUMEN
OBJECTIVES: Infertility is one of the main stressful events of life and a crisis affecting various dimensions of infertile couples' lives. Relaxation, as a strategy, can be effective in the individuals' resistance to stress and anxiety. Therefore, the present study aimed to assess the effect of relaxation on mother's anxiety and maternal-fetal attachment in primiparous women who used In Vitro Fertilization (IVF) to get pregnant. METHODS: In this clinical trial, 80 primiparous women who had used IVF to get pregnant were randomly divided into a control and an intervention group. The intervention group took part in four 90-min relaxation classes in addition to receiving the routine pregnancy care. Anxiety and maternal-fetal attachment were evaluated before and one month after the intervention. Also, maternal-infantile attachment score was computed after delivery. The statistical analyses were performed using the SPSS statistical software. Chi-square and independent t-test was used to analyze the data. RESULTS: The results revealed no significant difference between the two groups regarding the mean scores of anxiety and attachment before the intervention. However, a significant difference was observed in this regard after the intervention (41.4 ± 4.1 vs. 51.0 ± 10.4, P < 0.01). CONCLUSION: The study results showed that relaxation training was effective in reduction of anxiety and increase of maternal-fetal attachment in the women who had used IVF to get pregnant. Although there are other methods for reducing anxiety, relaxing can be used for IVF women due to its ease of use and its wide acceptance.
Asunto(s)
Ansiedad/terapia , Fertilización In Vitro/psicología , Relaciones Materno-Fetales/psicología , Apego a Objetos , Complicaciones del Embarazo/terapia , Atención Prenatal/métodos , Terapia por Relajación , Adolescente , Adulto , Ansiedad/psicología , Femenino , Humanos , Madres/psicología , Embarazo , Complicaciones del Embarazo/psicología , Resultado del Tratamiento , Adulto JovenRESUMEN
PURPOSE: The aim of this study was to determine the effect of music therapy on the anxiety levels and pregnancy rates of women who underwent in vitro fertilization-embryo transfer. METHODS: This prospective randomized controlled trial was conducted with 186 infertile women who presented to the In Vitro Fertilization Unit at the American Hospital in Turkey between April 2015 and April 2016. The infertile women who met the inclusion criteria were assigned to the music therapy group or the standard therapy group through block randomization. The study data were collected using the Personal Information Form, and State-Trait Anxiety Inventory. Early treatment success was determined by serum beta human chorionic gonadotrophin levels seven or ten days after the luteal day zero. For the analysis, descriptive statistics, chi-square test, Fisher's exact test, independent sample t-test were used. RESULTS: After the embryo transfer, the mean state anxiety scores decreased in both groups, and the mean trait anxiety score decreased in the music therapy group; however, the difference was not statistically significant (p>0.05). Clinical pregnancy rates did not differ between the music (48.3%) and standard (46.4%) therapy groups. CONCLUSION: After the two sessions of music therapy, state and trait anxiety levels decreased and pregnancy rates increased, but the difference was not significant. Therefore, larger sample sizes and more sessions are needed to evaluate whether music therapy has an effect on clinical outcomes.
Asunto(s)
Ansiedad/etiología , Ansiedad/terapia , Transferencia de Embrión/psicología , Fertilización In Vitro/psicología , Infertilidad Femenina/terapia , Musicoterapia , Índice de Embarazo , Adulto , Femenino , Humanos , Embarazo , Estudios Prospectivos , Resultado del Tratamiento , TurquíaRESUMEN
PURPOSE: Couples as dyads suffer from the diagnosis of infertility and related treatment. These couples commonly experience emotional and physical pain and tension in their marital lives. The purpose of this study is to report on the process of developing a potentially feasible and effective complex intervention for couples undergoing in vitro fertilization treatment in China. METHODS: The Medical Research Council (MRC) framework for developing and evaluating the complex intervention was adopted to guide the development of the Partnership and Coping Enhancement Programme (PCEP). In developing the PCEP, three steps were taken, namely, (1) identifying evidence by conducting literature reviews, a concept analysis and a qualitative study; (2) identifying/developing a theory-in this case, a preliminary Endurance with Partnership Conceptual Framework (P-EPCF) was proposed; and (3) modelling the process and outcomes of the PCEP. RESULTS: The PCEP that was developed is targeted mainly at the domains of the partnership mediators of stress in the P-EPCF. It consists of two sections-partnership and coping-and will be delivered to infertile couples on the day of embryo transfer. The main focuses of the programme are to facilitate mutual sharing and support in infertile couples, and to improve their individual and dyadic coping strategies while undergoing IVF treatment, especially in the period when they are waiting for the results of a pregnancy test and after the disclosure of a negative treatment outcome. The programme is couple-based, consisting of experience sharing, psychoeducation, meditation exercise, skill practise and supplemental written materials. CONCLUSIONS: The Partnership and Coping Enhancement Programme (PCEP) for couples undergoing in vitro fertilization treatment was developed according to the guideline of the MRC framework. It is recommended that a pilot study be conducted to evaluate its feasibility and to model the process and outcomes of the programme.
Asunto(s)
Transferencia de Embrión/psicología , Fertilización In Vitro/psicología , Infertilidad/psicología , Estrés Psicológico , China , Femenino , Humanos , Infertilidad/epidemiología , Infertilidad/fisiopatología , Relaciones Interpersonales , Masculino , Matrimonio/psicología , Embarazo , Esposos/psicologíaRESUMEN
This study compared responses to an in-person clown visit and a humorous film following in vitro fertilization and embryo transfer. Intervention was a 10-minute clown visit (n = 101) or 10-minute humorous video clip (n = 99). Demographic and fertility-related data and preintervention anxiety scores were collected. Participants completed an Evaluation of Intervention form postintervention. There were no group differences on demographic or fertility-related data or anxiety scores. Findings indicate while participants viewed the intervention positively, the clown visit offered a higher degree of satisfaction in more patients than did the film. Median evaluation scores were significantly higher for the clown visit, specifically reducing anxiety level and being more distracting. Both groups reported that the exposure made the clinic experience more pleasant and did not bother them, and most would recommend incorporating the intervention in routine treatment. However, free-text comments clearly expressed greater enthusiasm to the in-person clown intervention than to the film.
Asunto(s)
Transferencia de Embrión/psicología , Fertilización In Vitro/psicología , Estrés Psicológico/terapia , Adulto , Femenino , Humanos , Risoterapia , Satisfacción del Paciente , Adulto JovenRESUMEN
OBJECTIVE: To evaluate associations between the use of complementary medicine, quality of life (QoL), and lifestyle habits among women undergoing in vitro fertilization (IVF). METHODS: In a cross-sectional study, women aged 18-44 years undergoing an IVF cycle at a large IVF center in Israel between February 1, 2013 and April 30, 2015 were invited to complete a self-administered questionnaire. Patients who reported using of at least one complementary medicine intervention to treat infertility prior to IVF treatment were considered complementary-medicine users. Fertility QoL and lifestyle behaviors were compared between complementary-medicine users and non-users with the FertiQoL tools. RESULTS: Of 381 patients eligible to participate in the study, 323 completed the questionnaire; 110 (34.1%) participants were complementary-medicine users. Complementary-medicine users demonstrated higher scores for the FertiQol relational domain (P=0.005) and lower scores for the social domain (P=0.010). Complementary-medicine users reported greater utilization of psychosocial support (P<0.001), and higher rates of physical activity (P=0.004) and consulting with dietitians (P=0.050). CONCLUSIONS: Users of complementary medicine reported increased relational and lower social QoL, increased use of psychosocial support, and favorable healthy-lifestyle habits. Actively inquiring about the lifestyle habits and QoL of patients experiencing infertility could be useful in identifying patients who could benefit from psychosocial interventions or lifestyle recommendations.
Asunto(s)
Terapias Complementarias , Fertilización In Vitro/psicología , Infertilidad/terapia , Calidad de Vida , Adulto , Estudios Transversales , Ejercicio Físico , Femenino , Humanos , Israel , Estilo de Vida , Modelos Lineales , Autoinforme , Adulto JovenRESUMEN
Generally, undergoing an in vitro fertilization (IVF) treatment is an emotional and physical burden for the infertile woman, which may negatively influence the treatment outcome. We conducted a study to investigate the effectiveness of a mindfulness-based intervention (MBI) among women subjected to first IVF treatment at a fertility medical center in China. Among infertile women registered for their first IVF treatment, 58 completed the intervention, and 50 were assigned to a control group using a non-randomized controlled study. Standardized measures of mindfulness, self-compassion, emotion regulation difficulties, infertility-related coping strategies and fertility quality of life (FertiQoL) were endorsed pre- and post-MBI, and measure of pregnancy rates at the sixth months after the intervention. Both groups were shown to be equivalent at baseline. By the end of the intervention, women who attended the intervention revealed a significant increase in mindfulness, self-compassion, meaning-based coping strategies and all FertiQoL domains. Inversely, they presented a significant decrease in emotion regulation difficulties, active- and passive-avoidance coping strategies. Women in the control group did not present significant changes in any of the psychological measures. Moreover, there were statistically significant differences between participants in the pregnancy rates, the experiment group higher than the control group. Being fully aware of the present moment without the lens of judgment, seems to help women relate to their infertility and IVF treatment in new ways. This is beneficial for promoting their self-compassion, adaptive emotion regulation and infertility-related coping strategies, which, in turn, may influence the FertiQoL and pregnancy rates. The brief and nonpharmaceutical nature of this intervention makes it a promising candidate for women' use during first IVF treatment.
Asunto(s)
Fertilización In Vitro/psicología , Atención Plena/métodos , Adaptación Psicológica , Adulto , Concienciación , Emociones , Femenino , Fertilidad , Humanos , Infertilidad Femenina/psicología , Embarazo , Índice de Embarazo , Psicometría , Calidad de Vida , Autocontrol/psicología , Resultado del TratamientoRESUMEN
OBJECTIVE: To evaluate the prevalence and characteristics of complementary medical therapy (CMT) use among Israeli couples undergoing in vitro fertilization (IVF). METHODS: In a cross-sectional study, men and women undergoing treatment at four IVF units in Israel were invited to complete an anonymous questionnaire between May 2010 and December 2011. Patients were considered users of CMT if they reported that either partner used at least one type of CMT for treating infertility. Stepwise backward logistic regression was used to assess the independent effects of variables on CMT utilization. RESULTS: Of 511 patients approached, 400 (78.1%) completed the survey and 159 (39.8%) indicated that CMT for infertility was used by one or both partners. Higher CMT use was significantly associated with the treating hospital, post high-school education, more than three previous IVF trials, being employed, and using psychosocial support (all P<0.05). Most users (75/129; 58.1%) did not notify the IVF clinic medical staff about concurrent use of CMT. CONCLUSION: Use of CMTs was widely reported by Israeli patients undergoing IVF, particularly those with higher education, and those undergoing repeated IVF trials and receiving psychosocial support. IVF staff ought to be aware of the widespread utilization of CMTs because the impact of these therapies on IVF outcomes is inconclusive.
Asunto(s)
Terapias Complementarias/estadística & datos numéricos , Fertilización In Vitro/psicología , Infertilidad/terapia , Adulto , Estudios Transversales , Escolaridad , Composición Familiar , Femenino , Humanos , Israel , Masculino , Persona de Mediana Edad , Apoyo Social , Encuestas y Cuestionarios , Adulto JovenRESUMEN
PURPOSE: The study aimed to develop a mind-body therapeutic program and evaluate its effects on mitigating uncertainty, anxiety, and implantation rate of second-trial in vitro fertilization (IVF) women. METHODS: This study employed a nonequivalent control group nonsynchronized design. The conceptual framework and program content were developed from a preliminary survey of eight infertile women and the extensive review of the literature. Program focuses on three uncertainty-induced anxieties in infertile women: cognitive, emotional, and biological responses. To evaluate the effect of the intervention, the infertile women with unknown cause preparing for a second IVF treatment were sampled at convenience (26 experimental and 24 control). RESULTS: The experimental group in the study showed greater decrease in uncertainty and anxiety in premeasurements and postmeasurements than the control group did. However, no statistically significant differences in the implantation rate between groups were observed. CONCLUSION: This study is meaningful as the first intervention program for alleviating uncertainty and anxiety provided during the IVF treatment process. The positive effects of the mind-body therapeutic program in alleviating both uncertainty and anxiety have direct meaning for clinical applications.
Asunto(s)
Ansiedad , Fertilización In Vitro/psicología , Infertilidad Femenina/psicología , Terapias Mente-Cuerpo/métodos , Incertidumbre , Mujeres/psicología , Adulto , Ansiedad/psicología , Ansiedad/terapia , Estudios de Casos y Controles , Implantación del Embrión , Femenino , Humanos , Resultado del TratamientoRESUMEN
OBJECTIVES: To evaluate the influence of Hatha-yoga (HY) practice on distress of women before starting their first in vitro fertilization (IVF) cycle. STUDY DESIGN: We offered 143 consecutive women with couple infertility the opportunity to attend a free HY course lasting 3 months as a psychological support before starting their first IVF cycle. All women were asked to complete the State-Trait Anxiety Inventory-Y1 (STAY-Y1), Edinburgh Depression Scale (EDS) and General Health Questionnaire-12 (GHQ-12) at baseline (T1) and after 3 months (T2), to evaluate symptoms of anxiety, depression and distress, respectively. RESULTS: Of the 143 women, 120 completed all three questionnaires. Of these, 45 attended the HY course and 75 did not. At T1, EDS and GHQ-12 scores were significantly higher in the HY group than in the non-HY group. There were no group differences in STAI-Y1 scores. At T2 there were no group differences. When, in each group, the score of each questionnaire at T1 was compared to the score at T2, a significant T1 to T2 reduction was observed in the HY group (p<0.0001 for STAY-Y1 and GHQ-12, p<0.001 for EDS). CONCLUSIONS: Our data suggest that women who are more distressed are more likely to accept psychological support before starting an IVF cycle and that in these women HY practice is associated with distress reduction.
Asunto(s)
Ansiedad/terapia , Fertilización In Vitro/psicología , Estrés Psicológico/terapia , Yoga , Adulto , Ansiedad/psicología , Depresión/terapia , Femenino , Humanos , Infertilidad , Proyectos PilotoRESUMEN
PURPOSE: The study aimed to develop a mind-body therapeutic program and evaluate its effects on mitigating uncertainty, anxiety, and implantation rate of second-trial in vitro fertilization (IVF) women. METHODS: This study employed a nonequivalent control group nonsynchronized design. The conceptual framework and program content were developed from a preliminary survey of eight infertile women and the extensive review of the literature. Program focuses on three uncertainty-induced anxieties in infertile women: cognitive, emotional, and biological responses. To evaluate the effect of the intervention, the infertile women with unknown cause preparing for a second IVF treatment were sampled at convenience (26 experimental and 24 control). RESULTS: The experimental group in the study showed greater decrease in uncertainty and anxiety in premeasurements and postmeasurements than the control group did. However, no statistically significant differences in the implantation rate between groups were observed. CONCLUSION: This study is meaningful as the first intervention program for alleviating uncertainty and anxiety provided during the IVF treatment process. The positive effects of the mind-body therapeutic program in alleviating both uncertainty and anxiety have direct meaning for clinical applications.
Asunto(s)
Adulto , Femenino , Humanos , Ansiedad/psicología , Estudios de Casos y Controles , Implantación del Embrión , Fertilización In Vitro/psicología , Infertilidad Femenina/psicología , Terapias Mente-Cuerpo/métodos , Resultado del Tratamiento , Incertidumbre , Mujeres/psicologíaRESUMEN
Treatment advances in assisted reproductive technology (ART) such as oocyte donation and gestational surrogacy have introduced a new cohort of intended parents and new family constellations. Who these parents are and how their children are doing is the focus of this paper. Special emphasis will be paid to the impact of delayed parenthood on oocyte donation, the increasing numbers of gestational surrogacy participants (intended parents and surrogates), and the growing numbers of gay male couples seeking fatherhood through ART. While it appears that children of these new family constellations are doing well, research is limited and longitudinal studies of their health and well being are needed.
Asunto(s)
Hijos Adultos/psicología , Padres/psicología , Técnicas Reproductivas Asistidas , Adolescente , Adulto , Niño , Desarrollo Infantil , Divorcio , Femenino , Fertilización In Vitro/psicología , Identidad de Género , Homosexualidad Masculina/psicología , Humanos , Recién Nacido , Masculino , Donación de Oocito/psicología , Relaciones Padres-Hijo , Embarazo , Conducta Reproductiva/psicología , Técnicas Reproductivas Asistidas/psicología , Técnicas Reproductivas Asistidas/tendencias , Ajuste Social , Madres Sustitutas/psicología , Resultado del TratamientoRESUMEN
OBJECTIVE: To assess the effects of acupuncture combined Chinese materia medica for tonifying shen and soothing gan (CMMTSSG) on the anxiety and depression of patients with in vitro fertilization and embryo transplantation (IVF-ET), and to observe the treatment outcomes. METHODS: Totally 97 IVF-ET patients were randomly assigned to two groups, the acupuncture combined CMMTSSG (group A, 51 cases) and the Western medicine treatment group (group B, 46 cases). The long protocol of IVF-ET in a mid luteal phase was performed in all patients. Patients in group A received acupuncture and CMMTSSG (erzhi tiangui granule and xiaoyao granule) during the process of ovarian hyperstimulation, while those in group B only received the routines of IVF-ET. The improvement of Shen deficiency Gan depression syndrome (SDGDS) between after and before treatment were observed in the two groups. The changes of self-rating anxiety scale (SAS) and Beck depression inventory (BDI) score were observed. The endometrial thickness, typing, and endometrial blood flow resistance index (RI) on the day of injecting HCG, the number of retrieved oocytes, the rate of high quality oocytes, the fertilization rate, the rate of high quality embryos, and the clinical pregnancy rate were respectively compared between the two groups. RESULTS: The scores of SDGDS, SAS, and BDI were improved more obviously in group A than in group B, showing statistical difference (P < 0.01). There was no statistical difference in the endometrial thickness on the day of injecting HCG between the two groups (P > 0.05). The proportion of type A endometrium was 74.5% (38/51 cases) in group A and 45.7% (21/46 cases) in group B, showing statistical difference between the two groups (P < 0.01). The RI was significantly lower in group A (0.48 +/- 0.03) than in group B on the day of injecting HCG (0.52 +/- 0.06, P < 0.01). There was no statistical difference in the number of retrieved oocytes and the fertilization rate between the two groups (P > 0.05). The rate of high quality oocyte, the rate of high quality embryos, and the clinical pregnancy rate were all improved more significantly in group A than in group B, showing statistical difference between the two groups (P < 0.05). CONCLUSIONS: Acupuncture combined CM-MTSSG could obviously alleviate unfavorable emotions as anxiety and depression in patients with IVF-ET, effectively improve the treatment outcomes. Its effects might be correlated with lowering the excitability of the sympathetic nervous system, elevating the quality of oocytes, and improving the endometrial receptivity.
Asunto(s)
Terapia por Acupuntura , Ansiedad/terapia , Depresión/terapia , Medicamentos Herbarios Chinos/uso terapéutico , Transferencia de Embrión/psicología , Fertilización In Vitro/psicología , Adulto , Femenino , Humanos , Embarazo , Índice de Embarazo , Resultado del TratamientoRESUMEN
OBJECTIVES: This study examined the efficacy of a group intervention, the Integrative Body-Mind-Spirit (I-BMS) intervention, which aims at improving the psychosocial and spiritual well-being of Chinese women undergoing their first IVF treatment cycle. DESIGN: The I-BMS intervention facilitates the search of meaning of life in the context of family and childbearing, as well as the letting go of high IVF expectations. A randomized controlled study of 339 women undergoing first IVF treatment cycle in a local Hong Kong hospital was conducted (intervention: n= 172; no-intervention control: n= 167). METHODS: Assessments of anxiety, perceived importance of childbearing, and spiritual well-being were made at randomization (T(0) ), on the day starting ovarian stimulations (T(1)), and on the day undertaking embryo transfer (T(2)). RESULTS: Comparing T(0) and T(2), interaction analyses showed women who had received the intervention reported lower levels of physical distress, anxiety, and disorientation. They reported being more tranquil and satisfied with their marriage, and saw childbearing as less important compared to women in the control group. CONCLUSIONS: These findings suggest that I-BMS intervention was successful at improving the psychosocial and spiritual well-being of women undergoing their first IVF treatment cycle. This study highlights the importance of providing integrative fertility treatment that incorporates psychosocial and spiritual dimensions.