Ghanaian women's experiences of unsuccessful in-vitro fertilisation treatment, unravelling their meanings: a Heideggerian hermeneutic phenomenological study.

BACKGROUND: Women having experienced infertility over a period usually decide on an option for an invitro fertilisation treatment (IVF). However, in the quest to seek help and to be part of motherhood, they sometimes become unsuccessful in their fertility journey. The researchers aimed to explore the meanings and emotions attached to infertility and unsuccessful invitro fertilisation (IVF) treatment among Ghanaian women, as this area of inquiry is less explored in Africa and specifically in the Ghanaian context. METHODS: The study followed a qualitative approach and drew inspiration from the Heideggerian phenomenological philosophy and design. Six (6) women, aged between 29 and 40 years, who had experienced at least one unsuccessful IVF cycle, were purposefully selected from a private specialist fertility hospital in Kumasi, Ghana. One-on-one interviews were conducted with the participants, and the interviews were transcribed verbatim. The collected data was analyzed using Van Manen six-step framework, which helped to uncover the existential meanings and interpretations these women ascribed to their experiences. RESULTS: The results of the study revealed four main themes that were deemed essential aspects of meaning for the participants. These themes were: (1) Experiencing an Existential Faith and Hope. The participants described their journey through infertility and invitro fertilisation (IVF) treatment as a profound test of their existential faith and hope finding strength in maintaining a positive outlook despite the challenges and setbacks they faced., (2) Facing up to the Angst: This theme highlights the participants' courage in confronting the emotional dimensions of their struggles. The women acknowledged and confronted their anxieties, fears, and emotional distress associated with their infertility and unsuccessful IVF treatment., (3). Non-disclosedness: This theme refers to the participants' experiences of keeping their struggles with IVF treatment private, often due to societal and cultural factors. (4). Endured feelings of inadequacy of being-in-the-world-of-motherless: Participants expressed feelings of inadequacy, self-doubt, and a sense of being incomplete due to their inability to conceive and fulfill the societal role of motherhood. Their narratives revealed the profound impact of societal expectations on their self-perception and identity. CONCLUSION: The study's findings reveal insights into the experiences and interpretations of infertility and unsuccessful IVF treatment among Ghanaian women. Employing Heideggerian hermeneutics, the research elucidates the diverse existential, emotional, and societal aspects inherent in the struggles of infertility. The multifaceted nature of these women's journeys underscores the significance of a comprehensive approach to infertility care that recognizes the cultural, social, emotional, and existential dimensions of the IVF process. Additionally, the study emphasizes the necessity for culturally sensitive support systems and interventions to address the unique challenges faced by this population.

Association between domain-specific physical activity and mental health status after embryo transfer in IVF-ET-assisted pregnancy patients.

Physical activity has been shown to impact mental health in in vitro fertilization-embryo transfer (IVF-ET) patients, but the relationship between domain-specific physical activity and mental health in this population remains unclear. In a cross-sectional observational study, 208 patients undergoing IVF-ET with long-term ovulation induction cycles were recruited from a reproductive center. The International Physical Activity Questionnaire and the symptom checklist 90 (SCL-90) were used to assess physical activity levels and mental health status, respectively. Analyses of variance and linear regression analyses were conducted to identify the relationship between physical activity and mental health. There were differences between different physical activity level in times of transfers, years of infertility, and times of abortions. Patients with high levels of physical activity had fewer symptoms than those with low levels of physical activity. Occupation, transport and household physical activity had significant negative correlations with the respective SCL-90 factor scores. Linear regression analysis revealed that occupation physical activity was associated with lower depression and anxiety, and transport physical activity and household physical activity were associated with lower obsessive-compulsive, interpersonal sensitivity, depression, anxiety, and psychoticism scores. The study indicates that increased engagement in physical activity, specifically activities related to occupation, transportation, and household, may be associated with improved mental health among IVF-ET patients.

The impact of relationship status on IVF patients' quality of life.

Infertility treatments are emotionally taxing and include invasive and time-consuming procedures over extended periods of time. In light of the growing numbers of single mothers by choice, the objective of this study was to apply the Conservation of Resources Theory in the context of infertility care and examine whether relationship status constitutes a psychological resource that buffers the decline in quality of life during IVF treatments. We used the FertiQol questionnaire to compare the quality of life of IVF patients between 422 patients who are involved in a couple relationship ("attached") and 117 patients who are not ("unattached"). Results show that the total FertiQol was significantly higher among the attached participants; the Core FertiQol and the Treatment FertiQol were rated higher by the "attached." No significant differences were found between the attached and unattached for the Emotional and Social subscales. "unattached" participants report significantly lower levels of quality of life in the "mind-body" and "treatment tolerability" subscales than the "attached" participants. It is concluded that being involved in a long-term couple relationship is to be seen as a resource that buffers the decline in quality of life of infertile women undergoing IVF treatments.

Effectiveness of double ABCX-based psychotherapy for psychological distress among women undergoing in vitro fertilization-embryo transfer: a three-arm randomized controlled trial.

OBJECTIVE: This study aimed to evaluate the effectiveness of double ABCX-based psychotherapy for psychological distress during in vitro fertilization-embryo transfer (IVF-ET) among a female group (FG), couple group (CoG) and control group (CG). METHODS: A total of 201 women undergoing their first IVF-ET cycle were randomized into three groups. The 6-session intervention was delivered at each visit to the IVF clinic. The primary outcomes were depression and anxiety, and the secondary outcomes included sleep quality, serum cortisol (nmol/L) levels and the clinical pregnancy rate, which were assessed before and after the intervention. RESULTS: The group-by-time effects were significant for depression, anxiety, sleep quality and serum cortisol levels, with larger effect sizes in the FG than in the CoG. There was no significant difference in the pregnancy rate among the three groups. CONCLUSION: Psychotherapy effectively mitigated psychological distress, suggesting greater effectiveness for couples undergoing IVF couples than for women only. It is structured and easy to use during the IVF treatment cycle. TRIAL REGISTRATION NUMBER: https://register.clinicaltrials.gov (NCT03931187, retrospectively registered on April 23, 2019).

Double ABCX-based psychotherapy, which was developed in this study, effectively mitigated depression, anxiety, sleep disturbance and increased cortisol levels, suggesting greater effectiveness for couples undergoing IVF-ET than women only.Double ABCX-based psychotherapy is structured and easy to use during the IVF-ET treatment cycle, thereby presenting a promising and feasible approach to improve care for couples or women with assisted reproductive technique-related stress.

A longitudinal study of families created using egg donation: Family functioning at age 5.

Findings are reported from Phase 2 of a longitudinal study of family functioning in heterosexual-couple families with 5 year olds conceived using identity-release egg donation. Seventy-two egg donation families were compared to 50 in vitro fertilization (IVF) families (ethnicity: 93% White British) using standardized observational, interview, and questionnaire measures. There were no differences between family types in the quality of mother-child or father-child interaction, apart from lower structuring by fathers in egg donation families. Egg donation mothers and fathers reported higher levels of parenting stress and lower levels of confidence and competence than their IVF counterparts. Egg donation mothers reported lower social support and couple relationship quality, greater anger toward their child, and perceived their child as more angry and less happy, compared to IVF mothers. Egg donation fathers showed greater criticism and anger toward their child, less joy in parenting, and were less satisfied with the support they received, than IVF fathers. Children in egg donation families showed higher levels of externalizing problems than IVF children as rated by mothers, fathers, and teachers, whereas they were rated as having higher levels of internalizing problems by teachers only. Externalizing problems were predicted by mothers' lower initial social support, steeper increases in parenting stress and greater concurrent criticism, whereas internalizing problems were associated with poorer initial couple relationship quality as rated by mothers. Both were predicted by fewer gains in reflective functioning. There was a moderation effect such that parenting stress was a stronger predictor of externalizing problems for egg donation than IVF families. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Factors associated with postpartum depressive symptoms among women who conceived with infertility treatment.

Infertility treatment experiences may accumulate and influence postpartum psychological well-being among women with infertility. However, the association between infertility treatment experiences and postpartum depressive symptoms remained unclear. This cross-sectional survey aimed to describe depressive symptom scores of 180 women, who conceived while undergoing infertility treatment, at 2-6 months after childbirth, and to explore factors, including infertility history and treatment experiences, associated with postpartum depressive symptoms. Data were collected via telephone interviews and patient record reviews. Postpartum depressive symptoms were measured using the Edinburgh Postnatal Depression Scale, with a cutoff score of 10. The prevalence of postpartum depressive symptoms was 34.4 %. Higher perceived stress levels after childbirth than before undergoing infertility treatment, a duration of infertility diagnosis longer than three years, maternal age >35 years, pregnancy conceived through in vitro fertilization (IVF), and experiencing all three lines of infertility treatment, namely ovarian stimulation, intrauterine insemination, and IVF, were associated with a higher risk of postpartum depressive symptoms. Breastfeeding, social support, and baby sex in line with stated preference were negatively associated with postpartum depressive symptoms. There were no significant interactions between the variables. The women's infertility history and treatment experiences were found to have influenced their postpartum depressive symptoms, especially among women who had a long duration of infertility, conceived through IVF, and had received all lines of infertility treatment.

(De)Bonding with embryos: The emotional choreographies of Portuguese IVF patients.

In this article we develop the new concept of emotional choreography to describe how patients bond, debond and/or rebond with their embryos created in vitro using assisted reproductive technologies (ART). Using this concept, we explore how the patients' management of their own emotions intertwines with political, scientific, and religious factors. Our analysis relies on and further advances Thompson's concepts of ethical and ontological "choreography". It is through these forms of choreography that complex contemporary biomedical issues with high political, ethical, and scientific stakes are negotiated, and through which different actors, entities, practices, roles, and norms undergo mutual constitution, reinforcement and (re)definition. Our article draws on the analysis of 69 in-depth interviews and the results of an online survey with 85 respondents.

Perceived social support in solo women seeking treatment with donor gametes and in women in heterosexual couples seeking IVF-treatment with own gametes.

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.

Self-blame predicts anxiety and depression in infertile couples who opt for in vitro fertilisation (IVF) treatment.

The study examined the use of maladaptive coping strategies such as conflict, avoidance and self-blame in predicting anxiety and depression in couples undergoing IVF procedure. The target group consisted of 80 couples who started the IVF treatment at the Division of Obstetrics and Gynaecology, Ljubljana's University Medical Centre in Slovenia. The participants completed three scales: S/T Anxiety Inventory, CES Depression Scale, and Marital Coping Inventory. The results showed increased rates of depression compared to the normative population; 18% of women and 14% of men reported mild to moderate depression or the possibility of major depression. Women showed higher anxiety scores than men. Coping strategies predicted both depression and anxiety, with self-blame being the most toxic one. The study showed that self-blame is a coping strategy that should be properly addressed in the couples at the very outset of IVF treatment, to decrease emotional disorders and increase the likability of a succesful IVF medical procedures.

Assessment of patients' perceptions towards embryo disposition after donation of embryos to a research biobank.

PURPOSE: To explore perceptions towards embryo disposition among patients donating excess embryos to a research biobank. METHODS: Cross-sectional study of survey responses collected as part of enrollment in a research biobank. Patients are asked questions regarding the difficulty of their disposition decision, their alternative disposition choice if donation to research was not available, quality of the counseling they received, and if additional counseling throughout their treatment would have been beneficial. Survey responses use 5-point Likert scales, with "1" being lowest/least and "5" being highest/most. RESULTS: A total of 157 men and 163 women enrolled in the biobank. Median scores for difficulty of disposition decision were 3 for females and 2 for males, and for quality of counseling, the median scores were 4 for females and 3 for males. Seventy percent of patients would have chosen to discard their excess embryos had donation to research not been an option. Statistical analyses showed no significant difference in responses based on variations in race, religion, sexual orientation, and infertility diagnoses. Concordance of responses within heterosexual couples was tested and found to be poor to moderate. CONCLUSIONS: Assessing patients' perceptions towards embryo disposition after donation of their excess embryos to a research biobank affords a unique perspective. The difficulty of the disposition decision, the tendency to discard embryos in the absence of a means for donation to research, and the poor agreement between heterosexual partners highlight the importance of donation to research as an accessible disposition option and the need for a personalized approach to counseling and consenting for embryo disposition.

Women's quality of sleep and in vitro fertilization success.

Women undergoing in vitro fertilization (IVF) are emotionally challenged. Anxiety, depression, and sleep disturbances are common complaints. The impact of these symptoms on IVF outcome is however debated. In this study, we aimed at investigating whether sleep quality and psychological health can affect the chances of success of the procedure. Women undergoing IVF were recruited at the time of oocytes retrieval. Women's sleep quality and psychological health was assessed using the Pittsburgh Sleep Quality Index (PSQI), the Fertility Problem Inventory (FPI), and the Hospital Anxiety and Depression Scale (HADS). Baseline characteristics and results of the three scales were compared between women who did and did not succeed. Overall, 263 women were included, of whom 81 had a clinical pregnancy (31%). As expected, successful women were younger, and their ovarian reserve was more preserved. FPI and HADS scores did not differ. Conversely, a statistically significant difference emerged for the PSQI score, the median [interquartile range] in pregnant and non-pregnant women being 4 [3-5] and 5 [3-7], respectively (p = 0.004). The crude and adjusted OR of pregnancy in women with a PSQI > 5 (indicating impaired sleep quality) was 0.46 (95% CI 0.25-0.86, p = 0.02) and 0.50 (95% CI: 0.26-0.94, p = 0.03), respectively. In conclusion, low sleep quality is common in women scheduled for IVF and could influence the success of the procedure.

Quality-of-Life Assessment of Women Undergoing In Vitro Fertilization in Kazakhstan.

Infertility is a problem that affects millions of couples worldwide and has a significant impact on their quality of life. The recently introduced "Fertility Quality of Life Questionnaire (FertiQoL)" quickly became a gold standard for evaluation of the quality of life of patients suffering from infertility. The aim of this study was to determine the quality of life of Kazakhstani women coping with infertility problems by FertiQoL and assess the validity of the questionnaire. This cross-sectional study involved women of reproductive age undergoing an in vitro fertilization (IVF) cycle at a large IVF center in Kazakhstan in the period from 1 September 2020 to 31 September 2021. A total of 453 women out of 500 agreed to participate in the study, and the response rate was 90.6%. The overall Core FertiQoL was 56.95 ± 14.05, and the Treatment FertiQoL was 66.18 ± 11.13 points. Respondents with secondary infertility had statistically significantly higher Emotional (p < 0.001), Mind-body (p = 0.03), Social (p < 0.001), Environment (p = 0.02), and Treatment (p < 0.001) domains of FertiQoL than women with primary infertility. Respondents with a low income had the lowest levels of Total FertiQoL (56.72 ± 11.65). The longer duration of infertility of women undergoing IVF treatment presented the worse scale of Treatment and Total FertiQoL. Cronbach's alpha revealed good internal reliability for all FertiQoL subscales on the Kazakhstan women's questionnaire and averaged 0.8, which is an indicator of a high degree of reliability. The Total FertiQoL of Kazakhstan women undergoing IVF treatment was 59.6 ± 11.5, which is considerably lower than European countries. We identified statistically significant differences across medical and demographic groups. As this questionnaire had validity in Kazakhstan survey it possibly be used for both medical counseling and future investigation in our country.

Perceptions of Fertility Physicians Treating Women Undergoing IVF Using an Egg Donation.

In the course of their work, medical teams are routinely exposed to difficult and stressful situations. The few studies in the literature that have examined physicians' perceptions and responses to such situations have focused primarily on the fields of emergency medicine and chronic and terminal illness. However, the field of fertility medicine can also evoke complex feelings among physicians. The present qualitative study examined the perceptions of fertility physicians treating women undergoing egg donation. Semi-structured in-depth interviews were conducted with 20 fertility physicians, and a categorical analysis was performed. The main category to emerge was the physicians' perception of egg donation and its implications. Two prominent themes were identified within this category: doctor-patient communication surrounding egg donation and how the idea was presented to the patient; and doctors' perception of the implications of egg donation, including maternal identity, the relationship between mother and infant, and the mother's sense of the child's identity. This is the first study to consider the response to fertility treatments, a contemporary and sensitive topic, from the perspective of the physicians. The findings can contribute to physicians' understanding of themselves and can help to devise ways to assist them in managing their emotional responses to their work for the benefit of both themselves and their patients.

Case Management Improves Satisfaction, Anxiety, and Depression of Patients with Pregnancy Loss after In Vitro Fertilization and Embryo Transfer.

Objective: Pregnancy loss has negative impacts on both the physical and the mental health of expectant mothers, which calls for an in-depth investigation. In this study, we examined the effects of case management on patients with pregnancy loss after in vitro fertilization and embryo transfer (IVF-ET). Methods: 100 participants that had suffered pregnancy loss after IVF-ET-assisted pregnancy from January 2019 to March 2020 were divided into routine care and case management groups, each with 50 cases. For the routine care group, a doctor led the diagnostic and treatment processes and a nurse assisted with the treatment. For the case management group, a nurse led the patient diagnostic and treatment processes and a doctor controlled the diagnosis and treatment plan formulation. Case management models were established according to the comprehensive peripregnancy loss care of patients with pregnancy loss after IVF-ET-assisted pregnancy. The participants' outcomes (satisfaction, anxiety, and depression) were assessed at the time of pregnancy loss and 1 and 3 months after pregnancy loss during follow-up of the routine care and case management groups. Results: There was no statistical difference between the patients in the two groups with regard to their general information statistics (P > 0.05) or their satisfaction, anxiety, and depression at the time of pregnancy loss (P > 0.05). One month after pregnancy loss, there was no statistical difference in anxiety between the two groups (P > 0.05), but satisfaction was greater and depression was significantly reduced in the case management group compared with the routine care group (P < 0.05). Conclusion: Case management care can have a positive effect on improving the satisfaction, anxiety, and depression of patients that have had pregnancy loss after IVF-ET.

Stigma predicting fertility quality of life among Chinese infertile women undergoing in vitro fertilization-embryo transfer.

OBJECTIVE: To investigate stigma and fertility quality of life (FertiQoL) and identify predictors of FertiQoL in Chinese infertile women undergoing in vitro fertilization-embryo transfer (IVF-ET). METHODS: A descriptive correlational design was adopted to investigate the association between stigma and FertiQoL in 588 infertile women undergoing IVF-ET. The personal information questionnaire, Infertility Stigma Scale (ISS) and FertiQoL tool were used to measure study variables. RESULTS: The mean scores of ISS and FertiQoL were 62.59 (SD = 21.58) and 63.64 (SD = 13.72), respectively. There were significant differences of ISS scores among participants with different educational level, residence, occupation, religious belief, financial condition, age group, duration of infertility and infertility treatment, while significant differences of the FertiQoL scores were found in participants with different insurance status, determinism of etiology, infertile type, duration of infertility treatment and cycles of IVF-ET. Pearson's correlation analysis showed stigma was negatively correlated with FertiQoL (r = -0.081 to -0.669, p < .05). The self-devaluation (ß = -0.290, p < .001), social withdrawal (ß = -0.237, p < .001), family stigma (ß = -0.217, p < .001) and insurance status (ß = 0.066, p=.035) were identified as the significant predictor of FertiQoL accounting for 43.5% of variance. CONCLUSIONS: The stigma was significantly associated with FertiQoL in infertile women undergoing IVF-ET with higher level of stigma predicting poorer FertiQoL. More psychological support should be provided to infertile women to reduce stigma and improve FertiQoL.

Family resilience is a protective buffer in the relationship between infertility-related stress and psychological distress among females preparing for their first in vitro fertilization-embryo transfer.

The present study aimed to evaluate psychological distress and scrutinized whether family resilience plays a moderating role in the association between infertility-related stress and psychological distress among infertile females preparing for their first IVF-ET. A total of 492 infertile females completed self-reported measures including the Kessler 10 Psychological Distress Scale (K10), the fertility problem inventory (FPI), and the Family Resilience Assessment Scale (FRAS). The results showed 21 (65.2%) participants reported moderate or higher levels of psychological distress. While controlling for economic status, we found psychological distress to be positively linked to infertility-related stress (ß=0.483, P<0.001), and negatively related to family resilience (ß=-0.145, P=0.001). The simple slopes analysis showed that infertility-related stress had a weaker positive association with psychological distress for individuals at 1 SD (ß = 0.443, P < 0.001) above the mean on family resilience compared to those at 1 SD (ß = 0.537, P < 0.001) below the mean. Thus, it suggests that clinical practice should conduct family resilience-oriented interventions to facilitate family resilience among infertile females preparing for their first IVF-ET, with the goal to reduce psychological distress.

Resilience, Perceived Stress, and Depressed Mood in Women Under in Vitro Fertilization Treatment.

It has been suggested that women who display higher resilience levels may have less psychological distress during IVF. The aim of this study was to evaluate how infertile women deal with perceived stress, depressed mood, and sleep disturbances at the first IVF attempt and after one or more negative IVF outcomes depending on their level of resilience. An observational, cross-sectional study was carried out in a sample of 207 infertile women undergoing IVF procedures. The participants completed the short version of the Connor-Davidson Resilience Scale (CD-RISC), the short version of the European Spanish Version of Perceived Stress Scale (PSS-10), the Center of Epidemiologic Studies Depression Scale (CESD-10), and the Jenkins Sleep Scale (JSS). The relationship between CD-RISC scores ranked according to percentiles and mean PSS-10 scores revealed that women with strong resilience had lower perceived stress. After splitting the sample according to CD-RISC percentiles, differences were observed only at the first IVF attempt and the observed protective effect of high resilience scores appears to disappear following a negative IVF outcome. Women with high resilience are less likely to suffer from perceived stress or depressed mood during their first IVF attempt, this protective effect appears to be lost after a negative outcome.

Psychological status of infertile patients who had in vitro fertilization treatment interrupted or postponed due to COVID-19 pandemic: a cross-sectional study.

PURPOSE: To explore the psychological status of infertile women and men who had in-vitro fertilization (IVF) treatment interrupted or postponed because of the COVID-19 emergency. MATERIALS AND METHODS: An electronic survey (NCT04395755) was e-mailed between April and June 2020 to couples whose IVF treatments have been interrupted or postponed due to the COVID-19 pandemic. The presence and severity of symptoms suggestive of anxiety and/or depression were assessed using the Generalized Anxiety Disorder-7 (GAD-7) and the Patient Health Questionnaire-9 (PHQ-9). Subjects with preexisting psychiatric disorders were excluded. RESULTS: Overall, 524 out of 646 patients completed the survey. The prevalence of anxiety and/or depression feelings was significantly higher in women, mainly if aged more than 35 years and with a previous IVF attempt. The occurrence of these psychological symptoms was significantly associated with the time spent on COVID-19 related news per day and partner with evidence of psychological disorder and, in females, with a diagnosis of poor ovarian reserve, diagnosis of endometriosis or uterine fibroids. CONCLUSIONS: The psychological impact of the COVID-19 pandemic on the infertile couples who should have undergone IVF treatment has been significant. IVF centers should systematically offer these couples adequate psychological counseling to improve mental health.

The Role of Psychological Factors in the Outcome of In Vitro Fertilization in Women with Primary Infertility.

INTRODUCTION: Infertility is a multidimensional developmental crisis of the individual, couple, family and the population as a whole. This study concentrates on the psychological aspects of infertility treatment by in vitro fertilization (IVF). The aim of this study was to examine a connection between certain psychological factors - anxiety, depression, motivation for parenthood, styles of coping with stress - and the outcome of IVF. SUBJECTS AND METHODS: The study included 100 primarily infertile women aged 23-38 years, who underwent IVF procedure for the first time, at the Department of Gynaecology and Obstetrics of University Hospital Centre Zagreb. Regarding the outcome of IVF, they were divided into two groups, those with positive outcome (N=50), and those with negative outcome of IVF (N=50). We have applied: general data questionnaire, Parenthood motivation scale, COPE Inventory, and Depression, Anxiety, Stress Scales - 21. RESULTS: The dimension of motivation for parenthood Relationship and the styles of coping with stress Seeking emotional support, Planning and Active coping proved to be statistically significant predictors of IVF outcome. By increasing the results on the relationship, seeking emotional support and planning subscales, the likelihood of negative outcome was increased. By increasing the results on the active coping subscale, the likelihood of positive outcome was increased. Anxiety and depression symptoms did not prove to be statistically significant predictors of the IVF outcome. CONCLUSION: The role of psychological factors is important for understanding the diagnosis and treatment of infertility. They also provide the basis for creating guidelines for specific preventive and educational programs and for special forms of psychological counselling for individuals facing infertility.

Effectiveness of progressive muscle relaxation and laughter therapy on mental health and treatment outcomes in women undergoing in vitro fertilization: A randomized controlled trial.

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.