Introducing a quantitative method to calculate the rate of primary infertility

In the previous studies, the rate of primary infertility was reported differently. It seems the main reasons are related to the different methods of data collection and information analysis. Therefore, introducing a precise method to determine the infertile couples and the population exposed to the risk of infertility is an important issue to study primary infertility. The proposed methodology for assessing primary infertility rate has been designed and applied by Avicenna Research Institute in a national survey. Sampling was conducted based on probability proportional to size cluster method. In this survey, after reviewing the former studies, the reproductive history was used as a basis for data collection. Every reproductive event was recorded with a code and a date in the questionnaire. To introduce a precise method, all possible events were considered thoroughly and for each situation, it was determined whether these cases should be considered in numerator, denominator or it should be eliminated from the study. Also in some situations where the correct diagnosis of infertility was not possible, a sensitivity analysis was recommended to see the variability of results under different scenarios. The proposed methodology can precisely define the infertile women and the population exposed to the risk of infertility. So, this method is more accurate than other available data collection strategies. To avoid bias and make a consistent methodology, using this method is recommended in future prevalence studies

[ relationship of religiosity, personality dimensions and self-efficacy with coping style of nurses practitioner students]

Job stress is very common among nurses. The study of coping styles and related factors can contribute to affective response to stress. The purpose of present study was to investigate the relationship of religiosity and personality dimension and self-efficacy with coping style of nurse's students. This is a descriptive in the context of the cross-sectional study, which was performed in 2009. The study sample includes 323 nurse students, witch selected with cluster sampling model. Practitioner students spent at least 10 hours in week to work in hospitals. Data were collected through Islamic Religiosity Scale, NEO Inventory, General Self-Efficacy Scale and Ways of Coping Questionnaire, and then analyzed with the help of correlation and stepwise regression analysis. Results of regression analysis show that between religiosity, personality dimensions and self-efficacy, religiosity has more portion in predict of problem-focus coping style in nurses students, and only neuroticism is able to predicting of emotional-focus coping style in nurses students. With regarding to results, can concluded that religious instructions to nurses students can help them to have effective coping with stressful situations in clinical work. Also, guidance and accompanying of instructors with practitioner students to experience all pleasant and unpleasant aspects of clinical work, has important role in effective coping with them

Evaluating stigma among infertile men and women in Iran

Psycho-social aspects of physical disability may create more problems for the individual than the disability itself. The infertile may suffer from misjudgments or prejudices in different situations by their colleagues and relatives. All factors for this suffering can be evaluated in stigma settings which the infertile confront. In addition to these pathological settings, there are some opportunities which infertile people can enjoy for more adaptations with their social environments. The objective of this study was to become familiarized with different aspects of psycho- social life of the in fertile in the setting of Iranian culture. 268 fertile and infertile subjects were involved in this study from two different regions of Iran. Through a considerable number of interviews with infertile individuals in the pilot study, the styles of social interaction with people and also positive and negative constructs related to their social lives were recognized. Utilizing a suitable instrument [Repertory grid] and factor analysis of scores, disability factors concerning social aspects of infertility were discovered. Moreover, regression analysis and t-test [p<.05] were used for the analysis of the data. The statistical analysis including t-test, factor and regression analyses indicated that social comparison, as one of the sources for self, has an imminent role in the prediction of psychosocial adjustment of infertile individuals. Meanwhile, the infertile women showed more negative views in the elements "comparison with fertile people" and "my view toward infertility" but both fertile and infertile subjects did not show any significant differences in psychosocial adjustments. From the three sources of self-knowledge, social comparison, social feedback and self-observation, social comparison plays the first role and social feedback the second in the construction of stigma among infertile people. The results of this study showed the necessity of a health-oriented approach in the evaluation of psycho-social aspects of physical disability among infertile people and also the necessity of modifying and equalizing the functions of the three sources of self-knowledge through group therapy sessions

necessity of a comprehensive study on abortion in Iran

Each year health and lives of millions of people are endangered by the termination of unwanted pregnancies. Unsafe induced abortions happen very often all over the world, especially in developing countries which many lead to death and disability of women in their fertility years. The highest incidence of unsafe induced abortions are reported from developing countries, especially those that impose tighter legal restrictions. These important problems which inflict women, need to be addressed by a comprehensive study on different aspects of abortion in such societies as Iran, which is confronting about 80,000 abortions each year. On of the objectives of this study was familiarization with the problem of abortion in the Iranian society where religious, legal and cultural prohibitions have lead to an increase in unsafe induced abortions. Other objectives of this study were to evaluate the causes of this increase, to assess the need for educative information on different aspects of unsafe abortions, to familiarize the legislative authorities with the present condition of the country and to make preparations for a change in views and also to cultivate the social grounds to reduce the increasing rate of such abortions. This study was based on literature and documentation reviews. Considering the young age of the Iranian population, changes in the views of Iraian women on the family size, late marriages, absence of parents at home in most of the day time, committing unsafe abortions due to the pressures exerted by restrictive legislations, endangering physical, sexual and psychosocial health of men and women and the increased treatment expenses and their effect on the health care budget, require great steps to be taken to make changes in legislative policies by applying WHO's views on the concept of health to hopefully witness a pronounced reduction in unsafe abortions. It seems that there are the possibilities to achieve legal solutions by considering the comprehensive aspects of abortion and taking divagate of the uncertainties and absence of a unified jurisprudential view on the time of soul inspiration and by relying on the robust law of [hardship], prescription of abortion in some instarces can come true

Embryo reduction in multiple pregnancies

By the means of assisted reproductive technologies [ART], such as in vitro fertilization [IVF] and intracyctoplasmic sperm injection techniques [ICSI], more than one million infants have been born throughout the world. One of the interesting happenings in infertility treatment procedures, that needs to be addressed, is the occurrence of multiple pregnancies which is usually seen following the use of ovary stimulating medications, embryo hatching and transference of a high number of embryos for higher success rates. For reducing the chances of this problem and preventing subsequent complications during pregnancy, embryo reduction is employed for two purposes: 1. Embryo reduction in triple or higher pregnancies, for the prevention of fetal and maternal complications and 2. Selective embryo reduction in cases where one or more fetuses have malformations or chromosomal defects. Embryo reduction methods: Dilatation of cervix and suction of one or more fetuses, via transvaginal route, by the help of sonography and trans-abdominally by the use of sonography. Although medical doctors might not be eager enough to know about embryo reduction in multiple pregnancies, but they have to know about the procedures and be prepared for medical interventions in emergencies, based on ethical and legal principles or on the request of patients. The first step, especially in infertility clinics, is reducing the chances or preventing the occurrence of these instances. Although selective reduction of embryos is ethically and legally accepted, but before any moves taken, offering infertility counseling is essential and it should include the expression of the risks of multiple pregnancies and ethical issues in embryo reduction before the transference of embryo [s] to the uterus, as lack of information on these subjects may lead to more problems afterwards. This study reviews the medical and ethical aspects of the issue and also introduces embryo reduction techniques in multiple pregnancies,in methods employing ovarian stimulating medications and in in vitro fertilization techniques. This method of embryo reduction, will reduce the risks of abortion, premature births, birth of malformed children and fetal demise, otherwise these would be the case if measures are not taken to correct the problem

Psychosocial aspects of infertility from viewpoint of infertility treating physicians

Infertility phenomenon extra to medical science territory has been studied in the fields of behavior and social sciences. Infertility as a psychological crisis, has a lot if stress on infertile couples and in different ways, has threatened their mental health. Considering high expenses of fertility in Iran with its socio-cultural aspects, especially for women, has propounded special importance for studying of infertility phenomenon from psychological-social aspects. This research, as preliminary study, has studied viewpoint of Iranian physicians and specialists involved on infertility which have beneficial experiences in regard if infertile couples, as one if most important and reliable resources for cultural-social studies of infertility. This study is a purposive research which by design of psychological-social primary problems in infertility, it investigate the recognition if role if psychological-social factors from view point of Iranian physicians and recognition rate of importance of psychological-social problems with these physicians. In this way infertile couples get more psychological-social supports and also in respect of economical it prevent expending unnecessary time and expenses or performing improper medical treatments and it can accompany the medical treatments with more effective results. After validity inspection of sandbi questionnaire [1997] in primary study, for studying psychological-social factors involved in infertility, questionnaire with 40 questions was prepared and was delivered to 120 physicians and specialist of different fields involved in infertility affairs [Obs and Gyn, Urology, Embryology, Infectious disease and General practitioner]. Findings of this descriptive research showed that infertile on the viewpoint of Iranian physicians of infertile community in Iran, which needs more attention. Also, from their point of view, infertile communities belong to families with low income and infertility treatments enforce high expenses to them. Most common emotional and psychological problems of infertile couples were despair, frustration, fear and anxiety. It is has been accompanied in less cases with rage and violence. These problems, with familial and social problems, such as suspension of marital relations and conflicts such as second marriage, separation and divorce are of important matters, which make the psychological consultation services very important and vital. Hopelessness and despair, fear and anxiety, are important psychological factor diseases. Women are more than men patent to psychological hams in this regard. In view point of physicians, stress and glumness in causing infertility, consultation and psychological treatment and awareness of details of diagnostic and remedial proceedings in treatment and improvement of infertility, has effective role and presence of psychiatrist and consultant seem to be necessary in different treatment and clinical infertility wards. In this way, necessary psychological interventions will be provided in all process of before, during and after treatments