Infertilidade feminina e conjugalidade: revisão integrativa da literatura / Female infertility and conjugality: integrative literature review / Infertilidad femenina y conjugalidad: revisión integrativa de la literatura

A infertilidade repercute como uma problemática em diferentes âmbitos. No tocante à esfera do casal, trata-se de uma situação que pode afetar ambos os cônjuges e opera na satisfação conjugal. Portanto, o objetivo do presente estudo foi conhecer de que modo a conjugalidade é afetada pela infertilidade feminina a partir da produção científica nacional e internacional. Trata-se de uma revisão integrativa da literatura científica indexada nas bases/bibliotecas PUBMED, PsycINFO e LILACS entre 2008 e 2018, nos idiomas português, espanhol e inglês, que recuperou 34 publicações, as quais foram submetidas à análise crítica. Trata-se de uma produção predominantemente internacional, de abordagem quantitativa. A pergunta norteadora que conduziu a presente revisão foi respondida, de modo que se constatou que a infertilidade transforma a relação conjugal, na maioria das vezes negativamente, o que não tem influência direta do fator feminino enquanto causa. Em contrapartida, a busca por tratamento se mostra como um aspecto de coesão entre o casal, que se fortalece ao buscar um objetivo comum. Por isto, faz-se necessário o desenvolvimento de ações que almejem a melhoria na qualidade de vida conjugal e sexual dos casais que estão passando pelo diagnóstico e tratamento para infertilidade.

Infertility has repercussions as a problem in different areas. Regarding the sphere of the couple, this is a situation that can affect both spouses and operates in marital satisfaction. Therefore, the objective of the present study was to know how the conjugality is affected by the female infertility from the national and international scientific production. It is an integrative review of the scientific literature indexed in the databases/libraries PUBMED, PsycINFO and LILACS published between 2008 and 2018, in the Portuguese, Spanish and English languages, which recovered 34 publications, which were submitted to critical analysis. It is a predominantly international production, with a quantitative approach. The guiding question that led to the present revision was answered, so that it was found that infertility transforms the conjugal relationship, most often negatively, which has no direct influence of the female factor as cause. In contrast, the search for treatment is shown as an aspect of cohesion between the couple, which strengthens itself in pursuit of a common goal. Therefore, it is necessary to develop actions that aim at improving the marital and sexual quality of life of couples who are undergoing diagnosis and treatment for infertility.

La infertilidad repercute como una problemática en diferentes ámbitos. En cuanto a la esfera de la pareja, se trata de una situación que puede afectar a ambos cónyuges y opera en la satisfacción conyugal. Por lo tanto, el objetivo del presente estudio fue conocer de qué modo la conyugalidad es afectada por la infertilidad femenina a partir de la producción científica nacional e internacional. Se trata de una revisión integradora de la literatura científica indexada en PubMed, PsycINFO y LILACS entre 2008 y 2018, en portugués, español e Inglés, que se recuperó 34 publicaciones, que se sometieron a un análisis crítico. Se trata de una producción predominantemente internacional, de abordaje cuantitativo. La pregunta orientadora que condujo la presente revisión fue respondida, de modo que se constató que la infertilidad transforma la relación conyugal, en la mayoría de las veces negativamente, lo que no tiene influencia directa del factor femenino en cuanto causa. En contrapartida, la búsqueda por tratamiento se muestra como un aspecto de cohesión entre la pareja, que se fortalece al buscar un objetivo común. Por eso, se hace necesario el desarrollo de acciones que anhelan la mejora en la calidad de vida conyugal y sexual de las parejas que están pasando por el diagnóstico y tratamiento para la infertilidad.

The effect of antidepressant treatment on the HPA axis, changes in depression score and serum levels of TNF-α in depressed infertile women

Abstract Objectives This study aimed to explore the effect of antidepressant treatment on the HPA axis, changes in depression score, and serum levels of TNF-α in depressed infertile women. Methods In this randomized controlled trial research, 60 infertile women who had undergone in vitro fertilization (IVF) treatment with depression scores between 16-47 were divided into two groups. The intervention group with fluoxetine capsule was under treatment for two months before the embryo transfer, while the control group was given placebo. Depression score, serum levels of tumor necrosis factor alpha (TNF-α) as well as cortisol hormone levels were measured and recorded both before and after the intervention. The data were analyzed using SPSS version 21 software. Results We analyzed the data related to 55 subjects who had undergone embryo transfer. 7 subjects in the intervention group and 3 in the control group got pregnant. We observed a significant decrease in the depression score (p < 0/001) and serum levels of cortisol (p = 0/001) in the intervention group. There was a significant increase in the serum levels of TNF-α in the intervention group (p < 0/001). There was a significant difference between the two groups in the number of pregnancies (p = 0.04). However, there was no statistical difference between them with regard to the number of harvested oocytes (p = 0.174). Discussion Decrease in depression score and cortisol level, and an increase in the levels of TNF-α in the intervention group caused any changes in the number of oocytes in comparison with the control group. However, the number of pregnancies was larger in the intervention group.

Repercussões psicossociais da infertilidade inexplicada em mulheres / Psychosocial repercussions of unexplained infertility in women / Repercusiones psicosociales de la infertilidad inexplicada en mujeres

O objetivo foi compreender as repercussões psicossociais da infertilidade inexplicada em mulheres. Trata-se de um estudo transversal descritivo com abordagem qualitativa e exploratória. O procedimento metodológico utilizado nesse estudo compreendeu a realização de entrevistas semiestruturadas com dez mulheres que não apresentavam problema biológicos que impedisse a gestação, mas sofriam com a infertilidade. A análise das entrevistas se baseou na perspectiva da Teoria Fundamentada nos Dados. Foram analisadas quatro categorias que emergiram na análise discursiva das entrevistas: sem problemas biológicos, sem diagnóstico; repercussões nas relações sociais; repercussões na relação conjugal; e o sonho realizado e providências futuras. As repercussões psicossociais associadas à infertilidade inexplicada podem trazer grande desorganização na vida pessoal, social e laboral das mulheres que estão enfrentando esse problema.(AU)

The aimed was understand the psychosocial repercussions of unexplained infertility in women. This is a cross-sectional descriptive study with a qualitative and exploratory approach. The methodological procedure used in this study included semi-structured interviews with ten women who did not present biological problems that prevented pregnancy but who suffered from infertility. The analysis of the interviews was based on the perspective of the Grounded Theory. We analyzed four categories that emerged in the discursive analysis of the interviews: no biological problems, no diagnosis; repercussions on social relations; repercussions on the conjugal relationship; and the dream come true and future action. The psychosocial repercussions associated with unexplained infertility can lead to great disorganization in the personal, social and work life of the women who are facing this problem. Keywords: female infertility; unexplained infertility; assisted reproductive techniques.(AU)

El objetivo fue comprender las repercusiones psicosociales de la infertilidad inexplicada en mujeres. Se trata de un estudio transversal descriptivo con enfoque cualitativo y exploratorio. El procedimiento metodológico utilizado en ese estudio comprendió la realización de entrevistas semiestructuradas con diez mujeres que no presentaban problema biológico que impidiera la gestación, pero sufrían con la infertilidad. El análisis de las entrevistas se basó en la perspectiva de la Teoría Fundamentada en los Datos. Se analizaron cuatro categorías que surgieron en el análisis discursivo de las entrevistas: sin problemas biológicos, sin diagnóstico; repercusiones en las relaciones sociales; repercusiones en la relación conyugal; y el sueño realizado y providencias futuras. Las repercusiones psicosociales asociadas a la infertilidad inexplicada pueden traer gran desorganización en la vida personal, social y laboral de las mujeres que están enfrentando este problema.(AU)

What do Infertile Women Think about Oocyte Reception, Oocyte Donation, and Child Adoption? / O que as mulheres inférteis pensam em relação a ovo recepção, doação de oócitos e adoção de crianças?

Abstract Purpose The views of infertile couples regarding oocyte donation by third parties and adoption are unknown, as these may be interpreted as a final closure of the available options for conception. This study aimed to determine the acceptance of oocyte donation, oocyte reception, and child adoption of infertile women who submitted to assisted reproductive technology (ART) treatment Methods Sixty-nine women who were under treatment for infertility and submitted to ART procedures were included in this cross-sectional study. They were evaluated using semi-structured questionnaires administered during ovulation induction in a treatment cycle. Marital status, religion, years of schooling, occupation, type of infertility, age, duration of infertility, number of previous ART cycles, mean oocyte number per cycle, and mean number of embryos per cycle had no influence on a woman's acceptance of oocyte donation or oocyte reception. Results More than 90% of the patients thought that the subject of "adoption" should be brought up during their ART treatments, although they preferred to discuss this topic with psychologists, not doctors. Women with occupations were more willing to consider adoption. Conclusion The opinions of these patients on these issues seem to be based on personal concepts and ethical, religious, and moral values. Women preferred to discuss adoption with psychologists rather than doctors.

Resumo Objetivo Não se sabe ao certo o que os casais inférteis acham sobre doação de óvulos por terceiros e adoção, condições estas que podem ser interpretadas como um encerramento definitivo das opções disponíveis para concepção. Este estudo teve como objetivo determinar a aceitação da doação de oócitos, ovo recepção e adoção de crianças por mulheres inférteis submetidas a tratamento de reprodução assistida (RA). Métodos Sessenta e nove mulheres em tratamento para infertilidade e submetidas a procedimentos de RA foram incluídas neste estudo transversal. Elas foram avaliadas por meio de questionários semiestruturados administrados durante a indução da ovulação em um ciclo de tratamento. Resultados O estado civil, religião, escolaridade, ocupação, tipo de infertilidade, idade, duração da infertilidade, número de ciclos de RA anteriores, o número médio de oócitos por ciclo e de embriões por ciclo médio não tiveram influência sobre a aceitação da doação ou da recepção de oócitos. Mais de 90% das mulheres acha que o tema "adoção" deve ser discutido durante o tratamento de RA, porém preferem discutir este tema com psicólogos, e não com médicos. As mulheres com ocupações foram mais predispostas a considerar a adoção. Conclusão As opiniões destas pacientes sobre estas questões parecem ser baseadas em conceitos pessoais e valores éticos, religiosos e morais. As mulheres preferiam discutir a adopção com psicólogos, em vez de médicos.

efficacy of well-being therapy for depression in infertile women

Background: Infertility is a major public health problem with physical, psychological and social dimensions. High prevalence of psychological problems has been reported in infertile women. The objective of this study was to examine the effectiveness of well-being therapy [WBT] for depression in infertile women who were referred to an infertility center in Mashhad, Iran

Materials and Methods: This preliminary trial was conducted at the Montasariya Infertility Center, Mashhad, Iran, between July and October 2011. A group of 22 infertile women were randomly assigned into experimental [n=11] and control groups [n=11]. Patients were assessed with two self-rating inventories including the Psychological Well-being [PWB] and the Depression, Anxiety and Stress Scale-21 [DASS-21] before and after the interventions and the waiting-list period. WBT was performed in 8 to 10 sessions according to the published protocol

Results: Analysis of covariance [ANCOVA] showed a significant difference regarding the depression scores of experimental group between pre- and post-treatment as compared to control subjects

Conclusion: The results suggested the feasibility and clinical advantages of adding WBT to repertoire of the treatment techniques for depression in infertile women

Psychometric properties of the fertility quality of life instrument in infertile Iranian women

Background: Infertility and its treatment can have a considerable effect on a person's quality of life [QoL]. The Fertility QoL [FertiQoL] questionnaire is currently the most frequently used instrument to measure QoL in people with fertility problems. This study aims to examine the reliability and validity of the FertiQoL in infertile Iranian women

Materials and Methods: This cross-sectional study included 155 women with fertility problems in a referral fertility clinic in Tehran, Iran from January to March 2014. A battery of instruments was used: FertiQoL, Satisfaction with Life Scale [SWLS], Hospital Anxiety and Depression Scale [HADS], and a demographic questionnaire. Construct validity of the scale was evaluated using confirmatory factor analysis [CFA]. We assessed internal consistency with Cronbach's alpha and convergent validity was examined by correlating the FertiQoL with SWLS and HADS

Results: The results of the CFA generally supported the four-factor model of Core FertiQoL and two-factor model of Treatment FertiQoL. Both FertiQoL modules and their subscales revealed acceptable internal consistency that ranged from 0.643 to 0.911. However, the FertiQoL might be improved if Q15 and T2 items were removed from the scale. These items had low loadings on the Relational and Environment factors which decreased their internal consistency. The FertiQoL and their subscales significantly correlated with both SWLS and HADS, which confirmed convergent validity

Conclusion: The Persian version of the FertiQoL is a valid, reliable instrument to measure QoL in infertile women and seems to perform as well as the original English Version

Significados de la experiencia vivida del proceso de embarazo y parto de una mujer con diagnóstico de infertilidad que logra concebir mediante técnicas de reproducción asistida / Meanings of lived experience of pregnancy and labor of a woman with infertility diagnosis who did conceive through assisted reproduction techniques

OBJETIVO: Develar la experiencia vivida del proceso de embarazo y parto de una mujer con diagnóstico de infertilidad que logra concebir mediante técnicas de reproducción asistida. MÉTODO: Se trata de un estudio de caso con diseño fenomenológico. Se seleccionó una mujer portadora del fenómeno en estudio que accedió a compartir su experiencia mediante una entrevista en profundidad. La pregunta que guió el estudio fue ¿Cómo se muestra la experiencia vivida del proceso de embarazo y parto de una mujer con diagnóstico de infertilidad que logra concebir mediante técnicas de reproducción asistida? El análisis fue realizado de acuerdo a Streubert(1). Los pasos a seguir fueron: obtener la descripción de la participante, separar los supuestos del investigador ("bracketing"), leer la transcripción hecha "verbatim", revelar esencias, comprender las unidades de significado, desarrollar las descripciones, devolver a la participante para su validación, revisar literatura relevante, y compartir los resultados con la comunidad de enfermería. RESULTADOS: Destacan unidades de significado sobre sufrimiento por el tratamiento y las múltiples pérdidas que enfrenta la entrevistada. Se contraponen felicidad y angustia durante el embarazo, y esperanza al lograr el objetivo de vida planteado con su pareja. Surge el fortalecimiento del vínculo con su esposo, y finalmente miedo ante el verse enfrentada a la maternidad. Como conclusión se permite comprender que las mujeres enfrentadas a TRA tienen necesidades de cuidado únicas, por lo que el rol de enfermería es fundamental, sobre todo de acompañamiento. Se debe seguir estudiando este fenómeno en mujeres chilenas, e involucrar la perspectiva del padre.

OBJECTIVE: Reveal the lived experience of pregnancy and delivery of a woman diagnosed with infertility who did conceive through assisted reproduction techniques. METHOD: This is a case study with a qualitative health research design of phenomenology. The participant was a woman who is carrier of the phenomenon understudy and that agreedto share her experience through an in-depth interview. The study base question was ¿How the pregnancy and delivery process lived experience of a woman with infertility diagnosis who did conceive through assisted reproduction techniques is shown?. According to Streubert(1),the phenomenological analysis process steps are: to obtain the participant's description, to separate the assumptions of the researcher ("bracketing"), to read the transcript made "verbatim". Reveal essences, understand the units of meaning, develop the descriptions, return the participant for validation, review relevant literature, and share the results with the nursing community. RESULTS: There are significant units of meaning of suffering due to the treatment and the multiple losses that the interviewee faces. There is also the contrast between happiness and anguish in the course of pregnancy, and hope for having achieved the goal of life raised with her partner. The strengthening of the bond with her husband arises, and finally fears of being confronted with motherhood. As a conclusion, it is possible to understand that women facing ART have unique care needs, so the role of nursing is fundamental, especially accompaniment. This phenomenon should continue to be studied in Chilean women, and involve the perspective of the father.

Diagnósticos de enfermagem dos domínios autopercepção e enfrentamento/tolerância ao estresse relacionados à infertilidade feminina / Nursing diagnoses of the domains self-perception and coping/tolerance of stress related to female infertility

Objetivou-se caracterizar o perfil de diagnósticos de enfermagem dos domínios Autopercepção e Enfrentamento/Tolerância ao estresse apresentados por mulheres com queixa de infertilidade. Estudo descritivo, quantitativo, realizado com 40 mulheres, em uma unidade de assistência primária à saúde. Dados foram coletados por meio de formulário de entrevista elaborado para esta pesquisa. Identificou-se 20 diagnósticos. Disposição para poder melhorado, Disposição para enfrentamento melhorado, Disposição para resiliência melhorada, Ansiedade e Baixa autoestima situacional apresentaram maior frequência. Os achados revelaram que a infertilidade pode gerar ansiedade e afetar negativamente a autopercepção da mulher. Entretanto, esta clientela demonstrou disposição para otimizar seu nível de bem-estar. A identificação de diagnósticos contribui para o planejamento do cuidado e enriquece a qualidade do atendimento, possibilitando o preparo destas mulheres para a conquista ou não da maternidade, por meio de intervenções de enfermagem individualizadas, incluindo apoio emocional e psicossocial de acordo com a necessidade de cada uma

The objective was to characterize the profile of nursing diagnoses of the domains Self-perception and Coping/Tolerance of stress of women with infertility complaints. A descriptive, quantitative study conducted with 40 women, in a primary health care unit. Data was collected with an interview form created for this study. We identified 20 diagnoses. Improved readiness for power, Improved readiness for coping, Improved readiness for resilience, Anxiety and, Low situational self-esteem presented were more frequent. The findings revealed that infertility can generate anxiety and negatively affect women's self-perception. However, this clientele demonstrated readiness to optimize their wellbeing. Identification of diagnoses contributes with care planning and enriches the quality of assistance, allowing women to be prepared for achieving maternity or not, through individualized nursing interventions, including emotional and psychosocial support according to the need of each one of them.

O impacto da infertilidade: narrativas de mulheres com sucessivas negativas pelo tratamento de reprodução assistida / The impact of infertility: women's narratives with negative successive by assisted reproduction treatment

Objetivos: Descrever os impactos psicossociais da infertilidade em mulheres que tentam engravidar sem sucesso por meio da reprodução assistida. Métodos: Estudo observacional descritivo com abordagem qualitativa e exploratória. Os prontuários foram obtidos por meio de uma clínica de reprodução assistida em Goiânia-GO. Foram feitas quatro entrevistas com mulheres que se enquadraram nos critérios de inclusão e exclusão, por meio da técnica de entrevista semiestruturada. Resultados: Foram analisadas quatro categorias consideradas chave: diagnóstico e início do tratamento; falta de um apoio social; sentimento de fracasso; e perspectivas. A infertilidade gera uma série de sentimentos, como angústia, depressão, culpa, medo, exclusão social. Além disso, diminui a qualidade de vida e afeta diretamente na relação das mulheres com seus parceiros, parentes e ambiente de trabalho. Porém, apesar das frustrac¸ões o sentimento que prevaleceu é o de seguir tentando. Conclusões: O sofrimento psicossocial das mulheres frente aos sucessivos resultados negativos necessita ser mais bem abordado no âmbito das clínicas especializadas, para oferecer apoio psicossocial precoce para o enfrentamento das possíveis frustrações com os resultados negativos.(AU)

Objectives: Describe the psychosocial impact of infertility in women trying to conceive without success through assisted reproduction. Methods: This is a descriptive observational study with qualitative and exploratory approach. The records were obtained through assisted reproduction clinic in Goiânia-GO. Four interviews with women were conducted to meet the criteria for inclusion and exclusion, through semi-structured interview technique. Results: Four categories were analyzed considered key: diagnosis and initiation oftreatment; lack of social support, feelings of failure and future prospects. Infertility generates a series of feelings such as anxiety, depression, guilt, fear, social exclusion; decrease quality of life and directly affect the women's relationship with their partners, family and work environment. However, despite the frustrations the feeling that prevailed is trying to follow. Conclusions: The psychosocial suffering of women facing the successive negative results need to be better addressed in the context of specialized clinics providing early psychosocial support to cope with possible frustrations with negative results.(AU)

Psychosocial Problems and Coping Strategies among Turkish Women with Infertility

PURPOSE: The aim of our study was to determine the factors affecting the psychosocial problems of infertile Turkish women and to identify their coping strategies. METHODS: This study employed a descriptive qualitative approach. We conducted in-depth interviews to examine the psychosocial problems faced by infertile Turkish women. The participants were selected in two stages. In the first stage, 118 women diagnosed with primary infertility completed a personal information form and the Fertility Problem Inventory (FPI). In the second stage, in-depth interviews (lasting 45-90 minutes) were conducted with 24 (age 20 to 41 years) infertile women randomly selected from the groups formed according to their FPI global stress levels determined in Stage 1. Content analysis was used to examine the qualitative data. RESULTS: The results comprised nine main themes regarding the psychosocial problems encountered by women and the methods used to overcome these problems. These included the meaning attributed to being childless, negative self-concept, perceived social pressure, perceived social support, psychological symptoms, social withdrawal and isolation, spiritual coping, cherishing hope/restructuring life, and adopting traditional methods. Social pressure and stigma were common. Infertility was found to negatively affect the participants' self-perception and view of life. The women used spiritual methods for overcoming stress and avoiding society, as well as traditional fertility remedies. CONCLUSIONS: Infertile women suffer from various psychosocial problems because of infertility and they adopt emotion-focused coping methods.

O desejo de ser mãe e a barreira da infertilidade: uma compreensão fenomenologica / The desire to be mother and the barrier of infertility: a phenomenological understanding / El deseo de ser madre y la barrera de la infertilidad: una comprensión fenomenológica

Abalando o projeto parental de muitos casais, a infertilidade afeta distintas dimensões da vida do sujeito. Tal situação é mais peculiar à mulher, por não corresponder às expectativas de um mundo predominantemente fértil. O presente estudo buscou compreender de que forma a infertilidade afeta a vida e a autoimagem feminina de mulheres com problema de infertilidade que passaram por um tratamento de fertilização in vitro, procurando identificar os significados que elas atribuem à maternidade e à feminilidade. A fenomenologia heideggeriana foi adotada como suporte teórico e metodológico. Por meio de narrativas, foi realizada uma escuta fenomenológica de quatro mulheres em momentos existenciais distintos do tratamento de fertilização in vitro. Pode-se perceber que, ao mesmo tempo em que gera grandes esperanças, possibilitando a conquista da desejada gravidez, o tratamento mobiliza fortes reações emocionais...

Shaking the parental project of many couples, infertility affects several dimensions of the subject life. This situation is more peculiar to women, for not coresponde the expectations of a world predominantly fertile. This study sought to understand how infertility affects the life and female self-image of women with infertility problem which went through a treatment of in vitro fertilization, seeking to identify the meanings they attach to maternity and femininity. The heideggeriana phenomenology was adopted as theoretical and methodological support for this study. Through semi-structured interview, was done a phenomenological listening of four women who were at different existential moments in relation to cycle of in vitro fertilization treatment. It's possible to realize that at the same time it creates great expectations, making possible the achievement of desired pregnancy, the treatment mobilizes strong emotional reactions...

Dificultando el proyecto parental de muchas parejas, la infertilidad genera efectos en distintas dimensiones de la vida del sujeto. Tal situación es más ínsita a la mujer, por no corresponder a las expectativas de un mundo predominantemente fecundo. El presente estudio ha buscado comprender de qué forma la infertilidad afecta la vida y la imagen que las mujeres tienen de sí propias, cuando sufren problemas de infertilidad y deciden someterse a un procedimiento de fecundación in vitro. Particularmente, tratamos de identificar los significados que ellas atribuyen a la maternidad y a la feminidad. La fenomenología heideggeriana fue adoptada como suporte teórico y metodológico. Por medio de narraciones, fue realizada una "escucha" fenomenológica de cuatro mujeres en diferentes momentos existenciales del procedimiento de fecundación in vitro. Puede ser percibido que, al mismo tiempo en que son generadas grandes esperanzas, posibilitando la conquista del muy deseado embarazo, el tratamiento moviliza fuertes reacciones emocionales...

La construcción narrativa de la infertilidad. Mujeres que narran la experiencia de no poder concebir / A construção narrativa da infertilidade. Mulheres que narram a experiência de não poder conceber / The narrative construction of infertility. Women who tell the experience of not being able to conceive

Este artículo explora el rol de la narración en el proceso de negociación con la infertilidad, entendida como un quiebre en el curso vital proyectado, y forma parte de una investigación mayor en la que se indagó en Argentina el recurso a la reproducción asistida como respuesta a la infertilidad entre dos grupos de mujeres con dificultades reproductivas (electoras y no electoras de tratamientos procreativos). Recurriendo a una metodología cualitativa exploratoria, el análisis muestra que la narración es central para amortiguar el carácter "inesperado" de la infertilidad, reinscribir a la mujer dentro de los parámetros hegemónicos del género femenino, tramitar los sentimientos de injusticia y negociar una nueva posición frente al entorno. Al mostrar el importante rol de la narración en la construcción social de la infertilidad, este artículo busca realizar un aporte a un terreno escasamente explorado en Argentina...

Este artigo aborda o papel da narração no processo de negociação com a infertilidade, entendida como uma ruptura no curso vital projetado, e faz parte de uma investigação maior em que se indagou na Argentina sobre o recurso à reprodução assistida como resposta à infertilidade entre dois grupos de mulheres com dificuldades reprodutivas (eleitoras e não eleitoras de tratamentos procriativos). Recorrendo a uma metodologia qualitativa exploratória, a análise mostra que a narração é central para amortecer o caráter "inesperado" da infertilidade, reinscrever a mulher nos parâmetros hegemônicos do gênero feminino, tramitar os sentimentos de injustiça e negociar uma nova posição em face do entorno. Ao mostrar o importante papel da narração na construção social da infertilidade, este artigo procura trazer uma contribuição a um terreno escassamente explorado na Argentina...

As part of a wider project exploring the use of assisted reproductive technologies as an answer to infertility among two groups of women in Argentina (users and not users of reproductive medicine), the paper examines the role of narratives during the process of negotiation with infertility, understood as a major break with the projected life course. Making use of explorative qualitative methodologies, the analysis shows that narratives are central to the task of buffering the unforeseen character of infertility: reinserting the narrating women within the mainstream parameters of gender; managing feelings of unfairness; and negotiating a new position before significant others. By showing the important role of narratives in the social construction of infertility, this article makes a contribution to a field scarcely explored in Argentina...

O que influencia doação de óvulos quando não há compensação financeira? / What influences oocyte donation when there is no financial compensation?

Aim: To evaluate the influence of factors such as age, education level and previous treatment for infertility in the decision to donate or receive eggs. Methods: Patients visting our service for the first time answered the question: “Would you donate or receive eggs?”. We assessed whether the inclination to donate or receive was related to age, level of education and the previous unsuccessful treatment for infertility.Results: 313 patients were included and most (56.9%) said they would donate eggs while only 34.5% would receive a donation. When giving and receiving were evaluated jointly we observed a positive correlation between them (Pearson correlation: r = 0.537, p < 0.01). Patients that underwent previous treatments for infertility were significantly more prone to egg donation (63.4% yes vs. 36.6% no, p < 0.05 vs no previous treatment group), but not toreceive (41.8% yes vs. 58, 2% no). In high and low levels of education most patients were in favor of donation (55.4% and 61.3%, respectively), but against the idea of receiving (33.9%and 37.5%, respectively). There was no significant differences between groups. The age of the patients (< 35 years old or > 35 years old) did not influence the will do donate (58.2% and56.4% respectively) or receive eggs (36.9% and 33.0%, respectively).Conclusions: Our results help understand the factors that may influence the decision to participate in an egg-sharing scheme. We could speculate that patients who have previously undergone unsuccessful treatments are more open to egg-sharing, despite their age or educational background. It would also be relevant to investigate the psychosocial reasons that make couples more willing to donate eggs than receiving.

Objetivo: Avaliar a influência da idade, grau de escolaridade e tratamento anterior na decisão de doar ou receber óvulos. Pacientes e métodos: Mulheres atendidas em nosso serviço responderam à pergunta: “Vocêdoaria ou receberia óvulos?”. Avaliou-se a concordância de aceitação de ovodoação ou ovorecepção com a idade, o grau de escolaridade e tratamento anterior para infertilidade. Resultados: Foram incluídas 313 pacientes e a maioria (56,9%) respondeu que doaria óvulos enquanto apenas 34,5% receberiam. Houve correlação positiva entre doação e recepção (r = 0,537, p < 0,01). Pacientes submetidas a tratamento anterior de infertilidade se mostraram significativamente mais propensas à doação (63,4% sim vs 36,6% não, p < 0.05 vs sem tratamento anterior), mas não a receber (41,8% sim vs 58,2% não). Em níveis altos e baixos de escolaridade a maioria dos pacientes se mostrou a favor da doação (55,4% e 61,3%, respectivamente), mas contra a ideia de receber (37,5% e 33,9%, respectivamente), não houvediferenças significativas entre os grupos. A maioria das pacientes com menos ou mais de 35 anos de idade doaria (58,2% e 56,4%, respectivamente), mas não receberia (36,9% e 33,0%, respectivamente).Conclusões: Nossos resultados são relevantes para entender os fatores que podem influenciar na decisão de participar em um esquema de partilha de óvulos. Poderíamos especular que pacientes previamente submetidas a tratamentos mal sucedidos são mais aberta à ovodoação, apesar de sua idade ou formação educacional.

effect of marital violence on infertility distress among a sample of Turkish women

The aim of this study was to determine the relationship between marital violence and distress level among women with a diagnosis of infertility. This cross-sectional study consisted of 139 married women diagnosed as primary infertile who applied to an in vitro fertilization [IVF] center in Turkey, between September and December 2009. A descriptive information questionnaire developed by the researcher was used for data collection. In addition, an infertility distress scale [IDS] for determining the severity effect of infertility and the scale for marital violence against women [SDVW] for determining level of marital violence against the women were used. The total IDS score of the study sample was 37.76 +/- 10.53. There was no significant relationship between the age and education level of the women and the total IDS score. The total IDS score was higher in women who did not work and those being treated for infertility for more than three years. The total SDVW score of the study sample was 67.0 +/- 8.26. The total SDVW score was higher in women who had been trying to have a child for more than six years and had received infertility treatment for longer than three years. The employment status of the women and physical, emotional, and sexual violence scores had a statistically significant relationship with the IDS scores. The emotional violence score was found to have the highest significance among the variables affecting total IDS score. Marital violence is a factor increasing the distress of infertile women. Healthcare staff serving infertile couples should consider the possibility of domestic violence against women as a factor affecting the psychological infertility distress level

Frequency of depression among fertile and infertile women

To compare the frequency of depression among fertile and infertile women reporting in CMH Abbottabad. A case control study. This study was conducted in combined military hospital abbottabad, over a period of six months from January 2013 to June 2013. The inclusion criteria were all those patients who were married. All the cases were selected from the women reporting in the obstetrics and gynecology department of CMH Abbottabad for investigation and treatment of infertility. A total of 200 patients, 100 fertile and 100 infertile women were included. Patients were given questionnaire form with their consent for research. Beck depression inventory [BDI] was used to assess depression among fertile and infertile women. Other factors such as age, education level, and duration of infertility, pressure from family members, miscarriages, and support from husband were studied. Depression was significantly higher in infertile women as compared to fertile women i.e. 95% vs. 63% [p<0.001]. It was higher among women with more than 1 year of duration of marriage as compared to those with infertility of one year duration or less. Infertility is associated with depression

Effect of a Mind-Body Therapeutic Program for Infertile Women Repeating In Vitro Fertilization Treatment on Uncertainty, Anxiety, and Implantation Rate

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.

Mental health status of infertile couples based on treatment outcome

Infertility is accompanied by numerous psychological and social problems. Infertile couples are more anxious and emotionally distressed than other fertile people. Previous studies suggested that infertility is more stressful for women than men. The purpose of this study was to determine the status of general health of infertile couples. This cross-sectional study evaluated general health of 150 infertile couples attending to Yazd Research and Clinical Center for Infertility that were selected consequently. The data were gathered by the researchers, based on face to face interview before and after three months of treatment by two questionnaires. The first questionnaire had questions on demographic information and the second one was the General Health Questionnaire-28 [GHQ-28]. This questionnaire has four sub- scales areas. All data were transferred directly to SPSS 15 and analyzed. The mean age of women was 28.3 and men were 32.4 years. The scores for all sub- scales of GHQ in women were more than men. There was significant difference between age and general health at physical symptoms scales [p=0.002], anxiety and sleep disorders [p=0.003]. The age group 25-29 years had higher scores [more than 7] than other age groups. There was significant difference between the scale of social dysfunction and results of treatment. Our results, similar to the previous studies have revealed negative social and mental effects of infertility on women is more than men, so there is need that they be educated specially

A Structural Model for Quality of Life of Infertile Women

PURPOSE: The purpose of this study was to test a model for quality of life among infertile women. This model was based primarily on the concept of the Fertility Quality of Life by Boivin et al. (2011) and the Infertility Resilience Model by Rindenour (2009). METHODS: Fifteen measurable variables were used to estimate quality of life. They included endogenous variables such as fertility quality of life and resilience, and exogenous variables such as infertility related stress, depression, marital adjustment, and family support. Data sets (n=203) used for analysis were collected in a general hospital which had, on average, 400 assisted reproductive technologies per month. RESULTS: The assessment of the modified model indicated acceptable fit, with chi2/d.f=2.07, GFI=.90, AGFI=.89, NFI=.89, CFI=.91, RMSEA=.07. Depression, infertility related stress, marital adjustment, resilience, and family support had direct influences on quality of life. CONCLUSION: The results of this study should contribute to the development of nursing intervention programs to enhance quality of life using factors that affect fertiQol (fertility quality of life) of infertile women.

Knowledge and attitudes toward child adoption and fostering among infertile women in northern Nigeria

Background: Infertility is a public health problem in the developing countries. However, the role of child adoption or fostering in the management of infertile couples is underexplored, particularly in northern Nigeria. Materials and Methods: A cross-sectional study involving the use of a structured interview questionnaire was employed to collect information from clients attending the infertility clinic of Aminu Kano University Teaching Hospital (AKTH), Kano. The data were analyzed using MINITAB® 12.21 software. Percentages and means were used to describe categorical and quantitative variables, respectively. The chi-square test was used to assess the significance of associations using a confidence interval of 95%. Results: Majority of the respondents (69.7%) were between 25 and 34 years of age, and of Hausa/Fulani ethnic group (79.6%). Knowledge of child adoption was good in 59.2% of the respondents, while the willingness to adopt versus foster was 28.2% and 44.4%, respectively. Conclusion: There is a need to advocate for infertility counseling services, so as to support infertile clients in taking informed decisions regarding child adoption or fostering as viable options for having their own families

Calabash pregnancy: a malingering response to infertility complicated by domestic violence / Embarazo de calabaza: una respuesta de fingimiento a la infertilidad complicada con violencia doméstica

This is a case report of a 20-year old para 0+0 who presented with an 11-month pregnancy. On evaluation, the pregnancy was found to be a fake made-up 'calabash pregnancy There were no pregnancy symptoms and she had just menstruated three weeks prior to presentation. This was a deliberate event in response to delayed pregnancy attainment complicated by domestic violence. Domestic violence was in the form of verbal and physical abuse and later was on a monthly basis precipitated by onset of her menstrual flow. The patient's age, monogamous union and the fact that she is an orphan made her vulnerable to domestic violence.

Éste es un reporte de caso de una para 0 + 0 de 20 anos de edad, que se presentó con un embarazo de 11 meses. En la evaluación, se encontró que se trataba de un embarazo de calabaza, es decir, inventado, fingido. En realidad, no había ningún síntoma de embarazo, y había tenido la menstruación tres semanas antes de presentarse. Se trataba de un acontecimiento deliberadamente construido, en respuesta a una largamente demorada expectativa de lograr un embarazo, complicada con violencia doméstica. La violencia doméstica seproducía enforma de abuso verbalyfísico, precipitándose luego mensualmente con la aparición de cadaflujo menstrual. La edad de los pacientes, la unión monógama, y el hecho de que era huérfana, la hacía vulnerable a la violencia doméstica.