ABSTRACT
BACKGROUND: Being infertile comes as an overwhelming realization for couples trying to conceive. In consideration of rising rates of infertility worldwide, clinicians in India have also begun exploring this field for new possibilities, development and research. The purpose of this study was to estimate the proportion and predictors of infertility specific stress in males diagnosed with primary infertility. METHODS: This cross-sectional research was conducted in an assisted reproduction center, Manipal, India, on 300 infertile married males. The tools were "semi-structured questionnaire" compiled by the authors, "ICD-10 Classification of Mental and Behavioural Disorders (Clinical Descriptions and Diagnostic Guidelines) and" Psychological Evaluation Test for infertility. Multiple logistic regression analysis was carried out on data with p-value fixed as 0.05. RESULTS: The presence of stress was reported in 72% of male participants. The predictors of stress were nature and severity of their infertility diagnosis, sperm defects, urological condition and experience of corrective surgery undergone for it. Psychological stress in men was also predicted by present and past history of significant psychiatric morbidity and coping difficulties associated with it. CONCLUSION: The stress is both a common experience and at times a clinical condition associated with deteriorating mental and physical health in men seeking fertility treatments. As a prerequisite, Indian fertility clinics need to treat stress as an identifiable condition and devise ways of addressing it at all stages of assisted conception and reproductive treatments.
ABSTRACT
BACKGROUND: According to the existing literature on infertility, stress appears to be inevitably associated with infertility diagnosis and treatment in sub-fertile individuals. The epidemiological data on the prevalence and predictors of infertility-specific stress in cultural specific scenario are scarce. The objective of the present study was to estimate the prevalence of infertility-specific stress and identify predictors of infertility-specific stress in women diagnosed with primary infertility. MATERIALS AND METHODS: This cross-sectional study was conducted on 300 infertile married women, diagnosed with primary infertility. The tools used for the assessment were "semi-structured questionnaire" compiled by the authors, "ICD-10 Classification of Mental and Behavioral Disorders (Clinical Descriptions and Diagnostic Guidelines)," and "Psychological Evaluation Test for infertility." STATISTICAL ANALYSIS: Data were analyzed using SPSS (version 15). Chi-square test was used for univariate analysis followed by multiple logistic regressions between stress and the predictor variables. RESULTS AND DISCUSSION: The prevalence of stress among women was 80%. Univariate analysis revealed that predictors of stress were years of marital life, duration of infertility, infertility type, history of gynecological surgery, cycles of ovulation induction with timed intercourse and intra-uterine inseminations, present and past psychiatric morbidity, coping difficulties, gynecological diagnosis, and severity of premenstrual dysphoria. Multivariate analysis showed leading associations of stress with infertility type and coping difficulties.
ABSTRACT
BACKGROUND: Oocyte retrieval in women with low ovarian reserve is challenging and often results in poor pregnancy outcomes. AIM: The aim was to compare outcomes of oocyte retrieval using three aspiration methods in women with normal and low antral follicle counts (AFCs). STUDY DESIGN: Retrospective cohort study. SETTING: Tertiary care hospital. MATERIALS AND METHODS: Data from 172 women who underwent in-vitro fertilization/intracytoplasmic sperm injection over 3 years was studied after dividing into three groups: Group A (96) - normal AFC (≥10), direct oocyte retrieval at 120 mmHg, Group B (41) - low AFC (<10), direct retrieval at 140-mmHg, Group C (35) - low AFC, follicular flushing, and aspiration at 120-mmHg. In each group, oocyte yield, embryo quality, and pregnancy out comes were assessed. RESULTS: The oocyte and embryo yield in Groups A and B were comparable (P > 0.05) but were significantly less in Group C (P < 0.05). The pregnancy rates in Groups A and B were similar (35.4%, 39%) but were significantly less (17.1%) in Group C (P < 0.05). The live birth rate was 76% in Group A, 69% in Group B, and 50% in Group C. The miscarriage rates in the three groups were 21%, 31%, and 50%, respectively. CONCLUSION: Direct oocyte retrieval with 140-mmHg showed significantly better oocyte yield and pregnancy outcomes compared to flushing and aspiration in women with low AFC.
