Why do infertile males use psychological couple counselling?

The purpose of the present study was to identify characteristics of male patients that could be relevant for the uptake of psychological couple counselling for infertility. Therefore, 94 male patients who participated in psychological couple counselling were compared to 134 unselected infertility patients who attended an andrological clinic. Counselling users showed higher scores for depression and anxiety as well as a higher number of impaired sperm parameters. Multivariate analysis revealed that beyond the level of depression the number of impaired sperm parameters delivered additional information about the probability of a patient using counselling. For interpretation of these results the former research was broadly reviewed. It is suggested that an increased level of distress, the feeling of being responsible for infertility and few marital difficulties are relevant for the usage of couple counselling by male infertility patients. Practical consequences are discussed.

Coping with infertility: distress and changes in sperm quality.

Infertility represents a serious stressor for some patients as well as a risk factor for a decrease in sperm quality. The purpose of the present study was to identify coping strategies that went along with both better emotional and physical adjustment to infertility. The sample consisted of 63 patients who contacted an andrological clinic more than one time. Prior to clinical examination, patients filled out a questionnaire referring to the way in which they coped with their wives' previous menstruation. Participants also completed a scale assessing perceived distress due to infertility. Change in sperm concentration since baseline semen analysis and the level of distress were used to evaluate patient's adjustment. The better-adjusted patients showed less prominent overall coping efforts, and a higher proportion of distancing coping strategies. An improvement in sperm quality also was associated with a low cognitive involvement in infertility. Situational uncontrollability of infertility could be a moderator of the effectiveness of coping employed by the better-adjusted patients. In addition, the coping behaviour related to better adjustment could be due to a dispositional stress resistance factor. For clinical implementation of the findings, the attitudes of a patient and the expectations of his wife have to be taken into consideration.

Individual prognosis for changes in sperm quality on the basis of perceived stress.

BACKGROUND: In this study we examined whether stress has a negative influence on sperm quality. To investigate this issue we developed a scale assessing perceived stress resulting from infertility. METHODS AND RESULTS: The Infertility Distress Scale was constructed based on the data of 158 infertility patients contacting an andrological clinic for the first time. The Infertility Distress Scale consists of items assessing self-reported stress, different appraisals of infertility and cognitive involvement in infertility. The scale was shown to have good psychometric properties. Changes in sperm quality were predicted by this scale for 69 patients. Changes in sperm concentration and sperm motility were predicted correctly 75.4 and 65.6% of the time, respectively. While these prediction accuracies were significantly better than chance prediction, the Infertility Distress Scale had no predictive value for changes in morphology. CONCLUSION: Results indicate that distress caused by infertility is a risk factor for a decrease in sperm quality.

[Markers of the social network as criteria in the follow-up of patients of a therapeutic community]. / Merkmale sozialer Netzwerke als Kriterien zur Nachuntersuchung von Patienten einer therapeutischen Gemeinschaft.

The characteristics of the social networks and of the post-therapeutic process of 47 patients of a therapeutic community were studied four years after release. Groups of successful and unsuccessful patients were defined by the subjective rating of the health status and by a personality inventory. Depending on the criterias of success, we found significant differences in the characteristics of the posttherapeutic process. To some extent the groups differed also in the quality of the social relationships, the number of confidants and in the size of those parts of the social networks, which were build up by the family of the patients.