Complex factors related to marital and sexual satisfaction among couples undergoing infertility treatment: A cross-sectional study.

Objectives: This study assesses complex factors related to marital and sexual satisfaction among couples undergoing infertility treatment. Methods: This cross-sectional study was conducted with 140 couples who visited fertility centers in Iran, between September 2015 and July 2016. Data collection was done by Marital and Sexual Satisfaction Questionnaires and were analyzed by the IBM SPSS 26 software. Results: There was a significant difference between wives and husbands in the MSQ total scores (p = 0.027). However, there was no significant difference between wives and husbands in the SSQ total scores (p = 0.398). Sexual satisfaction and decision-maker in life among wives and husbands were significant predictors of MSQ. The kind of treatment, cause of infertility and BMI among wives and kinds of treatment, cause of infertility, and decision-maker among husbands were also significant predictors of SSQ. Conclusion: The findings of this study showed that there is a difference between the understanding of marital and sexual satisfaction in wives and their husbands. Healthcare providers need to pay more attention to these differences.

Investigation of social capital and its relationship with emotional adjustment in infertile couples: A cross-sectional study.

Background: Infertility is an abnormal event in the life of families and can have various consequences on a personal and social level. Therefore, infertile couples need to manage their emotional responses. Social capital, as one of the social determinants of health, can affect mental health. Objective: This study was conducted to determine the relationship between social capital and emotional adjustment in infertile couples. Materials and Methods: This cross-sectional study was conducted from October 2018 to February 2019 with 170 infertile couples visiting infertility centers in Sari, Iran. The data collection instruments included the social capital integrated questionnaire, an emotional adjustment scale and a demographic-reproductive checklist. Results: All the social capital dimensions, except for the groups and networks dimension, had a score of higher than 50 (more than the mean score). Based on ANCOVA and the multiple linear regression results, the dimension of trust and solidarity had a significant negative relationship with emotional adjustment (p = 0.01), but no significant relationship was observed between the other social capital dimensions and emotional adjustment. Conclusion: The trust and solidarity dimension had a significant relationship with emotional adjustment in infertile couples. Accordingly, increasing mutual trust between neighborhood residents can strengthen social capital, and in turn, improve emotional adjustment in infertile couples.

Relationship between coping/attachment styles and infertility-specific distress in Iranian infertile individuals: A cross-sectional study.

BACKGROUND: Infertility has been recognized as a stressful clinical condition, significantly affecting couples' emotional functioning. OBJECTIVE: To investigate the relationship between coping/attachment styles and infertility-specific distress (ISD) in infertile participants. MATERIALS AND METHODS: Atotal number of 240 infertile participants (120 women and 120 men) who attend the Outpatient Infertility Clinic in Sari, Iran between February and October 2017 were selected using the convenience sampling method. Data were collected using a questionnaire addressing sociodemographic variables. In addition, coping and attachment styles were evaluated via the Coping Strategies Questionnaire and the Revised Adult Attachment Scale by Collins and Read (1990); respectively. Ultimately, the Infertility Distress Scale was used to assess ISD. RESULTS: The mean ISD score was 42.53 ± 9.63. Secure and insecure attachment styles were observed in 37.9% and 62.1% of the cases, respectively. There was a significant difference among ISD and different groups of attachment styles (p = 0.001) and emotion-focused coping style (p = 0.021). However, no significant relationship was found between problem-focused coping style and ISD (p = 0.985). CONCLUSION: Considering the relationship between coping/attachment styles and ISD, it was recommended to implement stress prevention and coping education within the framework of coping/attachment theories for infertile individuals.

Effect of platelet-rich plasma on pregnancy outcomes in infertile women with recurrent implantation failure: a randomized controlled trial.

METHODS: This study was directed to assess the efficacy of autologous platelet-rich plasma (PRP) on pregnancy rate in recurrent implantation failure. Between 2016 and 2019, a total of 98 women who unsuccessful to be pregnant after three or more high-quality embryo transfers undergoing frozen-thawed embryo transfer with or without an intrauterine infusion of platelet-rich plasma. Thus, 0.5 ml of platelet-rich plasma at 4-6 times higher concentration than peripheral blood infused intrauterine 48 h before embryo transfer. A control group underwent standard protocol. RESULTS: There were no significant differences between the two groups in terms of age, body mass index and duration and cause of infertility and total transferred embryos and kind of treatment protocol, but secondary infertility and endometrial thickness 96 h before embryo transfer, was more in the intervention group. The clinical pregnancy (48.3% versus 23.26; p = .001) and ongoing pregnancy (46.7% versus 11.7%; p = .001) and implantation rate (58.3% versus 25%; p = .001) was more significant in the intervention group rather than controls. In conclusion, intrauterine infusion of platelet-rich plasma 48 h before freeze-thawed embryo transfer may have more effectiveness in in vitro fertilization (IVF) outcomes in recurrent implantation failure.

Age of Natural Menopause and Related Factors among the Tabari Cohort.

OBJECTIVES: The age of menopause is affected by several factors. In this study we aimed to identify the age of natural menopause and its related factors in a large-scale population-based cohort in Iran. METHODS: In this study, a subset of data collected during the enrollment phase of the Tabari cohort study was utilized. Reproductive history and other related data were collected using a structured questionnaire. Blood samples were obtained from all participants. Data were analyzed using chi-square test, independent t test, and ANOVA as well as a multivariate linear regression model. RESULTS: Among participants of the Tabari cohort, 2,753 were menopausal women. The mean age of natural and induced menopause was 49.2 ± 4.7 and 43.2 ± 6.4 years, respectively (P = 0.001). The number of pregnancies, duration of breastfeeding, level of education, residency, presence of thyroid disease, and body mass index affected the age of menopause. After adjustments for confounding variables, the number of pregnancies remained significantly associated with late menopause. CONCLUSIONS: The age of natural menopause in this study was similar to that in other studies, and the number of pregnancies was positively associated with the age of menopause after adjustments for confounding variables.

The efficacy of group counselling on perceived stress among infertile women undergoing in vitro fertilization treatment: An RCT.

BACKGROUND: One of the stressful and critical experiences that threat the individual, family, marital, and social stability is infertility. OBJECTIVE: To identify the effects of midwifery-led counselling programs on the perceived stress of the women undergoing assisted reproductive treatment. MATERIALS AND METHODS: In this randomized clinical trial, 50 infertile women who underwent in vitro fertilization treatment for the first time were enrolled in two groups. The intervention group received six sessions of group counselling by M.Sc. midwifery of counseling student and the control group received only the routine care. All participants filled Newton's standard questionnaire before and at the time of puncture, embryo transfer and the pregnancy test. RESULTS: The mean ± SD scores for the perceived infertility stress before the intervention in the control and the intervention groups were 167.92 ± 12.14 and 166.75 ± 13.27, respectively. The mean of perceived stress after intervention at the time of oocyte puncture in the control and case group were 177.12 ± 19.37 and 115.75 ± 13.88, at the time of embryo transfer were 179.40 ± 18.34 and 118.08 ± 15.37, and at the time of pregnancy test was 183.76 ± 14.97 and 120.50 ± 16.24, respectively. The perceived stress of infertility after intervention were statistically significant in the two group (p ≤ 0.001). CONCLUSION: Group counselling is one of the effective methods for reducing the perceived stress in the women undergoing assisted reproductive treatment.

Counseling-supportive interventions to decrease infertile women's perceived stress: A systematic review.

BACKGROUND: Infertility all around the world and in every culture is recognized as a stressful and critical experience that threatens individual, familial, marital, and social stability. Thus, in accordance with the importance of a woman's mental health and the possible impact of mental health on treatment outcome, finding a way to deal with perceived stress in women can help improve pregnancy outcomes. METHODS: This study is a systematic review on reducing perceived infertility stress in infertile women. The current study was undertaken using multiple databases such as SID, Irandoc, Magi ran, Google Scholar, PubMed, Science Direct, Scopus, Cochrane library, and CINAHL selected from articles pertinent to the study. The selection of papers was undertaken from 1990 through May 2016. The methodological quality was assessed. RESULTS: The initial search yielded a list of 725 papers, and then reviewers studied titles and abstracts. Thereafter, 68 papers were incorporated, and researchers reviewed summaries of all of the searched articles. Finally, the researchers utilized the data gained from 29 full articles so as to compile this review paper. Reviewing the studies conducted on reducing infertility perceived stress, the researchers classified related findings into two main categories: supportive and counseling intervention. CONCLUSION: Considering the fact that there is an international agreement that fertility centers need to offer counseling programs for psychological problems of the infertile, it is especially important to recognize counseling-supportive interventions for decreasing infertile women's perceived stress and to program plans for decreasing women's perceived stress. By investigating counseling-supportive stress, we hope that this study has stepped forward toward health care agent's familiarity with decreasing infertile women's perceived stress and, therefore, improving treatment consequences.

Knee Laxity Variations in the Menstrual Cycle in Female Athletes Referred to the Orthopedic Clinic.

BACKGROUND: Anterior cruciate ligament (ACL) rupture is the biggest concern for orthopedic surgeons who are involved in sports injuries, so most of ACL reconstruction surgeries are sports related. ACL injuries in female athletes are 2 - 8 times more common than male athletes in similar sport injuries. OBJECTIVES: The aim of this study was to compare knee laxity changes in the menstrual cycle in female athletes referred to the orthopedic clinic of Imam Khomeini hospital in the north of Iran, Sari, 2013. PATIENTS AND METHODS: The present descriptive study was conducted on 40 female athletes that were referred to the orthopedic clinic. Hormone levels, such as estrogen and progesterone were assessed by one laboratory in 3 phases of the menstrual cycle. We used Lachman test and anterior drawer test for knee laxity rate. The descriptive statistics were calculated as indices of central distribution of bonds (x ± SD) and relative frequency distribution was used for qualitative variables. RESULTS: The results of the current study showed that there is no significant difference in ACL laxity in female athletes in three phases of menstrual cycle; namely menstruation time, ovulation time and mid-luteal phase. CONCLUSIONS: Despite numerous studies and research in the field of knee laxity and effects of female hormones, many researchers do not agree about the effect of female hormones on knee laxity. The current study also reported no relationship between female hormones and knee laxity, while statistics show fundamental difference between male and female athletes.

Factors Associated With Marital Satisfaction in Infertile Couple: A Comprehensive Literature Review.

BACKGROUND: Many factors impact on marital satisfaction. Related factors include demographic factors, assisted reproductive techniques, psychological health, quality of life, psychological, socioeconomic and family support, and sexual function. METHODS: This study is a literature review of research studies conducted on factors associated with marital satisfaction in infertile couples. The current literature review search was undertaken using multiple databases selected from articles pertinent to the study. The selection of subjects was undertaken from1990 through 2015. The methodological quality was analyzed based on a checklist adopted from a systematic review. Quality assessment of full text studies was finally carried out by two reviewers. RESULTS: The initial search yielded a list of 445 papers, and then reviewers studied titles and abstracts. Thereafter, 69 papers were incorporated, and researchers reviewed summaries of all of the searched articles. Finally, the researchers utilized the data gained from 64 full articles so as to compile this review paper. Reviewing the studies conducted on marital satisfaction, they classified related findings into 6 categories: demographic factors, using fertility assisting methods, psychological health, life quality, economic, social, and family support, and sexual function. CONCLUSION: The results of this review article depicted that various factors play role in creating marriage life satisfaction in an infertile couple, so that paying attention to them can play an important role in continuing their treatment. Thus, to identify such factors is considered essential in their treatment protocol highly based on culture. Of the drawbacks of this research is that it has tried at best to employ the studies belonging to diverse countries with different cultures. Also, the number of the papers was considerably limited.

PP13 and PAPP-A in the First and Second Trimesters: Predictive Factors for Preeclampsia?

Background. Preeclampsia affects 5-6% of all pregnancies. Predictive factors of preeclampsia can be helpful in early diagnosis of this disease. In this study the predictive values of biochemical markers placenta protein 13 (PP13) and pregnancy-associated plasma protein A (PAPP-A) have been assessed in early diagnosis of preeclampsia. Methods. This case-control study was conducted on 1500 women who presented to a healthcare center of Sari, Iran, between 2010 and 2011. Blood samples were drawn in weeks 11-13 and 24-28 of pregnancy. Of them who developed preeclampsia were considered as case group. A control group consisted of similar women regarding mean age, body mass index (BMI), and pregnancy age. PAPP-A and PP13 serum levels were measured. Data were analyzed using proper statistical tests. Results. PAPP-A and PP13 serum levels were significantly lower in both the first and second trimesters in women who developed preeclampsia (P < 0.001). The cumulative value of all four variables with cut-off point of 238.5 has sensitivity, specificity of 91.0%, and undercurve surface of 0.968 which is the most diagnostic value for preeclampsia. Conclusion. It is possible to advantage measuring of PAPP-A and PP13 in the first and second trimesters especially their cumulative values in both trimesters for prediction of the incidence of preeclampsia.