HUBUNGAN RESILIENSI DENGAN INFERTILITY-RELATED STRESS PADA WANITA

Tujuan penelitian ini adalah untuk melihat hubungan antara resiliensi dengan infertility-related stress. Resiliensi adalah kualitas diri individu untuk bangkit atau bertahan dalam situasi sulit, sedangkan infertility-related stress atau stres infertilitas adalah stres yang muncul sebagai akibat dari infertilitas yang dialami. Tipe penelitian ini adalah kuantitatif dengan metode uji korelasional. Partisipan dalam penelitian ini adalah wanita yang mengalami infertilitas dan bertempat tinggal di Bali (n = 119) yang diperoleh dengan menggunakan teknik purposive sampling. Instrumen yang digunakan untuk mengukur variabel resiliensi adalah Connor-Davidson Resilience Scale (CD-RISC), sedangkan untuk mengukur variabel infertility-related stress menggunakan Copenhagen Multi Central Psychosocial Infertility-Fertility Problem Stress Scale (COMPI-FPSS). Kedua alat ukur tersebut telah diadaptasi ke dalam Bahasa Indonesia, masing-masing memiliki nilai reliabilitas sebesar .923 untuk CD-RISC dan .938 untuk COMPI-FPSS. Hasil dalam penelitian ini adalah terdapat hubungan antara resiliensi dengan infertility-related stress dengan nilai signifikansi .012 (p < .05) dengan koefisien korelasi menunjukkan arah hubungan negatif dan kekuatan hubungan yang lemah (-.229). Hasil tersebut memiliki arti bahwa makin tinggi tingkat resiliensi yang dimiliki, maka makin rendah tingkat stres infertilitas yang dirasakan dan begitu pula sebaliknya.

Διαχείριση stress και υπογονιμότητα

Η τυχαιοποιημένη, κλινική δοκιμή διεξήχθη στην Ιδιωτική Κλινική «Γένεσις Αθηνών», Ιατρική Μέριμνα Γυναικολογία και Χειρουργική Ανώνυμη Εταιρεία. Στόχος της μελέτης ήταν η συγκριτική ανάλυση δεδομένων σχετικών με το στρες γυναικών κατά τη διαδικασία εξωσωματικής γονιμοποίησης, προ και μετά παρέμβασης 8 συνεδριών για τη διαχείριση του στρες καθώς και ο συσχετισμός της διακύμανσης του στρες με την επιτυχία έκβασης της θεραπείας αναπαραγωγής. Στη μελέτη συμμετείχαν 74 γυναίκες ως ομάδα παρέμβασης και 70 γυναίκες ως ομάδα ελέγχου. Αρχικά, καταγράφηκαν κοινωνικο-δημογραφικά δεδομένα και το ιστορικό υγείας όλων των συμμετεχουσών και των συντρόφων τους. Ακολούθησε σειρά 8 εβδομαδιαίων συνεδριών διαχείρισης στρες στις οποίες συμμετείχε μόνο η ομάδα παρέμβασης. Κατά την 1η και 8η συνεδρία και οι δύο ομάδες συμπλήρωσαν ψυχομετρικά ερωτηματολόγια για τη συλλογή αρχικών και τελικών δεδομένων βάσει κλιμάκων μέτρησης κατάθλιψης, άγχους, στρες (Depression, Anxiety and Stress Scale-21 - DASS-21), αντιλαμβανόμενου στρες (Perceived Stress Scale 14 - PSS-14) και μέτρησης του στρες υπογονιμότητας (Fertility Problem Inventory - FPI). Μετά τη λήξη της παρέμβασης, καταγράφηκε η έκβαση της εξωσωματικής γονιμοποίησης όλων των συμμετεχουσών. Διεξάχθηκε στατιστική ανάλυση αναλογιών αρχικών και τελικών δεδομένων, ποσοτικών μεταβλητών και των σχέσεών τους και ανάλυση διασποράς επαναλαμβανόμενων μετρήσεων, ενώ η στατιστική σημαντικότητα ορίστηκε για p<0,05. Τα αποτελέσματα που καταγράφηκαν ήταν ότι η ομάδα παρέμβασης παρουσίασε σημαντική μείωση στρες (p<0,001) σύμφωνα με τις μετρήσεις όλων των παραμέτρων βάσει κλιμάκων PSS-14, DASS-21 και FPI με εξαίρεση την παράμετρο ανάγκης για γονεϊκότητα στην κλίμακα FPI για την οποία δεν καταγράφηκε σημαντική μεταβολή (p=0,002). H ομάδα ελέγχου παρουσίασε σημαντική αύξηση σε όλες τις[135]παραμέτρους και των τριών κλιμάκων (p<0,001). Η διαφορά επιπέδων στρες μεταξύ των δύο ομάδων, ανά κλίμακα και συνολικά, αξιολογήθηκε επίσης ως σημαντική ενώ δεν εντοπίστηκαν στατιστικά σημαντικές διαφορές αναφορικά με τα κοινωνικο- δημογραφικά και τα στοιχεία ιστορικού υγείας των συμμετεχουσών των ομάδων παρέμβασης και ελέγχου (p>0,05) για όλες τις παραμέτρους. Αναφορικά με την επιτυχία έκβασης της εξωσωματικής γονιμοποίησης, βρέθηκε ότι συσχετίζεται με το αντιλαμβανόμενο στρες βάσει κλίμακας PSS-14 (p=0,029) άλλα όχι με τα ψυχομετρικά δεδομένα των κλιμάκων DASS-21(p=0,197) και FPI (p=0,611). Καθοριστικό ρόλο στην έκβαση έπαιξαν οι ανεξάρτητες μεταβλητές που αφορούσαν στην ηλικία των συμμετεχουσών (p=0,046), η αύξηση της οποίας ήταν αντιστρόφως ανάλογη του ποσοστού επιτυχούς έκβασης και στο ιστορικό κρυψορχίας των συντρόφων τους (p=0,05), γεγονός που επηρέασε την αξιολόγηση της επίδρασης της παρέμβασης. Η μελέτη αποτελεί πιλοτική έρευνα με ενθαρρυντικά αποτελέσματα για την ωφέλεια παρεμβάσεων ψυχικής υποστήριξης γυναικών υπό θεραπεία υποβοηθούμενης αναπαραγωγής ενώ ο συσχετισμός διαχείρισης στρες ως προς την επιτυχία έκβασης της θεραπείας απαιτεί περαιτέρω διερεύνηση.

Spermatocele Mimicking Hydrocele: A Case Report in a Young Patient of 42 Years Old

A spermatocele is a cyst-like mass that usually forms on the epididymis; they are benign cystic accumulations of sperm. Depending on their size, they can mimic a hydrocele clinically and radiologically. We report the case of a giant spermatocele in a 42-year-old married. The patient had fathered two children with no fertility problem. This spermatocele gradually increases in volume for 4 years and requires surgical management in front of the scrotal pain and functional gene presented by the patient. Through this case, we present the diagnostic difficulty, the therapeutic approach through a literature review on the subject.

Impact of COVID-19 Pandemic on COMPI Fertility Problem Stress Scale and the State-Trait Anxiety Scale in Patients Undergoing IVF/ICSI

OBJECTIVE: This study aimed to investigate the effect of the COVID-19 outbreak on infertile couples dealing with stress and anxiety during in vitro fertilization treatment. STUDY DESIGN: 252 infertile patients who applied for in vitro fertilization treatment were included in this cross-sectional study. Data were collected via four data collection tools including socio-demographic form, COVID-19 Inventory (COVID-I), COMPI fertility problem stress scale (COMPI-FPSS), and state-trait anxiety scale. Data analysis was conducted by SPSS statistical software included statistical analysis such as averages, standard deviations, correlation, regression, and t-test. RESULTS: Both negative and weak correlations were found between COMPI fertility problem stress scale and subscales of state-trait anxiety scale as well as the total score of state-trait anxiety scale. In terms of socio-demographic characteristics of the participants and their responses in state-trait anxiety scale and ISS forms, the correlation coefficients were also so low. The results also showed that public officials, health professionals, and educators showed lower state-trait anxiety scale (stress-related anxiety) scores. CONCLUSION: During the COVID-19 pandemic, there was an increase in spontaneous pregnancy expectations. Although participants were mostly stressed because of the COVID-19 outbreak, they didn’t change their in vitro fertilization treatment plans during the outbreak.

Translation, Cultural Adaptation, and Psychometric Features of the Persian Version of the Copenhagen Multi-Centre Psychological Infertility-Fertility Problem Stress Scales (COMPI-FPSS)

Aims: This study was conducted for translation, cultural adaptation, and validation of the Persian version of the Copenhagen multi-centre psychological infertility-fertility problem stress scales (COMPI-FPSS). Study Design: This study was a methodological study. Place and Duration of Study: This research was done in an infertility clinic of an educational hospital in Rasht (north of Iran), from November 2019 to January 2020. Methodology: This study was performed in two phases including tool translation and psychometric testing. Totally, 200 infertile people selected through convenience sampling among subjects met inclusion criteria were included in the study. After obtaining permission from the original tool designer, the COMPI-FPSS (14 items) was translated into Persian using the forward-backward method. Face, content, and construct validity, as well as internal consistency (Cronbach's alpha coefficient and McDonald's coefficient omega) were evaluated, and test-retest was conducted. The data were analyzed using exploratory factor analysis (EFA) by SPSS software Ver. 16. Results: EFA led to retaining of 11 items with 3 factors of “personal domain”, “marital domain”, and “social domain”, which explained 54.42% of the total variance. Cronbach's alpha coefficient for the whole questionnaire was calculated as 0.89; also the overall McDonald's coefficient omega of the questionnaire was equal to 0.82. The correlation between the two test administrations with a 14-day interval was estimated as 0.93. Conclusion: The Persian version of the COMPI-FPSS with 11 items and 3 factors had the desired cultural adaptation, validity, and reliability and it is recommended to use it in the future studies and infertility treatment centers.

Is a dyadic stressor experienced as equally distressing by both partners? The case of perceived fertility problems

Using data from a population survey, this article explores whether perceptions of having a fertility problem among 926 U.S. couples in heterosexual relationships (women aged 25–45 and male partners) are associated with distress. Most couples did not perceive a fertility problem (58%). In almost a third (30%) of the couples, only women perceived a fertility problem; in 4%, only the men; and in nearly a fifth (19%), both perceived a problem. Adjusted for characteristics associated with fertility problems and depressive symptoms, those who perceived a problem exhibited significantly more depressive symptoms than those who did not. Fertility problems are sometimes experienced as individual because in some couples only one partner perceives a problem or has higher distress in response to their own rather than to their partners’ perceived problems. For women, fertility problems are experienced as a couple phenomenon because women were more distressed when both partners perceive a problem. The perception of fertility problems is gendered in that women were more likely to perceive a problem than men. Furthermore, men are most distressed when they perceive a problem and their partner does not.

Is infertility resolution associated with a change in women’s well-being?

STUDY QUESTION Is giving birth associated with improved subjective well-being among involuntarily childless women? SUMMARY ANSWER Resolution of infertility is associated with increased life satisfaction and self-esteem, but not with a decrease in depressive symptoms. WHAT IS KNOWN ALREADY Cross-sectional data and studies of treatment-seekers show that infertility is associated with lower subjective well-being. Childless women with infertility tend to report lower subjective well-being than women who experience secondary infertility, but a prospective study using a random sample of involuntarily childless women over time has not previously been conducted. STUDY DESIGN, SIZE, DURATION The sample for the current study includes all women without children who met medical criteria for infertility or perceived a fertility problem (N = 283) at baseline and who were interviewed in both waves (3 years apart) of the National Survey of Fertility Barriers (NSFB), in a random-digit dialing telephone survey. It is therefore possible to explore here whether there are differences in the association of infertility resolution and subjective well-being among women who do and do not perceive themselves as having a fertility problem. PARTICIPANTS/MATERIALS, SETTING, METHODS Depressive symptoms (as measured by the Center for Epidemiologic Studies—Depression Scale), self-esteem (as measured by a modified version of the Rosenberg Self-esteem Scale) and life satisfaction (as measured by a modified version of the Satisfaction with Life Scale) were assessed for all 283 participants at both waves. For all three variables, change scores of 47 involuntarily childless women who resolved their infertility through a live birth were compared to the scores for the 236 women who remained childless. A number of variables shown to be associated with subjective well-being among infertile women were included as controls. MAIN RESULTS AND THE ROLE OF CHANCE No relationship between infertility resolution and change in depressive symptoms was observed (b = −0.04; P &gt; 0.05). Involuntarily childless women who resolved their infertility improved in self-esteem (b = 0.74; P &lt; 0.01) and life satisfaction (b = 1.06; P &lt; 0.01). LIMITATIONS, REASONS FOR CAUTION Women were measured at only two time points. Only 47 women had a live birth between waves. While it is common practice to make causal interpretations based on panel data, such interpretations should be made with caution. In addition, the NSFB was conducted in the USA where medical expenditures are high and most fertility treatment expenses are not covered by insurance. Thus it may not be possible to generalize the findings to other modern industrialized societies. WIDER IMPLICATIONS OF THE FINDINGS Knowing that resolution of infertility is associated with improved subjective well-being is important for infertile couples and infertility professionals alike. STUDY FUNDING/COMPETING INTEREST(S) This research was supported in part by NICHD grant R01-HD044144 and NIGMS grant P20-GM109097 from the National Institutes of Health. The authors have no competing interests.

Stability and Change in Motherhood Status and Fertility Problem Identification: Implications for Changes in Self-Esteem

Because motherhood is a valued status, the life course perspective and the theory of conjunctural action suggest the following hypotheses: for women in the United States, gaining the valued identity “mother” should lead to an increase in self-esteem, while identification with a fertility problem identity should lead to a decrease in self-esteem. Using the nationally representative two-wave National Survey of Fertility Barriers (NSFB), we conducted change-score analysis with chained multiple imputation (MICE) to model attrition. We compared changes in self-esteem by change and stability in motherhood and self-identified fertility problem status among women who initially had no children. Results provide support for the hypotheses. All but one group—those who no longer identified a problem and who had a baby—had declines in self-esteem. Women who persisted with a fertility problem identity and did not have a baby had the steepest decline in self-esteem.