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Aims: The role of depression in subsequent infertility, miscarriage and stillbirth remains unclear. This study aimed to examine the association of a history of depression with these adverse outcomes using a longitudinal cohort study of women across their reproductive life span., Methods: This study used data from participants in the Australian Longitudinal Study on Women's Health who were born in 1973-1978. Participants ( N = 8707) were followed up every 3 years from 2000 (aged 22-27) to 2018 (aged 40-45). Information on a diagnosis of depression was collected from each survey, and antidepressant medication use was identified through pharmaceutical prescription data. Histories of infertility, miscarriage, and stillbirth were self-reported at each survey. Time-lagged log-binomial models with generalized estimating equations were used to assess the association of a history of depression up to and including in a given survey with the risk of fertility issues in the next survey., Results: Women with a history of depression (excluding postnatal depression) were at higher risk of infertility [risk ratio (RR) = 1.34, 95% confidence interval (CI): 1.21-1.48], miscarriage (RR = 1.22, 95%CI: 1.10-1.34) and recurrent miscarriages (≥2; RR = 1.39, 95%CI: 1.17-1.64), compared to women without a history of depression. There were too few stillbirths to provide clear evidence of an association. Antidepressant medication use did not affect the observed associations. Estimated RRs of depression with infertility and miscarriage increased with age., Conclusions: A history of depression was associated with higher risk of subsequent infertility, miscarriage and recurrent miscarriages.

Study Question: Which decision-making factors influence family building among permanently infertile couples?, Summary Answer: Ethical, legal, and financial considerations outweigh genetic relatedness in decision-making, favouring domestic gestational surrogacy, if this were possible, over international options., What Is Known Already: Permanent infertility affects 4-5% of people in the fertile age. Their family-building options include adoption, surrogacy, uterus transplantation, foster care, and intentional multiple parenthood. However, in most countries, including Denmark, legal barriers constrain these methods due to surrogacy restrictions, suspended international adoptions, and the experimental status of uterus transplantation. Despite existing research on surrogacy, adoption, and specific causes of permanent infertility, a significant gap remains in our understanding of how couples with permanent infertility make family-building decisions within these limited frameworks., Study Design, Size, Duration: This cross-sectional study with 150 permanently infertile Danish participants was conducted from June to November 2023 using an online questionnaire. Multiple strategies, such as online forums, fertility clinics, hospital departments, and snowballing, were used to recruit a diverse sample., Participants/materials, Setting, Methods: The study included couples aged 26-50 years facing permanent infertility due to the following primary causes: women without a uterus (15%), women with a non-functional uterus (47%) or women for whom pregnancy would be life-threatening (9%), male couples (16%), transgender partner couples (2%), and other causes (11%). The survey collected data on demographics, reproductive history, family-building choices, and communication strategies. Closed questions were analysed using descriptive statistics., Main Results and the Role of Chance: Among 150 respondents, 41% had used transnational surrogacy, 27% adoption, 14% chose to remain childless, and 19% were undecided. Critical factors on family-building decisions were ethical, legal, and financial concerns which ranked higher than genetic relatedness. Despite the complexity of family building, most participants were open about their child's origin and received social support. If all family-building methods were legal and available in Denmark, domestic gestational surrogacy would be the preferred method, with uterus transplantation and remaining childless being least popular., Limitations, Reasons for Caution: The sample size is relatively small, despite the use of a variety of recruitment strategies. Nevertheless, this has ensured a diverse cohort representing the different reasons for infertility and family-building choices. It is important to note that the strategies may have favoured individuals achieving parenthood., Wider Implications of the Findings: The finding of our study reveals a notable gap between available family-building options in Denmark and the preferences of couples facing permanent infertility. These insights could be instrumental for organizations reviewing and developing family-building frameworks. Furthermore, for healthcare professionals guiding couples experiencing infertility issues in their attempts to build a family, an understanding of these preferences is essential to facilitate informed decisions about their future family plans., Study Funding/competing Interest(s): The project was financed by the Independent Research Fund Denmark. The authors have no conflict of interest to declare., Trial Registration Number: N/A., (© The Author(s) 2024. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology.)

Purpose: Endometriosis and infertility are associated with impaired partnership and sexuality of the patients, but also of their male partners. Also, endometriosis is one of the most common causes of infertility, resulting in a large overlap of both pathologies. The aim of this study was to determine the association of different predictors of partnership and sexual satisfaction and dyadic effects in couples with endometriosis and infertility., Methods: A cross-sectional study was conducted with n = 62 women with endometriosis and n = 46 partners, including a total of n = 44 couples, some of whom were affected by infertility. The questionnaire included items on partnership, sexuality, depression, social support, and desire for a child. Multiple linear regression and the actor-partner-interdependence-model were used for analysis., Results: Significant dyadic effects only occurred in couples with both endometriosis and infertility. Depression showed a significant negative actor effect in men for partnership satisfaction and a negative actor and partner effect in women for sexuality satisfaction (p < .05). For women, social support showed a significant positive actor effect for partnership satisfaction (p < .05), age showed a significant actor and partner effect for sexuality satisfaction (p < .05)., Conclusion: The results show a significant association of endometriosis and infertility with partnership and sexuality satisfaction. Infertility could be a decisive factor. However, the large overlapping of both endometriosis und infertility in many couples support the importance of further studies to differentiate between the both effects., Trial Registration: German Clinical Trials Register DRKS00014362 on the 29.03.2018., (© 2024. The Author(s).)

Background: Fertility centre websites are a key sources of information on medically assisted reproduction (MAR) for both infertile people and the general public. As part of a global fertility market, they are also a window to attract potential future patients. They give formal and practical information but in the way the information is displayed, they also convey social representations, and in particular, gender representation in its intersectional dimension. The objective is to analyse the sex, class and race representations regarding reproduction and parenthood that are embedded in the content of fertility centre websites in eight European countries., Methods: The 5 most visible fertility centres that appeared in the first places on Internet search were selected for each country under study, except for one country which has only three fertility centres. In total, 38 fertility centre websites were considered for a thematic analysis using an iterative approach and a comprehensive perspective., Results: Each centre details its services and techniques according to the legal provisions in force in its country. However, on all the websites studied, the fertility centres demonstrate a strong gendered representation. The logos generally depict women or parts of their bodies, as do the photos, which mainly show white women with light eyes. The description of the causes of infertility and the techniques offered by the centres also highlights gender differences. Sperm donation, where MAR is reserved for heterosexual couples, is included among the techniques for women with the comment that it will enable them to fulfil their dream of becoming mothers., Conclusions: MAR, and through it the project of having a child and procreative work, is presented as a matter for white, cisgender and heterosexual women, thus fueling stratified reproduction and limiting reproductive justice. The research team formulated guidelines for fertility centres to encourage them to adopt a more inclusive approach in terms of sex, social class and race, so that the diversity of infertile people feel involved and welcome in these centres, to avoid misperceptions about infertility in the general population and to reinforce autonomy and justice in reproductive matters., (© 2024. The Author(s).)

Some couples report that their relationship satisfaction increases through the experience of infertility. Few studies exist which explain how this phenomenon occurs through specific variables. We hypothesized that John Gottman's constructs of friendship and intimacy as well as shared meaning could explain how couples can achieve increased relationship satisfaction. We examined a regression analysis of cross-sectional retrospective individual data for couples who are either experiencing infertility currently or have done so in the recent past. In our nonclinical sample (n = 903), mediation analyses indicated significant influencing pathways for the Gottman shared meaning system, indicating that this construct may explain how couples achieve greater emotional bonding and couple satisfaction through infertility. These findings provide couple therapists with potential areas of focus for couples navigating infertility through the lens of Gottman Method Couple Therapy, including ways to encourage deeper mutual shared meaning amidst the infertility experience., (© 2024 American Association for Marriage and Family Therapy.)

The present study aimed to examine the psychological impact of the COVID-19 pandemic on infertile patients. We adopted a comparison design and searched articles published from 1 September 2016 to 31 December 2019 as the control group, while articles published from 1 January 2020 to 31 April 2023 were treated as the pandemic group. Specifically, Web of Science, PubMed, Medline, PsycArticle, CNKI and PsycINFO were searched to identify potential eligible records. Risk of bias was assessed, and random-effects meta-analyses were conducted to estimate the prevalence of specific mental health problems. Forty studies with a total of 19,480 participants were included in the analysis. The pooled prevalence of anxiety in the pandemic group was significantly higher than that in the control group. The depression and stress prevalence in the pandemic group was higher than that in the control group, yet did not reach statistical significance. A subgroup analysis revealed region differences with developed countries exhibiting higher rates of anxiety and depression in the pandemic group, but the result was the opposite in the control group. Physiological factors, psychological factors and social factors correlated with infertile patients' mental health were identified. The COVID-19 pandemic had a significant negative impact on infertile patients' mental health, emphasizing the importance of ways to mitigate the risks during the pandemic., (© 2024 The Author(s). PsyCh Journal published by Institute of Psychology, Chinese Academy of Sciences and John Wiley & Sons Australia, Ltd.)

Infertility can be stressful for infertile couples. This study aims to examine the intra-dyadic associations between stigma, communication patterns, and infertility-related stress in couples undergoing artificial insemination by donor semen (AID). This cross-sectional study was conducted from January to April 2021. Two hundred and three couples undergoing AID were recruited from a reproductive centre in China. All of the couples completed a two-item stigma questionnaire, Communication Pattern Questionnaire, and Fertility Problem Inventory. The actor-partner interdependence mediation analysis was performed using AMOS 23.0. The analysis demonstrated significant actor-actor effects for couples undergoing AID. More specifically, higher levels of stigma among wives and husbands were associated with more negative communication patterns, thereby increasing their own infertility-related stress. Simultaneously, there was a significant partner-actor effect among infertile wives, demonstrating that the husband's stigma can affect his wife's infertility-related stress by influencing her communication patterns. Couples undergoing AID experience increased infertility-related stress when they have high levels of stigma and negative communication patterns, and husbands' stigma is correlated to wives' communication patterns. Therefore, dyadic interventions aiming to improving stigma and enhancing positive communication may be conducive to reducing infertility-related stress., (© 2024 John Wiley & Sons Ltd.)

Background: While there is a recognized role of optimizing lifestyle (diet and physical activity) behaviours in the management of infertility, the best practice remains unknown and factors influencing the lifestyle of people with infertility are not well understood., Objective and Rationale: This systematic review evaluated barriers and enablers to a healthy lifestyle in people with infertility, from the perspectives of people with infertility and health professionals, in order to inform optimal behavioural change strategies., Search Methods: Ovid MEDLINE(R), PsycINFO, EMBASE, EBM Reviews, and CINAHL were searched from inception to 28 August 2023. Eligible studies were qualitative and quantitative primary studies that explored barriers and/or enablers to lifestyle for infertility management. Quality assessment was performed using the Centre for Evidence-Based Management Critical Appraisal of a Survey Tool and the Critical Appraisal Skills Programme Qualitative Checklist. Data were analysed by thematic analysis with themes mapped to the Capability, Opportunity, Motivation and Behaviour (COM-B) model and Theoretical Domains Framework (TDF)., Outcomes: After screening 12 326 abstracts and 99 full-texts, 27 studies were included (12 quantitative, 6 qualitative and 9 mixed-methods) with 22 studies of women with infertility (n = 2524), 11 studies of men with infertility (n = 1407), and 6 studies of health professionals (n = 372). We identified barriers and enablers relating to capability (e.g. strategies for behaviour change), opportunity (e.g. limited time, resources, and money), and motivation (e.g. interplay between lifestyle and emotional state). Based on the identified themes, suggested intervention components to integrate into lifestyle management of infertility include facilitating development of self-management skills to support lifestyle change (e.g. self-monitoring, action planning, and goal setting) and incorporating mental health strategies (e.g. providing information about the benefits of healthy lifestyle behaviours for mental health and encouraging patients to reframe healthy lifestyle behaviours as self-care strategies)., Wider Implications: The findings have identified important factors that influence lifestyle management in people with infertility and have suggested relevant intervention components to consider when designing interventions. Given the paucity of qualitative studies identified, more research is needed to further understand the complex and interacting factors that shape lifestyle during the fertility journey., (© The Author(s) 2024. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology.)

Aims: The aim of this study is to introduce the Copenhagen Multi-Centre Psychosocial Infertility (COMPI)-Fertility Problem Stress Scales (COMPI-FPSS) into China and test its applicability in Chinese infertile population., Background: Infertility-related stress not only influences patients' psychological well-being but is also strongly associated with reduced pregnancy rates and poorer assisted conception outcomes, thus warranting focussed attention., Design: The design used in this study is a cross-sectional survey., Methods: A total of 418 participants were recruited by convenience sampling from March to July 2022. The data were randomly divided into two parts: one for item analysis and exploratory factor analysis and the other for confirmatory factor analysis and reliability test. The critical ratio and homogeneity test were used to verify the differentiation and homogeneity of the COMPI-FPSS; the construct validity was determined by explanatory and confirmatory factor analyses; Cronbach's α coefficient and Spearman-Brown coefficient were used to assess the reliability; and criterion validity was expressed using correlation coefficients for the Perceived Stress Scale and the Negative Affect Scale as the validity criteria., Results: The revised Chinese version of COMPI-FPSS has 11 items and 2 dimensions (i.e., personal stress domain and social stress domain). Exploratory factor analysis showed that the cumulative variance contribution rate of the two factors was 68.6%, and confirmatory factor analysis indicated that the model fitted well. The score of the COMPI-FPSS was significantly and positively associated with perceived stress and negative affect. The Cronbach's α coefficient of the total scale was 0.905, and the Spearman-Brown coefficient was 0.836, explaining excellent reliability., Conclusion: The revised Chinese version of COMPI-FPSS shows good reliability and validity, and it can be used to evaluate the infertility-related stress of infertile patients in China., (© 2023 John Wiley & Sons Australia, Ltd.)

This study sought to characterize fertility app use among women seen for infertility care and to investigate the association between fertility app use and quality of life. This survey-based study was conducted at an academic infertility clinic. Surveys were administered to patients who presented for a new infertility visit. One survey collected information regarding app use and the second survey was FertiQoL, an internationally validated instrument measuring quality of life in those with infertility. Descriptive statistics were used to characterize the patient population regarding app use and FertiQoL scores. Comparisons between those who did and didn't use an app were evaluated using t-tests and Cochran Armitage test for trend. 149 surveys were collected. Most (75.5%) participants reported using a fertility app. Most participants (85.1%) used a free app and nearly all (97.2%) found their app helpful. There was a significant difference (p = 0.0034) in satisfaction with one's quality of life between app users and non-app users with app users demonstrating higher satisfaction. There were no significant differences between app users and non-app users with their overall FertiQoL scores however there was a statistically significant difference (p = 0.031) in Relational sub-scores with app users displaying higher scores. While overall quality of life, measured by standardized measures, did not differ, self-perceived satisfaction with quality of life improved with more satisfaction reported in those using an app. This self-perceived satisfaction and increased quality of life surrounding relationships carries important implications, especially when one may face the stress of infertility and its treatment., (© 2024. The Author(s), under exclusive licence to Society for Reproductive Investigation.)

Objective: To explore men's and women's experiences regarding their history of sexual health when attending a fertility clinic., Methods: A qualitative study with semi-structured individual interviews was conducted among heterosexual males and females seeking infertility care at a public fertility clinic in Sweden in 2022-2023. The interviews were audio-recorded, transcribed verbatim and analyzed using qualitative content analysis., Results: Eight males and ten females were included. The analysis resulted in an overarching theme: A change from spontaneous to scheduled intercourse affects various aspects of sexual health. In the beginning of the relationship sex had been spontaneous, joyful and satisfying. However, sex was not always unproblematic, and there had been sexual changes. Sex with a reproductive purpose was scheduled according to ovulation, leading to changes in sexual behavior. Increased erectile problems in men and decreased frequency of orgasms in women, and a lack of sexual desire in both, were experienced. Men and women felt pressured to have sex when it became a requirement. Men's sexual and women's reproductive failures led to negative emotional reactions, including stress, frustration, disappointment, anxiety and guilt. Sexual and reproductive problems affected the relational well-being, leading to feelings of sharing the burden but also conflicts and sexual avoidance., Conclusions: Experiencing reproductive failures, sexual problems and negative emotional reactions can affect men's and women's sexual health. Therefore, an implication for clinical practice among healthcare professionals during evaluation of infertility, is a need to be aware of and ask questions about sexual health after reproductive failures., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Purpose: In 2015, assisted reproductive technology (ART) accounted for 1.7% of all U.S. births, donor eggs accounted for over 17,000 started cycles in 2015, and donor sperm accounting for 6.2% of all cycles started in 2014. With increasing utilization of donor gametes as a method of assisting patients with infertility, the number of babies born each year utilizing gamete donation will also continue to increase. This study aimed to elucidate factors impacting decision to donate, amongst a representative national population., Methods: A survey was distributed via the internet utilizing SurveyMonkey Enterprise with HIPAA compliance. Univariate regressions and frequencies were conducted between each demographic and personal characteristic and the willingness to donate. Log Binomial and linear regression was used categorical and continuous variables, and Risk ratios were calculated., Results: In this large survey study, 64% of men and 50% of women reported they would be willing to donate gametes, with the majority desiring monetary compensation. Men with a high Consumer Financial Protection Bureau score were less likely to report that they would consider donating sperm compared to a medium high CFPB score. No other financial indicators were associated with considering donating sperm. There were no associations between CFPB score and egg donation outcomes. Black or African American women were less likely to consider donating their eggs compared to other groups, and more likely to desire > $5000 in compensation., Conclusions: In this large survey study, a small minority of participants reported they would be willing to donate to an unknown infertility patient for reproductive purposes. High and very high CFPB scores were associated with willingness to donate games, but not with desire for monetary compensation or amount., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: In Sub-Saharan Africa (SSA), HIV (Human Immunodeficiency Virus) prevalence among reproductive-aged women remains high, and infertility among these women is common. The social consequences for these women are yet to be explored. This scoping review summarises the social consequences of living with HIV and infertility for SSA women., Methods: This scoping review of published peer-reviewed literature focused on the intersection of infertility and living with HIV among women in SSA. We followed the PRISMA guidelines for scoping reviews. We searched PubMed, Web of Science and SCOPUS and included all original research reports which met the inclusion criteria; women in Sub-Saharan Africa, living with HIV, and infertility., Results: Fourteen papers met the inclusion criteria. Both HIV diagnosis and infertility were reported as stigmatising experiences for women who desire to have children. The stigma of infertility had a greater negative impact on women than that of an HIV diagnosis. Familial, community support, and medical intervention were perceived vital to ensure women feel de-stigmatised and in control of their future, even without children., Conclusion: This is the first review demonstrating the social consequences of HIV and infertility on SSA women. Further research and interventions are needed to reduce the social consequences of infertility within SSA., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Fertility problems, often called infertility, have been defined as the inability to conceive or maintain pregnancy throughout one year of trying (World Health Organization, 2020). Because fertility problems can present unique medical, emotional, relational, and identity challenges, they are often difficult to talk about, and even well-intentioned messages can be perceived negatively. This study uses Communicated Sense-Making (CSM; Kellas & Kranstuber Horstman, 2015), particularly its mechanism of memorable messages, to explore what types of support-related messages people experiencing infertility find memorable. Results from semi-structured interviews ( N  = 54) indicate five supra-themes of memorable messages: (a) communicating solidarity; (b) attempting to minimize participants' stress; (c) communicating investment or interest in the patient's experience; (d) sharing expertise; and (e) absolving the patient of responsibility; we identify several sub-themes within each. We also explore patterns between message types, senders, and message valence: message themes were perceived as either positive, negative, or neutral based on the combination of sender and perceived intention. Theoretical and practical implications are discussed.

Study Question: How do adult transgender and gender diverse (TGD) people, who are infertile due to prior gender-affirming treatment, view their current infertility and their reproductive decisions made in the past?, Summary Answer: In a time where sterilization was mandatory, transgender adolescents prioritized gender-affirming treatment over their future fertility and would make the same choice today despite emotional challenges related to infertility experienced by some., What Is Known Already: Under transgender law in the Netherlands, sterilization was required for legal gender recognition until 2014, resulting in permanent infertility. The long-term consequences of this iatrogenic infertility in transgender adolescents who have now reached adulthood remain underexplored., Study Design, Size, Duration: Qualitative study design based on 21 in-depth one-on-one semi-structured interviews., Participants/materials, Setting, Methods: TGD people in a stage of life where family planning may be a current topic were eligible for participation. They all received gender-affirming treatment in adolescence prior to the legislation change in 2014. A purposeful sampling technique was used from participants of another ongoing study. Eleven people assigned female at birth and ten people assigned male at birth were included. Interview transcripts were thematically analysed using a modified version of Braun and Clarke's six steps theory., Main Results and the Role of Chance: Six main themes were generated: (i) personal considerations regarding fertility and fertility preservation in the past; (ii) external considerations regarding fertility and fertility preservation in the past; (iii) current vision on past considerations and decisions; (iv) Current experiences and coping with infertility; (v) future family building; (vi) advice regarding fertility and fertility preservation decision-making., Limitations, Reasons for Caution: Selection, recall, and choice supportive bias may play a role in interpreting our results., Wider Implications of the Findings: This study highlights the importance of tailored counselling and comprehensive information on fertility preservation for transgender individuals, especially adolescents, undergoing gender-affirming treatment., Study Funding/competing Interest(s): N/A., Trial Registration Number: N/A., (© The Author(s) 2024. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology.)

Research Question: What is the attitude of Belgian women of reproductive age towards enucleated egg donation? Does the willingness of women to donate differ when they would donate enucleated or whole eggs?, Design: In 2022, an online survey was conducted among a representative sample of 1000 women in Belgium aged 18-50 years. The item on willingness to anonymously donate enucleated eggs was dichotomized into those willing to donate and those not willing to donate or uncertain., Results: No statistically significant difference was found between the willingness to donate enucleated eggs and whole eggs (whether anonymously or identifiably). Anonymity, however, affected the willingness to donate, with considerably fewer women willing to donate identifiably. The respondents were divided about their parental status if they were to donate enucleated eggs, with less than one-half (44%) not considering themselves to be a genetic mother. Women willing to donate enucleated eggs anonymously were less likely to view themselves as a genetic mother of the child compared with others. Fewer than one in five considered the technique unacceptable because the resulting child would carry genetic material of three persons., Conclusions: Women in the general population did not show a greater willingness to donate enucleated eggs than whole eggs. The fact that the respondents were strongly divided on whether or not they would consider themselves to be a genetic mother of the resulting child may explain this result. Other factors, such as the potential high risk for the child, may also have contributed to less willingness., (Copyright © 2024 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.)

Objectives: This qualitative study aimed to comprehend the psychological well-beings and available interventions of current Chinese infertile patients, as well as investigate more integrated and effective patient support interventions, if necessary., Background: It is well known that infertility is a difficult struggle. Assisted reproductive technologies (ART) provide patients with the hope of having a child, but they also cause them pain and stress. There is a dearth of research on the mental health of infertile patients, particularly in developing nations such as China., Method: Individual interviews were conducted with eight experienced clinicians at the Reproductive Medicine Center from five different hospitals. On the basis of the grounded theory, interviews were transcribed and recursively analysed with the NVivo 12 Plus software by a research team., Results: 73 categories were created, which were then grouped into 12 subthemes that were combined to form the following themes: Theme I: Psychological Distress; Theme II: Sources of Distress; Theme III: Protective Factors; and Theme IV: Interventions., Conclusions: The themes of subjective experience identified in the study reveal infertile patients' emotional disturbance and resources of distress, consistent with previous related studies. Despite limitations such as the relatively small number of participants and the exclusively self-report nature of qualitative study, the findings of the study imply the importance of emotional and physical support networks for infertile patients at Reproductive Medicine Centers, consistency of psychological awareness and adequate professional supports.

Background: Both the diagnosis and the process of undergoing fertility treatment have a considerable negative effect on a person's quality of life (QoL). The evaluation of this effect is essential to offer comprehensive and high-quality care. The FertiQoL questionnaire is the most widely used instrument to evaluate QoL in people with fertility issues., Objective: This study is aimed at examining the dimensionality, validity and reliability of the Spanish version of the FertiQoL questionnaire in a sample of Spanish heterosexual couples undergoing fertility treatment., Methods: FertiQoL was administered to 500 people (50.2% women; 49.8% men; average age 36.1 years) recruited from a public Assisted Reproduction Unit in Spain. In this cross-sectional study, Confirmatory Factor Analysis (CFA) was used to analyse the dimensionality, validity and reliability of FertiQoL. Discriminant and convergent validity were assessed using the Average Variance Extracted (AVE), and model reliability was shown by Composite Reliability (CR) and Cronbach's alpha., Results: CFA's results support the 6-factor solution of the original FertiQoL (RMSEA and SRMR <0.09; CFI and TLI >0.9). However, several items had to be eliminated due to their low factorial weights - in particular, items Q4, Q5, Q6, Q11, Q14, Q15 and Q21. Moreover, FertiQoL showed good reliability (CR >0.7) and validity (AVE >0.5)., Conclusion: The Spanish version of FertiQoL is a reliable and valid instrument in measuring QoL in heterosexual couples undergoing fertility treatment. The CFA confirms the original 6-factors model but indicates that by eliminating some items the psychometric properties could improve. However, further research is recommended to address some of the measurement issues.

Objectives: To gain a deeper understanding of the real experiences and needs of the patients of Peutz-Jeghers syndrome (PJS) with fertility concerns., Design: A qualitative study., Methods: Phenomenological research and Semi-structured method were conducted with the patients of PJS ( N  = 16), and the interview data were analyzed using inductive content analysis strategies., Results: 16 patients were interviewed, including 13 women and 3 men partners. We identified 5 themes, including: (i) Heritability of disease, (ii) Potential risks of reproduction; (iii) The difficulties in raising children; (iv) family and social support. (V) Need support from multiple sources., Conclusion: The findings of this study demonstrate that patients with Peutz-Jeghers syndrome (PJS) who are of childbearing age experience various reproductive concerns and other manifestations. Therefore, it is essential to offer individualized psychological interventions for PJS patients at different psychological stages, with the support of healthcare professionals, family, and social networks.

Background: To educate the public on how best to support people with fertility problems, a narrative short film "Ten Things Not to Say to Someone Struggling with Infertility" was created, depicting the impact that helpful versus unhelpful dialogue has on someone with fertility problems., Methods: Before and after watching the video, 419 participants from the public were presented with a hypothetical vignette describing a woman experiencing fertility problems and asked about the likelihood that they would endorse a series of helpful and unhelpful statements when communicating with the protagonist. Pre and post endorsement of helpful versus unhelpful statements were compared, as were self-perceived knowledge about the mental health aspects of fertility problems, confidence in providing emotional support to someone with fertility problems, and empathy for the protagonist., Results: Participants endorsed fewer unhelpful statements after the video relative to before ( M(SD) = 2.2(2.3) vs. 1.3(2.3), p < .001) and fewer participants endorsed at least one unhelpful statement (72% to 47%, p < .001). Self-perceived knowledge of fertility problems, confidence in providing support, and empathy increased at post-test ( p s < .001; Cohen's d = .56-.83) indicating medium-large effects., Conclusions: A narrative short film appears to be an effective dissemination strategy for sensitizing the public to the emotional struggles of individuals experiencing fertility problems.

The aim of this study is to explore knowledge, attitude and behaviour about infertility among young people, to prevent risk factors which should threaten fertility of young people.455 non-medical and medical students participated to this study, by a simple random sampling method. Knowledge state of non-medical group about infertility management was lower than medical group. Participants of non-medical group (p = 0,041) had low knowledge about definition and causes than participants of medical group. 11,5% of female and 10,9% of male of non-medical group opted for Traditional-healer as first solution if treatment fails , none of medical group suggested this option. The first advice of respondents of non-medical was polygamy, adoption and divorce (P= 0,001). Respondents of medical (p= 0,038) had proposed to try fertility treatments more than once time if treatment fails. Government should increase efforts to improve knowledge about infertility for all scholar programs., Competing Interests: The Authors declared no conflict of interest, (African Journal of Reproductive Health © 2024.)

Background: Depression is increasingly recognized as a factor affecting infertility and the causal relationship between them remains controversial. The aim of this study was to explore the relationship between depression and infertility using Mendelian randomization (MR) and cross-sectional study, and to explore the potential mediating role of obesity., Methods: The cross-sectional study used data from the National Health and Nutrition Examination Survey (NHANES) 2013-2018. Multivariable-adjusted logistic regression was used to assess the association between depression and infertility risk, and mediation analysis was to examine the mediating effect of obesity. Then, we performed MR analyses to investigate the causal effect of depression on infertility. Instrumental variables for depression were obtained from a genome-wide association meta-analysis (135,458 cases and 344,901 controls), and summary level data for infertility were obtained from the FinnGen database (6,481 cases and 68,969 controls)., Results: In the cross-sectional study, a total of 2,915 participants between the ages of 18 and 45 were included, of whom 389 were infertile. We observed that depression was strongly associated with an increased risk of infertility (OR=1.66, 95%CI: 1.19, 2.33), and this relationship remained significant in mild (OR=1.45, 95% CI: 1.09, 1.93), moderate (OR=1.89, 95% CI: 1.26, 2.84), and severe depression (OR=1.74, 95% CI: 1.02, 2.99). Mediation analysis showed that obesity mediated 7.15% and 15.91% of the relationship between depression and infertility for body mass index and waist circumference. Furthermore, depression significantly increased the risk of infertility in both the general obesity (OR=1.81, 95%CI=1.20-2.73, P<0.01) and abdominal obesity populations (OR=1.57, 95%CI=1.08-2.27, P=0.02) populations. In addition, the MR analysis also revealed a significant positive causal relationship between genetically predicted depression and infertility (OR=1.32, 95% CI: 1.03, 1.70)., Conclusion: Depression is associated with an increased risk of infertility, with obesity playing a significant mediating role. This study underscores the importance of incorporating mental health and weight management in infertility treatment strategies., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Xu, Zhuang, Cao and Yang.)

Infertility is not a fatal disease but it really produces infertility-related stress and affects individuals' quality of life to a great extent. This study aims to investigate the relations among infertility-related stress, negative emotions and quality of life in infertile outpatients, and suppose gender difference as well as Dark Triad, which contained three dark personality traits: Machiavellianism, narcissism, and psychopathy, would moderate the relations. 105 infertile outpatients age range 20-49 completed a cross-sectional questionnaire on the Fertility Quality of Life scale, the Fertility Problem Inventory, the Hospital Anxiety and Depression Scale a the Chinese version of Dirty Dozen. Results showed that negative emotions mediated the relations between infertility-related stress and quality of life. Dark Triad could not moderate the relations between infertility-related stress, negative emotions, and quality of life, but gender can moderate the associations between infertility-related stress and negative emotions. Specifically, the association between infertility-related stress and negative emotions was stronger in men than in women. Infertility-related stress has direct and indirect effects on infertile outpatients' quality of life. It is important to consider the important roles of emotions and gender difference between patients, and delivering targeted intervention programs., (© 2024. The Author(s).)

Infertility refers to the inability to conceive after 12 months of regular, unprotected sexual intercourse. Psychosocial aspects of infertility research are predominant in developed countries. A scoping review of psychosocial aspects of infertility research conducted in Africa between 2000 and 2022 was conducted. Twelve databases and grey literature were searched for articles. Studies were included if they were published in English and included findings from patients diagnosed with primary or secondary infertility. A total of 2 372 articles were initially found and screening resulted in 116 articles being included in the scoping review. Most of the studies (81%) were conducted in Nigeria, Ghana and South Africa. Psychosocial aspects explored included quality of life, barriers to treatment, attitudes and stigma, and sociocultural and religious aspects of infertility, among others. The review maps published psychosocial research in the context of infertility in Africa and identifies gaps for future research., (© 2024. The Author(s).)

Background: Infertility is a global health challenge impacting quality of life, particularly in low and middle-income countries such as Sudan. The Fertility Quality of Life (FertiQoL) tool, a standardized questionnaire, is pivotal in assessing fertility-related quality of life. However, existing research on its utility has primarily been conducted in Global North and High-Income Countries, highlighting the need to shift away from neocolonialism to promote truly inclusive research and effective healthcare practices. Science diplomacy, through the adaptation and culturally sensitive implementation of research tools, can serve as a catalyst for addressing health disparities on a global scale. This study aims to assess methodological and cultural considerations that impact the implementation of the FertiQoL tool in Sudan, framed within the context of science diplomacy and neocolonialism. By investigating the challenges and opportunities of utilizing this tool in a non-Western cultural setting, we seek to contribute to the broader discussion on decolonizing global health research., Methods: Utilizing an explanatory sequential design involving surveys and interviews, we conducted a study in a Sudanese fertility clinic from November 2017 to May 2018. A total of 102 participants were recruited using convenience sampling, providing socio-demographic, medical, and reproductive history data. The Arabic version of FertiQoL was administered, with 20 participants interviewed and 82 surveyed (40 self-administered and 42 provider-administered). We applied descriptive statistics, one-way ANOVA, thematic analysis, and triangulation to explore methodological and cultural nuances., Results: Most participants were educated women who lived in urban areas. While the ANOVA results revealed no statistically significant differences in FertiQoL scores based on the mode of administration [core score ( F (2,99) = 1.58, p  = 0.21, η 2  = 0.03) and domain scores: emotional ( F (2,99) = 1.85, p  = 0.16, η 2  = 0.04); mind/body ( F (2,99) = 1.95, p  = 0.15, η 2  = 0.04); relational ( F (2,99) = 0.18, p  = 0.83, η 2  = 0.04); and social ( F (2,99) = 1.67, p  = 0.19, η 2  = 0.03)], qualitative insights unveiled vital cultural considerations. Interpretation challenges related to concepts like hope and jealousy emerged during interviews. Notably, the social domain of FertiQoL was found to inadequately capture the social pressures experienced by infertile individuals in Sudan, underscoring the importance of region-specific research. Despite these challenges, participants perceived FertiQoL as a comprehensive and valuable tool with broader utility beyond assessing fertility-related quality of life., Conclusion: Our findings emphasize the significance of incorporating cultural sensitivity into the interpretation of FertiQoL scores when implementing it globally. This approach aligns with the principles of science diplomacy and challenges neocolonial structures by acknowledging the unique lived experiences of local populations. By fostering cross-cultural understanding and inclusivity in research, we can enhance the implementation of FertiQoL and pave the way for novel interventions, increased funding, and policy developments in the Global South, ultimately promoting equitable global health., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Bayoumi, Koert, Boivin, McConnell, Wolde, Siddiqui, Elmusharaf and Viswanath.)

Background: Social problems related to infertility are associated with a significant psychological burden for the involved couple. Previous studies have shown the positive effects of couple interactions on the psychological health of these couples; however, the specific conditions of participating in assisted reproductive treatments (ART) might influence the effect of couple collaboration. Therefore, the present study aimed to evaluate the relationship between couple collaboration, well-being during infertility, and the psychological indicators of infertile couples undergoing fertility treatment., Methods: This cross-sectional study was conducted on 200 ART volunteer couples. Couple collaboration and well-being during infertility were evaluated using a validated researcher-made questionnaire, and the level of depression, anxiety, and stress was evaluated using the DASS-21 questionnaire in both couples. Statistical analysis was performed using the plug-in application PROCESS macro for SPSS and AMOS software., Results: The results showed that couple collaboration was correlated with the level of depression, anxiety, and stress. Moreover, depression, anxiety, and stress levels were correlated with well-being during infertility. The direct and indirect effect of couple collaboration on the depression level was significant; however, the direct effect of couple collaboration on the level of anxiety and stress was not significant, and the effect of couple collaboration on these indicators was mediated by well-being during infertility. The fit index of the equation modelling showed a good fit of the relationship path between the variables of couple collaboration, well-being during infertility, and psychological indicators (CMIN = 4.196, p = 0.260)., Conclusion: The results of this study show that the specific conditions of participating in ART may affect the direct effects of couple interaction on an infertile couple's levels of anxiety and stress. These results suggest that in order to develop mental health programs for infertile couples, strategies based on couple collaboration that are associated with higher well-being during infertility should be developed and presented., (© 2024. The Author(s).)

Introduction: Infertility increases women's risk of intimate partner violence (IPV). Cognitive behavioral therapy (CBT) is commonly used to treat mental health problems among fertility treatment seeking patients. CBT has not been tested for its potential to reduce IPV in this population. We pilot test the use of CBT to prevent IPV and improve patients' mental health in a fertility clinic in Jordan., Methods: Of 38 eligible fertility-treatment seeking couples, 16 consented and underwent up to 11 CBT sessions (average = 9) over 3 months. Interviews at baseline and 16 weeks post intervention (endline) assessed IPV, quality of life, social support, coping, and fear of spouse. Wilcoxon signed-rank and McNemar's tests were used to assess change in outcomes., Results: At baseline, women's rates of IPV, depression, and anxiety were 75%, 87.5%, and 75% respectively, whereas men's rates of depression and anxiety were each 80%. Average baseline post-traumatic stress disorder (PTSD) symptoms for men and women were 3.3 and 2.7 respectively out of 5. IPV decreased 25% after treatment, and women reported less spousal fear. For both men and women, depression, anxiety, and PTSD symptoms decreased and social support and fertility quality of life improved., Conclusion: Psychosocial support should be standard of care for the treatment of infertility given the burden of mental health problems and IPV and the utility of CBT in this patient population. Co-design with couples is needed to identify strategies to bolster participation along with population-based interventions to combat the stigma of infertility and mental health service use and enhance women's status., (© 2024. The Author(s).)

Study Question: Does the Mind/Body Program for Infertility (MBPI) perform better, due to certain distinctive elements, than a partly matched support group in improving the wellbeing and medically assisted reproduction (MAR) outcomes of women with elevated distress levels in a clinical setting?, Summary Answer: While robust enhancements occurred in the wellbeing overall, the cognitive behavioural and formalized stress management elements of the MBPI allowed a significantly stronger improvement in trait anxiety, but not in other mental health and MAR outcomes, compared with a support group., What Is Known Already: Mind-body psychological programmes adjacent to MAR have been found to improve women's mental states and possibly increase chances of pregnancy. However, not enough is known about the programme's effectiveness among patients with elevated distress levels in routine clinical settings, nor is it clear which of its particular ingredients are specifically effective., Study Design, Size, Duration: A pre-post design, single-centre, randomized controlled trial was performed between December 2019 and October 2022 (start and end of recruitment, respectively). The sample size (n = 168) was calculated to detect superiority of the MBPI in improving fertility-related quality of life. Randomization was computer-based, with random numbers concealing identities of patients until after allocation., Participants/materials, Setting, Methods: The trial was conducted at a large university teaching hospital. A total of 168 patients were randomly assigned to the mind-body (MBPI) group (n = 84) and the fertility support (FS) control group (n = 84). Patients received a 10-week, 135-min/week group intervention, with the FS group following the same format as the MBPI group, but with a less restricted and systematic content, and without the presumed effective factors. The number of patients analysed was n = 74 (MBPI) and n = 68 (FS) for post-intervention psychological outcomes, and n = 54 (MBPI) and n = 56 (FS) for pregnancy outcomes at a 30-month follow-up., Main Results and the Role of Chance: Significant improvements occurred in both groups in all psychological domains (adjusted P < 0.001), except for treatment-related quality of life. Linear mixed-model regression analysis did not reveal significantly greater pre-post improvements in the MBPI group than in the FS group in fertility-related quality of life (difference in differences (DD) = 4.11 [0.42, 7.80], d = 0.32, adjusted P = 0.124), treatment-related quality of life (DD = -3.08 [-7.72, 1.55], d = -0.20, adjusted P = 0.582), infertility-specific stress (DD = -2.54 [-4.68, 0.41], d = -0.36, adjusted P = 0.105), depression (DD = -1.16 [3.61, 1.29], d = -0.13, adjusted P = 0.708), and general stress (DD = -0.62 [-1.91, 0.68], d = -0.13, adjusted P = 0.708), but it did show a significantly larger improvement in trait anxiety (DD = -3.60 [-6.16, -1.04], d = -0.32, adjusted P = 0.042). Logistic regression showed no group effect on MAR pregnancies, spontaneous pregnancies, or live births., Limitations, Reasons for Caution: The follow-up only covered MAR-related medical outcomes and no psychological variables, and their rates were not equal in the two groups. Biological factors other than age, aetiology, and duration of infertility may have confounded the study results. Loss to follow-up was between 5% and 10%, which may have led to some bias., Wider Implications of the Findings: The psychologically and medically heterogeneous sample, the normal clinical setting and the low attrition rate all raise the external validity and generalizability of our study. The MBPI works not only in controlled conditions, but also in routine MAR practice, where it can be introduced as a cost-effective, low-intensity psychological intervention, within the framework of stepped care. More studies are needed to further identify its active ingredients., Study Funding/competing Interest(s): The authors received no financial support for the research, authorship, and/or publication of this article. The authors have no conflict of interest to disclose., Trial Registration Number: ClinicalTrials.gov NCT04151485., Trial Registration Date: 5 November 2019., Date of First Patient’s Enrolment: 15 December 2019., (© The Author(s) 2024. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology.)

Background: While there exists an ample body of research in international contexts focused on the characterization and quantification of infertility psychological distress, the level of scholarly scrutiny directed towards this phenomenon within the context of China remains scant., Aims and Objectives: To investigate the formation and developmental processes of psychological distress associated with infertility and infertility treatment among women within the Chinese cultural context and to construct a theoretical framework that elucidates this phenomenon., Design: Qualitative approach with grounded theory methodology., Methods: This study was conducted within the reproductive medicine department of a tertiary-level hospital located in central China from May to August 2023. Twenty-seven women who experienced infertility and underwent assisted reproductive treatment (ART) were interviewed. The interview sessions spanned durations ranging from 20 min to 1 h and 35 min. Data analysis included open coding, axial coding and selective coding. The study is reported using the COREQ checklist., Results: The infertility psychological distress experienced by women undergoing ART is a socially constructed phenomenon influenced by a dynamic interplay of forces that construct and conciliate it. The formation and progression of infertility psychological distress are rooted in the process of self-construction. A Middle-Ranged Theory titled 'self-reconstruction under the dome of infertility and infertility treatment' (SUDIT theory) was developed to explain this phenomenon. Within this framework, infertility psychological distress manifests across three distinct phases under the gambling of the constructive force and conciliative force: (1) distress of disrupting the former self; (2) distress linked to the struggling present self; and (3) the renewed-self harmonized with distress., Conclusions: It is imperative for healthcare professionals and policymakers to acknowledge the socially constructed nature of infertility psychological distress, and proactively implement measures aimed at ameliorating it., Patient or Public Contribution: No patient or public contribution., (© 2024 The Authors. Journal of Clinical Nursing published by John Wiley & Sons Ltd.)

Purpose: Cancer survivors may experience infertility and sexual dysfunction following cancer treatment. Survivors report significant gaps in oncofertility care and consider these issues important, yet they are rarely discussed. The aims of this study were to evaluate survivors' sexual and reproductive complications across age groups and to identify specific groups of survivors at risk for sexual and reproductive complications., Method: We report data collected from survivors of cancers diagnosed in childhood, adolescence and adulthood following the development and piloting of a reproductive survivorship patient reported outcome measure (RS-PROM)., Results: One hundred and fifty survivors participated in the study (mean age at cancer diagnosis was 23.2 years [SD, 10.3 years]). About 68% of participants expressed concerns about their sexual health and function. Survivors (50%) expressed at least one body image concern, with the female gender the most common risk factor for all subgroups. A total of 36% of participants reported at least one concern regarding their fertility, with more male than female survivors reporting fertility preservation prior to treatment. Females compared with male participants were more likely to feel less physically attractive after treatment (OR = 3.83, 95% CI = 1.84-7.95, p < 0.001). More females than males were also more likely to feel dissatisfied with the appearance of a scar(s) after treatment (OR = 2.36, 95% CI = 1.13-4.91, p = 0.02)., Conclusion: The RS-PROM identified multiple reproductive complications and concerns for cancer survivors in the survivorship period., Implications for Cancer Survivors: Utilising the RS-PROM in conjunction with a clinic appointment could help identify and address cancer patients' concerns and symptoms., (© 2023. Crown.)

Background: While assisted reproductive technologies (ART) have helped many people experiencing infertility become pregnant, the ART process can take a psychological toll. This study examined whether and how perceived stress- and depression-related symptoms vary among individuals at different stages of the infertility and ART process, and whether ART-specific stressors and emotional support are associated with mental health symptomatology., Methods: Data were collected using an online REDCap survey administered between July 2021 and March 2022. The survey was administered to 240 participants who had experienced infertility, including those who had not yet accessed ART, those undergoing ART but who were not yet pregnant, those currently pregnant through ART, and those who had given birth in the last year through ART. Each participant completed the Cohen Perceived Stress Scale (range 0-40) and the Edinburgh Depression Scale (range 0-30). Participants who had undergone ART were asked about their experience of ART-specific stressors and how helpful partner and provider support had been during the ART process. Survey data were analyzed using ANOVA and multivariate linear regressions., Results: 88% of participants reported medium or high levels of perceived stress, and 43.8% of respondents showed probable indications of depression. Perceived stress and depression symptoms were significantly higher for individuals currently undergoing, but not yet pregnant from, ART treatments. These effect sizes were substantial; for example, depression scores in this group were five points higher than among currently pregnant individuals and nine points higher than among postpartum individuals. For the subset of participants who had used or were currently undergoing ART (N = 221), perceived social stigma and the physical and time demands of ART were significantly associated with higher stress and depression symptoms, while partner emotional support was associated with lower perceived stress., Conclusions: The ART process exacerbates perceived stress and depression symptoms among individuals experiencing infertility. Given the potential long-term impacts on both parent and child wellbeing, clinicians and policymaking groups, including the American Society for Reproductive Medicine (ASRM), should consider making access to mental health services a standard of care during infertility treatment., (© 2024. The Author(s).)

Background: The aim of this systematic review was to reveal which of the coping strategies used by one partner are protective of and which pose a risk to the other partner's psychological adjustment during the treatment of infertility., Material and Methods: A systematic search of four electronic databases (PubMed, APA PsycINFO, SCOPUS, ScienceDirect), as well as the references of the retrieved articles, was performed between May and September 2023 for studies published from 1990 until 2023, using appropriate MeSH terms and associated text words. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Using an a priori developed pilot data extraction form, authors performed an independent extraction of articles. Information on participants, coping mechanisms, and psychological adjustment was extracted from each study. Relevant articles were critically appraised, and a narrative synthesis was conducted based on the different designs and outcome measures among the included studies., Results: A total of 194 articles were retrieved, and 187 were excluded for not meeting the inclusion criteria. After duplicates had been removed, five studies were included in the review. The results revealed that the psychological adaptation of infertile couples at an interpersonal level may be correlated with both the type of coping and the stage of the stressor (infertility treatment or in vitro fertilisation - IVF)., Conclusion: This systematic review suggests that health professionals could design and apply interventions based on modifying the coping mechanisms of infertile spouses to increase levels of well-being and decrease levels of distress., (© 2024 Meropi Moutzouri et al., published by Sciendo.)

Background: Over the past decade, nationally representative research elucidating the association between depression and infertility has been notably lacking. Our study aimed to investigate the association between depression and infertility among women of childbearing age., Methods: Our study encompassed 3,654 women aged 18 to 45 years from the National Health and Nutrition Examination Survey (NHANES) 2013-2018. Infertility was defined as a positive response to the query: "Have you attempted to conceive for a minimum of one year without achieving pregnancy?" Depression was evaluated by the Patient Health Questionnaire (PHQ-9) score (range, 0-27). Multiple logistic regression analyses and subgroup analyses stratified by age and race/ethnicity were conducted to investigate the association between depression and infertility. Furthermore, fitted smoothing curves and threshold effect analysis were utilized to depict the nonlinear relationship., Results: Total PHQ-9 score was associated with infertility in the fully adjusted model (OR 1.04, 95% CI 1.01-1.07, P = 0.010), and this relationship exhibited a non-linear pattern, reaching a saturation point at 13, as substantiated by the fitting of smoothed curves. Additionally, the association remained robust when stratified by age but not by race/ethnicity., Limitations: Cross-sectional design and recall biases., Conclusions: In this cross-sectional study, depression was associated with infertility among women of childbearing age in the fully adjusted models. This observed association holds potential relevance for clinicians tasked with enhancing psychological well-being during infertility management strategies., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Wan, He. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objective: Infertility affects one in six women worldwide, playing a large role on an individual's psychosocial wellbeing and quality of life. The purpose of this review was to examine the experiences of Muslim women with infertility., Methods: A Prisma-guided literature review was conducted in Scopus, CINAHL, PubMed, Embase, PsychInfo, and Google Scholar. Sample inclusion criteria included research that examined the psychosocial consequences of infertility in women, used a qualitative design, were from a Muslim majority country or specified participants were Muslim, and were published in the English-language since 2013. Thematic analysis was used to synthesize the findings into themes., Results: Fourteen qualitative studies that explored the experiences of Muslim women with infertility were included for analysis. Women's responses were categorized into three focus areas: (1) emotional responses, (2) interpersonal relationships, and (3) social relationships. From these focus points, six overarching themes were identified that illustrated the challenges faced by Muslim women experiencing infertility: (1) identity crisis, (2) low self-esteem and depression, (3) abuse and harassment, (4) a weakened marital bond, (5) stigma, and (6) social exclusion and isolation ., Clinical Implications: Review of the literature provided an initial entrée into understanding the experiences of Muslim women with infertility. Understanding the unique role of infertility within a religious community equips nurses and other providers with the knowledge that discussions surrounding infertility must be conducted with cultural sensitivity. Further research should be conducted to explore and offer culturally tailored educational materials that align with the religious preferences of Muslim women., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Competing Interests: Declaration of Competing Interest The author declares that she has no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Background: Son preference is known to be prevalent in developing countries and has dire consequences for the family, particularly girls and women. It is speculated that the prevalence of son preference may be high among fertility clinic attendees, and that son preference may be the reason for seeking fertility care in Nigeria., Objectives: To determine the prevalence and risk factors for son preference among fertility seekers in Enugu, Nigeria., Materials and Methods: Questionnaire-based cross-sectional study of fertility clinic attendees from the University of Nigeria Teaching Hospital Ituku-Ozalla Enugu and the Pink Petals Fertility Clinic Enugu from April 1 to September 30, 2023. Eligible and consenting participants were interviewed. Data collection was with a pretested interviewer-administered questionnaire, which contained three sections: biodata, obstetrics and gynecological data and 3-point son preference questions. The proportion of those who scored 3 (son preference) was documented. The analysis was both descriptive and inferential using IBM SPSS statistics for Windows, version 22.0 Armonk, NY, USA: IBM Corp., Results: Of the 422 participants interviewed, 416 (98.6%) completed the study with a nonresponse rate of 6 (1.4%). The overall prevalence of son preference was 10.1% (42/416) and all 42 (10.1%) were in the clinic to have a male baby. The risk factors for son preference were less than tertiary education (P < 0.001, adjusted odds ratio [AOR] = 6.46, confidence interval [CI] 2.79-14.98) and family pressure to have a male baby (P = 0.03, AOR = 3.41, CI 1.72-7.13)., Conclusions: One in 10 couples who attend an infertility clinic in Enugu, Nigeria, has a preference for son, and having a male child is the sole purpose of such a visit. Being under family pressure and not having tertiary education were the predictive risk factors for son preference in the study population., (Copyright © 2024 Copyright: © 2024 Annals of African Medicine.)

Purpose: To investigate the abortion views and reproductive concerns of current in vitro fertilization patients after the US Supreme Court Dobbs v. Jackson decision, which overturned the Roe v. Wade decision guaranteeing abortion access., Methods: This is a cross-sectional survey of English-speaking patients undergoing in vitro fertilization from January to November 2022 at a large academic institution in a state with restricted abortion care. Participants completed a 43-question electronic survey which measured feelings about abortion, future fertility treatments, and embryo disposition both quantitatively and qualitatively., Results: Of 543 eligible patients, 267 (49%) consented to participate when called and were sent the survey. Of those, 180 (67%) completed it, resulting in a total completion rate of 33%. The majority believe abortion should be legal in the case of birth defects (90.8%) or rape or incest (90.3%). A significant proportion (91.4%) expressed concerns about abortion being illegal in the state that they receive infertility care. They reported some concern about making embryos (89.6%), controlling what happens to them (95.4%), and discarding them (94.4%). Patients wrote about their concerns with pursuing fertility treatments, fear of not having access to needed medical care, and the desire to remain close to states with less restrictive abortion laws., Conclusions: The evolving political landscape surrounding access to reproductive care has created significant concerns regarding legal regulation of these treatments and the disposition of embryos. By understanding patients' concerns, health care providers can more effectively advocate for the protection of fertility treatments and patients' autonomy in embryo disposition., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Purpose: This study aimed to determine the levels of maternal and paternal attachment and the factors that affect them in individuals who had a baby after infertility treatment., Methods: This study followed a descriptive cross-sectional design in accordance with STROBE guidelines. The research was conducted in the infertility clinic of a university hospital and included 128 participants, consisting of 64 mothers and 64 fathers. Data were collected using the 'Personal Information Form-Mother', 'Personal Information Form-Father', 'Maternal Attachment Inventory (MAI)', and 'Postnatal Paternal-Infant Attachment Questionnaire (PPAQ)'., Results: The study found that the mothers had an average MAI score of 102.35 ± 3.05, while the fathers had an average PPAQ score of 82.21 ± 4.27. A significant correlation was observed between the mothers' MAI score and the duration of their marriage. Similarly, a significant correlation was observed between the fathers' PPAQ score and the duration of their marriage, the duration of their infertility diagnosis, and the duration of their infertility treatment (p < 0.05). The correlation analysis between the MAI score and the mean score of the PPAQ's subscale of pleasure in interaction was weakly significant and positive (r = 0.26; p = 0.032). However, there was no significant relationship between the MAI score and the PPAQ score (r = 0.18; p = 0.146)., Conclusions: The study findings indicate that parents who conceive through infertility treatment exhibit high levels of attachment to their babies. Healthcare professionals should assess the attachment levels of both mothers and fathers who have undergone infertility treatment and be mindful of the factors that influence it., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

This study focused on the psychological, social, and cultural dimensions of infertility among women with infertility in Harare Urban who have utilised traditional healthcare systems to address their infertility problem. It also emphasises their coping strategies for dealing with the challenges encountered along the infertile journey. This was a qualitative study using a phenomenological approach, focusing on the experiences of five women. Data from the interviews was analysed using a simplified version of Hycner's (1985) five-step explication process. The study produced three main themes: psychological experiences, socio-cultural experiences, and coping experiences, along with seven sub-themes. The results showed that women experienced intense distress, sorrow, and self-blame because of their inability to have children, further compounded by the stigma they faced from their families and communities. Women with infertility are subjected to derogatory labels, social contempt, ridicule, and being undervalued, which leads them to develop coping strategies to endure the adverse encounters. These coping mechanisms can have either positive or negative effects on their overall welfare. The exploration of psychological, socio-cultural factors, and coping mechanisms of women with infertility problems' presents a chance to co-create interventions that empower them., Competing Interests: The Authors declared no conflict of interest, (African Journal of Reproductive Health © 2024.)

Objective: To improve screening for depression in patients who are initiating fertility treatment at a reproductive endocrinology and infertility (REI) center by screening all patients at their initial visit using the Patient Health Questionnaire-9 (PHQ-9)., Design: This quality improvement project was conducted using a plan-do-study-act cycle implemented with a postintervention study design., Setting/local Problem: A medium-size REI center in a mid-Atlantic U.S. metropolitan area where screening for mental health status in patients initiating fertility treatments was not occurring., Participants: Patients who were scheduled in person with REI providers for a new patient consult regarding fertility were declared eligible., Intervention/measurements: The PHQ-9 was administered by providers at initial consults for patients seeking fertility treatments from October 2022 to February 2023. Three cycles of the plan-do-study-act model were used to execute change. For all patients who scored 5 to 9 (mild depression), conversations regarding counseling referrals occurred. For all patients who scored ≥10 (moderate to severe depression), a referral for counseling and medication management was generated. Data were analyzed via descriptive statistics., Results: A total of 115 participants were included. A screening rate of 84.3% (n = 97) was achieved for patients initiating treatment. Of the 97 screened, 21 patients had a score of ≥5; 19 were given a referral for counseling. However, none of the patients attended a counseling session or started medication prescribed by their primary care provider during the 2-month follow-up period. Barriers identified included costs, personal preferences, and access to services., Conclusion: The PHQ-9 screening tool was implemented at an REI clinic to improve the frequency of mental health screenings and provide necessary referrals. However, additional follow-up is needed to ensure patients are receiving appropriate mental health care., (Copyright © 2024 AWHONN. Published by Elsevier Inc. All rights reserved.)

Background and Aim: The relationship between psychological factors and treatment outcomes with assisted reproductive technology has sparked considerable debate. This study aims to investigate the emotional risk factors in couples seeking infertility treatment using assisted reproductive technology in Sari, Iran, from 2020 to 2022., Materials and Methods: This research is a cross-sectional study and emotional risk factors and other related factors were examined using the Persian version of the SCREENIVF demographic, social, and clinical status questionnaire, social, and clinical status questionnaire before using Assisted reproductive technology in 460 infertile couples selected from infertility treatment centers in Sari City, Iran. The samples were randomly selected using a table of random numbers. Data analysis was performed using SPSS version 22 software., Results: The mean age of the male and female participants were 31.70 ± 5.71 and 35.22 ± 5.48, respectively. The results regarding emotional risk factors and other related factors revealed that the variables of remarriage (P = 0.048) and exposure of spouse to emotional risk factors (P = 0.001), history of depression disorder (P = 0.007), and history of anxiety disorder (P = 0.009) were significantly correlated with the exposure of women to emotional risk factors. Furthermore, men's exposure to emotional risk factors was significantly correlated with primary education (P = 0.026) and diploma (P = 0.043) levels, age (P = 0.006), and wife's exposure to emotional risk factors (P = 0.001)., Conclusion: By identifying infertile couples who are at risk of emotional risk factors, healthcare professionals can provide appropriate support and interventions to mitigate the emotional challenges associated with infertility. This proactive approach can significantly enhance couples undergoing infertility treatment's well-being and mental health., (© 2024. The Author(s).)

Evaluating couples' coping with infertility and its impact on their mental health is valuable in designing supportive programs. Since infertility is a shared problem in married life, coping with it requires collaborative coping strategies. Therefore, the aim of the present study was to design and psychometrically evaluate the collaborative coping with infertility questionnaire (CCIQ) in candidates of assisted reproductive techniques (ART). The exploratory factor analysis of a 27-item questionnaire designed based on the Likert scale in the Persian language was evaluated through the principal component analysis method in a cross-sectional study conducted on 200 couples who volunteered for ART. The cut-off point of factor loadings was considered 0.4. Furthermore, the criterion validity of the questionnaire was evaluated using a 12-item revised Fertility Adjustment Scale (R-FAS) and its relationship with the score of the CCIQ. Moreover, the internal consistency of the questionnaire was evaluated using Cronbach's alpha correlation coefficient. In the exploratory factor analysis, 20 items with a factor loading above 0.4 were extracted under three factors. The three extracted factors with a value above one explained 43.78% of the variance of CCIQ. The factor loading of the accepted items ranged between 0.402 and 0.691. External reliability was confirmed with Cronbach's alpha coefficient of 0.98. The relationship between CCIQ and R-FAS score was significant (p < 0.0001). The results of the study showed that the 20-item CCIQ enjoyed acceptable validity and reliability in the three dimensions of 'dynamic interaction,' 'reorganizing married life goals,' and 'perception about infertility,' which can be used to evaluate collaborative coping with infertility questionnaire in ART candidates., (© 2024. The Author(s).)

Purpose: We explored and compared perspectives of reproductive endocrinology and infertility specialists (REIs) and in vitro fertilization (IVF) patients regarding polygenic embryo screening (PES), a new type of preimplantation screening that estimates the genetic chances of developing polygenic conditions and traits in the future., Methods: Qualitative thematic analysis of semi-structured interviews with US-based REIs and IVF patients., Results: Clinicians and patients often held favorable views of screening embryos for physical or psychiatric conditions, though clinicians tended to temper their positive attitudes with specific caveats. Clinicians also expressed negative views about screening embryos for traits more frequently than patients, who generally held more positive views. Most clinicians were either unwilling to discuss or offer PES to patients or were willing to do so only under certain circumstances, while many patients expressed interest in PES. Both stakeholder groups envisioned multiple potential benefits or uses of PES and raised multiple potential, interrelated concerns about PES., Conclusion: A gap exists between clinician and patient attitudes toward PES; clinicians generally maintained reservations about such screening and patients indicated interest in it. Clinicians and patients sometimes imagined using PES to prepare for the birth of a predisposed or "affected" individual-a rationale that is often associated with prenatal testing. Many clinicians and patients held different attitudes depending on what is specifically screened, despite the sometimes blurry distinction between conditions and traits. Considerations raised by clinicians and patients may help guide professional societies in developing guidelines to navigate the uncertain terrain of PES., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Objective: To explore the lived experiences of fathers in the perinatal period after infertility., Design: A descriptive, phenomenological study., Setting: Researcher's private office and participants' homes in an Eastern Canadian province., Participants: Eight fathers who met the eligibility criteria., Methods: We recruited a purposive sample of eight participants and held one-on-one interviews in person, by telephone, and via virtual platforms. We analyzed the verbatim transcripts of the audiotaped interviews using Colaizzi's phenomenological data analysis method., Results: We uncovered seven themes that described the lived experiences of participants: The Journey: A Long Winding Road, Roles and Responsibilities: Supporter and Protector, Support: The Often-Forgotten Parent, Challenges and Hurdles: Bumps on the Road, So Many Feelings: The Rollercoaster, Coping: Living on the Road, and Reflection: An Unforgotten Journey. Participants shared their experiences of the perinatal period after infertility as long journeys and described how bumps along the road marked these journeys. The journeys were essential parts of their lives that they continued to remember years later., Conclusion: The perinatal experience after infertility is an important and remembered time for fathers. It is essential to involve and support them in the perinatal process to facilitate positive experiences and overall family health, especially after infertility. There is an ongoing need to conduct research with fathers and to develop evidence-based programming and resources to assist them in the perinatal period after infertility., Competing Interests: Conflict of Interest The authors report no conflict of interest or relevant financial relationships., (Copyright © 2023 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.)

Backgroud: To investigate the factors influencing fertility quality of life in infertile men, constructing a structural equation model of the factors influencing fertility quality of life in infertile men, and to provide suggested measures for improving fertility quality of life in infertile men., Methods: It is a Observational study. Infertile men (n = 250) attending a fertility centre in a hospital in Xinjiang, matched 1:2 men with no obvious male factor in the control group (n = 500).The Quality of Fertility Life Scale, the Social Support Scale, the Fertility Stress Scale and the Positive Attention Awareness Scale were used to conduct the survey. The model was constructed by applying the maximum likelihood estimation method in Mplus 8.3 software, to explore the factors influencing the quality of reproductive life of infertile men through path analyses. Differences between the case and control groups were statistically significant (P < 0.05) in terms of total fertility quality of life scores, core entry dimensions, affective responses, physical and mental relationships, selective treatment dimensions, and treatment tolerance., Results: Past medical history, history of exposure to hazardous environments, health insurance reimbursement, social support, fertility stress, and mindfulness are important factors affecting the quality of fertility life of infertile men., Conclusion: The quality of fertility life of infertile men is not optimistic. By improving the level of mindfulness, fertility stress, and social support, we propose appropriate measures to improve the quality of fertility life of infertile men. These measures can improve their confidence in clinical diagnosis and infertility treatment, enabling them to cope positively with these challenges., (© 2024. The Author(s).)

Purpose: The purpose of this study was to examine the association between fertility issues and demographic characteristics of unmarried adolescent and young adult cancer survivors. Methods: We conducted a survey among cancer survivors who were 15-39 years old and unmarried at the time of cancer diagnosis and 20-45 years old at the time of the survey. Views on fertility issues, originally developed based on the results of a qualitative study conducted with the same inclusion criteria, were used to assess thoughts and feelings regarding fertility issues. Results: Through exploratory factor analysis of the 128 respondents who either had children or desired children, two factors related to fertility issues were identified: "anxiety related to the possibility of not being able to have children" and "pressure from others to have children." Multiple regression analysis was performed to examine the association between these factors and demographic characteristics. The analysis revealed that being male and having a partner were significant predictors for both factors for views on fertility issues. Additionally, younger age at the time of diagnosis was a significant predictor for the first factor. Conclusions: Greater fertility issues among unmarried cancer survivors were associated with younger age at diagnosis, having a partner, and being male. Surprisingly, contrary to previous findings, male cancer survivors experienced more significant fertility problems than women. This result may be attributed to the well-established gender roles in Japan, where men are predominantly considered the heirs and inheritors of the family.

Objectives: The present study aims to investigate whether each coping style used by Vietnamese people living with infertility diagnosis is associated with specific types of infertility-related stress (IRS)., Methods: In this cross-sectional design study, 997 patients with primary infertility diagnosis from three hospitals and two clinics in three regions of Vietnam completed questionnaire that consisted of Fertility Problem Inventory, the Copenhagen Multi-Centre Psychosocial Infertility and other questions. Four different linear regression analyses were performed on four coping styles. The five types of IRS and covariates were included in these models., Findings: The results show that participants who experience all five types of IRS reported the dominant use of active-avoidance coping, while having four types of IRS, except for social concern, was associated with higher use of meaning-based coping. Utilising active-confronting coping was reported to be the outcome of experiencing increasing need for parenthood and decreasing rejection of child-free lifestyle. Choice of passive-avoidance coping was more common among those with increasing social concern and need for parenthood. Age and educational level impacted infertile people's choice of avoidance coping strategies., Conclusions: The results provide evidence to understand the direct impact of each type of IRS on infertile people's choice of coping styles to better support them during their individual and family therapy.

This systematic review was carried out to describe QoL and resilience in infertile patients, as well as the relationship between them, and to give a theoretical foundation for clinical practice. The databases of CNKI, Wanfang data, VIP database, PubMed, Web of Science, and Embase were searched without a time limit. A narrative synthesis of relevant articles was undertaken. This systematic review was registered on PROSPERO in advance. Of 21 studies eligible for inclusion in this review, 13 focused on the relationship between QoL and resilience, 5 on QoL influencing factors (resilience included), and 3 on mediation effect analysis on mental health (resilience as a mediator). Resilience can significantly predict the QoL of infertile patients. It seems plausible that more resilient couples will be less vulnerable to the stress of infertility. A global consortium of infertile population research could make cross-cultural comparisons of QoL and resilience possible. Future research should focus on resilience therapies., Systematic Review Registration: This systematic review was registered on PROSPERO in advance (CRD42023414706)., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Liu, Dou, Qin, Zhao, Zheng, Wang, Zhang, Guan and Tian.)