Not conceiving, and losing a pregnancy or a newborn.
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301 to 325 of 627Hypogonadotropic hypogonadism revisited.
Impaired testicular function, i.e., hypogonadism, can result from a primary testicular disorder (hypergonadotropic) or occur secondary to hypothalamic-pituitary dysfunction (hypogonadotropic). Hypogonadotropic hypogonadism can be congenital or acquired. Congenital hypogonadotropic hypogonadism is divided into anosmic hypogonadotropic hypogonadism (Kallmann syndrome) and congenital normosmic isolated hypogonadotropic hypogonadism (idiopathic hypogonadotropic hypogonadism). The incidence of congenital hypogonadotropic hypogonadism is approximately 1-10:100,000 live births, and approximately 2/3 and 1/3 of cases are caused by Kallmann syndrome (KS) and idiopathic hypogonadotropic hypogonadism, respectively. Acquired hypogonadotropic hypogonadism can be caused by drugs, infiltrative or infectious pituitary lesions, hyperprolactinemia, encephalic trauma, pituitary/brain radiation, exhausting …
matched on Infertility, Male (mesh), infertility (text)
Impact of male obesity on infertility: a critical review of the current literature.
Objective: To evaluate the current understanding of the effects and potential mechanisms of obesity on male fertility.
Design: Literature review of articles pertaining to obesity and male infertility.
Result(s): Recent population-based studies suggest an elevated risk for subfertility among couples in which the male partner is obese and an increased likelihood of abnormal semen parameters among heavier men. Male factor infertility is associated with a higher incidence of obesity in the male partner. Obese men exhibit reduced androgen and SHBG levels accompanied by elevated estrogen levels. Reduced inhibin B levels correlate with degree of obesity and are not accompanied by compensatory increases in FSH. This complexly altered reproductive hormonal profile suggests that endocrine dysregulation in obese men may explain the increased risk of altered semen parameters and infertility. Additio…
matched on Infertility, Male (mesh), infertility (text)
ICSI: hype or hazard?
Ever since its introduction in clinical practice more than 10 years ago, intracytoplasmic sperm injection (ICSI) has been the subject of ongoing debate regarding its indications and safety. ICSI is hyped because of its potential to give couples with severe male factor infertility a chance to conceive, and because of its apparently low fertilization failure rate compared with 'classic' in vitro fertilization (IVF). Concerns about ICSI are related to technical, biological and genetic hazards. ICSI has been branded 'the ultimate rape of the oocyte', as the oocyte membrane is mechanically pierced, appearing to bypass all biological and genetic selection. ICSI has been linked in a number of reports to an increased incidence of chromosomal anomalies, congenital abnormalities and perinatal hazards in offspring conceived with this technique. The etiology of the increased risk of chromosomal anom…
matched on Infertility, Male (mesh), infertility (text)
Psychosocial Care of Pregnancy Loss in the Emergency Department.
Introduction: Emergency departments in the United States manage nearly 900,000 visits annually for early pregnancy loss. Patients frequently report limited emotional support, inadequate provider knowledge, and insufficient communication.
Methods: A pre- and postintervention design was used to assess ED staff knowledge, attitudes, and supportive care skills related to reproductive grief. Demographic data were collected. Paired t tests evaluated changes across 7 educational domains.
Results: The analytic sample (N = 39) consisted of chaplains (7.7%), nurses (61.6%), patient care assistants (7.7%), radiology technicians (5.1%), social workers (5.1%), and ED technicians (12.8%). Postintervention analyses demonstrated increased mean scores across all domains, including emotional support, patient-centered care, discharge planning, bereavement care, community resources, staff support, and commu…
matched on Abortion, Spontaneous (mesh), miscarriage (text), pregnancy loss (text)
Providing emotional care for early pregnancy loss: Development and evaluation of a new training module for healthcare providers.
Background: Miscarriage is a common life event that frequently causes significant grief and distress. The emotional impact of miscarriage has been shown to be strongly influenced by patients' and partners' experiences interacting with healthcare providers during the miscarriage diagnosis and treatment: positive experiences are associated with reduced perinatal grief, whereas negative interactions can aggravate the traumatic impact of the loss. Unfortunately, healthcare providers frequently report feeling ill-equipped and unprepared to provide adequate emotional care for miscarriage. As such, there is an urgent need for effective training material to support healthcare providers in this important care.
Method: Here, we report a quasi-experimental study evaluating the effectiveness of a new training module that we recently developed to empower healthcare providers when providing emotional …
matched on Abortion, Spontaneous (mesh), miscarriage (text), pregnancy loss (text)
Further Hierarchies of Loss: Tracking Relationality in Pregnancy Loss Experiences.
The article extends Robson and Walter's concept of hierarchies of loss by describing further factors which afford differential social legitimacy to death-related losses. Drawing on our separate research with women in England who have experienced pre-viability pregnancy loss through different types of miscarriage and termination for foetal anomaly, we note that closeness of relationship to the object of loss does hierarchise pregnancy loss. However, other relational elements are also implicated, including ontological positions on what it was which was lost, in relation to other individually and socially experienced losses. Hierarchies are both imposed and agentially used by those who are implicated. This wider analysis extends the concept of hierarchies of loss so it can include experiences which do and do not involve grief and bereavement, and experiences of social recognition alongside …
matched on Abortion, Spontaneous (mesh), miscarriage (text), pregnancy loss (text)
Silverio SA, George-Carey R, Memtsa M, Kent-Nye FE, Magee LA, Sheen KS, Burgess K, Oza M, Storey C, Sandall J, PUDDLES UK Collaboration, Easter A, von Dadelszen P, Jurković D (2024)MEDLINE-indexed journal, not yet read by usBMC pregnancy and childbirth3 citations Preliminary findings on the experiences of care for women who suffered early pregnancy losses during the COVID-19 pandemic: a qualitative study.
Background: Women who suffer an early pregnancy loss require specific clinical care, aftercare, and ongoing support. In the UK, the clinical management of early pregnancy complications, including loss is provided mainly through specialist Early Pregnancy Assessment Units. The COVID-19 pandemic fundamentally changed the way in which maternity and gynaecological care was delivered, as health systems moved to rapidly reconfigure and re-organise services, aiming to reduce the risk and spread of SARS-CoV-2 infection. PUDDLES is an international collaboration investigating the pandemic's impact on care for people who suffered a perinatal bereavement. Presented here are initial qualitative findings undertaken with UK-based women who suffered early pregnancy losses during the pandemic, about how they navigated the healthcare system and its restrictions, and how they were supported.
Methods: In-k…
matched on Abortion, Spontaneous (mesh), miscarriage (text), pregnancy loss (text)
The relationship between healthcare satisfaction after miscarriage and perinatal grief symptoms: A cross-sectional study on Portugal residents.
Objective: 15-20% of identified pregnancies result in miscarriage, which may lead to persistent symptoms of psychological morbidities in some women. Healthcare satisfaction is among the factors believed to influence such negative psychological responses. Here, we present the results of a study conducted in Portugal that analyzes the relationship between healthcare satisfaction, information and support provision and perinatal grief symptoms.
Methods: In a cross-sectional study, symptoms of perinatal grief, degree of satisfaction with healthcare received, and information and support provision data were collected through an online survey aimed at women in Portugal who suffered a miscarriage. 873 were considered eligible. Correlations were performed between perinatal grief scores and healthcare satisfaction rates. Finally, the proportions of information and support received were compared aft…
matched on Abortion, Spontaneous (mesh), miscarriage (text), pregnancy loss (text)
"If it has happened once, it can happen again". The impact of previous pregnancy loss on anxious women's ongoing pregnancies: A qualitative study from Pakistan.
Background: Pregnancy loss that includes both miscarriage and stillbirth cause significant psychological distress for women including anxiety, depression, and grief that persist long after physical recovery. This study focuses on the experiences of women in Pakistan, where pregnancy loss rates are high.
Objective: To explore how pregnant women with anxiety symptoms and a history of pregnancy loss perceive their past experiences with the loss and how it affects overall well-being in their current pregnancy.
Design: Qualitative methods were used to explore the impact of previous pregnancy loss on the well-being of pregnant women.
Setting: This qualitative research was embedded within a randomized control trial conducted in a tertiary care facility in Rawalpindi, Pakistan.
Participants: Data were collected through in-depth interviews with 18 pregnant women who had experienced pregnancy loss…
matched on Abortion, Spontaneous (mesh), miscarriage (text), pregnancy loss (text)
Women's desires for mental health support following a pregnancy loss, termination of pregnancy for medical reasons, or abortion: A report from the STRONG Women Study.
Objective: We report on women's mental health care desires following a miscarriage, medical termination, or abortion.
Method: 689 women completed a questionnaire on reproductive history, health care following miscarriage/medical termination/abortion, and current mental health. Descriptive statistics and logistic regression analyses examined: miscarriage/termination/abortion incidence, desires for mental health support following miscarriages/terminations/abortions, and current mental health.
Results: Of 365 women with a pregnancy history, 37% reported ≥1 miscarriage, 9% ≥1 medical termination, 16% ≥1 abortion, and 3% endorsed all three. Current mental health did not differ between women with a history of miscarriage/termination/abortion and those with only live births (p = 0.82). Following miscarriage, 68% of women discussed options for the medical management of pregnancy loss with their …
matched on Abortion, Spontaneous (mesh), miscarriage (text), pregnancy loss (text)
The psychological impact of Early Pregnancy Loss in Portugal: incidence and the effect on psychological morbidity.
Introduction: Worldwide, up to a quarter of all recognized pregnancies result in Early Pregnancy Loss (EPL), also known as miscarriage. For many women, this is a traumatic experience that leads to persistent negative mental health responses. The most common morbidity reported in studies from different countries is complicated grief, usually comorbid with depression, anxiety, and Post-Traumatic Stress Disorder (PTSD). To our best knowledge, no studies characterizing the psychological impact of EPL have been made in Portugal.
Methods: An online survey was conducted to evaluate clinical symptoms of perinatal grief, anxiety, depression, and PTSD in women who suffered a spontaneous loss within 20 weeks of gestation. Out of 1,015 women who answered this survey, 873 were considered eligible, and subsequently distributed in 7 groups according to the time passed between their loss and their part…
matched on Abortion, Spontaneous (mesh), miscarriage (text), pregnancy loss (text)
A Multidisciplinary, Family-Oriented Approach to Caring for Parents After Miscarriage: The Integrated Behavioral Health Model of Care.
Miscarriage is increasingly gaining recognition, both in scientific literature and media outlets, as a loss that has significant and lasting effects on parents, though often disenfranchised and overlooked by both personal support networks and healthcare providers. For both men and women, miscarriage can usher in intense grief, despair, and difficulty coping, and for women in particular, there is evidence of increased prevalence of depression, anxiety, and post-traumatic stress. Additionally, miscarriage can contribute to decreased relationship satisfaction and increased risk of separation, all while stigma and disenfranchisement create a sense of isolation. Despite this increased need for support, research indicates that many parents experience their healthcare providers as dismissive of the significance of the loss and as primarily focusing only on the physical elements of care. Researc…
matched on Abortion, Spontaneous (mesh), miscarriage (text), pregnancy loss (text)
Social work intervention for women experiencing early pregnancy loss in the emergency department.
Often referred to as miscarriage, Early Pregnancy Loss (EPL) is the spontaneous death of a fetus experienced within the first 20 weeks of gestation and is the most common complication in pregnancy. Symptoms of an impending EPL are routinely managed in the Emergency Department (ED). EPL can have a substantial impact on women, potentially leading to psychological and emotional health issues and risks to future pregnancies. Despite the high prevalence of EPL, many women suffer in silence due to the common societal belief that EPL are insignificant. Many women experience EPL as an ambiguous loss and are at risk for disenfranchised grief. Compassionate, patient-centred care has been identified by women as an essential and often missing aspect of ED care and can have a profound impact on the overall well-being of women after EPL. Social workers play a critical role in the ED given that they pr…
matched on Abortion, Spontaneous (mesh), miscarriage (text), pregnancy loss (text)
History of pregnancy loss increases the risk of mental health problems in subsequent pregnancies but not in the postpartum.
While grief, emotional distress and other mental health conditions have been associated with pregnancy loss, less is known about the mental health impact of these events during subsequent pregnancies and births. This paper examined the impact of any type of pregnancy loss on mental health in a subsequent pregnancy and postpartum. Data were obtained from a sub-sample (N = 584) of the 1973-78 cohort of the Australian Longitudinal Study on Women's Health, a prospective cohort study that has been collecting data since 1996. Pregnancy loss was defined as miscarriage, termination due to medical reasons, ectopic pregnancy and stillbirth. Mental health outcomes included depression, anxiety, stress or distress, sadness or low mood, excessive worry, lack of enjoyment, and feelings of guilt. Demographic factors and mental health history were controlled for in the analysis. Women with a previous pre…
matched on Abortion, Spontaneous (mesh), miscarriage (text), pregnancy loss (text)
[The trauma of miscarriage--factors influencing the experience of anxiety after early pregnancy loss].
The experience of miscarriage results in tremendous emotional disturbance for many affected women. Depression, anxiety, (pathological) grief, and posttraumatic stress symptoms are commonly experienced reactions. Several factors influence the level of emotional distress, like age, previous experience of miscarriage, or social support. In this work, we investigated the level of emotional distress after miscarriage using a novel methodological approach. Through the world wide web, N = 500 texts of women who reported freely on their miscarriage were accessed and analyzed using the Dresden Anxiety Dictionary, a German computerized version of the Gottschalk-Gleser speech analysis. The women were 28 years old on average. The texts were written, on average, about 28 days after the miscarriage. Women's pregnancy had lasted between 2 and 40 weeks (M = 12). The scores pertaining to death anxiety an…
matched on Abortion, Spontaneous (mesh), miscarriage (text), pregnancy loss (text)
Time to pregnancy in subfertile women in German gynecological practices: analysis of a representative cohort of more than 60,000 patients.
Background: The aim of this study was to assess the time from the first subfertility diagnosis to pregnancy (TTP) and to elucidate factors influencing TTP for patients in German gynecological practices comprising a representative sample and provide a realistic picture of the current situation in Germany.
Methods: The study collective included all women with first-time diagnoses of female infertility (ICD: N97) or unfulfilled desire for children (ICD: Z31) from the representative database (IMS Disease Analyzer). Demographic data on patients such as their age (ranges 18-25, 26-30, 31-35, 36-40 or 51-50) and information on previous pregnancies and births and concomitant diseases were collected. Data pertaining to 61,815 women from 433 gynecological practices in Germany with a first diagnosis of female infertility or an unfulfilled desire for children were analyzed. The period of data collec…
matched on Infertility, Female (mesh), Pregnancy Rate (mesh), Reproductive Techniques, Assisted (mesh), infertility (text)
Relationships in IVF couples 20 years after treatment.
Background: Involuntary childlessness is a psychological and social dilemma for at least one but usually both members of the childless couples and is thought to have a lifelong impact on many of these couples. Studies of the long-term effects are scarce and the participation rate in published studies is generally very low. We therefore intended to analyse relationships and family structure in couples 20-23 years after the women in these couples had received IVF treatment.
Methods: The data are drawn from answers from 788 individuals-81% of the individuals treated. ENRICH has been used to analyse the relationships in those couples who stated that they have remained a couple since their IVF treatment. In total, 412 men and women (206 couples) answered the ENRICH inventory. A total of 14 men and 137 women answered the ENRICH, without their spouse answering the inventory.
Results: We found t…
matched on Infertility (mesh), Fertilization in Vitro (mesh)
Psychological correlates of prenatal attachment in women who conceived after in vitro fertilization and women who conceived naturally.
Background: Investigators have pointed out that long-awaited pregnancies, such as those after in vitro fertilization (IVF), are emotionally vulnerable. In addition, higher pregnancy-related distress has been found among women pregnant after in vitro fertilization compared with women with "naturally" achieved pregnancy. The aim of this study was to compare prenatal attachment among IVF mothers and control mothers (women who conceived naturally), and to study relationships between prenatal attachment and psychosocial variables.
Methods: Fifty-six IVF women from IVF clinics and 41 control women from antenatal clinics in Stockholm were assessed in gestational weeks 26 and 36. They completed self-rating scales measuring prenatal attachment, personality, marital relationship, anxiety, and depression.
Results: Prenatal attachment increased as the pregnancy progressed in both groups. Prenatal at…
matched on Infertility (mesh), Fertilization in Vitro (mesh)
Otani-Matsuura A, Sugiura-Ogasawara M, Ebara T, Matsuki T, Tamada H, Yamada Y, Omori T, Kato S, Kano H, Kaneko K, Matsuzaki K, Saitoh S, Kamijima M, Japan Environment and Children’s Study Group (2022)MEDLINE-indexed journal, not yet read by usJournal of reproductive immunology9 citations Depression symptoms during pregnancy and postpartum in patients with recurrent pregnancy loss and infertility: The Japan environment and children's study.
There are a limited number of studies in which the depression status was followed up throughout pregnancy and postpartum to 1 year after delivery though 8.6-33% of women with recurrent pregnancy loss (RPL) and 10-25% of women who undergo in vitro fertilization and embryo transfer (IVF-ET) suffer from depression. We examined whether RPL and IVF-ET affect depressive symptoms during pregnancy and postpartum. A nationwide large-scale birth cohort study known as the "Japan Environment and Children's Study (JECS)" was conducted. The subjects consisted of 99,202 pregnant women recruited between January 2011 and March 2014. The Kessler Psychological Distress Scale was used for the 1st trimester, 2nd/3rd trimester and 1 year postpartum. The Edinburgh Postnatal Depression Scale was used for the first and the sixth month postpartum. The screening instruments were used to quantify depressive symptom…
matched on Infertility (mesh), pregnancy loss (text), infertility (text)
Longitudinal study of emotional experiences, grief and depressive symptoms in women and men after miscarriage.
Objective: Although miscarriage is common and affects up to 20% of pregnant women, little is known about these couples' short term and long term experiences after miscarriage. The aim of the present study was to study emotional experience, grief and depressive symptoms in women and men, one week and four months after miscarriage.
Research design /setting: Women, (n = 103), and their male partner (n = 78), were recruited at the gynecological clinic after miscarriage. Control women were recruited from the general population. Three validated questionnaires concerning psychological wellbeing and mental health, RIMS, PGS and MADRS-S were answered by the participants one week and four months after the miscarriage.
Findings: It was shown that for women, the emotional experiences of miscarriage, grief and depressive symptoms were more pronounced than for their male partners. Grief and depressive…
matched on Abortion, Spontaneous (mesh), miscarriage (text), infertility (text)
Couples and Miscarriage: The Influence of Gender and Reproductive Factors on the Impact of Miscarriage.
Objective: We sought to understand the effect of gender, age, mental health history, and reproductive factors on the appraisal of miscarriage in couples.
Design: We conducted a secondary analysis of data from the Couples Miscarriage Healing Project.
Sample: We analyzed data from 341 couples who had miscarried within 3 months of the original study recruitment.
Method: Multifactorial analysis of variance was used to analyze baseline effects of gender, age, mental health history, infertility, number of miscarriages, living children, and gestational age on the impact of miscarriage as measured by the three subscales of the Revised Impact of Miscarriage Scale: Isolation/Guilt, Devastating Event, and Loss of Baby.
Results: Women scored significantly higher than men on all measures. Younger couples in whom either member had been previously treated for anxiety, depression, or grief were more lik…
matched on Abortion, Spontaneous (mesh), miscarriage (text), infertility (text)
Social disparities in the use of ART treatment: a national register-based cross-sectional study among women in Denmark.
Study question: How are educational level, labor market attachment and income associated with receiving a first ART treatment in either the public or private healthcare sector among women in Denmark?
Summary answer: Higher educational level and income as well as labor market attachment were associated with higher probability of initiating ART treatment at public and private fertility clinics among women in Denmark.
What is known already: Infertility is common in populations worldwide, and the approach to this issue differs between societies and healthcare systems. In the public Danish healthcare system, ART treatment is free of charge, and the direct cost for patients is therefore low. In the private healthcare sector in Denmark, ART treatment is self-financed. There is limited knowledge about the association between socioeconomic factors and seeking ART treatment, although previous stud…
matched on Infertility (mesh), Fertility (mesh), infertility (text)
Jackson Levin N, Tan CY, Stelmak D, Iannarino NT, Zhang A, Ellman E, Herrel LA, Walling EB, Moravek MB, Chugh R, Haymart MR, Zebrack B (2023)MEDLINE-indexed journal, not yet read by usJournal of adolescent and young adult oncology24 citations Banking on Fertility Preservation: Financial Concern for Adolescent and Young Adult Cancer Patients Considering Oncofertility Services.
Purpose: Financial concern is a major issue for adolescent and young adult (AYA) cancer patients. Furthermore, unaddressed oncofertility challenges (e.g., infertility) are linked to psychological distress and decreased overall quality of life. Little is known about how financial concern in terms of oncofertility (i.e., concern regarding affording fertility preservation [FP] services) impacts AYAs' decision making and experiences. Methods: AYA cancer patients (n = 27) aged 12-25 years whose cancer treatment conferred risk of infertility were recruited through electronic health record query. Participants completed semi-structured interviews, which were recorded, transcribed, and deductively coded for themes related to information needs, knowledge of treatment effects on fertility, and reproductive concerns after cancer. Emergent, inductive themes related to financial concern were identifie…
matched on Infertility (mesh), Fertility (mesh), infertility (text)
Rodriguez-Wallberg KA, Ahlgren J, Smedby KE, Gorman JR, Hellman K, Henriksson R, Ståhl O, Wettergren L, Lampic C (2023)MEDLINE-indexed journal, not yet read by usActa oncologica (Stockholm, Sweden)13 citations Prevalence and predictors for fertility-related distress among 1010 young adults 1.5 years following cancer diagnosis - results from the population-based Fex-Can Cohort study.
Background: Cancer treatment during reproductive ages may negatively impact fertility and there is a need of firm knowledge about the prevalence and predictors of fertility-related distress. The aim was to examine fertility-related distress in a population-based sample of young women and men recently treated for cancer and to identify predictors for this outcome.
Material and methods: This nationwide cohort study included 1010 individuals (694 women and 316 men), mean age 34.5 ± 4.9 and 32.1 ± 5.5, respectively, diagnosed with breast, cervical, ovarian, testicular cancers, brain tumors or lymphoma at ages 18-39 in Sweden. Participants completed a survey 1.5-year post-diagnosis to assess fertility-related distress (RCAC), emotional distress (HADS) and self-efficacy, as well as sociodemographic and clinical factors and fertility preservation. Logistic regression was used to examine associa…
matched on Infertility (mesh), Fertility (mesh), infertility (text)
The link between infertility-related distress and psychological distress in couples awaiting fertility treatment: a dyadic approach.
While there is broad evidence to suggest that individual stress increases, and that high couple relationship quality reduces the risk for psychological distress, our understanding of these associations in couples dealing with infertility remains limited. In this cross-sectional study, we used dyadic data-analysis (Actor-Partner Interdependence Model; APIM) to examine the effects of infertility-related distress (experienced as an individual risk factor) and couple relationship quality (experienced as a couple-based resource), on psychological distress in a sample of 116 infertile couples. 59% of women and 23% of men reported clinical levels of psychological distress, 71% of women and 45% of men reported infertility-related distress, and 3% of participants reported low couple relationship quality. Infertility-related distress predicted psychological distress at the individual level ('actor…
matched on Infertility (mesh), Fertility (mesh), infertility (text)