Skip to main content

Advertisement

SpringerLink
Log in

Assisted reproductive technology treatments and quality of life: a longitudinal study among subfertile women and men

  • Assisted Reproduction Technologies
  • Published:
Journal of Assisted Reproduction and Genetics Aims and scope Submit manuscript

Abstract

Purpose

Quality of life (QoL) may represent a comprehensive indicator for the assessment of the psychological impact of complex clinical conditions, such as infertility. Infertile women have a worse QoL compared to both infertile men and non-infertile controls. However, the initial phases of infertility treatments have been frequently investigated using cross-sectional study designs. This prospective longitudinal study aimed at assessing the health-related QoL change across different phases of assisted reproductive technology (ART) treatments in subfertile women and men.

Methods

Eighty-five subfertile women and men undergoing ART cycles were assessed at the beginning of the ovarian stimulation, during oocyte retrieval before discharging, and around 14 days after the embryo transfer. QoL was assessed through the Short Form 36.

Results

Irrespective of the cause of infertility, work status, and age, QoL levels decreased from the first to the third assessment, and women scored significantly lower than men to each QoL indicator. Additionally, a higher number of previous ART failures had a negative impact on QoL, irrespective of gender and the phase of treatment. ART outcome marginally affected women’s QoL across time.

Conclusion

Infertile women have a worse QoL throughout all phases of ARTs compared to men, and this difference increases in infertile patients with more than one previous ART failure.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Kupka MS, Ferraretti AP, de Mouzon J, Erb K, D’Hooghe T, Castilla JA, et al. Assisted reproductive technology in Europe, 2010: results generated from European registers by ESHRE. Hum Reprod. 2014;10:1–15.

    Google Scholar 

  2. Italian NHI. Relazione del ministro della salute al parlamento sullo stato di attuazione della legge contenente norme in materia di procreazione medicalmente assistita. 2013. http://www.iss.it/binary/rpma/cont/9_Report_PMA_Dati_2013_ULTIMA.pdf.

  3. Lukse MP, Vacc NA. Grief, depression, and coping in women undergoing infertility treatment. Obstet Gynecol. 1999;93:245–51.

    CAS  PubMed  Google Scholar 

  4. Chiaffarino F, Baldini MP, Scarduelli C, Bommarito F, Ambrosio S, D’Orsi C, et al. Prevalence and incidence of depressive and anxious symptoms in couples undergoing assisted reproductive treatment in an Italian infertility department. Eur J Obstet Gynecol Reprod Biol. 2011;158:235–41.

    Article  PubMed  Google Scholar 

  5. Newton CR, Sherrard W, Glavac I. The Fertility Problem Inventory: measuring perceived infertility-related stress. Fertil Steril. 1999;72:54–62.

    Article  CAS  PubMed  Google Scholar 

  6. Oddens BJ, den Tonkelaar I, Nieuwenhuyse H. Psychosocial experiences in women facing fertility problems—a comparative survey. Hum Reprod. 1999;14:255–61.

    Article  CAS  PubMed  Google Scholar 

  7. Verhaak CM, Smeenk JMJ, Van Minnen A, Kremer JAM, Kraaimaat FW. A longitudinal, prospective study on emotional adjustment before, during and after consecutive fertility treatment cycles. Hum Reprod. 2005;20:2253–60.

    Article  CAS  PubMed  Google Scholar 

  8. Knoll N, Schwarzer R, Pfüller B, Kienle R. Transmission of depressive symptoms: a study with couples undergoing assisted-reproduction treatment. Eur Psychol. 2009;14:7–17.

    Article  Google Scholar 

  9. Verhaak CM, Smeenk JMJ, Evers AWM, Kremer JAM, Kraaimaat FW, Braat DDM. Women’s emotional adjustment to IVF: a systematic review of 25 years of research. Hum Reprod Update. 2007;13:27–36.

    Article  CAS  PubMed  Google Scholar 

  10. Brandes M, Van Der Steen JOM, Bokdam SB, Hamilto CJCM, De Bruin JP, Nelen WLDM, et al. When and why do subfertile couples discontinue their fertility care? A longitudinal cohort study in a secondary care subfertility population. Hum Reprod. 2009;24:3127–35.

    Article  CAS  PubMed  Google Scholar 

  11. Gameiro S, Boivin J, Dancet E, de Klerk C, Emery M, Lewis-Jones C, et al. ESHRE guideline: routine psychosocial care in infertility and medically assisted reproduction—a guide for fertility staff. Hum Reprod. 2015;30:1–11.

    Article  Google Scholar 

  12. Boivin J, Domar AD, Shapiro DB, Wischmann T, Fauser BC, Verhaak CM. Tackling burden in ART: an integrated approach for medical staff. Hum Reprod. 2012;27:941–50.

    Article  PubMed  Google Scholar 

  13. Chachamovich JR, Chachamovich E, Ezer H, Fleck MP, Knauth D, Passos EP. Investigating quality of life and health-related quality of life in infertility: a systematic review. J Psychosom Obstet Gynaecol. 2010;31:101–10.

    Article  PubMed  Google Scholar 

  14. Chachamovich JR, Chachamovich E, Zachia S, Knauth D, Passos EP. What variables predict generic and health-related quality of life in a sample of Brazilian women experiencing infertility? Hum Reprod. 2007;22:1946–52.

    Article  CAS  PubMed  Google Scholar 

  15. Martins MV, Basto-Pereira M, Pedro J, Peterson B, Almeida V, Schmidt L, et al. Male psychological adaptation to unsuccessful medically assisted reproduction treatments: a systematic review. Hum Reprod Update. 2016;22(4):466–78.

  16. Schmidt L. Psychosocial burden of infertility and assisted reproduction. Lancet. 2006;367:379–80.

    Article  PubMed  Google Scholar 

  17. Coeffin-Driol C, Giami A. The impact of infertility and its treatment on sexual life and marital relationships: review of the literature. Gynecol Obstet Fertil. 2004;32:624–37.

    Article  CAS  PubMed  Google Scholar 

  18. Nelson CJ, Shindel AW, Naughton CK, Ohebshalom M, Mulhall JP. Prevalence and predictors of sexual problems, relationship stress, and depression in female partners of infertile couples. J Sex Med. 2008;5:1907–14.

    Article  PubMed  Google Scholar 

  19. Khademi A, Alleyassin A, Amini M, Ghaemi M. Evaluation of sexual dysfunction prevalence in infertile couples. J Sex Med. 2008;5:1402–10.

    Article  PubMed  Google Scholar 

  20. Drosdzol A, Skrzypulec V. Quality of life and sexual ffunctioning of Polish infertile couples. Eur J Contracept Reprod Health Care. 2008;13(3):271–81.

    Article  PubMed  Google Scholar 

  21. Smith NK, Madeira J, Millard HR. Sexual function and fertility quality of life in women using in vitro fertilization. J Sex Med. 2015;12:985–93.

    Article  PubMed  Google Scholar 

  22. Tan S, Hahn S, Benson S, Janssen OE, Dietz T, Kimmig R, et al. Psychological implications of infertility in women with polycystic ovary syndrome. Hum Reprod. 2008;23:2064–71.

    Article  CAS  PubMed  Google Scholar 

  23. Wischmann T. Implications of psychosocial support in infertility—a critical appraisal. J Psychosom Obstet Gynaecol. 2008;29:83–9.

    Article  PubMed  Google Scholar 

  24. Chen TH, Chang SP, Tsai CF, Juang KD. Prevalence of depressive and anxiety disorders in an assisted reproductive technique clinic. Hum Reprod. 2004;19:2313–8.

    Article  PubMed  Google Scholar 

  25. Fassino S, Piero A, Boggio S, Piccioni V, Garzaro L. Anxiety, depression and anger suppression in infertile couples: a controlled study. Hum Reprod. 2002;17:2986–94.

    Article  CAS  PubMed  Google Scholar 

  26. Karabulut A, Özkan S, Oğuz N. Predictors of fertility quality of life (FertiQoL) in infertile women: analysis of confounding factors. Eur J Obstet Gynecol Reprod Biol. 2013;170:193–7.

    Article  PubMed  Google Scholar 

  27. Teskereci G, Oncel S. Effect of lifestyle on quality of life of couples receiving infertility treatment. J Sex Marital Ther. 2013;39:476–92.

    Article  PubMed  Google Scholar 

  28. Karaca N, Karabulut A, Ozkan S, Aktun H, Orengul F, Yilmaz R, et al. Effect of IVF failure on quality of life and emotional status in infertile couples. Eur J Obstet Gynecol Reprod Biol. 2016;206:158–63.

    Article  PubMed  Google Scholar 

  29. Maroufizadeh S, Ghaheri A, Omani SR. Factors associated with poor quality of life among Iranian infertile women undergoing IVF. Psychol Health Med. 2017;22:145–51.

    Article  PubMed  Google Scholar 

  30. Domar AD, Gross J, Rooney K, Boivin J. Exploratory randomized trial on the effect of a brief psychological intervention on emotions, quality of life, discontinuation, and pregnancy rates in in vitro fertilization patients. Fert Steril. 2015;104:440–51.

    Article  Google Scholar 

  31. Chan CHY, Lau HPB, Tam MYJ, Ng EHY. A longitudinal study investigating the role of decisional conflicts and regret and short-term psychological adjustment after IVF treatment failure. Hum Reprod. 2016;31:2772–80.

    Article  PubMed  Google Scholar 

  32. Boivin J, Lancastle D. Medical waiting periods: imminence, emotions and coping. Womens Health. 2010;6:59–69.

    Google Scholar 

  33. Aragona C, Mohamed MA, Espinola MSB, Linari A, Pecorini F, Micara G, et al. Clinical complications after transvaginal oocyte retrieval in 7,098 IVF cycles. Fertil Steril. 2011;95:293–4.

    Article  PubMed  Google Scholar 

  34. Goldberg D, Williams P. A user’s guide to the General Health Questionnaire. Windsor: NFER-Nelson; 1988.

    Google Scholar 

  35. Piccinelli M, Bisoffi G, Bon MG, Cunico L, Tansell M. Validity and test-retest reliability of the italian version of the 12-item General Health Questionnaire in general practice: a comparison between three scoring methods. Compr Psychiatry. 34(3):198–205.

  36. Ware JEJ, Kosinski M. SF-36 physical and mental health summary scales: a manual for users of version 1 (2nd ed.). Lincoln: QualiMetric Incorporated; 2001.

    Google Scholar 

  37. Apolone G, Mosconi P, Ware JEJ. Questionario sullo stato di salute SF-36. Manuale d’uso e guida all’interpretazione dei risultati. Milan: Guerini Associati; 2000.

    Google Scholar 

  38. Moura-Ramos M, Gameiro S, Canavarro MC, Soares I. Assessing infertility stress: re-examining the factor structure of the Fertility Problem Inventory. Hum Reprod. 2011;27:496–505.

    Article  PubMed  Google Scholar 

  39. Monti F, Agostini F, Paterlini M, Andrei F, De Pascalis L, Palomba S, et al. Effects of assisted reproductive technology and of women’s quality of life on depressive symptoms in the early postpartum period: a prospective case-control study. Gynecol Endocrinol. 2015;31:374–8.

    Article  PubMed  Google Scholar 

  40. Engel GL. The need for a new medical model: a challenge for biomedicine. Holist Med. 1989;4(1):37–53.

    Article  Google Scholar 

  41. Heredia M, Tenías JM, Rocio R, Amparo F, Calleja MA, Valenzuela JC. Quality of life and predictive factors in patients undergoing assisted reproduction techniques. Eur J Obstet Gynecol Reprod Biol. 2013;167:176–80.

    Article  CAS  PubMed  Google Scholar 

  42. Rashidi B, Montazeri A, Ramezanzadeh F, Shariat M, Abedinia N, Ashrafi M. Health-related quality of life in infertile couples receiving IVF or ICSI treatment. BMC Health Serv Res. 2008;8:186.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Culley L, Hudson N, Lohan M. Where are all the men? The marginalization of men in social scientific research on infertility. Reprod BioMed Online. 2013;27:225–35.

    Article  PubMed  Google Scholar 

  44. Boivin J, Takefman J, Braverman A. The fertility quality of life (FertiQoL) tool: development and general psychometric properties. Hum Reprod. 2011;26:2084–91.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Aarts JWM, Huppelschoten AG, van Empel IWH, Boivin J, Verhaak CM, Kremer JAM, et al. How patient-centred care relates to patients’ quality of life and distress: a study in 427 women experiencing infertility. Hum Reprod. 2012;27:488–95.

    Article  CAS  PubMed  Google Scholar 

  46. Mousavi SA, Masoumi SZ, Keramat A, Pooralajal J, Shobeiri F. Assessment of questionnaires measuring quality of life in infertile couples: a systematic review. J Reprod Infertil. 2013;14:110–9.

    PubMed  PubMed Central  Google Scholar 

  47. Su CT, Ng HS, Yang AL, Lin CY. Psychometric evaluation of the Short Form 36 Health Survey (SF-36) and the World Health Organization Quality of Life Scale Brief Version (WHOQOL-BREF) for patients with schizophrenia. Psychol Assess. 2014;26:980–9.

    Article  PubMed  Google Scholar 

  48. Ware JE, Gandek B, Kulasekaran A, Guyer R. Evaluation of smoking-specific and generic quality of life measures in current and former smokers in Germany and the United States. Health Qual Life Outcomes. 2015;13:1.

    Article  Google Scholar 

  49. Zhou K, Zhuang G, Zhang H, Liang P, Yin J, Kou L, et al. Psychometrics of the Short Form 36 Health Survey Version 2 (SF-36v2) and the Quality of Life Scale for Drug Addicts (QOL-DAv2. 0) in Chinese mainland patients with methadone maintenance treatment. PLoS One. 2013;8(11):e79828.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Abbaszadeh F, Kafaei Atrian M, Masoudi Alavi N, Bagheri A, Sadat Z, Karimian Z. Relationship between quality of life and depression in pregnant women. Nurs Midwifery Stud. 2013;2:193–7.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Gharacheh M, Azadi S, Mohammadi N, Montazeri S, Khalajinia Z. Domestic violence during pregnancy and women’s health-related quality of life. Glob J Health Sci. 2015;8:27–34.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Gameiro S, Boivin J, Peronace L, Verhaak CM. Why do patients discontinue fertility treatment? A systematic review of reasons and predictors of discontinuation in fertility treatment. Hum Reprod Update. 2012;18:652–69.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  53. Dancet EAF, Nelen WLDM, Sermeus W, De Leeuw L, Kremer JAM, D’Hooghe TM. The patients’ perspective on fertility care: a systematic review. Hum Reprod Update. 2010;16:467–87.

    Article  CAS  PubMed  Google Scholar 

  54. Dancet EAF, Van Empel IWH, Rober P, Nelen WLDM, Kremer JAM, D’Hooghe TM. Patient-centred infertility care: a qualitative study to listen to the patient’s voice. Hum Reprod. 2011;26:827–33.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychology, University of Bologna, Viale Berti Pichat 5, 40127, Bologna, Italy

    Francesca Agostini, Fiorella Monti & Federica Andrei

  2. Unit of Obstetrics and Gynecology, IRCCS – ASMN of Reggio Emilia, Reggio Emilia, Italy

    Marcella Paterlini, Stefano Palomba & Giovanni Battista La Sala

  3. University of Modena and Reggio Emilia, Modena, Italy

    Giovanni Battista La Sala

Authors
  1. Francesca Agostini
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Fiorella Monti
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Federica Andrei
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Marcella Paterlini
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Stefano Palomba
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Giovanni Battista La Sala
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

F.M. contributed to the conception of the study and was responsible for the research program. F.A. contributed to the conception of the study and to the manuscript revision and participated in the critical discussion. F.A. contributed to the data analysis and participated in the manuscript drafting and critical discussion. M.P. participated in the study conception, data collection, and critical discussion. S.P. contributed to the manuscript revision, participated in the critical discussion and in manuscript drafting, and gave the final approval of the version to be published. G.B.L.S. participated in the study design and gave the final approval of the version to be published.

Corresponding author

Correspondence to Francesca Agostini.

Ethics declarations

The study was conducted in accordance with the Helsinki Declaration. All patients (women and their partners) had written information about the study protocol, the specific consent was obtained, and a written informed consent to use non-sensitive data for research was signed.

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Agostini, F., Monti, F., Andrei, F. et al. Assisted reproductive technology treatments and quality of life: a longitudinal study among subfertile women and men. J Assist Reprod Genet 34, 1307–1315 (2017). https://doi.org/10.1007/s10815-017-1000-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10815-017-1000-9

Keywords

Search

Navigation