The Needs of Infertile Couples after Unsuccessful Treatment with Assisted Reproductive Technologies: A Systematic Review of Literature

Document Type : Review Article

Authors

1 PhD Student in Reproductive Health, Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

2 Professor, Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

3 Assistant Professor, Community-Based Psychiatric Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

4 Associate Professor, Department of Community Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

5 Associate Professor, Department of Obstetrics and Gynecology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Background: Infertility is recognized as one of the major medical problems in the world. Infertility treatment is a complex, long, and stressful process, and may lead to unsuccessful treatment. It seems necessary to follow up the patients after unsuccessful treatment, to identify their needs and desires, and to provide health services for their health promotion. Therefore, this systematic review was conducted to investigate the needs and preferences of infertile couples after unsuccessful treatment with assisted reproductive technologies (ARTs).Methods: In this systematic review, searching was performed without time restrictions in PubMed, Scopus, the Cochrane Library, PsycINFO, Web of Science databeses, as well as Google Scholar search engine, and Iranian databases including Magiran, Scientific Information Database (SID), Iranpsych, Clinical key, and Iranmedex. Keywords included infertility treatment, assisted reproductive techniques, needs, expectations, unsuccessful treatmen,t and their equivalent words. The relevant articles were retrieved from English and Persian databases. The articles were independently evaluated by two researchers, and disagreements were discussed with the third author.Findings: 24 eligible studies (16 cross-sectional and 8 cohort studies), published between the years 1980 and 2019, were included in the study. The needs expressed by infertile patients in these studies includes educational-informational needs, the need to psychological counseling, supportive needs, men's special needs, the need to strategies for stress management, the need for couples counseling, and the need for receiving respect and empathy from health care staff.Conclusion: Infertile couples' needs included a wide spectrum of needs including educational, psychological, supportive, and counseling needs as well as men's special needs. Recognition of this vulnerable group’s needs can help policymakers and programmers to plan and implement counseling services in fertility clinics. In such a way, the quality of health services in these clinics would be improved and infertile couples' needs would be met.

Keywords


  1. World Health Organization. Infertility is a global public health issue [Online]. [cited 2017]; Available from: URL: https://www.who.int/reproductivehealth/topics/infertility/perspective/en/
  2. Hodin S, Harvard TH. The Burden of Infertility: Global Prevalence and Women's Voices from Around the World [Online]. [cited 2017 Jan 18]; Available from: URL: https://www.mhtf.org/2017/01/18/the-burden-of-infertility-global-prevalence-and-womens-voices-from-around-the-world/
  3. Mascarenhas MN, Flaxman SR, Boerma T, Vanderpoel S, Stevens GA. National, regional, and global trends in infertility prevalence since 1990: A systematic analysis of 277 health surveys. PLoS Med 2012; 9(12): e1001356.
  4. Stahlman S, Fan M. Female infertility, active component service women, U.S. Armed Forces, 2013-2018. MSMR 2019; 26(6): 20-7.
  5. Direkvand Moghaddam A, Delpisheh A, Sayehmiri K. An investigation of the worldwide prevalence of infertility as a systematic review. Qom Univ Med Sci J 2016; 10(1): 76-87. [In Persian].
  6. Direkvand Moghadam A, Delpisheh A, Sayehmiri K. The prevalence of infertility in Iran, a systematic review. Iran J Obstet Gynecol Infertil 2014; 16(81): 1-7. [In Persian].
  7. Greil AL, Slauson-Blevins K, McQuillan J. The experience of infertility: A review of recent literature. Sociol Health Illn 2010; 32(1): 140-62.
  8. Benksim A, Elkhoudri N, Addi RA, Baali A, Cherkaoui M. Difference between primary and secondary infertility in morocco: Frequencies and associated factors. Int J Fertil Steril 2018; 12(2): 142-6.
  9. Berek JS. Berek and Novak's gynecology. 15th ed. Philadelphia, PA: Lippincott Williams and Wilkins; 2012.
  10. Nouri M, Lotfi K, Askari G. The effect of coenzyme q10 supplementation on male infertility: A systematic review on randomized clinical trial studies. J Isfahan Med Sch 2019; 36(504): 1401-7. [In Persian].
  11. Szamatowicz M. Assisted reproductive technology in reproductive medicine - possibilities and limitations. Ginekol Pol 2016; 87(12): 820-3.
  12. Segev J, van den Akker O. A review of psychosocial and family functioning following assisted reproductive treatment. Clin Eff Nurs 2006; 9(2): e162-e170.
  13. Luke B. Pregnancy and birth outcomes in couples with infertility with and without assisted reproductive technology: with an emphasis on US population-based studies. Am J Obstet Gynecol 2017; 217(3): 270-81.
  14. ESHRE Capri Workshop Group. Failures (with some successes) of assisted reproduction and gamete donation programs. Hum Reprod Update 2013; 19(4): 354-65.
  15. Kushnir VA, Barad DH, Albertini DF, Darmon SK, Gleicher N. Systematic review of worldwide trends in assisted reproductive technology 2004-2013. Reprod Biol Endocrinol 2017; 15(1): 6.
  16. Rostami Dovom M, Ramezani Tehrani F, Abedini M, Amirshekari G, Mehrabi Y. Prevalence of primary and secondary infertility among 18-49 years old Iranian women: A population-based study in four selected provinces. Hakim Health Sys Res 2014; 16(4): 294-301. [In Persian].
  17. Schmidt L, Sejbaek CS. The psychosocial consequences of infertility and fertility treatment. Ugeskr Laeger 2012; 174(41): 2459-62. [In Danish].
  18. Jacobs MB, Klonoff-Cohen H, Agarwal S, Kritz-
  19. Silverstein D, Lindsay S, Garzo VG. Predictors of treatment failure in young patients undergoing in vitro fertilization. J Assist Reprod Genet 2016; 33(8): 1001-7.
  20. Vahratian A, Smith YR, Dorman M, Flynn HA. Longitudinal depressive symptoms and state anxiety among women using assisted reproductive technology. Fertil Steril 2011; 95(3): 1192-4.
  21. Verhaak CM, Smeenk JM, van MA, Kremer JA, Kraaimaat FW. A longitudinal, prospective study on emotional adjustment before, during and after consecutive fertility treatment cycles. Hum Reprod 2005; 20(8): 2253-60.
  22. Maroufizadeh S, Karimi E, Vesali S, Omani SR. Anxiety and depression after failure of assisted reproductive treatment among patients experiencing infertility. Int J Gynaecol Obstet 2015; 130(3): 253-6.
  23. Volgsten H, Svanberg AS, Olsson P. Unresolved grief in women and men in Sweden three years after undergoing unsuccessful in vitro fertilization treatment. Acta Obstet Gynecol Scand 2010; 89(10): 1290-7.
  24. 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(6): 652-69.
  25. Huppelschoten AG, van Dongen AJ, Philipse IC, Hamilton CJ, Verhaak CM, Nelen WL, et al. Predicting dropout in fertility care: A longitudinal study on patient-centredness. Hum Reprod 2013; 28(8): 2177-86.
  26. Khalili MA, Kahraman S, Ugur MG, Agha-Rahimi A, Tabibnejad N. Follow up of infertile patients after failed ART cycles: a preliminary report from Iran and Turkey. Eur J Obstet Gynecol Reprod Biol 2012; 161(1): 38-41.
  27. Rockliff HE, Lightman SL, Rhidian E, Buchanan H, Gordon U, Vedhara K. A systematic review of psychosocial factors associated with emotional adjustment in in vitro fertilization patients. Hum Reprod Update 2014; 20(4): 594-613.
  28. Maleki-Saghooni N, Amirian M, Sadeghi R, Latifnejad Roudsri R. Effectiveness of infertility counseling on pregnancy rate in infertile patients undergoing assisted reproductive technologies: A systematic review and meta-analysis. Int J Reprod Biomed (Yazd) 2017; 15(7): 391-402.
  29. Frederiksen Y, Farver-Vestergaard I, Skovgard NG, Ingerslev HJ, Zachariae R. Efficacy of psychosocial interventions for psychological and pregnancy outcomes in infertile women and men: A systematic review and meta-analysis. BMJ Open 2015; 5(1): e006592.
  30. Yazdani F, Elyasi F, Peyvandi S, Moosazadeh M, Galekolaee KS, Kalantari F, et al. Counseling-supportive interventions to decrease infertile women's perceived stress: A systematic review. Electron Physician 2017; 9(6): 4694-702.
  31. Giahi L, Mohammadmoradi S, Javidan A, Sadeghi MR. Nutritional modifications in male infertility: a systematic review covering 2 decades. Nutr Rev 2016; 74(2): 118-30.
  32. Luk BH, Loke AY. The impact of infertility on the psychological well-being, marital relationships, sexual relationships, and quality of life of couples: A systematic review. J Sex Marital Ther 2015; 41(6): 610-25.
  33. Dyer SJ, Patel M. The economic impact of infertility on women in developing countries a systematic review. Facts Views Vis Obgyn 2012; 4(2): 102-9.
  34. Latifnejad Roudsari R, Allan HT, Smith PA. Iranian and English women's use of religion and spirituality as resources for coping with infertility. Hum Fertil (Camb) 2014; 17(2): 114-23.
  35. Golmakani N, Ebrahimzadeh Zagami S, Esmaily H, Vatanchi A, Kabirian M. The relationship of the psychological coping and adjustment strategies of infertile women with the success of assisted reproductive technology. Int J Reprod Biomed (Yazd) 2019; 17(2).
  36. Latifnejad Roudsari R, Allan H, Smith P. A qualitative inquiry into the mediating role of religion and spirituality in adjusting marital relationships of infertile women. Journal of Midwifery and Reproductive Health 2013; 1(1): 33-41.
  37. Ebrahimzadeh Zagami S, Latifnejad Roudsari R, Janghorban R, Mousavi Bazaz SM, Amirian M, Allan HT. Infertile couples' needs after unsuccessful fertility treatment: A qualitative study. J Caring Sci 2019; 8(2): 95-104.
  38. Wiersema NJ, Drukker AJ, Mai BT, Giang HN, Nguyen TN, Lambalk CB. Consequences of infertility in developing countries: Results of a questionnaire and interview survey in the South of Vietnam. J Transl Med 2006; 4: 54.
  39. Rauprich O, Berns E, Vollmann J. Information provision and decision-making in assisted reproduction treatment: Results from a survey in Germany. Hum Reprod 2011; 26(9): 2382-91.
  40. Porter M, Bhattacharya S. Helping themselves to get pregnant: A qualitative longitudinal study on the information-seeking behaviour of infertile couples. Hum Reprod 2008; 23(3): 567-72.
  41. Jafarzadeh-Kenarsari F, Ghahiri A, Habibi M, Zargham-Boroujeni A. Exploration of infertile couples' support requirements: A qualitative study. Int J Fertil Steril 2015; 9(1): 81-92.
  42. Bergart AM. The experience of women in unsuccessful infertility treatment: what do patients need when medical intervention fails? Soc Work Health Care 2000; 30(4): 45-69.
  43. Ebrahimzadeh Zagami S, Latifnejad Roudsari R, Janghorban R, Mousavi Bazaz SM, Amirian M, Allan HT. A qualitative study of the challenges experienced by Iranian infertile couples after unsuccessful assisted reproductive technologies. International Journal of Women's Health and Reproduction Sciences 2019; 7(3): 331-8.
  44. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: Explanation and elaboration. BMJ 2009; 339: b2700.
  45. von EE, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies. BMJ 2007; 335(7624): 806-8.
  46. Wu J, Ma J, Zhang WH, Di W. Management and outcomes of pregnancy with or without lupus nephritis: a systematic review and meta-analysis. Ther Clin Risk Manag 2018; 14: 885-901.
  47. Domar AD, Rooney K, Hacker MR, Sakkas D, Dodge LE. Burden of care is the primary reason why insured women terminate in vitro fertilization treatment. Fertil Steril 2018; 109(6): 1121-6.
  48. Bennett LR. Infertility, womanhood and motherhood in contemporary Indonesia: Understanding gender discrimination in the realm of biomedical fertility care. Intersections: Gender and Sexuality in Asia and the Pacific 2012; 28: 1-12.
  49. Dyer SJ, Abrahams N, Mokoena NE, van der Spuy ZM. 'You are a man because you have children': experiences, reproductive health knowledge and treatment-seeking behaviour among men suffering from couple infertility in South Africa. Hum Reprod 2004; 19(4): 960-7.
  50. Satir DG, Kavlak O. Use of the internet related to infertility by infertile women and men in Turkey. Pak J Med Sci 2017; 33(2): 265-9.
  51. Hadizadeh-Talasaz F, Roudsari RL, Simbar M. Decision for disclosure: The experiences of Iranian infertile couples undergoing assisted reproductive donation procedures. Hum Fertil (Camb) 2015; 18(4): 265-75.
  52. Hesselvik LM. Life after infertility: A grounded theory of moving on from unsuccessful fertility treatment [PhD Thesis]. Hertfordshire, UK: University of Hertfordshire; 2017.
  53. Martins MV, Peterson BD, Almeida V, Mesquita-Guimaraes J, Costa ME. Dyadic dynamics of perceived social support in couples facing infertility. Hum Reprod 2014; 29(1): 83-9.
  54. Karaca A, Unsal G. Psychosocial problems and coping strategies among Turkish women with infertility. Asian Nurs Res (Korean Soc Nurs Sci) 2015; 9(3): 243-50.
  55. Lund R, Sejbaek CS, Christensen U, Schmidt L. The impact of social relations on the incidence of severe depressive symptoms among infertile women and men. Hum Reprod 2009; 24(11): 2810-20.
  56. Latifnejad Roudsari R, Allan HT. Women's experiences and preferences in relation to infertility counselling: A multifaith dialogue. Int J Fertil Steril 2011; 5(3): 158-67.
  57. Ying LY, Wu LH, Loke AY. The experience of Chinese couples undergoing in vitro fertilization treatment: Perception of the treatment process and partner support. PLoS One 2015; 10(10): e0139691.
  58. Culley LA, Hudson N, Rapport FL, Katbamna S, Johnson MR. British South Asian communities and infertility services. Hum Fertil (Camb) 2006; 9(1): 37-45.
  59. Alper MM, Brinsden PR, Fischer R, Wikland M. Is your IVF programme good? Hum Reprod 2002; 17(1): 8-10.
  60. Taghipour A, Karimi FZ, Roudsari RL, Kimiaei SA, Mazlom SR, Amirian M. Women's perceptions and experiences of the challenges in the process of male infertility treatment: A qualitative study. Electron Physician 2017; 9(5): 4349-56.
  61. Place I, Laruelle C, Kennof B, Revelard P, Englert Y. What kind of support do couples expect when undergoing IVF treatment? Study and perspectives. Gynecol Obstet Fertil 2002; 30(3): 224-30. [In French].
  62. Taebi M, Ebadi A, Ozgoli G, Kariman N. Translation and psychometric evaluation of the Infertility Stigma Consciousness Questionnaire. J Isfahan Med Sch 2019; 36(506): 1457-62. [In Persian].
  63. Ezabadi Z, Mollaahmadi F, Mohammadi M, Omani SR, Vesali S. Identification of reproductive education needs of infertile clients undergoing assisted reproduction treatment using assessments of their knowledge and attitude. Int J Fertil Steril 2017; 11(1): 20-7.
  64. Bennett LR, Wiweko B, Bell L, Shafira N, Pangestu M, Adayana IB, et al. Reproductive knowledge and patient education needs among Indonesian women infertility patients attending three fertility clinics. Patient Educ Couns 2015; 98(3): 364-9.
  65. Himmel W, Meyer J, Kochen MM, Michelmann HW. Information needs and visitors' experience of an Internet expert forum on infertility. J Med Internet Res 2005; 7(2): e20.
  66. Sylvest R, Furbringer JK, Schmidt L, Pinborg A. Infertile men's needs and assessment of fertility care. Ups J Med Sci 2016; 121(4): 276-82.
  67. Karimi FZ, Taghipour A, Latifnejad Roudsari R, Kimiaee SA, Mazloum SR, Amirian, M. Psycho - social effects of male infertility in Iranian women: A qualitative study. The Iran J Obstet Gynecol Infertil 2016, 19(10):20-32. [In Persian].
  68. Karimi FZ, Taghipour A, Roudsari RL, Kimiaei SA, Mazlom SR, Amirian M. Cognitive emotional consequences of male infertility in their female partners: A qualitative content analysis. Electron Physician 2015; 7(7): 1449-57.
  69. Schick M, Rosner S, Toth B, Strowitzki T, Wischmann T. Exploring involuntary childlessness in men - a qualitative study assessing quality of life, role aspects and control beliefs in men's perception of the fertility treatment process. Hum Fertil (Camb) 2016; 19(1): 32-42.
  70. Latifnejad Roudsari R, Rasolzadeh Bidgoly M, Mousavifar N, Modarres Gharavi M. The effect of collaborative counseling on perceived infertility-related stress in infertile women undergoing IVF. Iran J Obstet Gynecol Infertil 2011; 14(4): 22-31. [In Persian].
  71. Latifnejad Roudsari R, Rasoulzadeh Bidgoli M. The effect of collaborative infertility counseling on marital satisfaction in infertile women undergoing in vitro fertilization: A randomized controlled trial. Nurs Midwifery Stud 2017; 6(2): e36723.
  72. Rasoulzadeh Bidgoli M, Latifnejad Roudsari R. The effect of the collaborative infertility counseling model on coping strategies in infertile women undergoing in vitro fertilization: A randomized controlled trial. International Journal of Women's Health and Reproduction Sciences 2018; 6(1): 47-54.
  73. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009; 6(7): e1000097.
  74. Norouzi S, Motlagh Z, Masoumi N, Tavassoli E, Moghaddam F. Educational need assessment of infertile women admitted to Yazd Reproductive Sciences Institute. International Journal of Women's Health and Reproduction Sciences 2017; 5(2): 123-8.
  75. Babore A, Stuppia L, Trumello C, Candelori C, Antonucci I. Male factor infertility and lack of openness about infertility as risk factors for depressive symptoms in males undergoing assisted reproductive technology treatment in Italy. Fertil Steril 2017; 107(4): 1041-7.
  76. Taebi M, Gandomani SJ, Nilforoushan P, Gholami Dehaghi A. Association between infertility factors and non-physical partner abuse in infertile couples. Iran J Nurs Midwifery Res 2016; 21(4): 368-71.
  77. Pasch LA, Holley SR, Bleil ME, Shehab D, Katz PP, Adler NE. Addressing the needs of fertility treatment patients and their partners: Are they informed of and do they receive mental health services? Fertil Steril 2016; 106(1): 209-15.
  78. Mikkelsen AT, Madsen SA, Humaidan P. Psychological aspects of male fertility treatment. J Adv Nurs 2013; 69(9): 1977-86.
  79. Baldur-Felskov B, Kjaer SK, Albieri V, Steding-Jessen M, Kjaer T, Johansen C, et al. Psychiatric disorders in women with fertility problems: Results from a large Danish register-based cohort study. Hum Reprod 2013; 28(3): 683-90.
  80. Vassard D, Lund R, Pinborg A, Boivin J, Schmidt L. The impact of social relations among men and women in fertility treatment on the decision to terminate treatment. Hum Reprod 2012; 27(12): 3502-12.
  81. Su TJ, Tzeng YL, Kuo PC. The anxiety of Taiwanese women with or without continuity treatment after previous in vitro fertilisation failure. J Clin Nurs 2011; 20(15-16): 2217-23.
  82. Hammarberg K, Baker HW, Fisher JR. Men's experiences of infertility and infertility treatment 5 years after diagnosis of male factor infertility: a retrospective cohort study. Hum Reprod 2010; 25(11): 2815-20.
  83. Peronace LA, Boivin J, Schmidt L. Patterns of suffering and social interactions in infertile men: 12 months after unsuccessful treatment. J Psychosom Obstet Gynaecol 2007; 28(2): 105-14.
  84. Schmidt L, Holstein BE, Boivin J, Sangren H, Tjornhoj-Thomsen T, Blaabjerg J, et al. Patients' attitudes to medical and psychosocial aspects of care in fertility clinics: findings from the Copenhagen Multi-centre Psychosocial Infertility (COMPI) Research Programme. Hum Reprod 2003; 18(3): 628-37.
  85. Malin M, Hemmink E, Raikkonen O, Sihvo S, Perala ML. What do women want? Women's experiences of infertility treatment. Soc Sci Med 2001; 53(1): 123-33.
  86. Bryson CA, Sykes DH, Traub AI. In vitro fertilization: A long-term follow-up after treatment failure. Hum Fertil (Camb) 2000; 3(3): 214-20.
  87. Laffont I, Edelmann RJ. Perceived support and counselling needs in relation to in vitro fertilization. J Psychosom Obstet Gynaecol 1994; 15(4): 183-8.