Psychosocial interventions for infertile couples:A scoping review

Objective:To bring out current evidence regarding psycho-social interventions for infertility care,and identify the best practices in clinical care.Methods:An in-depth literature review on infertility care intervention was conducted using data from multiple databases:PubMed,EMBASE,Google Scholar,and PsycINFO.The relevant articles selected were between 2008 and 2022.Results:A literature search turned up 1798 citations,of which 25 studies were included after rigorous analysis.Various intervention categories have been constantly utilised to provide support and promote mental health,of which acceptance and commitment therapy(ACT)and cognitive behaviour therapy(CBT)were used most frequently.The interventions exhibited diversity in both content and composition,and addressed a wide range of issues.Conclusions:The review emphasizes that psycho-social interventions have a positive effect on psychological issues,relationships,and pregnancies among couples and can be incorporated into fertility-care practices.

Risk behaviours associated with HIV and AIDS among couples in Rwamiko Sector, Gicumbi District, Rwanda

Background:Risk behaviours have been linked to the spread of the Human Immunodeficiency Virus(HIV)epidemic in both urban and rural areas.Despite the progress made in the fight against HIV,it remains a public health concern worldwide.Risk behaviours such as not using condoms,having multiple sexual partners,and engaging in early sexual activity increase the risk of HIV infection.Therefore,it is important to assess these risk behaviours and understand the relationship between different factors and HIV,specifically among couples,in order to better understand the dynamics of the epidemic.The main objective of this study was to assess risk behaviours for HIV and AIDS among couples in Rwamiko sector,Gicumbi District,and suggest appropriate interventions for this group.Methods:This cross-sectional survey aimed to assess associated HIV and AIDS risk behaviours among couples in Rwamiko Sector,Gicumbi District,in order to determine the dynamics of the epidemic in this group and suggest appropriate interventions.Data was collected using a self-administered questionnaire and a multistage cluster random sampling technique.The collected data was then computed,analyzed,and presented in the form of tables and figures.Descriptive statistics were used to analyze all variables.Multivariate logistic regression was used to calculate odds ratios and 95%confidence intervals(CI)to investigate the relationship between the assessed factors,such as independent and dependent variables.The association between the studied factors was described using odds ratios with 95%CIs.Results:The majority of respondents were in the age group of 30-39 years.All respondents were married,and approximately 45%had completed primary education.The majority of respondents were unemployed.Respondents reported receiving HIV information from multiple sources,including radio,TV,films,school,church,health workers,parents,and friends.The findings of this study showed that some participants had knowledge about HIV transmission and prevention,while others did not.The proportion of respondents with a high level of HIV and AIDS knowledge was 30.61%(n=60),while moderate knowledge accounted for 53.57%(n=105).Furthermore,the proportion of respondents with a low level of knowledge on HIV and AIDS was 15.81%(n=31).The attitude towards HIV and AIDS was positive for 58.16%(n=114)of respondents,while 41.83%(n=82)had a negative attitude.None of the respondents reported using injection drugs.Significant associations were found between age(P-value=0.002,odds ratio(OR)=3.4,95%CI=1.59-7.67),gender(p=0.001,OR=2.6,95%CI=1.44-4.68),and alcohol consumption.There was also an association between age(P=0.001,OR=5.13,95%CI=2.04-12.91)and having multiple sexual partners.Conclusion:The majority of couples in Rwamiko Sector,Gicumbi District have a moderate level of knowledge and a positive attitude towards HIV and AIDS.However,the proportions of respondents with a low level of knowledge and a negative attitude should not be overlooked.The results of this study suggest the need to improve communication messages related to HIV,its transmission risks,and safer sexual behavior,particularly among couples in Rwamiko Sector,Gicumbi District.

Profile of Discordant Couples for Human Immunodeficiency Virus Infection Followed in Kinshasa: Case of Monkole Medical Center

Background: Programs targeting serodiscordant couples in Africa are not a priority in efforts to prevent Human Immunodeficiency Virus (HIV) infection, although a large proportion of these occur in stable relationships, of which serodiscordance accounts for about two-thirds with a high risk of seroconversion of the seronegative partner. Objective: The objective of this study was to describe the profile of HIV serodiscordant couples followed in Kinshasa, DRC. Methods: Descriptive cross-sectional study to describe the profile of different heterosexual HIV serodiscordant couples followed at the Monkole Medical Center in Kinshasa, DRC, from November 2021 to June 2022. The data were collected from the information sheets elaborated by the research team as well as from the information provided by the computerized files of the patients managed at the Infectious Diseases Unit of the Monkole Medical Center after the signature of the informed consent. An average of 8 cc of blood was taken from a peripheral vein in the patient’s forearm, and was stored in EDTA tubes at −20˚C, of which at least 6 mL were used for biochemical analyses, 2 spots of 200 μL for each partner were stored on filter paper at −20˚C and were used for DNA extraction. Nested PCR confirmed the serological diagnosis. Results: Out of a total of 482 heterosexual couples followed for HIV at the Monkole Medical Center, 28 (5.8%) were HIV serodiscordant, of which 14 (2.9%) couples agreed to participate in the present study. The mean age was 43.39 ± 10 years with extremes ranging from 24 to 62 years. The patients were mainly from the informal sector (53.6%) and weighed between 61 and 71 kg (46.4%). Sexual intercourse continued in all couples, without condom use (85.7%) for desire of procreation (82.1%);although the great majority of HIV-negative partners (85.7%) were not under ARV prophylaxis. Leukopenia was found in 42.9% of HIV-negative partners compared to 21% of HIV-positive partners;all partners had a predominantly lymphocytic white blood cell count. 21.4% of HIV-negative partners had high HDL, 14.3% of HIV-positive partners had low HDL, and 14.3% of HIV-negative partners had high LDL. Chi-square and Pearson correlation tests showed no relationship between the biochemical parameters performed and the couples’ serodiscordance for HIV. Conclusion: The frequency of HIV discordant couples in Kinshasa is significant. Serodiscordance is encountered in young intellectual and entrepreneurial couples with a desire to procreate. It is desirable to carry out further analyses for better management of these couples.

Factors Associated with Unmet Need for Family Planning among Couples Living in Urban and Rural Areas of Guinea in 2019

Introduction: Unmet need for family planning (UNFP) is defined as women with unmet needs who want to stop or delay childbearing but are not using any method of contraception. The objective of this study was to analyze the factors associated with unmet needs for family planning among couples living in rural and urban areas of Guinea in 2019. Methodology: This was a prospective, analytical cross-sectional, multicenter study of a six-month period from August 1, 2018 to January 31, 2019, focusing on couples with unmet needs for family planning. Result: Among 189 couples interviewed, 567 had UNFP (33.3%), the reasons for not using modern contraceptive methods were desire for pregnancy (AOR = 2.74, 95% CI: 1.74, 4.31), husband’s refusal (AOR = 0.23, 95% CI: 0.06, 0.81), spousal attitude (AOR = 0.20, 95% CI: 0.130, 30), birth spacing (AOR = 2.10% to 95%: 1.16, 3.82), difficulty with a new pregnancy (AOR = 0.17, 95% CI: 0.04, 0.74), and spousal attitude (AOR = 0.20, 95% CI: 0.14, 0.30). Conclusion: The involvement of spouses, especially in rural communities, would help achieve family planning objectives and reduce unmet needs for family planning.

Quality of life of infertile couples in the Gaza Strip, Palestine

Objective:To investigate the quality of life of infertile couples who seek in vitro fertilizations(IVFs)by gender in the Gaza Strip,Palestine.Methods:A cross-sectional study was conducted,from February 2019 to November 2019,among 383 infertile couples selected through convenient sampling.A valid and reliable Arabic version of the fertility quality of life questionnaire(FertiQoL)was used in data collection.One way analysis of variance and independent t-test were applied to compare between males and females.Results:The mean age of males and females was(34.54±8.54)years and(29.28±6.71)years,respectively.More than half of them had university degree(64%and 60%,respectively).The mean duration of infertility was(5.66±3.54)years.The mean males’scores of FertiQoL and its subscales(emotion,mind/body,social,core,tolerability,and treatment)were significantly higher than females’scores(P<0.05).Conclusions:Males have higher scores of FertiQoL and its subscales than females.The mean score of FertiQoL increases with better education,but decreases with increase of age,duration of marriage,duration of infertility and number of IVF attempts.Routine psychological assessment and counseling are necessary for infertile women taking into considerations factors affecting their quality of life.

Live birth rates of assisted reproductive technology treatment and spontaneous conception among subfertile couples in Singapore: A follow-up study

Objective: To explore the potential predictors of a live birth (LB) outcome among subfertile couples of Asian ethnicity undergoing the first fertility treatment cycle;to assess the cumulative live birth rates after successive cycles;and to determine the incidence rate of spontaneous conception (SC).Methods:Subfertile couples were grouped according to treatment modalities at the first fertility treatment cycle: intrauterine insemination (IUI),in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI) and no treatment, and were followed-up for duration up to seven years. Multivariable logistic regression analysis was used for statistical analyses. Results: Age of female subjects [35-38 years, odds ratio (OR): 0.39;≥39 years, OR: 0.14], uterine factor subfertility (OR: 5.24), and treatment modalities (ORs: IUI 0.25, IVF 2.33 and ICSI 1.91) significantly predicted a LB outcome (P<0.05). The cumulative live birth rates were 11.7% IUI, 41.5% IVF, 27.5% ICSI and 22.6% from frozen embryo transfer cycles. The cumulative SC rate was 24.6% in the non-treated group and 10.7% in the treated group. All LBs from IVF cycles were delivered by the second cycle and within four years, compared to SC delivery of within five years in the non-treated group and six years in the treated group. Conclusions:Age of female subject, uterine factor and modalities of treatment are significant predictors for LB outcome at the first cycle. Higher delivery rates could be achieved following fewer successive IVF cycles and within a shorter duration compared to SC.

Spousal communication, fertility preference and other factors affecting contraceptive use among married couples in Ekiti State, Nigeria

Objective:To assess and compare the relationship between spousal communication,fertility preference,and other factors with contraceptive use among married couples in Ekiti State,Nigeria.Methods:This cross-sectional study was carried out in AdoEkiti Local Government Area of Ekiti State,Nigeria between the 12th of August 2017 and the 15th of February 2018.A pre-tested,semi-structured interviewer-administered questionnaire was used to collect data from 976 respondents by a multi-stage sampling technique.Data were analyzed(univariate,bivariate,and binary logistic regression analysis)using SPSS version 24.0.Factors that showed statistical significance(P<0.05)were included in a binary logistic regression to determine significant predictors of contraceptive use.Results:The proportion of respondents currently using contraceptives was 56.9%.The education status of the respondents revealed that those with primary education were more likely to use contraceptives than those without formal education[adjusted odds ratio(aOR)8.4,95%confidence interval(CI)1.97-36.2,P<0.001].Respondents with fair spousal communication were more likely to use contraceptive than those with poor communication(aOR 4.9,95%CI 2.80-8.71,P<0.001).In addition,fertility preference of 4 or less children was found to be significantly associated with contraceptive use(aOR 3.0,95%CI 1.67-5.50,P<0.001)compared to a preference of more than 4 children.Finally,the urban respondents were more likely to use contraceptives than those in the rural setting(aOR 1.7,95%CI 1.16-2.41,P=0.047).Conclusions:Educational status,residential site,spousal communication,and fertility preference significantly influence the level of contraceptive use among married couples.Couples should endeavor to discuss more on issues bordering on their fertility preference and contraceptive issue.Government should formulate policies to improve the rural uptake of contraceptives using identified target interventions.

Uptake of in-vitro fertilization among couples attending fertility clinic in a tertiary health institution

Objective:To identify factors that determine the uptake of in-vitro fertilization(IVF),and to determine the predicting effect of the identified factors on the uptake of IVF among couples attending fertility clinic at a tertiary health institution in Benin City,Nigeria.Methods:This study adopted a cross-sectional descriptive design.A self-structured questionnaire tested was validated and administered to 250 couples who attended fertility clinic.Data were collected from March 2021 to June 2021 and were analyzed using the Statistical Package for Social Science(SPSS)version 21.Data were presented and interpreted using descriptive statistics and inferential statistics such as Chi-square,univariate statistics and multivariate logistic regression analysis.Results:Among 250 couples,154(61.6%)were willing to adopt IVF.The multivariate logistic regression analysis showed that catholic religion[odds ratio(OR)0.21,95%confident interval(CI)0.54-0.73],family income(OR 1.50,95%CI 1.10-2.00)and age(OR 1.04,95%CI 1.01-1.10)were the major factors that determined the uptake of IVF,with P-value of<0.001,0.018 and 0.031,respectively.Conclusions:The uptake of IVF could be sustained or improved on,if the government should improve on the cost of living for families,and religious leaders need to be encouraged to pass on the information about IVF to their members to be well guided about the possibilities of IVF.

Childcare,Elderly Caring and Off-farm Employment of Rural Couples in China

Based on the representative sample survey data of more than 1 000 farmers in 101 villages of 25 counties of 5 provinces in China,within the framework of family collective decision-making,this paper studied the effects and heterogeneity of childcare and elderly caring on the off-farm employment mode of rural couples. It found that caring the children younger than 3 years old significantly reduces the possibility of offfarm employment of rural couples;conversely,if there is 60-80 years old member in the family,it will significantly increase the possibility of off-farm employment of rural couples or the wives. Caring the children above 12 years old or the elderly older than 80 years old reduces the possibility of off-farm employment of the husbands. Whether there is preschool education service facility in the village has no effect on the off-farm employment of the couples.

Current Situations and Challenges Concerning Sexual Health among Unmarried Couples Composed of a Mix of Japanese, South Korean Nationals, and Ethnic Koreans Born in Japan (<i>Zainichi</i>): A Qualitative Study

South Korean nationals are heavily represented in Japan’s foreign population, making up around 20% of all foreign residents in the country. Koreans in Japan can be viewed in two groups: Korean nationals who work or study in Japan, and those of Korean ancestry who were born in Japan or otherwise have historical reasons for residency (commonly called zainichi). There are certain differences seen in gender roles and Confucianism-based traditional culture among Japanese, South Korean nationals, and zainichi. This qualitative study examined consciousness and attitudes about marriage, family planning, and work-life balance in unmarried couples among these three groups. Semi- structured interviews were conducted with five unmarried couples comprising two members from the above three groups (age range: 20 - 35 years), residing in the Kinki region of western Japan. Twelve categories, 25 subcategories, and 79 codes were extracted from 636 contexts. Values regarding sexual health were analyzed from four viewpoints: marriage, family planning, work-life ba- lance, and sexual concerns. The results showed that the couples thought positively about marriage and family planning, while they had several sources of anxiety related to Confucian values and problems stemming from their different nationalities/roots. It is possible that gender roles and Confucian beliefs affect their sexual health. The study underscores that health professionals should provide pertinent knowledge and skills about family planning and child rearing, as well as premarital sexual health counselling, for unmarried couples composed of Japanese, South Korean nationals, and zainichi.

Positive Massage for Couples’ Wellbeing and Relationships: The Bridge between Positive Psychology and Massage

Although positive psychology interventions are generally aimed at individuals, when considering couples, a dyadic approach may be more effective. In terms of a couples’ wellbeing, their relationship is one of the most important factors. As such, interventions targeted for both members’ wellbeing via their relationship are likely to be of value. Currently, there exist limited dyadic positive activity interventions available in positive psychology, and notably, tactile intervention is lacking. Massage is the evidence based tactile health modality that has long history as a therapeutic intervention, as well as being one of the most natural human health-oriented behaviours. The current commentary argues for the link between positive psychology and massage, and that “Positive Massage” can be a bridge between the hitherto distinct entities of positive psychology and massage. Furthermore, based on the conceptual theoretical model of the link between Positive Massage and wellbeing, we propose that Positive Massage can be an effective positive intervention impacting on couples’ wellbeing and enhancing their relationships.

Longtime Couples Tell Their Story: An Integrated Constructivist View of Marital Relationships

The current study was designed to explore how longtime couples understand and manage their marital relationships into later time of their lives.An integrated approach of social exchanged and symbolic interactionism was adopted to understand how longtime couples develop,organize,and adjust their experience of marriage via active exchange and interactions.Participants were five Caucasian heterosexual couples who have been married for more than 18 years.A narrative interview was conducted on each couple separately.Participants were asked to tell a story of how their marriages started and developed in time jointly.Four major processes emerged from the current study displayed how longtime couples proactively engage in managing their life together as a union.The current study revealed a series of exploratory results concerning how individuals in marital relationships communicate and cooperate with each other in the process of their marital relationship development.It also identified an interesting point of view concerning how couples actively manage their negative experiences regarding critical transitioning life events related to their marriage.This adds evidence to understand and predict marital outcomes from a micro-social constructivist approach.Implications about couples and family counseling from a social-constructive approach,as well as the probability of synthesizing a social-constructivist family framework with a systemic family framework,are thus provided.

Chronic Immune Activation and Sexual Exposure among HIV Serodiscordant Couples in Senegal

Purpose: In Sub-Saharan Africa, an important proportion of incident HIV cases occur among heterosexual serodiscordant couples (HSDC) but the majority of HIV negative partners can remain seronegative. These are called HIV-exposed seronegative (HESN). We aimed to compare immune activation (IA) levels between HESN, their HIV infected counterparts (HIV+ partners) and HIV unexposed uninfected individuals (HIV-neg Controls) and to evaluate the association between sexual exposure to HIV (SEHIV) and IA. Methods: We conducted a cross-sectional study in Dakar, Senegal on 148 participants recruited between November 2013 and February 2014: 40 HIV-neg Controls, 54 HESN and 54 HIV+ Partners. SEHIV was evaluated individually using questionnaires. IA level was measured by plasma level of β2-microglobulin (β2m). Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for the different associations. Results: The median levels of β2m were 1.57 mg/l (IQR: 1.37 - 1.77), 2.14 mg/l (IQR: 1.76 - 2.43) and 2.24 mg/l (IQR: 1.80 - 3.17) for HIV-neg Controls, HESN and HIV+ partners, respectively. After adjustment, HESN had similar levels of IA with HIV+ partners but significantly higher than that of HIV-neg Controls (adjusted OR = 6.28;95% CI: [2.19 - 18.00]). The association between IA and SEHIV was evaluated in the HIV negative individuals. High frequency of SEHIV was associated with a β2m > 2.2 mg/l (OR = 6.56;95% CI: [1.71 - 25.21]);significantly more than median cut off value of >1.81 mg/l. Conclusions: Our study shows that, despite being uninfected with HIV, HESN individuals show a high level of IA, which was depended on the level of SEHIV.

Happiness for Infertile Couples： An Introduction to Zhangzhou Medical Centre for Treatment of Infertility

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Perceptions of Couples Who Use Jadelle Implant in Blantyre District, Malawi

Malawi has a high total fertility rate of 5.7 per woman and Jadelle implant may be an ideal option for couples who want to practice family planning. Jadelle is a long term contraceptive which is inserted just under the skin of a woman’s upper, inner arm by a nurse or midwife and prevents a woman from getting pregnant for a period of five years. But the use of Jadelle for family planning depends on perceptions of couples. The purpose of this study was to explore the perceptions of couples who choose Jadelle as their family planning method at a Central Hospital in Blantyre district. This study used a descriptive qualitative design. A purposive sample of 5 couples was used. Ethical clearance was granted by relevant authorities. Data was analysed through content analysis. The findings showed that the following nine themes emerged from the qualitative data: 1) men and women perspectives about mode of action of Jadelle;2) knowledge about effectiveness and efficacy of Jadelle among men and women;3) sources of information about Jadelle;4) information given to Jadelle users by providers;5) benefits of Jadelle;6) challenges associated with Jadelle;7) myths associated with Jadelle;8) attitudes of providers of Jadelle and 9) role played by men regarding use of Jadelle. In conclusion, this study found that both men and women generally lacked knowledge of Jadelle. Men play a vital role when couples are choosing contraceptives. Every opportunity should be utilised at antenatal, postnatal and family planning clinics to teach individuals about family planning. This may allow women and men to make informed choices about the use of Jadelle.

Contraceptive Goals and Evaluation of Newlymarried Couples in Shanghai，China

Based on the data from the survey of 7,872 newly married couples,who got the marriage licenses in two districts of Shanghai,during the period from Aug.1987 to Aug.1988, we analyzed contraceptive goals evaluation and acceptability of newlyAl married couples within fifteen months alter their marriage and before their having a baby. About hail of couples had ever used contraception after marriage,mainly for reason of 'expecting to be relaxed temporarily' and 'expecting to be pregnant'. The contraceptive methods commonly used were rhythm and condom, in general for reason Of 'convenience in use' as well as 'harmlessness to health' and 'e/fectiveness'. The reason ic r switching contraceptive methods was 'interference with intercourse' and 'low effectiveness'. 64 percent oj couples were unwilling to use pill, mainly /or /ear of 'harm to health'.The factors affecting acceptability of pill and injection were wife' s age at marriage, her educational level, occupation and character, couple's contraceptive knowledge and their health status and monthly income.

Fertility Intentions of Childbearing Age Couples in Shanghai

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Marriage Choices in Contemporary Italy.Couples’Places of Meeting Between Individualization and Structural Determinants

This article focuses on the study of the places where spouses first met in contemporary Italy.Using data provided by the nationally representative survey“Family,Social Subjects and the Life Cycle”,carried out in 2016 by Italian National Institute of Statistics(Istat)and made available in 2020,the article investigates trends in couples’places of meeting and the relation between contexts of meeting and structural determinants such as social class and territorial affiliation.The results support the idea that even in contemporary societies partner’s choice is shaped by a set of social and cultural constraints and is not solely the result of personal preferences inspired by the ideal of romantic love.

Depression in HIV-Infected Compared to Their Seronegative Partners in Serodiscordant Couples in Ouagadougou (Burkina Faso)

Introduction: Depression is common in HIV/AIDS. We aim to investigate the frequency and the grade of this mental disorder in partners and determine its influence on sexual dysfunctions in serodiscordant couples in Ouagadougou. Patients/Method: This cross-sectional study was monitored from 1 January to 31 June 2010 in the internal medicine department of CHUYO, Ouagadougou. HIV-infected patients and their seronegative partners who gave their consent were included. Depression was diagnosed using the Beck Depression Inventory 13 items (BDI-13). Results: Eighty heterosexual and monogamous serodiscordant couples were studied. 31 (38.7%) HIV-infected and 23 (28.7%) seronegative partners were affected by depression;p = 0.18. The score of depression was 3.5 ± 2.1 in HIV-infected and 3.3 ± 1.6 in seronegative partners;p = 0.85. Depression was diagnosed in both partners in 13 couples (16.2%) and in only one partner in 28 couples (35%). Depression was diagnosed at least for one partner in 40 (51.3%) couples where sexual dysfunctions affected partner (s) and in 1 (50%) couple where no sexual dysfunction was reported. Conclusion: Psychological assessment is needed for a better management of HIV/AIDS in serodiscordant couples.

Should China Allow Couples to Have a Second Child?

China’s family planning policy is back in the spotlight.Guangdong, the country’s most populous province according to the latest population census,has officially applied to the Central Government for permission for it lifting family planning restrictions.If the application is approved,couples in which either the husband or wife is an only child will be allowed to have a second child,according to Zhang Feng, family planning chief in Guangdong.