Academic literature on the topic 'Conjugal infertility'

Segundo dados da Organização Mundial da Saúde, estima- -se que entre 60 e 80 milhões de pessoas em todo o mundo enfrentem dificuldades para levar a cabo seu projeto de paternidade e maternidade em algum momento da vida. Desejar ter filhos mas se deparar com a impossibilidade desse processo produz uma ampla gama de sentimentos, tais como medo, ansiedade, tristeza, frustração, desvalia e vergonha, desencadeando, por vezes, quadros importantes de estresse. A situação de infertilidade pode provocar efeitos devastadores tanto na esfera individual como conjugal, interferir nas relações sociais e na qualidade de vida. Muitas mulheres inférteis percebem a situação como estigmatizante, causadora de sofrimento psíquico e isolamento social.

In recent years, the study of male factor in conjugal infertility, has received more attention since it was recognized as an important cause of infertility in 30-50% of the cases; and to the diminishing quality of semen, observed during the last decades, possibly related to environmental polution.Alterations in sperm motility has been included as a direct cause of male infertility along with the traditionally known causes. Frequently these alterations have been related to morphological changes of spermatozoa. The morphology and size of sperm cells are higly variable in human semen and abnormal forms also can be found in fertile men. Experimental data demonstrate that abnormal spermatozoa are not functional cells. There are many clinical reports that associate spermatic dismorphy with infertility. Previously reported abnormalities in the sperm morphology related to infertility include: acrosomal agenesis, defects in the dynein arms and fibrous sheath displasia. Therefore, it is important to undertake the ultrastructural study of spermatozoa to determine subcellular pathology of the gamete which could explain the reproductive failure, specially if there is no evident cause of the motility defect or if there has been no response to treatment, or if the assisted reproductive programs have failed repeatedly.

Background: Most of the couples suffering from infertility report it to be the most stressful and depressing period of their life, more so if it is a primary infertility. Studies regarding the prevalence and role of infertility-specific stress especially in eastern part of India is very limited. The objective of the present study was to estimate the prevalence of infertility-specific stress and its role in marital adjustment in women diagnosed with infertility.Methods: It was a cross-sectional study done on 80 married couple diagnosed with infertility (both primary and secondary) over 1 year from July 2016 to June,2017. Dyadic Adjustment Scale (DAS), "semi-structured questionnaire" compiled by the authors and "ICD-10 Classification of Mental and Behavioral Disorders (Clinical Descriptions and Diagnostic Guidelines)" were used for the evaluation. The analysis was done using SPSS (version 16) and Chi-square test.Results: Around 86% infertile women and 21% infertile men were found to suffer from mental stress. Infertility related stress were more in patients with primary infertility than in secondary one. Women mostly (56.5%) coped with stress by self-blaming whereas men (58.2%) by blaming the partner.Conclusions: Mental stress was significantly associated with infertility. In fact, maladjustment in marital relation caused by the stress adversely affected the conjugal life and thus also the fertility. Proper counselling of both partners might be helpful to solve this problem.

The paper is written in reply to Christopher Oleson's “Dignitas personae and the Question of Heterologous Embryo Transfer” in this issue. Oleson provides a very perceptive and comprehensive commentary on the key texts. This reply articulates my reasons for continued skepticism on whether Dignitas personae has settled the question on embryo rescue. The source of my skepticism concerns Oleson's key premise according to which heterologous embryo transfer for treating infertility and for rescue are the same moral acts. I argue that they are in fact different moral acts not merely in virtue of different intentions, but in virtue of their order. Embryo transfer is properly ordered to the end of rescue, but is inapposite for treating infertility—as this would replace the conjugal act. I conclude by offering several reductio ad absurdum arguments that argue in favor of embryo rescue.

A reductive reading of Humanae vitae seeks to limit its appeal to a ban on contraception. In truth, however, it offers a vision of human sexuality and conjugal love with broad and enduring relevance. In setting forth the intrinsic complementarity and irreducibility of the unitive and procreative dimensions of the conjugal act, Paul VI has given us a hermeneutical key for assessing many contemporary ethical dilemmas in human reproductive medicine. From this perspective, this article seeks to apply the logic of Humanae vitae to several real-life scenarios confronted by medical practitioners, educators, and ethicists working in the field of fertility and reproductive health. These include a consideration of the ethics of prescribing hormonal contraceptives, the possibilities of investigating male infertility, issues of cooperation in counseling and assisting conception in same-sex relationships, the ethics pertaining to assisted reproductive technology (ART), the contested case of prenatal adoption, and the application of double-effect reasoning. Summary: On the occasion of the fiftieth anniversary of the promulgation of Pope Paul VI’s encyclical Humanae vitae, this article seeks to defend its enduring relevance to modern-day society, through application of its reasoning to contemporary dilemmas in reproductive medicine. It considers real cases of the ethics of prescribing hormonal contraceptives, of investigating male infertility, of cooperating in counseling and assisting conception in same-sex relationships, of ART, of prenatal adoption, and the application of double-effect reasoning.

Objective : To investigate the influence of anthropometric indices on seminal parameters. Methods : Men who underwent treatment for conjugal infertility during the period of October, 2011, to March, 2012, were randomly selected. Patients with any prior diseases related to sperm alterations were excluded. Patients were submitted to an anthropometric evaluation to obtain body mass index, and the seminal analysis was made through a spermogram. Two anthropometric methods of classification were used: body mass index (normal and altered) and abdominal circumference (<94cm and >94cm). Data were analyzed by statistical tests. Results : The group with the altered body mass index presented lower volumes of ejaculated volume and a larger percentage of patients with abdominal circumference <94cm presented with progressive forms of spermatozoa below reference values. However, in the statistical tests, there was no significant difference. Conclusion : No significant difference was found in the sperm quality relative to the body mass index or abdominal circumference.

Abstract We describe a luminescence immunoassay for measuring transferrin in human seminal plasma. Human transferrin conjugated with 7-[(N-4-aminobutyl)-N-ethylamino]naphthalene-1,2-dicarboxylic acid hydrazide was used to monitor the immunological reaction. The conjugate was stable for at least one year. The sensitivity (2 ng per tube) of the assay allows measurement of this protein in diluted seminal plasma. Results by this method (y) correlated well (r = .9681) with those by a conventional RIA method (x): y = 1.000x + 1.646 micrograms per ejaculate. Seminal transferrin concentrations are reported for normal control subjects, vasectomized subjects, and infertile patients. The method described appears suitable for measurement of seminal transferrin as an index of Sertoli cell function in male infertility.

The aim of investigation was to assess the characteristics of the epidemic process of the incidence and prevalence of infertility and gonococcal infection, taking into account the demographic situation in Perm region.Materials and methods. The official statistics of the Center for Hygiene and Epidemiology in the Perm Region for 2003–2017 were analyzed (form 2), the territorial body of the Federal State Statistics Service in the Perm Region. The long-term dynamics of general morbidity, distribution of the patients by age, sex, social status, morbidity in combination with HIV infection, the detection of gonococcal infection by various specialists and methods of laboratory diagnostics were studied using the method of retrospective epidemiological analysis. Statistical processing was carried out using the program Statistica 7.0. To determine the relationship between the individual parameters, a simple correlation analysis was used with the calculation of the conjugacy coefficient of the Pearson traits (r).Results. In the Perm region, despite the positive rate of natural population growth, the number of inhabitants in 2010-2016 decreased by 14.5 thousand people. Every year the number of women in adolescent and youthful age falls. It has been shown that the leading factor in the formation of infertility is inflammatory diseases of the reproductive organs and the presence of comorbid pathology. It was established leading value in the pathogenesis of infertility of gonococcal infection. The features of the epidemic process of gonorrhea in the Perm region was shown.Conclusion. In a large number of cases, the complication of the demographic situation in the province is associated with infection of the genital tract. It is necessary to use more widely the possibilities of microbiological diagnostics.

Leptin is the 16 kDa product of the obese gene secreted by white adipose tissue in proportion to energy intake. In several species, plasma leptin levels correlate with, and may be and endogenous signal of, the extent of body fat reserves. Leptin acts via the hypothalamus to regulate feed intake in rodents and may control gonadal activity through this same axis. Significantly, the mutant ob/ob mouse lacks functional leptin and is both hyperobese and infertile. Leptin may be a useful diagnostic and/or therapeutic aid in high-yielding dairy cows in which infertility is rising inexorably and is anecdotally linked to the scale of the early post-partum negative energy balance. Our objectives were to recombinantly synthesise, and raise antibody to, a leptin-protein conjugate and to develop a useful and specific RIA for ruminant leptin.

Made available in DSpace on 2016-04-28T20:38:12Z (GMT). No. of bitstreams: 1 Dissertacao Solange Lopes de Souza.pdf: 1466736 bytes, checksum: 797e05a9eb1db203bfa59e1d4154d4e7 (MD5) Previous issue date: 2005-12-07<br>Conselho Nacional de Desenvolvimento Científico e Tecnológico<br>This study examined the process of coping with conjugal infertility during diagnostic investigation offered to 30 couples. Instruments addressed to investigation of life events, such as SF-36 General Life Quality Instrument, instrument about coping strategies, questionnaire about the couples clinical history, questionnaire about diagnostic medical evaluation and a rule for semi structured interview concerning the process of coping with infertility, have been used. The interviews have been recorded, transcribed, and analyzed by using SPAD T program. Afterwards, the meanings attached by the couples to the experience they were living in the search for having a biological child, so as personal meanings and senses of motherhood, fatherhood and the importance of a child in their lives, have been verified. As showed by the analyses of the instrument about coping strategies, there was low use of the eight factors under investigation; the more frequently used among them were: the ones which require self control, search for social support, problem solving, and positive revaluation. No differences have been verified between men and women. Analyses of SF-36 General Life Quality Instrument showed that couples life quality lay between good and excellent conditions. Significance level of functional aptitude, vital force, social issues, mental health, and pain has been observed in the female group; the male group showed significance levels of general health state, physical limitation, functional aptitude, pain, vital force, and mental health. Analyses about occurrence of life events showed low reports or absence of significant changes in the couples life, such absence being an indicator to risk factor and a sign of alert to possibilities of distress development. An important factor has been identified at the moment of the semi structured interview concerning identification of available forms and resources of coping. Analyze of the speech produced by the couples showed that they presented a lack of syntony in the quality of their relationship, what produced interferences on mutual support during the search for a solution to problems to be faced, specifically when it concerned infertility. Suggestions of programmed sexual intercourse showed themselves as a factor that interferes on stability of personal relationship. It brings difficulties to the couple. To think about the meanings of a child has become a shocking exercise. This fact is probably associated to the function that is still attributed to a biological child as someone who would legitimate affective relationships, the possibility of which being questioned when a child is adopted. Semi structured interview has showed itself as an essential instrument to investigate and fathom coping factors. This resource promoted a different hearing of anxiety, making possible a better reflection to the couples about coping with their difficulties when facing investigation and treatment of infertility<br>Este estudo examinou o processo de enfrentamento da infertilidade conjugal durante investigação diagnóstica junto a 30 casais. Trabalhou-se com instrumentos voltados à investigação de eventos vitais: Instrumento Genérico de Qualidade de Vida SF-36, instrumento sobre estratégias de enfrentamento, questionário sobre história clínica do casal, questionário sobre avaliação médica diagnóstica e roteiro de entrevista semidirigida para investigar o processo de enfrentamento da infertilidade pelo casal. As entrevistas foram gravadas, transcritas e analisadas utilizando-se o programa SPAD T. Posteriormente, verificaram-se os significados atribuídos pelos casais à experiência pela qual estavam passando diante da busca de um filho biológico, assim como as significações e sentidos pessoais de maternidade, paternidade e importância do filho em suas vidas. As análises do instrumento sobre estratégias de enfrentamento mostraram que houve pouca utilização dos oito fatores investigados, sendo que os mais utilizados pelos casais foram: aqueles que exigem autocontrole, busca de suporte social, resolução de problema e reavaliação positiva. Não houve diferenças entre homens e mulheres. As análises do Instrumento Genérico de Qualidade de Vida SF-36 identificaram que a qualidade de vida dos casais situou-se entre condição boa e excelente. Observou-se nível de significância no grupo feminino em capacidade funcional, vitalidade, aspectos sociais, saúde mental e dor; o grupo masculino mostrou níveis de significância para estado geral de saúde, limitação física, capacidade funcional, dor, vitalidade e saúde mental. As análises sobre ocorrência de eventos vitais mostraram baixos índices ou ausência de mudanças significativas na vida dos casais, sendo a ausência indicadora de fator de risco e sinal de alerta para possibilidade de desenvolvimento de estresse. Importante fator foi identificado ao se trabalhar com entrevista semidirigida voltada à identificação de formas e recursos de enfretamento disponíveis. A análise do discurso produzido pelos casais mostrou que estes apresentaram descompasso na qualidade do relacionamento, surgindo interferências quanto ao apoio mútuo na busca de solução dos problemas a serem enfrentados, especificamente, em relação à infertilidade. As propostas de relações sexuais programadas mostraram ser fator que interfere na estabilidade do relacionamento pessoal ocasionando dificuldades para marido e esposa. Pensar sobre o significado de um filho mostrou ser um exercício impactante. Este fato pode estar associado à função ainda atribuída a um filho biológico, como aquele que irá legitimar as relações afetivas, cuja possibilidade é posta em dúvida quando se adota uma criança. A entrevista semidirigida constituiu instrumento indispensável para investigação e aprofundamento dos fatores de enfrentamento. Esse recurso promoveu uma escuta diferenciada da ansiedade, permitindo maior reflexão aos casais sobre o enfrentamento das suas dificuldades diante do processo de investigação e tratamento da infertilidade

Made available in DSpace on 2016-04-28T20:39:50Z (GMT). No. of bitstreams: 1 Susan Carol Albert.pdf: 2673009 bytes, checksum: d602a8eccd650cf0e2d4e5e1fd339e31 (MD5) Previous issue date: 2008-06-06<br>Coordenação de Aperfeiçoamento de Pessoal de Nível Superior<br>This research sought to obtain a better understanding of the complex question of infertility within the conjugal relationship. The basic premise for this research was that infertility is not only an individual issue but also a conjugal issue and needs to be addressed as such. Although in general only one of the partners receives a diagnosis of infertility, infertility is best understood as a couple level stresser , since within the conjugal relationship both partners become infertile. We adopted a qualitative approach to this research. Given that this study focused on a specific question existing within the marital relationship, brief therapy was adopted as the procedure to approach this question. The research involved two couples in stable, long term relationships, the first couple received 15 sessions and the second couple received 13 sessions, focusing on the complex interpersonal relations that develop between the partners in their attempt to deal with the issue of infertility within their marriage. Two instruments were used during the brief therapy to discuss this issue, the genealogical tree and Sandplay, which enabled a qualitative analysis of the verbal manifestations that accompanied the drawing of the genealogical tree and the Sandplay images made. An analysis of the results suggests that various factors are involved in the conflicts related to infertility, including: the influence of the family of origin, the ambivalence felt towards maternity and paternity, the nature of the communication between the partners and the possibility of grieving for the idealized child. We believe that brief therapy with Sandplay offers the possibility of a more conscious dialogue being developed between the partners, which enables the transformation of defense mechanisms and the strengthening of each individual and consequent transformation of the conjugal self<br>Esta pesquisa procurou obter um melhor entendimento da complexa questão da infertilidade dentro da relação conjugal. Nosso estudo baseou-se na premissa de que a infertilidade não é uma questão apenas individual, mas também conjugal, e precisa ser assim considerada. Embora, em geral, apenas um dos cônjuges receba o diagnóstico de infertilidade, essa questão pode ser abordada de melhor forma quando considerada como fator estressante para o casal, pois dentro da relação conjugal, os dois ficam inférteis. O método escolhido para esta pesquisa foi qualitativo. Considerando que nosso estudo examinou uma questão específica que existia dentro da relação conjugal, a terapia breve foi considerada como procedimento adequado para abordar essa questão. Com dois casais em relacionamentos estáveis foram realizados 15 sessões por o primeiro casal e 13 sessões por o segundo casal, cujo foco eram as relações interpessoais complexas desenvolvidas entre os cônjuges nas suas tentativas de lidar com o assunto da infertilidade dentro do casamento. Na terapia breve foram utilizados dois instrumentos, o genetograma e o Sandplay, o que permitiu uma análise qualitativa das manifestações verbais dos desenhos dos genetogramas e dos cenários feitos nas caixas de areia. A análise dos resultados sugere que dos conflitos relativos à infertilidade participam vários fatores: a influência da família de origem, a ambivalência frente à maternidade e paternidade, a natureza da comunicação entre os cônjuges e a possibilidade de luto da criança idealizada. Consideramos que a terapia breve com Sandplay oferece uma possibilidade de desenvolvimento de um diálogo mais consciente entre os cônjuges, o que permite a transformação de mecanismos de defesa e o fortalecimento de cada um e a conseqüente transformação do Self conjugal

Made available in DSpace on 2014-12-17T14:14:04Z (GMT). No. of bitstreams: 1 SimoneNB.pdf: 1450571 bytes, checksum: 491d3f4e3cfc42edec5aafb00ea04f6a (MD5) Previous issue date: 2004-09-15<br>Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior<br>Purpose: assess the frequency of stress and anxiety levels in infertile women, correlate these aspects with risk factors and qualitatively analyze feelings resultant from the inability to conceive, in order to obtain data for specific psychological guidance. Methods: the case-control study included a total of 302 women, 152 being infertile (case group: 30.3 ? 5.4 years), and 150 non-fertile (control group: 25.7 ? 7.9 years). The quantitative approach involved the application of Lipp s Stress Symptoms Inventory (LSSI) and State-Trait Anxiety Inventory (STAI), whereas the qualitative approach consisted of a semi-structured interview. Response variables considered were: stress frequency and anxiety scores (State and Trait). Statistical analysis compared frequencies and medians between groups, by means of qui-squared and Mann-Whitney tests, respectively, and constructed logistical regression models to test associations between response variables and risk factors considered. Qualitative data were analyzed descriptively and categorized in order to perform correspondence analysis. The level of significance was 5%. Results: in the study sample, stress frequency was higher in the case group than in the control(61.8 and 36.0%, respectively), however, significant differences were not observed between groups in relation to stress phases and predominant symptomology type. With respect to anxiety, there were no significant differences between case and control groups as to median state scores [39.5 (35.0 46.0) and 41.0 (35.7 47.0 ); respectively) and anxiety trait scores [44.0 (34.0 51.0) and 42.0 (36.0 49.2); respectively). Risk factors significantly associated with greater risk for high anxiety scores in the case group were: primary infertility, unawareness of the causal factor, diagnostic phase investigation, religion, lack of children from other marriages and the fact that the woman was previously married. The qualitative approach demonstrated that infertility provokes emotional responses, such as sadness, anxiety, anger, fear and guilt. Conclusions: it can be concluded that infertile women are more vulnerable to stress; however, they are capable of adapting to stressful events without serious physical or psychological compromising<br>Objetivo: avaliar a freq??ncia de estresse e n?veis de ansiedade em mulheres inf?rteis, correlacionar esses aspectos com fatores de risco e analisar, qualitativamente, os sentimentos advindos da incapacidade de conceber, de forma a obter subs?dios para uma orienta??o psicol?gica espec?fica. M?todos: o estudo incluiu um total de 302 mulheres, sendo 152 inf?rteis (grupo caso: 30,3 ? 5,4anos), e 150 n?o-inf?rteis (grupo controle: 25,7 ? 7,9 anos). A abordagem quantitativa envolveu a aplica??o do Invent?rio de Sintomas de Estresse de Lipp (ISSL) e Invent?rio de Ansiedade Tra?o-Estado (IDATE), ao passo que a abordagem qualitativa consistiu de uma entrevista semi-estruturada. As vari?veis resposta consideradas foram: freq??ncia de estresse e escores de ansiedade (Estado e Tra?o). A an?lise estat?stica compreendeu a compara??o de freq??ncias e medianas entre os grupos, por meio dos testes qui-quadrado e Mann-Whitney, respectivamente, assim como a constru??o de modelos de regress?o log?stica para testar associa??es entre as vari?veis resposta e os fatores de risco considerados. Os dados qualitativos foram analisados de forma descritiva e categorizados para realiza??o de an?lise de correspond?ncia. O n?vel de signific?ncia adotado foi de 5%. Resultados: na amostra estudada, a freq??ncia de estresse foi maior no grupo caso do que no controle (61,8 e 36,0%; respectivamente), no entanto, n?o foram observadas diferen?as significativas entre os grupos com rela??o ?s fases do estresse e tipo de sintomatologia predominante. Em rela??o ? ansiedade, n?o houve diferen?as significativas entre os grupos caso e controle quanto ?s medianas dos escores de estado (39,5 e 41,0; respectivamente) e tra?o (44,0 e 42,0; respectivamente) de ansiedade. No grupo caso, os fatores de risco associados significativamente com estresse ou ansiedade foram: infertilidade prim?ria, desconhecimento do fator causal, fase de investiga??o diagn?stica, religi?o e aus?ncia de filhos advindos de outros casamentos. Na abordagem qualitativa, as mulheres inf?rteis expressaram as seguintes respostas emocionais predominantes: tristeza, ansiedade, raiva, medo e culpa. Conclus?es: os resultados permitem concluir que as mulheres inf?rteis est?o mais vulner?veis ao estresse, no entanto, s?o capazes de responder aos eventos estressores de forma adaptativa, sem comprometimentos mais s?rios nas ?reas f?sica e psicol?gica

Introdução: A infertilidade é uma condição que afeta, universalmente, um percentual expressivo (8-15%) dos casais da população, sendo esta, uma condição associada frequentemente, a um incremento nas taxas de disfunção sexual e desajuste conjugal. Objetivos: Avaliar a função sexual de mulheres com infertilidade conjugal e avaliar o risco para ansiedade e depressão em mulheres com infertilidade conjugal. Métodos: Estudo controlado com 280 mulheres em idade reprodutiva, sendo 140 atendidas no Setor de Reprodução Humana do Departamento de Ginecologia e Obstetrícia da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (FMRP-USP) e 140 controles recrutadas na população geral de Ribeirão Preto - SP. A função sexual foi avaliada pelo Índice de Função Sexual Feminina (IFSF), e o risco para ansiedade e depressão foi aferido pela Escala de Ansiedade e Depressão (HAD-A, HAD-D). Resultados: Participaram do estudo 280 mulheres, sendo 140 do Grupo Infértil (GI) e 140 do Grupo Controle (GC). Do GI, 104(74,29%) apresentavam infertilidade primária, e 36(25,71%) infertilidade secundária, por fator feminino em 64(45,71%), fator masculino em 38(27,73%) e, em ambos 35(25,54%) dos casos. Do GI, 64(45,71%) foram submetidas a FIV/ICSI. Houve diferença significativa entre os grupos em relação a mediana de idade (GI 36 [32-38]; GC 34 [31-37]), (p=0,02). Não houve diferença entre os grupos em relação ao número de mulheres com menos de 40 anos e com idade maior ou igual a 40 anos (p=0,40). E também não houve diferença significativa entre os dois grupos em relação a idade dos parceiros, número de relações sexuais/semana, IMC, peso e estado civil. Houve diferença entre os grupos em relação ao tempo de relacionamento (GI, 11,80 ± 4,84 anos (1,50-24) vs. GC, 10,40 ± 5,73 (0,50-26), p=0,03). Estratificando por tempo de relacionamento no GI 10(7,14%) tinham < 5 anos de relacionamento contra 27(19,29%) no GC e, no GI 130(92,86%) tinham > 5 anos de relacionamento contra 113(80,71%) do GC, (p<0,01). A análise do IFSF evidenciou risco para disfunção sexual em 47(33,57%) do GI, e em 49(35%) do GC (p=0,90) e não houve diferença significativa entre os domínios do IFSF, a não ser pela diferença encontrada no domínio excitação, que foi maior no GC (p=0,04). Não houve diferença entre os grupos em relação ao risco para ansiedade e depressão. Os fatores de risco para disfunção sexual (DS), ansiedade e depressão, nos dois grupos, ajustado para as variáveis: faixa etária, IMC, estado civil, tempo de relacionamento, escolaridade, gestação, anticoncepção, partos, psicoterapia, cigarro, álcool, faixa etária do parceiro, risco para DS, ansiedade e risco para depressão evidenciou que mulheres que apresentam risco para ansiedade tem maior risco para DS. Mulheres com risco para depressão evidenciaram risco aumentado para DS. A DS foi fator de risco para ansiedade e depressão. As mulheres casadas apresentaram menos risco para depressão do que mulheres amasiadas. Conclusão: As mulheres não apresentaram risco para disfunção sexual em relação aos controles. A ansiedade e depressão constituem risco para disfunção sexual nessa amostra.<br>Introduction: Infertility is a condition that affects, universally, a significant percentage (8- 15%) of couples. Infertility is often linked to an increase in sexual dysfunction rates and marital conflict. Objectives: To assess sexual function of infertile women and to assess the risk for anxiety and depression in infertile women. Methods: This is a controlled study with 280 women in reproductive age, being 140 women attended in Human Reproduction Sector of the Department of Gynecology and Obstetrics of the Ribeirão Preto Medical School, University of São Paulo (FMRP-USP), and 140 controls recruited from the general population in Ribeirão Preto - SP. Sexual function was assessed by the Female Sexual Function Index (FSFI), and the risk for anxiety and depression was measured by the Anxiety and Depression Scale (HAD-A, HAD-D). Results: Twenty eight women participated in this study, being 140 women in infertile group (IG) and 140 controls (CG). In the IG, 104 (74.29%) had primary infertility, and 36 (25.71%) secondary infertility. In the entire sample female factor was evident in 64 (45.71%) and male factor in 38 (27.73%), and both 35 (25.54%) cases. In the IG, 64 (45.71%) underwent FIV / ICSI. There was a significant difference between groups in relation to median age (IG 36 [32-38]; CG 34 [31-37]) (p = 0.02). There was no significant difference between groups in the number of women = 40 years (p = 0.40). There was no significant difference between groups regarding the age of partners, number of sexual intercourse/week, BMI, weight and marital status. There was difference between groups regarding the time of relationship (IG, 11.80 ± 4.84 years (1.50 to 24) vs. CG, 10.40 ± 5.73 (0.50 to 26), p = 0.03). Stratifying for relationship time in IG 10 (7.14%) were < 5 years of relationship vs. 27 (19.29%) in the CG, and IG 130 (92.86%) had > 5 year relationship vs. 113 (80.71%) CG (p <0.01). The risk for sexual dysfunction was observed in 47 (33.57%) of the IG, and in 49 (35%) of the control group (p = 0.90). There was no significant difference between the majority scores of FSFI, but there was significant difference between groups regarding arousal domain, which was higher in CG (p = 0.04). There was no difference between groups regarding the risk for anxiety and depression. Risk factors for sexual dysfunction (SD), anxiety and depression in both groups, adjusted for the variables: age, BMI, marital status, length of relationship, education, pregnancy, contraception, birth, psychotherapy, cigarettes, alcohol, partner\'s age, risk for SD, anxiety and risk for depression showed that women who are at risk for anxiety have a higher risk for SD. Women at risk for depression, showed increased risk for SD. The SD was a risk factor for anxiety and depression. Married women showed less risk for depression than women who only live together with a partner. Conclusion: Infertile women showed no risk for sexual dysfunction compared to controls. Anxiety and depression are risk for sexual dysfunction in this sample.

Dissertação de Mestrado apresentada ao ISPA - Instituto Universitário<br>Objectivo: Avaliar o Perfil de Personalidade e o Relacionamento Conjugal em casais inférteis. Método: Estudo exploratório e observacional descritivo, de correlação das variáveis. Participaram 30 casais com problemas de infertilidade, 30 homens e 30 mulheres, recolhidos na Associação Portuguesa de IN(Fertilidade). Foram utilizados o Questionário de Caracterização Sócio-demográfica, o NEO-FFI-20 (Bertoquini & Ribeiro, 2006) e a Escala de Relacionamento Conjugal (Gomez & Leal, 2008). Resultados: Verificou-se que existem correlações estatisticamente significativas entre o Perfil de Personalidade e o Relacionamento Conjugal. Nomeadamente entre o Neuroticismo e o Consenso Diádico, entre Conscienciosidade de Expressão de Afectos, bem como a Conscienciosidade sobre a Coesão Diádica. Discussão: O Perfil de Personalidade e o Relacionamento Conjugal dos casais têm um papel fundamental na compreensão de atitudes e comportamentos de modo ajudar na problemática da infertilidade. Conclusão: O Perfil de Personalidade e o Relacionamento Conjugal dos casais afirmam-se como constructos importantes no desenvolvimento e implementação de programas ou estratégias de intervenção com casais inférteis.<br>ABSTRACT: Objective: To assess the Personality Profile and the Marital Relation, in infertile couples. Method: Exploratory and Observational descriptive group correlation study. 60 couples whith infertility problems participated in the study (30 Men and 30 Women). Data was collected at Associação Portuguesa (IN)Fertilidade. A Sociodemographical Questionnaire, the NEO-FFI-20 (Bertoquini & Ribeiro, 2006) and the Marital Relation Scale (Gomez & Leal, 2008) were used. Results: Results show statistically significant differences between the Personality Profile and the Marital Relation. Namely between Neuroticism and Dyadic Consent, between Conscientiousity and the Expression of Afection as well as Conscientiousity and Dyadic Cohesion. Discussion: The Personality Profile and the Marital Relation of the couples has a fundamental importance in the comprehension of attitudes and behaviors to help in the infertility problematic. Conclusion: The Personality Profile and the Marital Relation are important intervention constructs in development and implementation of programs or strategies with infertile couples.

Dissertação de mestrado em Psicologia Clínica e da Saúde (Intervenções Cognitivo-Comportamentais nas Perturbações Psicológicas e Saúde) apresentada à Faculdade de Psicologia e de Ciências da Educação da Universidade de Coimbra<br>A infertilidade é uma experiência desafiante, afetando o ajustamento conjugal e individual dos casais. No entanto, existe uma grande variabilidade no ajustamento individual e conjugal dos indivíduos inférteis. O presente estudo teve como objetivo analisar o papel mediador do coping diádico do próprio e do parceiro, na relação entre o impacto do stress associado à infertilidade e o ajustamento individual e conjugal dos casais inférteis. Métodos: Neste estudo transversal, 67 casais inférteis preencheram escalas de auto-resposta que avaliavam o stress associado à infertilidade, o coping diádico, o ajustamento emocional e o ajustamento conjugal. A análise de trajectórias (Path analysis) foi conduzida de modo a avaliar os efeitos diretos e indiretos do impacto do stress associado à infertilidade no ajustamento emocional e conjugal. Resultados: O coping diádico do próprio, nos homens, e o coping diádico do parceiro, nas mulheres, apresentaram um efeito mediador na relação entre o impacto do stress associado à infertilidade e o ajustamento conjugal. Os resultados também sugerem que, nos homens, o impacto do stress associado à infertilidade se associa a menores níveis de sintomatologia depressiva através da perceção de maiores níveis de coping diádico pelo próprio, que por sua vez se associam a níveis mais elevados de ajustamento conjugal. Conclusões: Os resultados enfatizam a importância das estratégias de coping diádico dos homens para o ajustamento conjugal de ambos os membros do casal, mas também para os níveis de sintomatologia depressiva dos homens. Mais ainda, os resultados sugerem que os processos diádicos têm um maior impacto no ajustamento emocional dos homens à infertilidade. Os dados salientam a importância de considerar a experiência do homem no tratamento da infertilidade, reforçando a natureza diádica desta experiência.<br>Infertility is a challenging experience, with impact both at an individual level and in couple’s relationship. However, there is great variability in dyadic and individual adjustment of infertile individuals. The current study aimed to investigate the mediating role of dyadic coping by self and by partner in the relation between infertility stress impact and emotional and dyadic adjustment to infertility. Methods: In this cross-sectional study, 67 infertile couples answered self-report questionnaires about their infertility related stress, dyadic coping, emotional and dyadic adjustment. Path analysis were conducted to examine direct and indirect effects between infertility stress impact and dyadic and individual adjustment. Results: Men’s dyadic coping by self and women’s dyadic coping by partner had a mediator effect on the relation between the impact of infertility stress and dyadic adjustment. Results also showed that men’s infertility stress impact was associated with lower levels of depression through higher perceived dyadic coping by self, which was in turn associated with higher dyadic adjustment. Conclusions: The results highlight the importance of men’s dyadic coping strategies for couples’ dyadic adjustment, as well as for men’s depression levels. Moreover, our evidence also suggests that, for men, dyadic processes have a greater impact on his emotional adjustment to infertility. These data emphasize the importance of involving men in the fertility treatment process, reinforcing the dyadic nature of infertility processes.

Este estudo teve como objetivo geral conhecer as características da vivência da gravidez, nos homens e nas mulheres, após sucesso das técnicas de procriação medicamente assistida (PMA), nomeadamente quanto à relação conjugal, psicopatologia e dimensões da vivência psicológica da gravidez. A amostra deste estudo é constituída por 22 casais, apresentado um total de 44 indivíduos, com idades compreendidas entre os 30 e os 47 anos. Os instrumentos utilizados na recolha dos dados foram a Escala de Atitudes sobre a Gravidez e a Maternidade, a Escala de Atitudes sobre a Gravidez e a Paternidade, a Escala Hospitalar de Ansiedade e Depressão e a Escala Revista de Ajustamento Diádico. Os resultados obtidos sugerem que existem diferenças significativas relativamente às atitudes sobre a gravidez e maternidade/paternidade das mulheres e dos homens que recorreram à PMA com as da amostra padrão. Os resultados dos dois últimos instrumentos indicam que não há diferenças significativas entre os géneros da amostra do estudo relativamente aos níveis de ansiedade, depressão e ajustamento diádico. Apesar disso foi possível verificar a existência de ansiedade em 27.3% das mulheres e em 9.1% dos homens. Relativamente à depressão não se verificou a sua existência em nenhum dos indivíduos da amostra do estudo.<br>The purpose of this study was to know the characteristics of the experience of pregnancy, in both men and women, after successfully resorting to medically assisted reproduction techniques (MART), especially on the subject of the conjugal relationship, psychopathology and the dimensions of the psychological experience of pregnancy. The sample of this study comprises 22 couples, numbering 44 people in total, with ages between 30 and 47 years. The instruments used in collecting data were the Scale of Attitudes towards Pregnancy and Motherhood, the Scale of Attitudes towards Pregnancy and Fatherhood, The Hospital Anxiety and Depression Scale and The Revised Dyadic Adjustment Scale. The results suggest that there are significant differences concerning the attitudes towards pregnancy and motherhood/fatherhood of women and men who resorted to MART. The results of the last two instruments indicate that there is no major difference among the genders regarding the levels of anxiety, depression and couple adjustment. Despite that, it was possible to ascertain the existence of anxiety in 27.3% of the women and 9.1% of the men. Moreover, there was no evidence of depression in any of the individuals of the study sample.

This introductory chapter talks about how infertility impedes reproduction among a disproportionate percentage of Middle Eastern men. This epidemic of male infertility—which many men attribute to their unrelenting life stresses, including war—has led to a recalibration of manhood. The notions of a “childless couple” or “child-free living” have yet to enter the cultural lexicon. This phenomenon of happily married but childless Middle Eastern couples is explored from Middle Eastern men's own perspectives. Many men do not want to be perceived as domineering patriarchs; they do not view fatherhood as the be-all and end-all of masculinity; they value conjugal intimacy and privacy, and they often adore their wives as friends and lovers, having learned sexuality together in the context of dual premarital virginity.

This chapter discusses how husbands' loving commitments toward their wives are a major part of Middle Eastern conjugality and an important feature of emergent masculinities in the region. Even seemingly traditional men such as Hatem—a farmer from a “closed” rural Syrian community—defy masculine stereotypes. Although conventional wisdom suggests that Middle Eastern men routinely divorce their infertile wives, Hatem's case provides evidence to the contrary. His story suggests that enduring conjugal commitments are a key feature of emergent masculinities in the Middle East, even in the face of intractable infertility. According to studies, this is as true among lower-class Middle Eastern couples, both urban and rural, as it is among cosmopolitan elites.