| Psychiatric Intervention Improved Pregnancy Rates in Infertile Couples .. cacher .... voir plus ..
Background: Infertility has mental, social, and reproductive consequences. The aim of this study is to evaluate the effect of psychiatric intervention on the pregnancy rate of infertile couples. Methods: In an experimental and intervention-control study, 638 infertile patients who were referred to a university infertility clinic were evaluated; 140 couples (280 patients) with depression (from mild to severe) in at least one of the spouses were followed. All couples provided informed consent and were randomly numbered from 1 to 140. Those with even numbers were assigned to the psychological intervention before infertility treatment, and those with odd numbers were assigned to the psychological intervention during infertility treatment. Patients in the experimental group received 6–8 sessions of psychotherapy (individually) before beginning infertility treatment and were given Fluoxetine (antidepressant) at 20–60 mg per day during the psychotherapy period. The control group did not receive any intervention. Three questionnaires, the Beck Depression Inventory (BDI), the Stress Scale (Holmes-Rahe), and a sociodemographic questionnaire, were administered to all patients before and after treatment. The clinical pregnancy rate was compared between the two groups based on sonographic detection of gestational sac 6 weeks after the last menstrual period. The data were analysed by t test, X2 and logistic regression methods. Results: Pregnancy occurred in 33 (47.1%) couples in the treatment group and in only 5 (7.1%) couples in the control group. There was a significant difference in pregnancy rate between the treatment and control groups (X2= 28.318, P < 0.001). To determine the effectiveness of psychiatric interventions on pregnancy, a logistic regression analysis was used. In this analysis, all demographic and infertility variables were entered in a stepwise manner. The results showed that in the treatment group, Pregnancy in the treatment group was 14 times higher than the control group (95% CI 4.8 to 41.7). Furthermore, cause of infertility was an effective factor of pregnancy. The adjusted odds ratio in male factor infertility was 0.115 (95% CI 0.02 to 0.55) and in both factors (male and female) infertility was 0.142 (95% CI 0.03 to 0.76) compared with the unexplained group. In this study, no other variables had any significant effect on pregnancy. Conclusion: Based on the effectiveness of psychiatric interventions in increasing pregnancy rate, it is crucial to mandate psychiatric counselling in all fertility centres in order to diagnose and treat infertile patients with psychiatric disorders.
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| Retard de conception- infertilité .. cacher .... voir plus ..
La définition standard de la stérilité implique habituellement l'absence de grossesse chez un couple engagé avec des rapports sexuels aléatoires sur une période de 12 mois.
Mais, avec des rapports sexuels en période fertile reconnue par l’observation de la glaire (rapports sexuels orientés par la connaissance de la période fertile), la grossesse est plus rapidement obtenue. Il a été démontré que, après 3 cycles avec des rapports en période fertile reconnue par l’observation de la glaire, 90 pour cent des femmes en couples de fertilité normale ont conçu un enfant.
Ces données suggèrent que la définition de la stérilité peut être modifiée (D'après T Hilgers, The NaProTechnology Revolution, page page 235, modifié): si le couple n'a pas conçu après 3 cycles de rapports sexuels axés sur la fertilité, il y a une forte suspicion d'un problème d'infertilité.
Il existe 2 types d'infertilité :
L'infertilité primaire se réfère à des couples qui n'ont pas conçu d'enfant.
L'infertilité secondaire se réfère à des couples qui ont conçu au moins une fois, mais qui n'y pas parviennent pas maintenant.
... lire plus sur ce sujet .... | | Source: Littérature médicale, niveau d'évidence non connu |