Analysis of severe psychological stressors in women during fertility treatment: Japan-Female Employment and Mental health in Assisted reproductive technology (J-FEMA) study.
Assisted reproductive technology
Employment
Fertility treatment
K6 score
Stress
Journal
Archives of gynecology and obstetrics
ISSN: 1432-0711
Titre abrégé: Arch Gynecol Obstet
Pays: Germany
ID NLM: 8710213
Informations de publication
Date de publication:
07 2021
07 2021
Historique:
received:
21
08
2020
accepted:
24
11
2020
pubmed:
3
1
2021
medline:
11
11
2021
entrez:
2
1
2021
Statut:
ppublish
Résumé
To identify risk factors for severe psychological stress in women undergoing fertility treatment. This cross-sectional, multi-center study was conducted from August to December 2018. We recruited 1672 subjects who completed an anonymous, self-reported questionnaire regarding fertility treatment, conditions at work and home, and psychological stress using K6 score, which estimates psychological distress during the previous 30 days. We further focused our analysis on 1335 subjects who were working when starting fertility treatment. Of 1672 women, mean K6 score (range 0-24) was 4.8 ± 4.4, including 103 women (6.2%) with K6 score ≥ 13 (high K6), and classified as probable severe psychological distress. Multivariate logistic regression analysis showed that high K6 was strongly associated with low annual family income of ≤ USD55,700 (JPY6 million) (odds ratio [OR] 1.89, 95% confidence interval [CI] 1.04-3.42), infertility duration of ≥ 2 years (OR 1.87, 95% CI 1.08-3.25), and no experience of childbirth (OR 2.04, 95% CI 1.05-3.97). Focusing on 1335 working women, 266 (19.9%) experienced resignation from work. High K6 was strongly associated with low family income (OR 2.83, 95% CI 1.52-5.28), cessation of professional duties (OR 2.08, 95% CI 1.05-4.14), infertility-related harassment in the workplace (OR 2.07, 95% CI 1.08-3.98), and perceived difficulties to continue working during fertility treatment (OR 2.94, 95% CI 1.15-7.50). Severe psychological stressors in women during fertility treatment included low family income, long infertility duration, childlessness, infertility-related harassment, and perceived difficulty in working conditions or cessation from work. Establishment of mental health care support systems is urgently required in this population.
Identifiants
pubmed: 33386414
doi: 10.1007/s00404-020-05923-6
pii: 10.1007/s00404-020-05923-6
pmc: PMC7775729
doi:
Types de publication
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
253-261Références
Rooney KL, Domar AD (2018) The relationship between stress and infertility. Dialogues Clin Neurosci 20:41–47
doi: 10.31887/DCNS.2018.20.1/klrooney
Chen TH, Chang SP, Tsai CF, Juang KD (2004) Prevalence of depressive and anxiety disorders in an assisted reproductive technique clinic. Hum Reprod 19:2313–2318
doi: 10.1093/humrep/deh414
Lynch CD, Sundaram R, Maisog JM, Sweeney AM, Buck Louis GM (2014) Preconception stress increases the risk of infertility: results from a couple-based prospective cohort study–the LIFE study. Hum Reprod 29:1067–1075
doi: 10.1093/humrep/deu032
Domar AD, Clapp D, Slawsby EA, Dusek J, Kessel B, Freizinger M (2000) Impact of group psychological interventions on pregnancy rates in infertile women. Fertil Steril 73:805–811
doi: 10.1016/S0015-0282(99)00493-8
Gourounti K, Anagnostopoulos F, Vaslamatzis G (2011) The relation of psychological stress to pregnancy outcome among women undergoing in-vitro fertilization and intracytoplasmic sperm injection. Women Health 51:321–339
doi: 10.1080/03630242.2011.574791
The Ministry of Health Labor and Welfare in Japan. Overview of vital statistics in 2015. https://www.mhlw.go.jp/toukei/saikin/hw/jinkou/geppo/nengai15/dl/kekka.pdf . 2016.
Broekmans FJ, Soules MR, Fauser BC (2009) Ovarian Aging: Mechanisms and Clinical Consequences. Endocr Revi 30:465–493
doi: 10.1210/er.2009-0006
Faddy MJ, Gosden RG, Gougeon A, Richardson SJ, Nelson JF (1992) Accelerated disappearance of ovarian follicles in mid-life: implications for forecasting menopause. Hum Reprod 7:1342–1346
doi: 10.1093/oxfordjournals.humrep.a137570
Schwartz D, Mayaux MJ (1982) Female fecundity as a function of age: results of artificial insemination in 2193 nulliparous women with azoospermic husbands. Federation CECOS N Engl J Med 306:404–406
doi: 10.1056/NEJM198202183060706
te Velde ER, Pearson PL (2002) The variability of female reproductive ageing. Hum Reprod Update 8:141–154
doi: 10.1093/humupd/8.2.141
Irahara M, Kuwahara A, Iwasa T, Ishikawa T, Ishihara O, Kugu K et al (2017) Assisted reproductive technology in Japan: a summary report of 1992–2014 by the Ethics Committee, Japan Society of Obstetrics and Gynecology. Reprod Med Biol 16:126–132
doi: 10.1002/rmb2.12014
Ishihara O, Jwa SC, Kuwahara A, Katagiri Y, Kuwabara Y, Hamatani T et al (2020) Assisted reproductive technology in Japan: a summary report for 2017 by the Ethics Committee of the Japan Society of Obstetrics and Gynecology. Reprod Med Biol 19:3–12
doi: 10.1002/rmb2.12307
The Ministry of Internal Affairs and Communications in Japan. Labor force survey from statistics bureau. https://www.stat.go.jp/data/roudou/2.html . 2018.
Takaki J, Hibino Y (2014) Family-related opinions and stressful situations associated with psychological distress in women undergoing infertility treatment. Int J Environ Res Public Health 11:9068–9081
doi: 10.3390/ijerph110909068
Matsubayashi H, Hosaka T, Izumi S, Suzuki T, Makino T (2001) Emotional distress of infertile women in Japan. Hum Reprod 16:966–969
doi: 10.1093/humrep/16.5.966
Kessler RC, Andrews G, Colpe LJ, Hiripi E, Mroczek DK, Normand SL et al (2002) Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med 32:959–976
doi: 10.1017/S0033291702006074
Furukawa TA, Kawakami N, Saitoh M, Ono Y, Nakane Y, Nakamura Y et al (2008) The performance of the Japanese version of the K6 and K10 in the World Mental Health Survey Japan. Int J Methods Psychiatr Res 17:152–158
doi: 10.1002/mpr.257
Prochaska JJ, Sung HY, Max W, Shi Y, Ong M (2012) Validity study of the K6 scale as a measure of moderate mental distress based on mental health treatment need and utilization. Int J Methods Psychiatr Res 21:88–97
doi: 10.1002/mpr.1349
De Berardis D, Mazza M, Marini S, Del Nibletto L, Serroni N, Pino MC et al (2014) Psychopathology, emotional aspects and psychological counselling in infertility: a review. Clin Ter 165:163–169
pubmed: 24999571
Sejbaek CS, Hageman I, Pinborg A, Hougaard CO, Schmidt L (2013) Incidence of depression and influence of depression on the number of treatment cycles and births in a national cohort of 42,880 women treated with ART. Hum Reprod 28:1100–1109
doi: 10.1093/humrep/des442
Shani C, Yelena S, Reut BK, Adrian S, Sami H (2016) Suicidal risk among infertile women undergoing in-vitro fertilization: Incidence and risk factors. Psychiatry Res 240:53–59
doi: 10.1016/j.psychres.2016.04.003
Verhaak CM, Smeenk JM, Evers AW, Kremer JA, Kraaimaat FW, Braat DD (2007) Women’s emotional adjustment to IVF: a systematic review of 25 years of research. Hum Reprod Update 13:27–36
doi: 10.1093/humupd/dml040
Fushimi M, Saito S, Shimizu T, Kudo Y, Seki M, Murata K (2012) Prevalence of psychological distress, as measured by the Kessler 6 (K6), and related factors in Japanese employees. Commun Ment Health J 48:328–335
doi: 10.1007/s10597-011-9416-7
The Ministry of Health Labor and Welfare in Japan. Comprehensive survey of living conditions. https://www.mhlw.go.jp/toukei/saikin/hw/k-tyosa/k-tyosa18/index.html . 2017.
The Ministry of Health Labor and Welfare in Japan. Support for couples suffering from infertility. https://www.mhlw.go.jp/stf/seisakunitsuite/bunya/0000047270.html . 2016.
The Ministry of Health Labor and Welfare in Japan. Investigation about problems to affect in balance of infertility treatment and work. https://www.mhlw.go.jp/stf/houdou/0000197936.html . 2017.
Evers JLH (2002) Female subfertility. Lancet 360:151–159
doi: 10.1016/S0140-6736(02)09417-5
Leijdekkers JA, Eijkemans MJC, van Tilborg TC, Oudshoorn SC, McLernon DJ, Bhattacharya S et al (2018) Predicting the cumulative chance of live birth over multiple complete cycles of in vitro fertilization: an external validation study. Hum Reprod 33:1684–1695
doi: 10.1093/humrep/dey263
Verhagen TE, Dumoulin JC, Evers JL, Land JA (2008) What is the most accurate estimate of pregnancy rates in IVF dropouts? Hum Reprod 23:1793–1799
doi: 10.1093/humrep/den209
Nybo Andersen AM, Wohlfahrt J, Christens P, Olsen J, Melbye M (2000) Maternal age and fetal loss: population based register linkage study. BMJ 320:1708–1712
doi: 10.1136/bmj.320.7251.1708
Li W, Newell-Price J, Jones GL, Ledger WL, Li TC (2012) Relationship between psychological stress and recurrent miscarriage. Reprod Biomed Online 25:180–189
doi: 10.1016/j.rbmo.2012.03.012
Sugiura-Ogasawara M, Furukawa TA, Nakano Y, Hori S, Aoki K, Kitamura T (2002) Depression as a potential causal factor in subsequent miscarriage in recurrent spontaneous aborters. Hum Reprod 17:2580–2584
doi: 10.1093/humrep/17.10.2580
Kuroda K (2018) Lifestyle habits and pregnancy loss. In: Kuroda K, Brosens JJ, Quenby S, Takeda S (eds) Treatment strategy for unexplained infertility and recurrent miscarriage. Springer Singapore, Singapore, pp 95–104
doi: 10.1007/978-981-10-8690-8_9
Clifford K, Rai R, Regan L (1997) Future pregnancy outcome in unexplained recurrent first trimester miscarriage. Hum Reprod 12:387–389
doi: 10.1093/humrep/12.2.387
Stray-Pedersen B, Stray-Pedersen S (1984) Etiologic factors and subsequent reproductive performance in 195 couples with a prior history of habitual abortion. Am J Obstet Gynecol 148:140–146
doi: 10.1016/S0002-9378(84)80164-7