Objetivo: A parentalidade constitui-se como um desejo comum a muitos indivíduos, mas em alguns casos a sua concretização implica o recurso a técnicas de reprodução medicamente assistida, como a doação de gâmetas ou a gestação de substituição. Em virtude da escassez de estudos sobre atitudes face à doação/receção de gâmetas e gestação de substituição, este estudo pretendeu explorar as atitudes de indivíduos em idade reprodutiva relativamente a estas técnicas. Métodos: Participaram 551 sujeitos com idades entre os 18 e os 40 anos, recrutados através de amostragem por bola de neve. Foi solicitado o preenchimento de um questionário desenvolvido especificamente para o estudo, disponibilizado numa plataforma online, que avaliou o posicionamento dos sujeitos face à doação/receção de gâmetas e gestação de substituição. Resultados: A maioria dos participantes revelou uma atitude positiva perante a doação/receção de gâmetas. No caso da doação a principal motivação indicada foi a de ajudar um casal que não pode ter filhos. Relativamente à receção de gâmetas, os dados sugerem tratar-se de uma circunstância bem aceite pelos participantes. Já no que se refere à gestação de substituição, ainda que exista um posicionamento favorável à sua legalização, nem todos os participantes considerariam essa possibilidade, ainda que aqueles que a equacionariam refiram que se sentiriam felizes por concretizar o sonho de se tornar mãe/pai. Conclusões: Na globalidade, a receção/doação de gâmetas é vista de um modo favorável. Aspetos como realizar o desejo de parentalidade e poder cuidar de uma criança desde o seu nascimento são relevantes, sugerindo uma menor valorização da componente genética. Por sua vez a doação de gâmetas parece relacionar-se com motivações altruístas, podendo ser potenciada com a existência de aconselhamento. A complexidade da gestação de substituição poderá contribuir para a existência de uma menor abertura, ainda que os sujeitos estejam de acordo com a sua legalização em Portugal.
IntroductionThe literature has shown that young adults reveal lack of knowledge about factors that influence fertility. Given this gap of knowledge regarding fertility, several authors indicate the need for awareness-raising and promotion of attitudes and behaviors that preserve fertility.ObjectiveThis study aimed to assess the knowledge about factors that affect fertility as well as the impact of information transmission on this topic.Materials and methodsFive hundred and fifty-one subjects aged between 18 and 40 years old without children completed an online questionnaire specifically developed for this study. Two assessment moments were considered and participants were randomly assigned to three groups:– video group;– website group;– control group.The video and website groups accessed information on fertility-related factos such as age, weight, exercise, substance abuse, irregular menstrual cycles, pollution, etc. The control group had no access to this information.ResultsMale participants revealed more knowledge about the factors that affect fertility in both moments. Participants in the groups that had access to fertility information (video group and website group) improved their level of expertise. No significant differences were found in the control group.Discussion/conclusionGroups that watched the video or visited the website where information on fertility-related lifestyle and other factors was available increased their level of knowledge, suggesting that education on this subject should be provided to general population. The means used for the information dissemination had no impact on the improvement of knowledge.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Study question Does infertility-related psychological inflexibility play a role in the relationship between infertility-related stress domains and psychopathological symptoms (depression, anxiety)? Summary answer Infertility-related psychological inflexibility mediated the relationship between infertility-related stress domains and depression. There were no effects between infertility-related stress domains and anxiety symptoms. What is known already The emotional impact of infertility may include anxiety and depressive symptoms and these seem to be related to stress. Beliefs about the importance of parenthood (need for parenthood) and rejection of a childfree lifestyle, as well as the impact of infertility in several life areas (social, sexual, and relationship) are conceptually considered two infertility-related stress domains. Although the relationship between infertility-related stress and psychopathological symptoms has been previously recognized, the mechanism underlying this relationship remains undetermined. Psychological inflexibility has been pointed as a core transdiagnostic process contributing to the development and maintenance of several psychological difficulties. Study design, size, duration Cross-sectional study. Participants were recruited through the Associação Portuguesa de Fertilidade (patients’ association). Inclusion criteria were age (18 years or older) and an infertility medical diagnosis. Data were collected online through self-report instruments between June and December 2019. Participants/materials, setting, methods: A sample comprising 287 women pursuing infertility medical treatment (at different stages) completed online a sociodemographic questionnaire, the depression and anxiety subscales of the Depression, Anxiety and Stress Scales (DASS – 21), the Psychological Inflexibility Scale - Infertility (PIS-I), and the Fertility Problem Inventory (FPI). Descriptive and correlational analyses were computed through SPSS v. 26, and path analyses were estimated in AMOS (v. 24) with bootstrap procedures (2000 samples). Main results and the role of chance Correlation analyses revealed that FPI domains (importance of parenthood and impact on life domains), depressive and anxiety symptoms were significantly and positively associated with PIS-I. A mediation analysis was conducted to examine whether PIS-I mediated the effect of FPI domains on depressive and anxiety symptoms. Paths showing not to be statistically significant were removed. This model showed a good fit to the empirical data: χ2(4) = 1.59, p = .810, CMIN/DF = .40; TLI = 1.00; CFI = 1.00; RMSEA = .00, 95% CI = .00 to .06. The effect of the importance of parenthood on depressive symptoms revealed to be both direct (b = .03; SEb = .01; Z = 2.46; p = .014; β= .15) and partially mediated by the PIS-I (b = .31, 95% CI = .24 to .37, p = .018). The effect of the impact of infertility in several life areason depressive symptoms was fully mediated by PIS-I (b = .15, 95% CI = .10 to .21, p = .008). This model explained 43% of the total variance of depressive symptoms. No significant effects were found for anxiety symptoms. Limitations, reasons for caution Participants were at different stages of their fertility treatment. Data collection was completed online and this tends to recruit participants with more access to online platforms. Results rely on cross-sectional and self-report data. Wider implications of the findings: Results suggest the relevance of targeting processes encompassing psychological inflexibility, such as cognitive fusion, experiential avoidance, conceptualized self, conceptualized past and future, lack of values clarity, and inability to commit with values-driven actions, in psychological interventions designed for women with infertility. Trial registration number N/A.
Study question Does pain-related psychological inflexibility play a role in the relationship between psychopathological symptoms (depression, anxiety, stress) and pain intensity in women with endometriosis? Summary answer Pain-related psychological inflexibility acts as a mediator exclusively between depressive symptoms and pain intensity. Psychopathological symptoms did not reveal a direct effect on pain intensity. What is known already Endometriosis is a chronic and incapacitating condition frequently involving the experience of pain (e.g., dysmenorrhea, ovulation pain, dyspareunia, chronic pelvic pain). Women dealing with endometriosis may present impaired health-related quality of life and psychological distress, with depressive, anxiety, and stress symptoms being commonly reported. Pain-related psychological inflexibility involves emotion regulation processes, such as avoidance of pain and cognitive fusion with pain. Cognitive and behavioural processes influence the relationship between pain and psychopathological symptoms, and pain-related psychological inflexibility showed to be an underlying mechanism in this relationship. Study design, size, duration Cross-sectional study. Participants’ recruitment was completed through the Associação Portuguesa de Apoio a Mulheres com Endometriose and the Associação Portuguesa de Fertilidade (endometriosis and infertility patients’ associations). Inclusion criteria were age (18 years or older) and an endometriosis medical diagnosis (self-reported). Data collection occurred between February 2018 and May 2018. Participants/materials, setting, methods A sample encompassing 209 women with an endometriosis diagnosis completed online a sociodemographic questionnaire, the Depression, Anxiety and Stress Scales (DASS – 21), the Numeric Pain Rating Scale (NPRS), and the Psychological Inflexibility in Pain Scale (PIPS-PT). Descriptive and correlational analyses were carried out using SPSS v. 26, and path analyses were estimated in AMOS (v. 24) with bootstrap procedures (2000 samples). Main results and the role of chance Participants’ age ranged from 18 to 50 years old with a mean of 34.03 (SD = 6.44) years. The majority of participants were married (n = 112; 53.6%), followed by single (n = 54; 25.8%). Regarding years of education, a mean of 14.62 years (SD = 2.80) was found. Participants reported that their endometriosis diagnosis had been established for 4.55 years (SD = 4.56). Correlation analyses showed that depressive, anxiety and stress symptoms were significantly and positively associated with pain intensity and pain-related psychological inflexibility. A mediation analysis was conducted to examine whether pain-related psychological inflexibility mediated the effect of psychopathological symptoms on pain intensity. Paths showing not to be statistically significant were removed. The final model defining an effect of depressive symptoms on pain intensity mediated by pain-related psychological inflexibility explained 26% of the variance. This model showed a good fit to the empirical data: χ2(5) = 10.75, p = .057, CMIN/DF = 2.15; TLI = .98; CFI = .99; RMSEA = .07, 95% CI = .00 to .14. Depressive symptoms predicted elevated pain intensity fully through higher pain-related psychological inflexibility (b = .05; SEb = .01; Z = 8.45; p < .001; β= .51). Limitations, reasons for caution Although path analysis is a powerful statistical technique, our findings rely on cross-sectional and self-report data. The study was disseminated through patients’ associations, limiting the inclusion of people who do get in touch with such organizations. Moreover, online recruitment tends to recruit participants with more access to online platforms. Wider implications of the findings: Pain-related psychological inflexibility seems to be a relevant construct to be addressed in the psychological assessment of women dealing with endometriosis. Furthermore, results suggest the relevance of targeting emotion regulation processes, and not only focus on reducing pain, in pain management interventions. Trial registration number N/A.
IntroductionSocietal changes in the last decades led to the arise of new paradigms on gender equity. Studies addressing fertility/infertility issues have been conducted mainly in women and in this research area, male partners have deserved less attention. More recently there has been a major focus on the idea that fertility/infertility aspects have to be conceptualized from a couples’ perspective.GoalsThe current study sought to explore attitudes towards gamete donation and surrogacy in a sample of young men in reproductive age.MethodsA total of 111 males with ages ranging from 18 to 40 years old and without children completed an online questionnaire addressing attitudes towards gamete donation and surrogacy.ResultsThe majority of participants (77.3%) would be willing to donate their sperm, and their main motivation for doing that would be to feel “happy to help a couple struggling to have a child”. Participants stated that the likelihood of donating would increase if they were able to attend counseling, to complete the procedure in an IVF center located in their residence area, and being provided with more information about infertility. Regarding surrogacy 82% are in favor of this procedure legalization and 49.5% would be willing to use it if they needed.ConclusionMen showed a positive attitude towards sperm donation and surrogacy, emphasizing the importance of counseling and information availability on these topics. This may suggest that they are willing to get involved when fertility issues are addressed.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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