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Quality of life, anxiety and depression of German, Italian and French couples undergoing cross-border oocyte donation in Spain.
Hum Reprod. 2017 09 01; 32(9):1862-1870.HR

Abstract

STUDY QUESTION

What is the quality of life (QoL) and mental health of infertile heterosexual couples from different nations (Italy, Germany and France) undergoing cross-border oocyte donation (OD) in Spain?

SUMMARY ANSWER

Women have lower QoL and more anxiety than their male partners; overall French couples have lower QoL than their Italian and German counterparts.

WHAT IS KNOWN ALREADY

In Europe, thousands of couples move across national borders annually to seek ARTs, primarily OD, driven mainly by legal restrictions in their countries of origin. Most research shows that infertility and ARTs affect patients' mental health and QoL. The decision to undergo reproductive care abroad might add further emotional and practical complexity. Reliable information on how this experience affects the mental health and QoL of cross-border reproductive care (CBRC) patients is lacking. Moreover, most research has focused on women, and further research on male partners and intercultural differences is needed.

STUDY DESIGN, SIZE, DURATION

Cross-sectional study including 548 heterosexual individuals (347 women, 201 men) from Italy, Germany and France seeking IVF with donated oocytes in Barcelona, Spain between March and November 2013.

PARTICIPANTS/MATERIALS, SETTING, METHODS

A total of 432 couples were invited to participate and handed a questionnaire set. Questionnaires were answered separately and anonymously by each member of the couple on the day of embryo transfer. The questionnaire set included the Fertility Quality of Life (FertiQoL) instrument, the generic Hospital Anxiety and Depression Scale (HADS) instrument and three close-ended questions assessing perceived usefulness, desire, and use of psychological support. The overall response rate was 63.4%.

MAIN RESULTS AND THE ROLE OF CHANCE

Men reported significantly higher scores than women in the emotional (+13.74; P < 0.001), mind-body (+13.39; P < 0.001) and social (+4.11; P < 0.01) FertiQoL domains, at multilevel analysis controlled for confounder factors. Intercultural differences in QoL of couples were seen. French individuals had significantly lower emotional (-6.44; P < 0.01), mind-body (-7.41; P < 0.001) and relational scores (-6.41; P < 0.001) compared to Italians. Germans showed higher social scores (+6.41; P < 0.001) but lower relational scores (-8.94; P < 0.002) than Italians. Men reported significantly lower anxiety scores for the HADS than their partners (-1.38; P < 0.001), and German couples reported lower anxiety (-1.70; P = 0.003) and depression than their Italian counterparts (-1.56; P < 0.001). French patients were more likely to have required support by a mental health professional due to fertility problems in the past (+0.19; P < 0.001).

LIMITATIONS, REASONS FOR CAUTION

The scope of this study is limited to heterosexual couples undergoing cross-border OD. Caution on the interpretation of the results in men is advised, mainly because only three men for every five women completed the questionnaire.

WIDER IMPLICATIONS OF THE FINDINGS

These findings call for further work to identify the true nature of the differences in QoL and mental health observed.

STUDY FUNDING/COMPETING INTEREST(S)

None.

Authors+Show Affiliations

Clínica EUGIN, Travessera de les Corts 322, Barcelona 08029, Spain.Cardiff Fertility Studies Research Group, School of Psychology, Cardiff University, Park Place Cardiff, CF10 3AT, UK.Fundació Privada EUGIN, Travessera de les Corts 318, Barcelona 08029, Spain.Clínica EUGIN, Travessera de les Corts 322, Barcelona 08029, Spain.Clínica EUGIN, Travessera de les Corts 322, Barcelona 08029, Spain.Clínica EUGIN, Travessera de les Corts 322, Barcelona 08029, Spain.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28854722

Citation

Madero, S, et al. "Quality of Life, Anxiety and Depression of German, Italian and French Couples Undergoing Cross-border Oocyte Donation in Spain." Human Reproduction (Oxford, England), vol. 32, no. 9, 2017, pp. 1862-1870.
Madero S, Gameiro S, García D, et al. Quality of life, anxiety and depression of German, Italian and French couples undergoing cross-border oocyte donation in Spain. Hum Reprod. 2017;32(9):1862-1870.
Madero, S., Gameiro, S., García, D., Cirera, D., Vassena, R., & Rodríguez, A. (2017). Quality of life, anxiety and depression of German, Italian and French couples undergoing cross-border oocyte donation in Spain. Human Reproduction (Oxford, England), 32(9), 1862-1870. https://doi.org/10.1093/humrep/dex247
Madero S, et al. Quality of Life, Anxiety and Depression of German, Italian and French Couples Undergoing Cross-border Oocyte Donation in Spain. Hum Reprod. 2017 09 1;32(9):1862-1870. PubMed PMID: 28854722.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Quality of life, anxiety and depression of German, Italian and French couples undergoing cross-border oocyte donation in Spain. AU - Madero,S, AU - Gameiro,S, AU - García,D, AU - Cirera,D, AU - Vassena,R, AU - Rodríguez,A, PY - 2016/09/23/received PY - 2017/06/30/accepted PY - 2017/9/1/entrez PY - 2017/9/1/pubmed PY - 2018/5/22/medline KW - FertiQoL KW - Hospital Anxiety and Depression Scale (HADS) KW - cross-border reproductive care KW - oocyte donation (OD) KW - psychosocial well-being KW - quality of life SP - 1862 EP - 1870 JF - Human reproduction (Oxford, England) JO - Hum Reprod VL - 32 IS - 9 N2 - STUDY QUESTION: What is the quality of life (QoL) and mental health of infertile heterosexual couples from different nations (Italy, Germany and France) undergoing cross-border oocyte donation (OD) in Spain? SUMMARY ANSWER: Women have lower QoL and more anxiety than their male partners; overall French couples have lower QoL than their Italian and German counterparts. WHAT IS KNOWN ALREADY: In Europe, thousands of couples move across national borders annually to seek ARTs, primarily OD, driven mainly by legal restrictions in their countries of origin. Most research shows that infertility and ARTs affect patients' mental health and QoL. The decision to undergo reproductive care abroad might add further emotional and practical complexity. Reliable information on how this experience affects the mental health and QoL of cross-border reproductive care (CBRC) patients is lacking. Moreover, most research has focused on women, and further research on male partners and intercultural differences is needed. STUDY DESIGN, SIZE, DURATION: Cross-sectional study including 548 heterosexual individuals (347 women, 201 men) from Italy, Germany and France seeking IVF with donated oocytes in Barcelona, Spain between March and November 2013. PARTICIPANTS/MATERIALS, SETTING, METHODS: A total of 432 couples were invited to participate and handed a questionnaire set. Questionnaires were answered separately and anonymously by each member of the couple on the day of embryo transfer. The questionnaire set included the Fertility Quality of Life (FertiQoL) instrument, the generic Hospital Anxiety and Depression Scale (HADS) instrument and three close-ended questions assessing perceived usefulness, desire, and use of psychological support. The overall response rate was 63.4%. MAIN RESULTS AND THE ROLE OF CHANCE: Men reported significantly higher scores than women in the emotional (+13.74; P < 0.001), mind-body (+13.39; P < 0.001) and social (+4.11; P < 0.01) FertiQoL domains, at multilevel analysis controlled for confounder factors. Intercultural differences in QoL of couples were seen. French individuals had significantly lower emotional (-6.44; P < 0.01), mind-body (-7.41; P < 0.001) and relational scores (-6.41; P < 0.001) compared to Italians. Germans showed higher social scores (+6.41; P < 0.001) but lower relational scores (-8.94; P < 0.002) than Italians. Men reported significantly lower anxiety scores for the HADS than their partners (-1.38; P < 0.001), and German couples reported lower anxiety (-1.70; P = 0.003) and depression than their Italian counterparts (-1.56; P < 0.001). French patients were more likely to have required support by a mental health professional due to fertility problems in the past (+0.19; P < 0.001). LIMITATIONS, REASONS FOR CAUTION: The scope of this study is limited to heterosexual couples undergoing cross-border OD. Caution on the interpretation of the results in men is advised, mainly because only three men for every five women completed the questionnaire. WIDER IMPLICATIONS OF THE FINDINGS: These findings call for further work to identify the true nature of the differences in QoL and mental health observed. STUDY FUNDING/COMPETING INTEREST(S): None. SN - 1460-2350 UR - https://www.unboundmedicine.com/medline/citation/28854722/Quality_of_life_anxiety_and_depression_of_German_Italian_and_French_couples_undergoing_cross_border_oocyte_donation_in_Spain_ L2 - https://academic.oup.com/humrep/article-lookup/doi/10.1093/humrep/dex247 DB - PRIME DP - Unbound Medicine ER -