Concerns of Infertile Women Candidates for Egg Donation: A Qualitative Study

  • Maryam Bagheri Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
  • Mina Jafarabadi Vali e asr Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran
  • Seyedeh Fatemeh vasegh Rahimparvar Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
  • Ahmad Ali Nourbala Department of Psychology, School of Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
  • Zahra Behboodi Moghadam Mail Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
Keywords:
Infertility, Egg Receiver, Egg Donation, Concern, Reproductive Health, Qualitative Study

Abstract

Objective: Women with premature ovarian insufficiency, menopause, gonadal dysgenesis, and genetic disorders as well as those with a history of recurrent in vitro fertilization failure may benefit from the assisted fertility techniques. These women experience concerns that directly affect their married life especially in egg donation treatment. This study was conducted to investigate the reproductive health concerns of infertile women who were candidates for egg donation.Materials and methods: This qualitative content analysis was conducted in 17 infertile women who were referred to Imam Khomeini Hospital Infertility Clinic from July 2018 to March 2019. The participants were selected through purposeful sampling. Data were collected through individual in-depth semi-structured interviews. A conventional qualitative content analysis approach was adopted for data analysis using the MAXQDA12 software.Results: The results of data analysis showed five themes, including threatened married life, lack of supportive situation, religious beliefs, psychosocial damage, and damaged feminine identity.Conclusion: Infertility is usually accompanied by a great psychological sadness referred to as "stress of infertility". Assisted reproductive techniques (ART) are also a source of stress for patients; therefore, it has a significant impact on the marital relationship and mental health of infertile women. Hence, there is a need for psychological support from the treatment team to reduce woman reproductive health concerns.

References

1. Harlow SD, Campbell OM. Epidemiology of menstrual disorders in developing countries: a systematic review. BJOG 2004; 111: 6-16.
2. ICPD Beyond 2014, 29th United Nations General Assembly Special Session on the follow-up to the Programme of Action of the International Conference on Population and Development Beyond 2014.
3. Zegers-Hochschild F, Adamson GD, de Mouzon J, Ishihara O, Mansour R, Nygren K, et al. The International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) revised glossary on ART terminology, 2009. Human Reproduction 2009; 24: 2683–7.
4. Murugappan G, Li S, Lathi RB, Baker VL, Eisenberg ML. Increased risk of incident chronic disease in infertile women: analysis of US claims data. Fertility and Sterility 2018: 110: e78.
5. International conference on population and Development (ICPD). Cairo, Egypt. 1994.
6. Rooney kl, Domar AD. The relationship between stress and infertility. Dialogues Clin Neurosci 2018; 20: 41-7.
7. Berek JS, Novak E. Berek & Novak's gynecology. Lippincott Williams & Wilkins.15thedition.2012.
8. Abasi Shavazi MJ, Asgai Khaneghah A, Razeghi Nasrabad HB. Life Experience with Infertility; a case study in Tehran. Women research. J ReProd Infertil 2005; 3: 91-113. [Persian].
9. World Health Organization. Current practices and controversies in assisted reproduction. Sexual and reproductive health. Report of a meeting on “Medical, Ethical and Social Aspects of Assisted Reproduction” held at WHO Headquarters in Geneva, Switzerland. 2001.
10. Bokaie M, Simbar M, Yassini Ardekani SM. Sexual behavior of infertile women: a qualitative study. Iran J Reprod Med 2015; 13: 645-56.
11. Nelson CJ, Shindel AW, Naughton CK, Ohebshalom M, Mulhall JP. Prevalence and predictors of sexual problems, relationship stress, and depression in female partners of infertile couples. J Sex Med 2008; 5: 1907-14.
12. Perlis N, Lo KC, Grober ED, Spencer L, Jarvi K. Coital frequency and infertility: Which male factors predict less frequent coitus among infertile couples? Fertil Steril 2013; 100: 511-5.
13. Dumont F. A History of Personality Psychology: Theory, Science, and Research from Hellenism to the twenty–First Century. Cambridge university press. 2010.
14. Marci R, Graziano A, Piva I, Lo Monte G, Soave I, Giugliano E, et al. Procreative sex in infertile couples: the decay of pleasure? Health and Quality of Life Outcomes 2012; 10: 140-6.
15. Wischmann TH. Sexual disorders in infertile couples: an update. Curr Opin Obstet Gynecol 2013; 25: 220-2.
16. Vakilian K, Mirzaii K, NajmAbadi. Reproductive health in Iran: international conference on population and development goals. Oman Med J 2011; 26: 143-7.
17. Bracewell-Milnes T, Saso S, Abdalla H, Thum MY. A systematic review investigating psychosocial aspects of egg sharing in the United Kingdom and their Potential effects on egg donation numbers. Hum Fertil (Camb) 2018; 21: 163-73.
18. Direkvand Moghadam A, Delpisheh A, Sayehmiri K. The trend of infertility in Iran, an original review and meta-analysis. Nurs Pract Today 2014; 1: 46-52.
19. Gardner DK, Weissman A, Howles CM, Shoham Z. Textbook of Assisted Reproductive techniques Technologies: Laboratory and Clinical Perspectives (Reproductive Medicine and Asst. Reproduction). 2018.
20. National Centers for Chronic Prevention and Health Promotion division of Reproductive Health Assisted Reproductive Technology. National Summary report. 2015.
21. Golombok S, Cook R, Bish A, Murray C. Families Created by the New Reproductive Technologies: Quality of Parenting and Social and Emotional Development of the Children. Child Dev 1995; 66: 285–98.
22. Bustillo M, Krysa LW, Coulam CB. Uterine receptivity in an oocyte donation programme. Hum Reprod 1995; 10: 442–5.
23. Wischmann T, Schilling K, Toth B, Rosner S, Strowitzki T, Wohlfarth K, et al. Sexuality, self-esteem and partnership quality in infertile women and men. Geburtshilfe Frauenheilkd 2014; 74: 759-63.
24. Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today 2004; 24: 105-12.
25. Inhorn MC. Right to assisted reproductive technology: overcoming infertility in low-resource countries. Int J Gynecol Obstet 2009; 106: 172-4.
26. Jain K, Radhakrishnan G, Agrawal P. Infertility and psychosexual disorders: Relationship in infertile couples. Indian J Med Sci 2000; 54: 1-7.
27. Oddens BJ, den Tonkelaar I, Nieuwenhuyse H. Psychosocial experiences in women facing fertility problems a comparative survey. Hum Reprod 1999; 14: 255-61.
28. Coeffin-Driol C, Giami A. The impact of infertility and its treatment on sexual life and marital relationships: review of the literature. Gynecol Obstet Fertil 2004; 32: 624-37. [French].
29. Muller MJ, Schilling G, Haidl G. Sexual satisfaction in male infertility. Arch Androl 1999; 42: 137-43.
30. Repokari L, Punamaki RL, Unkila-Kallio L, Vilska S, Poikkeus P, Sinkkonen J, et al. Infertility treatment and marital relationships: a 1-year prospective study among successfully treated ART couples and their controls. Hum Reprod 2007; 22: 1481-91.
31. Direkvand Moghadam A, Delpisheh A, Direkvand Moghadam AZ. Effect of Infertility on Sexual Function: A Cross-Sectional Study. J Clin Diagn Res 2015; 9: QC01–QC03.
32. Piva I, Lo Monte G, Graziano A, Marci R. A literature review on the relationship between infertility and sexual dysfunction: does fun end with baby making? Eur J Contracept Reprod Health Care 2014; 19: 231-7.
33. Martins MV, Peterson BD, Almeida V, Mesquita-Guimaraes J, Costa ME. Dyadic dynamics of perceived social support in couples facing infertility. Hum Reprod 2014; 29: 83-9.
34. Tao P, Coates R, Maycock B. The impact of infertility on sexuality: A literature review Australas Med J 2011; 4: 620-7.
35. Klemetti R, Raitanen J, Sihvo S, Saarni S, Koponen P. Infertility, mental disorders and well-being--a nationwide survey. Acta Obstet Gynecol Scand 2010; 89: 677-82.
36. Jamali S, Zarei H, Rasekh Jahromi A. The relationship between body mass index and sexual function in infertile women: a cress-sectional survey. Iran J Reprod Med 2014; 12:189-98.
37. Bayar U, Basaran M, Atasoy N, Kokturk F, Arikan II, Barut A, et al. Sexual dysfunction in infertile couples: evaluation and treatment of infertility. J Pak Med Assoc 2014; 64: 138-45.
38. Bunting L, Boivin J. Knowledge about infertility risk factors, fertility myths and illusory benefits of healthy habits in young people. Hum Reprod 2008; 23: 1858-64.
39. Schmidt L. Social and psychological consequences of infertility and assisted reproduction - what are the research priorities? Hum Fertil (Camb) 2009; 12: 14-20.
40. Aggarwal RS, Mishra V, Jasani AF Incidence and prevalence of sexual dysfunctionin infertile females. Middle East Fertility Society Journal 2013; 18: 187-90.
41. Khodakarami N, Hashemi S, Seddigh S, Hamdiyeh M, Taheripanah R. Life experience with infertility; a phenomenological study. J Reprod Fertil 2010; 10: 287-97.
42. Aduloju OP, Olaogun OD, Aduloju T. Quality of life in women of reproductive age: a comparative study of infertile and fertile women in a Nigerian tertiary centre. J Obstet Gynaecol 2018; 38: 247-51.
43. Lara L, Salomao PB, Romao AP, Reis RM, Navarro PA, Rosa-e-Silva AC, et al. Effect on infertility on the sexual function of couples: state of the Art. Recent Pat Endocr Metab Immune Drug Discov 2015; 9: 46-53.
44. Buster JE. Managing female sexual dysfunction. Fertil Steril 2013; 100: 905-15.
45. Zare Z, Amirian M, Golmakani N, Mazlom R, Laal Ahangar M. Sexual dysfunction in infertile women. Int J Reprod BioMed (yazd) 2016; 14: 89-94.
46. Besharat MA, Hoseinzadeh Bazargani R. A comparative study of fertile and infertile women's mental health and sexual problems. Iranian journal of psychiatry and clinical psychology 2006; 12: 146-53. [Persian]
47. Ozturk S, Sut HK, Kucuk L. Examination of sexual functions and depressive symptoms among infertile and fertile women. Pak J Med Sci 2019; 35: 1355-60.
48. Audu BM. Sexual dysfunction among infertile Nigerian women. J Obstet Gynaecol 2002; 22: 655-7.
49. Farajkhoda T, Latifnejad Roudsari R, Abbasi M. An exploratory study to develop a practical ethical framework for reproductive health research. Iran J Reprod Med 2013; 11: 31-8.
50. Kucur Suna K, Ilay G, Aysenur A, Kerem Han G, Eda Ulku U, Pasa U, Fatma C. Effects of Infertility Etiology and Depression on Female Sexual Function. J Sex Marital Ther 2016; 42: 27-35.
51. Purewal S, van den Akker OB. Systematic review of oocyte donation: investigating attitudes, motivations and experiences. Hum Reprod Update 2009; 15: 499-515.
52. Purewal S, van den Akker OB. British women’s attitudes towards oocyte donation: Ethnic differences and altruism. Patient Educ Couns 2006; 64: 43-9.
53. Englert Y. Ethics of oocyte donation are challenged by the health care system. Hum Reprod 1996; 11: 2353-5.
54. Greenfeld DA, Klock SC. Disclosure decisions among known and anonymous oocyte donation recipients. Fertil Steril 2004; 81:1565-71.
55. Local babies, Global Science: Gender, Religion and in Vitro Fertilization in Egypt. New York Routledge. 2003.
56. Bagheri-Lankarani N, Zarei F, Zandi M, Omani Samani R, karimi M. The Experiences of Women Fertilized through Egg Donation during Their Treatment Process. Evidence Based Care Journal 2014; 6: 63-70.
57. Latifnejad Roudsari R, Allan HT, Smith PA. Navigating
the spiritual journey of infertility: Muslim and Christian infertile women’s experiences. Religion and Psychology. Nova Science Publishers 2009; 208-41.
58. Razeghi Nasrabad HB. “Socio-cultural aspect of infertility in Iran.” PhD Thesis, Tehran University, 2005.
59. Ramezanzadeh F, Haghollahi F, Bagheri M, Masoomi M, Abedi-Nia N, Jafar-Abadi M. Attitudes of Donors and ReciPients Toward Ethical Issues in Oocyte Donation. Journal of Reproduction& Infertility 2009; 10: 71-80. [Persian]
60. Eggers S, Kirchengast S. The polycystic ovary syndrome–a medical condition but also an important psychosocial problem. Coll Antropol 2001; 25: 673-85.
61. Ridenour AF, Yorgason JB, Peterson B. The Infertility Resilience Model: Assessing Individual, Couple, and External Predictive Factors.  Contemporary Family Therapy 2009; 31: 34-5.
62. Fekkes M, Buitendijk SE, Verrips GHW, Braat DDM, Brewaeys AMA, Dolfing JG, et al. Health‐related quality of life in relation to gender and age in couples planning IVF treatment. Human Reproduction 2003; 18: 1536-43.
63. Inhorn MC, Van Balen F. Infertility around the Globe: New Thinking on Childlessness, Gender, and Reproductive Technologies. University of California Press. 2002.
64. Mohammadi MR, Khalajabadi Farahani F. Emotional and Psychological Problems of infertility and strategies to overcome them. Journal of Reproductive& Infertility 2001; 2: 33-9. [Persian]
65. Winkvist A, Akhtar HZ. God should give daughters to rich families only: attitudes towards childbearing among low-income women in Punjab, Pakistan. Soc Sci Med 2000; 51: 73-81.
66. Hadizadeh-Talasaz F, Latifnejad Roudsari R, Simbar M. Decision for disclosure: The experiences of Iranian infertile couples undergoing assisted reproductive donation procedures. Hum Fertil (camb) 2015; 18:
265–75.
67. Soderstrom-Anttila V, Salevaara M, Suikkari AM. Increasing openness in oocyte donation families regarding disclosure over 15 years. Hum Reprod 2010; 25: 2535–42.
68. Shahraki Z, Davari Tanha F, Ghjarzadeh M. Depression, Sexual dysfunction and sexual quality of life in women with infertility. BMC women’s health 2018; 18: 92.
69. Shoji M, Hamatani T, Ishikawa S, Kuji N, Ohta H, Matsui H, et al. Sexual Satisfaction of infertile couples assessed using the Golombok-Rust Inventory of Sexual Satisfaction (GRISS). Sci Rep 2014; 4: 5203.
70. Reporaki L, Punamaki RL, Unkila-Kallio L, Vilska S, poikkeus P, Sinkkonen J, et al. Infertility treatment and marital relationship: a 1-year prospective study among successfully treated ART couples and their controls. Hum Reprod 2007; 22: 1481-9.
71. Kucur Suna K, Ilay G, Aysenur A, Kerem Han G, Eda Ulku U, Pasa U, et al. Effects of Infertility Etiology and Depression on Female Sexual Function. J Sex Marital Ther 2016; 42: 27-35.
72. Winkelman WD, Katz PP, Smith JF, Rowen TS; Infertility Outcomes Program Project Group. The sexual impact of infertility among women seeking fertility care. Sex Med 2016; 4: e190-7.
73. Zabihi rigcheshme M, Mirzaian B, Hasanzade R, Shahidi M. Comparing sexual attitudes of fertile and infertile couples. J Mazandaran Univ Med Sci 2012; 21: 272-81. [Persian]
74. Chachamovich JR, Chachamovich E, Ezer H, Fleck MP, Knauth D, Passos EP. Investigating quality of life and health-related quality of life in infertility: a systematic review. Journal of Psychosomatic Obstetrics & Gynecology 2010; 31: 101-10.
75. Cai L, Liu J, Lu SH, Yin J. Female Sexual Dysfunction and Timed Intercourse: A Prospective Study of 105 infertile women. Advances in Reproductive Sciences 2015; 3: 92-6.
76. Hadizadeh-Talasaz F, Simbar M, Esmaily H, Latifnejad Roudsari R. Development and Validation of a Decision-Making Donor Conception Questionnaire in Iranian Infertile Couples. International Journal of Fertility & Sterility 2019; 13: 215-24.
77. Latifnejad Roudsari R, Hadizadeh Talasaz F, Simbar M, Khadem Ghaebi N. Challenges of Donor Selection: The Experiences of Iranian Infertile Couples Undergoing Assisted Reproductive Donation Procedures. Iranian Journal of Obstetrics, Gynecology and Infertility 2014; 16: 1-13.[ Persian]
78. Pacheco Pahla A, Lourenco MF. Psychological and Cross-Cultural aspects of infertility and human sexuality. Adv Psychosom Med 2011; 31:164-83.
Published
2020-07-18
How to Cite
1.
Bagheri M, Jafarabadi M, Rahimparvar SF, Nourbala AA, Behboodi Moghadam Z. Concerns of Infertile Women Candidates for Egg Donation: A Qualitative Study. J Fam Reprod Health. :21-31.
Section
Original Articles