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Comment on "Disability, psychiatric symptoms, and quality of life in infertile women: a cross-sectional study in Turkey".

Summary: The aim of this work is to comment on the study about disability, psychiatric symptoms and quality of life in infertile women of Turkey that was published in this Journal. We suggest that future studies use larger samples, consider the influence of factors such as cause of infertility and assisted reproductive techniques (ARTs) and, last but not least, exclude other comorbidites which may influence the data analysis.

Key words: infertility; disability; quality of life

[Shanghai Arch Psychiatry. 2016; 28(6): 353-354.

Dear Editor,

We read with great interest the article by Sezgin and colleagues [1] about psychiatric symptoms, disability and quality of life in fertile and infertile women in Turkey. We agree that infertility is a very stressful experience for women and it can also be influenced by socio-cultural factors. For this reason, it is important to investgate the role of these factors in order to beter understand the effects of infertility both in women and couples.

Although we appreciated the methodology used by the authors, we take the opportunity to point out several elements which would let us further realize the results of this study.

First of all, the authors could have used a larger sample in order to increase the validity of their data analysis. Moreover, the study enrolled women who had a diagnosis of infertility but authors did not specify the type of infertility nor the cause (primary infertility, male factor infertility/female factor infertility or both, unexplained infertility). Indeed, many studies about this topic have underlined that the causes of infertility have a different impact on emotional and psychological well-being of women affected. [2, 3] So, we think that authors should have considered this element in their study.

Also, it is not clear what the type of infertility treatment discussed in the study is and if enrolled women are on their first attempt at treatment or not. Literature underlines that the different types of assisted reproductive techniques (ARTs) differently affect the emotional state of both women and couples. In addition, the failure of treatment may influence the quality of life and the relatonship within the couple so it is important to consider this variable as well . [4]

We would like to know if women with a history of anxiety and depression or with organic pathologies that may affect psychological well-being were excluded from the sample. If these women were not excluded, it would not be possible to conclude that the results registered among the women of this study were related to their infertility condition rather than to other pathologies.

As regards the tests used by the authors, the results are based on the use of self-report psychometric measures. According to our opinion, it is important to consider that these results may have been influenced by a series of individual factors which may limit the validity of self-evaluation instruments. Moreover, it would be interesting to use a test more specific to people suffering from infertility such as the Fertility Quality of Life questionnaire (FertQoL) [5].

Finally, it is important to investigate the consequences of infertility for the partners of the affected women. Indeed, many studies have demonstrated that the experience of infertility may affect sexual function, partner relatonal satisfaction and general well-being within the couple. [2]

In conclusion, based on these data and our experience, we strongly suggest that future studies use larger samples, consider the influence of factors such as cause of infertility and assisted reproductive techniques (ARTs) and, last but not least, exclude other comorbidites which may influence the data analysis.

Conflict of interest

The authors report no conflict of interest related to this manuscript.

Funding support

No funding was provided to prepare this manuscript.

Authors' contributon

Agnese Maria Chiara Rapisarda collected the available data from the literature; Valentina Lucia La Rosa wrote the draft of the Manuscript; Antonio Simone Lagana revised the Manuscript; Salvatore Giovanni Vitale provided insightful comments, supervised the development of the Manuscript and gave the final approval.

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References:

[1.] Sezgin H, Hocaoglu C, Guvendag-Guven ES. Disability, psychiatric symptoms, and quality of life in infertile women: a cross-sectional study in Turkey. Shanghai Arch Psychiatry. 2016; 28(2): 86-94. doi: http://dx.doi.org/10.11919/j.issn.1002-0829.216014

[2.] El Kissi Y, Romdhane AB, Hidar S, Bannour S, Ayoubi Idrissi K, Khairi H, et al. General psychopathology, anxiety, depression and self-esteem in couples undergoing infertility treatment: a comparative study between men and women. Eur J Obstet Gynecol Reprod Biol. 2013; 167(2): 185-189. doi: http://dx.doi.org/10.1016/j.ejogrb.2012.12.014

[3.] Lagana AS, Vitale SG, Iaconianni P, Gatti S, Padula F. Male Infertility during Antihypertensive Therapy: Are We Addressing Correctly The Problem? Int J Fertil Steril. 2016; 10(3): 267-269

[4.] Muscatello MR, Lorusso S, Bruno A, Reale R, Ciura GL, Lagana AS, et al. Anger in women treated with assisted reproductive technology (ART): effects on mother and newborn. J Matern Fetal Neonatal Med. 2016; 29(5): 813-817

[5.] Boivin J, Takefman J, Braverman A. The fertility quality of life (FertQoL) tool: development and general psychometric propertes. Hum Reprod. 2011; 26(8): 2084-2091. doi: htp://dx.doi.org/10.1093/humrep/der171

Salvatore Giovanni Vitale (1), Valentna Lucia La Rosa (2*), Agnese Maria Chiara Rapisarda (3), Antonio Simone Lagana (1)

(1) Unit of Gynecology and Obstetrics, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, Via Consolare Valeria 1, 98125 Messina, Italy.

(2) Unit of Psychodiagnostics and Clinical Psychology, University of Catania, Via Santa Sofa 78, 95124, Catania, Italy.

(3) Department of General Surgery and Medical Surgical Specialtes, University of Catania, Via Santa Sofa 78, 95124, Catania, Italy.

(*) correspondence: Valentna Lucia La Rosa. Mailing address: Via S. Sofa 78, Catania 95124, Italy. E-Mail: psicolarosa@gmail.com

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Dr. Salvatore Giovanni Vitale obtained a medical degree in 2009 from University of Catania, Italy, and he specialized in Obstetrics and Gynecology in 2015 at University of Catania, Italy. He currently conducts his research activity in the Department of Human Pathology in Adulthood and Childhood "G. Barresi" at University of Messina, Italy. He is also the author of numerous scientific papers. His research interests are infertility, gynaecological and endoscopic surgery and prenatal diagnostics.
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Title Annotation:Correspondence
Author:Vitale, Salvatore Giovanni; la Ros, Valentna Lucia; Rapisarda, Agnese Maria Chiara; Lagana, Antonio
Publication:Shanghai Archives of Psychiatry
Article Type:Report
Geographic Code:7TURK
Date:Dec 1, 2016
Words:1035
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