Jennifer A. Wessel M.D., Ph.D. , Monique H. Mochtar M.D., Ph.D. , Rik van Eekelen Ph.D. , Leoni A. Louwé M.D., Ph.D. , Eugenie M. Kaaijk M.D., Ph.D. , Mariëtte Goddijn M.D., Ph.D. , Madelon van Wely Ph.D. , Femke Mol M.D., Ph.D.
{"title":"不明原因不孕不育夫妇的生活质量和性交频率与宫内人工授精加卵巢刺激的比较","authors":"Jennifer A. Wessel M.D., Ph.D. , Monique H. Mochtar M.D., Ph.D. , Rik van Eekelen Ph.D. , Leoni A. Louwé M.D., Ph.D. , Eugenie M. Kaaijk M.D., Ph.D. , Mariëtte Goddijn M.D., Ph.D. , Madelon van Wely Ph.D. , Femke Mol M.D., Ph.D.","doi":"10.1016/j.xfre.2025.06.001","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>To study the impact of 6 months of expectant management (EM) compared with 6 months of intrauterine insemination with ovarian stimulation (IUI-OS) on the health-related quality of life (HRQoL), anxiety and depression scores and the coital frequency in couples with unexplained subfertility and a poor prognosis for natural conception.</div></div><div><h3>Design</h3><div>A study alongside the ExIUI trial, a multicentre randomized controlled trial.</div></div><div><h3>Subjects</h3><div>Couples with unexplained subfertility and a poor prognosis for natural conception based on the score of Hunault.</div></div><div><h3>Intervention</h3><div>Women in both groups were asked to fill in the Fertility Quality of Life (FertiQol) and Hospital Anxiety and Depression Scale (HADS) questionnaires at 3 moments and to keep a diary with their periods and dates of coitus.</div></div><div><h3>Main Outcome Measures</h3><div>Health-related quality of life scores, anxiety and depression scores, and coital frequency.</div></div><div><h3>Results</h3><div>Of the 178 women, 161 (90%) filled in at least one questionnaire. Women allocated to EM scored significantly lower on the relational domain compared with women allocated to IUI-OS (overall mean difference, –5.93; 95% confidence interval [CI], –10.64 to –1.22). We found no difference between the two groups in the social domain (overall mean difference, –4.72; 95% CI, –9.88 to 0.45). No difference between the two was found in anxiety (overall mean difference, –0.20; 95% CI, –1.44 to 1.04) or depression scores (overall mean difference, 0.22; 95%CI, –0.86 to 1.30). Among all women allocated to either EM or IUI-OS, anxiety and depression scores increased over time. Seventy-nine (44%) out of 178 women filled in at least one month of their diary and reported on a total of 497 cycles and registered 2,026 dates of coitus. The median coital frequency per cycle was 4 (interquartile range [IQR]: 1–7) in the EM group and 3 (IQR: 0–7) in the IUI-OS group. The median coital frequency in the fertile window per cycle was 2 (IQR: 0–3) in EM and 1 (IQR: 0–3) in IUI-OS, which was a statistically significant difference.</div></div><div><h3>Conclusion</h3><div>Compared with IUI-OS, 6 months of EM resulted in a lower HRQoL on the relational domain, comparable anxiety and depression scores and higher coital frequency in the fertile window.</div></div><div><h3>Clinical Trial Registration Number</h3><div>Dutch Trial register NL5455 (NTR5599).</div></div>","PeriodicalId":34409,"journal":{"name":"FS Reports","volume":"6 3","pages":"Pages 374-380"},"PeriodicalIF":2.2000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The impact of expectant management compared with intrauterine insemination with ovarian stimulation on quality of life and coital frequency in couples with unexplained subfertility\",\"authors\":\"Jennifer A. Wessel M.D., Ph.D. , Monique H. Mochtar M.D., Ph.D. , Rik van Eekelen Ph.D. , Leoni A. Louwé M.D., Ph.D. , Eugenie M. Kaaijk M.D., Ph.D. , Mariëtte Goddijn M.D., Ph.D. , Madelon van Wely Ph.D. , Femke Mol M.D., Ph.D.\",\"doi\":\"10.1016/j.xfre.2025.06.001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><div>To study the impact of 6 months of expectant management (EM) compared with 6 months of intrauterine insemination with ovarian stimulation (IUI-OS) on the health-related quality of life (HRQoL), anxiety and depression scores and the coital frequency in couples with unexplained subfertility and a poor prognosis for natural conception.</div></div><div><h3>Design</h3><div>A study alongside the ExIUI trial, a multicentre randomized controlled trial.</div></div><div><h3>Subjects</h3><div>Couples with unexplained subfertility and a poor prognosis for natural conception based on the score of Hunault.</div></div><div><h3>Intervention</h3><div>Women in both groups were asked to fill in the Fertility Quality of Life (FertiQol) and Hospital Anxiety and Depression Scale (HADS) questionnaires at 3 moments and to keep a diary with their periods and dates of coitus.</div></div><div><h3>Main Outcome Measures</h3><div>Health-related quality of life scores, anxiety and depression scores, and coital frequency.</div></div><div><h3>Results</h3><div>Of the 178 women, 161 (90%) filled in at least one questionnaire. Women allocated to EM scored significantly lower on the relational domain compared with women allocated to IUI-OS (overall mean difference, –5.93; 95% confidence interval [CI], –10.64 to –1.22). We found no difference between the two groups in the social domain (overall mean difference, –4.72; 95% CI, –9.88 to 0.45). No difference between the two was found in anxiety (overall mean difference, –0.20; 95% CI, –1.44 to 1.04) or depression scores (overall mean difference, 0.22; 95%CI, –0.86 to 1.30). Among all women allocated to either EM or IUI-OS, anxiety and depression scores increased over time. Seventy-nine (44%) out of 178 women filled in at least one month of their diary and reported on a total of 497 cycles and registered 2,026 dates of coitus. The median coital frequency per cycle was 4 (interquartile range [IQR]: 1–7) in the EM group and 3 (IQR: 0–7) in the IUI-OS group. The median coital frequency in the fertile window per cycle was 2 (IQR: 0–3) in EM and 1 (IQR: 0–3) in IUI-OS, which was a statistically significant difference.</div></div><div><h3>Conclusion</h3><div>Compared with IUI-OS, 6 months of EM resulted in a lower HRQoL on the relational domain, comparable anxiety and depression scores and higher coital frequency in the fertile window.</div></div><div><h3>Clinical Trial Registration Number</h3><div>Dutch Trial register NL5455 (NTR5599).</div></div>\",\"PeriodicalId\":34409,\"journal\":{\"name\":\"FS Reports\",\"volume\":\"6 3\",\"pages\":\"Pages 374-380\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2025-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"FS Reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2666334125000959\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"FS Reports","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666334125000959","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
The impact of expectant management compared with intrauterine insemination with ovarian stimulation on quality of life and coital frequency in couples with unexplained subfertility
Objective
To study the impact of 6 months of expectant management (EM) compared with 6 months of intrauterine insemination with ovarian stimulation (IUI-OS) on the health-related quality of life (HRQoL), anxiety and depression scores and the coital frequency in couples with unexplained subfertility and a poor prognosis for natural conception.
Design
A study alongside the ExIUI trial, a multicentre randomized controlled trial.
Subjects
Couples with unexplained subfertility and a poor prognosis for natural conception based on the score of Hunault.
Intervention
Women in both groups were asked to fill in the Fertility Quality of Life (FertiQol) and Hospital Anxiety and Depression Scale (HADS) questionnaires at 3 moments and to keep a diary with their periods and dates of coitus.
Main Outcome Measures
Health-related quality of life scores, anxiety and depression scores, and coital frequency.
Results
Of the 178 women, 161 (90%) filled in at least one questionnaire. Women allocated to EM scored significantly lower on the relational domain compared with women allocated to IUI-OS (overall mean difference, –5.93; 95% confidence interval [CI], –10.64 to –1.22). We found no difference between the two groups in the social domain (overall mean difference, –4.72; 95% CI, –9.88 to 0.45). No difference between the two was found in anxiety (overall mean difference, –0.20; 95% CI, –1.44 to 1.04) or depression scores (overall mean difference, 0.22; 95%CI, –0.86 to 1.30). Among all women allocated to either EM or IUI-OS, anxiety and depression scores increased over time. Seventy-nine (44%) out of 178 women filled in at least one month of their diary and reported on a total of 497 cycles and registered 2,026 dates of coitus. The median coital frequency per cycle was 4 (interquartile range [IQR]: 1–7) in the EM group and 3 (IQR: 0–7) in the IUI-OS group. The median coital frequency in the fertile window per cycle was 2 (IQR: 0–3) in EM and 1 (IQR: 0–3) in IUI-OS, which was a statistically significant difference.
Conclusion
Compared with IUI-OS, 6 months of EM resulted in a lower HRQoL on the relational domain, comparable anxiety and depression scores and higher coital frequency in the fertile window.
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