Post on 11-Apr-2017
transcript
PowerPoint Presentation
Time Urgency Perfectionism Stress and its Relationship to Infertility
By Antonio RodriguesMandy Rodrigues
ESHRE STUDY
Preconception stress increases the risk of infertility Life Study CD Lynch et al
Higher levels of stress measured by high Salivary Alpha Amylase - increased time to pregnancy (TTP)
29% reduction fecundity- more than 2 fold reduction in fertility
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Pre laparoscopic psychological assessment of personality type and its correlation with the diagnosis of endometriosis
TIME URGENCYTime urgency relates to a persistent inner feeling of being rushed in all activities, irrespective of whether there is a need to actually do things quickly.
PERFECTIONISMHigh expectations, value control, dont like make mistakes, dont like critique, black and white thinking.
PERSONALIZINGSelf Blame and internalizing emotion
SCARCITYBlaming others and externalizing emotions
STRESS
RealvsSelf InducedAdrenalinvsNoradrenalin/ Cortisol
Faster, better, sicker: time urgency perfectionism stress and womens health Antonio Rodrigues, Edward Wolff & Mandy Rodrigues (1998)2nd Edition (2003)
Validating TUPS testsRecognising / reporting on symptoms and diseasesReporting on 10-week TUPS stress management programReporting on post course results - special reference to the dramatic, statistically significant reduction in these
World Congress of Behavioural Medicine
Light sensitivityPalpitationsPanic attacksChest pain or discomfortIncreased skin temperature or sweatingThe appearance of skin rashes
Trouble concentratingLow self esteemIrritabilitySexual difficultiesSelf consciousness
Feelings of inadequacy46 Symptoms
PREGNANCY RATESFollowing TUPS Stress management course:
54 patients IVF
The effect of a 10 week 67% pregnancy rate
Customized, structuredonpregnancy rates in women undergoing in vitro fertilization
Development of an online 10 week TUP stress management program updated and redesigned in 2014
Chapter 27: The Psychological Management of Infertility Mandy Rodrigues & Antonio Rodrigues (2015)
Clinical Relevance
Identifying the female patients who fit this stress profile. High incidence endometriosis, poor post coital tests and autoimmune diseaseSuggesting management to increase their pregnancy rate
Managing Time Urgency Perfectionism Stress
By Mandy RodriguesCLINICAL PSYCHOLOGIST
We are not BLAMINGBut rather empowering.Instead of our patients feeling helpless and powerlessWe want to give them more than an average chance of conceiving
Practice goals:
* Including donor/ surrogate assessments
FERTILITY COUNSELLING: Why?
Lack of controlHigher incidence of PTSDHigher incidence of depressionSense of isolation Rollercoaster effectIndependent coping
AIM OF TUPS MANAGEMENT Reducing TUP stress across course
Recognizing TUP stress and reactions (1-5)
Implementing skills to manage stress (6-10)
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THE TUP STRESS CYCLEHOOK
Snowball effectRelentlessBecomes habit
BUT 90% IS SELF INDUCED
People dont know how to driveScarcity reaction
WorkableMeasurableQuantifies HooktimeLogicalCan be done online/ app on smart phone
Abstract definition of stress demands exceeding expectationsExample of traditional stress measure device divorceWorkable components of stress cycle
AIM OF TUPS MANAGEMENT Reducing TUP stress across course
Recognizing TUP stress and reactions (1-5)
Implementing skills to manage stress (6-10)
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2
3
THE TUP STRESS CYCLEHOOK
Snowball effectRelentlessBecomes habit
BUT 90% IS SELF INDUCED
People dont know how to driveScarcity reaction
AVOID THE HOOK
Predictable or Unpredictable
Real or Self Induced
Or interrupt the STRESS CYCLE at one or more points
From BEHAVIOURAL PSYCHOLOGYCognitive behavioural TherapyPsychoneuroimmunology
RELAXATION AssertivenessCognitive restructuring
Interactive exercises reading and voice recordingsDaily homework exercisesWorkbookRelaxation audio download
Research indicates linkHigher TUPS, lower copingInfertility disempoweringCompletely mobileSystematic and practical
Finally, slow and steady wins the race.
Measuring Chronic Stress in Infertility female patients presenting to Medfem Fertility ClinicCorrelating Salivary Alpha Amylase with the Psychological TUPS testing
Amylase U/mlTUPS TestTups ScreenSymptomsGADTUP D21,51169827,2140119268,11828,213293175,24311251062781732851409433,2159137238,53034,7977940,05134,9628282,9437,218819041105638,6134125208,72338,61274014211387,31244991127451601421892248141138168,21049,41229053174148189,8196910511510410381151141771625Average in the Life Study
kim@medfem.co.za