Reproductive health – University of Copenhagen

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IFSV English > Sections > Section of Social Medicine > Research > Reproductive health

Reproductive health

The research group uses epidemiological methods and qualitative research methods when studying reproductive health. Our 6 main research topics are: 1) psychosocial consequences of infertility and medically assisted reproduction; 2) psychiatric disorders and medically assisted reproduction; 3) cancer and assisted reproduction, 4) the prevalence of infertility and the results of medically assisted reproduction; 5) family formation, and 6) prevention of infertility and involuntarily childlessness.

Program Coordinator:

Associate Professor, DMSci, PhD Lone Schmidt

Our research programme includes:

COMPI The Copenhagen Multi-centre Psychosocial Infertility Research Programme

The life-time prevalence of infertility is around 25 % among couples having tried to achieve parenthood. Around 3-6 % of 45-year old women have due to their own infertility and/or partner infertility never delivered a child. Infertility is thus a frequent reproductive disease. In Denmark 8-10 % of all children are born after medically assisted reproduction treatment. Infertility and its treatment are severe low-control stressors having substantial psychosocial consequences. Furthermore, psychiatric disorders as e.g., eating disorders and depression, are linked in complex ways with infertility and with the outcome of medically assisted reproduction. The knowledge on whether infertility and/or assisted reproduction treatment are risk factors for women developing a cancer is sparse. Our research programme is based on two of the largest cohort studies among fertility patients internationally.

The research programme is conducted in collaboration with the Fertility Clinics at the Juliane Marie Centre, Rigshospitalet, Copenhagen University Hospital; Odense University Hospital; Horsens Hospital, and Psychiatric Centre, Rigshospitalet, Copenhagen University Hospital.

Aims:

1) To investigate the psychosocial consequences of infertility and medically assisted reproduction treatment with a focus on stress, coping, communication, social relations, and sense of coherence.

2) To investigate the complex pattern between psychiatric disorders as e.g., depression, eating disorders, schizophrenia and medically assisted reproduction.

3) To investigate whether assisted reproduction is a risk factor among women for developing cancer

4) To study decision-making processes and patterns in relation to family formation among fertility patients not having achieved parenthood after assisted reproduction.

5) To investigate the results of medically assisted reproduction treatment according to e.g., age, socio-economic position, overweight and to conduct a cost-effectiveness analyses of fertility treatment for a large cohort of patients.

Study populations

COMPI Infertility Cohort

A longitudinal cohort study among 2,250 participants who initiated fertility treatment during the years 2000-2001. This cohort has been followed prospectively with 3 self-reported questionnaires, with data from medical fertility treatment files, and with national register data on births.

COMPI DANAC (Danish National ART-Couple) Cohort

A register-based cohort study population among approx. 43,000 women and their partners who have had at least one ART treatment during 1994-2009 registered in the Danish National IVF-register and an age-matched background population of approx. 215,000 women not having received ART treatment and their partners. The DANAC Cohort has in Statistics Denmark been linked to national data from the Medical Birth Register, The Danish Psychiatric Central Research Register, the Danish National Prescription Register, and with national socio-demographic registers. Currently the cohort will be linked also to the Danish National Hospital Discharge Register and the Danish Cancer Registry.

The research group

Section of Social Medicine

  • Ulla Christensen, Associate Professor, PhD
  • Charlotte Ø. Hougaard, Data manager, cand.polyt.
  • Mads Kamper-Jørgensen, Associate Professor, PhD
  • Rikke Lund, Associate Professor, PhD
  • Gitte Lindved Petersen, Research assistant, MSc in public health science
  • Lone Schmidt (Programme Coordinator), Associate Professor, DMSci, PhD
  • Camilla Sandal Sejbæk, PhD-student, MSc in public health science
  • Randi Sylvest, Master student in public health science

Others

  • Maria Assens, Research assistant, MD
  • Liora Baor, Senior Lecturer, PhD, School of Social Work, Ashkelon Academic College, Israel
  • Lene Tølbøll Blenstrup, Post.doc, PhD, Aalborg University, Denmark
  • Jacky Boivin, Professor, CPsychol, PhD, Cardiff Fertility Studies Research Group, School of Psychology, Cardiff University, United Kingdom
  • Terkel Christiansen, Professor, COHERE, Department of Business and Economics, University of Southern Denmark, Denmark
  • Ninna Ebdrup, medical student
  • Sofia Gameiro, Associate Professor, PhD, Cardiff Fertility Studies Research Group, School of Psychology, Cardiff University, United Kingdom
  • Ida Hageman, Head of Psychiatric Centre Copenhagen, Rigshospitalet, Copenhagen University Hospital, Denmark
  • Lisbeth B Knudsen, Professor, Aalborg University, Denmark
  • Mariana Veloso Martins, Post.doc, PhD, Porto University, Portugal
  • Brennan Peterson, Associate Professor, PhD, Department of Psychology, Chapman University, California, US
  • Anja Pinborg, Consultant, DMSci, the Fertility Clinic, Rigshospitalet, Copenhagen University Hospital, Denmark
  • Matthew Pirritano, PhD, Health Care Agency, Orange, LA, California, US
  • Ditte Vassard, Research assistant, MSc in Public Health Science, Denmark

 

Contact

Programme Coordinator, Associate Professor, DMSci, PhD Lone Schmidt

On-going sub-project

Depressive symptoms, depression, infertility, and medically assisted reproductive treatment

PhD-project 2011-2015

Camilla Sandal Sejbæk, PhD-student, MSc in Public Health Science, Denmark

Depression and infertility is linked in complex ways. Infertility is a risk factor for depression, and depression is a risk factor for reduced probability of achieving a pregnancy. The primary aim of this project is to study the complex pathways between depression, infertility, and assisted reproduction. We explore both whether depression decreases the probability for achieving a live birth after assisted reproduction, and whether number of assisted reproduction treatment cycles and no live birth increases the risk of depression among women. Furthermore, we want to investigate the risk for developing a depression among men in assisted reproduction.

Eating disorders, infertility and medically assisted reproduction treatment

Project 2011-2013

Maria Assens, Research Assistant, MD, Denmark

The aim is to study the prevalence of women in assisted reproduction having an eating disorder diagnoses, and to investigate whether these women’s outcome of assisted reproduction treatment differ from women not diagnosed with an eating disorder.

Schizophrenia and related psychotic disorders, infertility, and medically assisted reproductive treatment

Project 2011-2013.

Ninna Ebdrup, medical student, Denmark

The aim is to study the prevalence of women in assisted reproduction having a diagnoses for schizophrenic disorder, and to investigate whether these women’s outcome of assisted reproduction treatment differ from women not diagnosed with a schizophrenic disorder.

Risk of cancer among women with a history of assisted reproductive technology treatment Project 2013-2016

Gitte Lindved Petersen, forthcoming PhD-student, MSc in Public Health Science, Denmark

The objective is to study whether women in assisted reproduction treatment more often than other women are diagnosed with hormone sensitive cancers (breast, endometrial, and ovarian cancer) and non-hormone sensitive cancers after ART-treatment. We investigate whether the risk of developing a cancer is associated with number of assisted reproductive treatment cycles. Furthermore, whether hormonal drugs used in ART treatment are associated with changes in estrogen level in breast cancer cells and in a steroid cell assay.

Family histories and the establishing of daily life after fertility treatment

Collaborative project 2011-2013

Professor Lisbeth B Knudsen, Aalborg University, Denmark

Post.doc. Lene Tølbøll Blenstrup, Denmark

Research Assistant Gitte Lindved Petersen, Denmark

Associate Professor Lone Schmidt, Denmark

The aim is to study decision-making processes and family formation among couples not having achieved parenthood after medically assisted reproduction treatment. Further, we investigate which psychosocial factors are associated with continued medically assisted reproduction and/or adoption after one year of unsuccessful treatment.

Protective and risk factors in couples facing infertility

Post.doc-project 2013-2019

Mariana Veloso Martins, Post.doc., PhD, Porto University, Portugal

A cross-cultural validity study on the COMPI scales for infertility-specific stress, coping, and communication. This study is based on several projects from European countries and from Asia having used these scales in studies among fertility patients.

Selected publications

Schmidt L, Hageman I, Hougaard CO, Sejbaek CS, Assens M, Ebdrup NH, Pinborg A. Psychiatric disorders among women and men in assisted reproductive technology (ART). The Danish National ART-Couple (DANAC) cohort: protocol for a longitudinal, national register-based cohort study. BMJ Open 2013: 3: e002519.

Petersen GL, Schmidt L, Pinborg A, Kamper-Jørgensen M. The influence of female and male body mass index on live births after assisted reproductive technology treatment - a nationwide register-based cohort study. Fertility and Sterility, Advance Access February 2013.

Sejbaek CS, Hageman I, Pinborg A, Hougaard CO, Schmidt L. Incidence of depression and influence of depression on the number of treatment cycles and births in a national cohort of 42880 women treated with ART. Human Reproduction 2013; 28: 1100-1109.

Martins MV, Peterson BD, Costa P, Costa ME, Lund R, Schmidt L. Interactive effects of social support and disclosure on fertility-related stress. Journal of Social and Personal Relationships, Advance Access January 2013.

Vassard D, Lund R, Pinborg A, Boivin J, Schmidt L. The impact of social relations among men and women in fertility treatment on the decision to terminate treatment. Human Reproduction 2012; Human Reproduction 2012;27:3502-3512.

Schmidt L, Sobotka T, Bentzen JG, Nyboe Andersen A on behalf of the ESHRE Reproduction and Society Task Force. Demographic and medical consequences of the postponement of parenthood. Human Reproduction Update 2012;18:29-43.

Pinborg A, Gaarslev C, Hougaard CO, Nyboe Andersen A, Andersen PK, Boivin J, Schmidt L. Influence of female bodyweight on IVF outcome: a longitudinal multicentre cohort study of 487 infertile couples. RMB Online 2011;23:490-499.

Peterson B, Pirritano M, Block J, Schmidt L. How does marital benefit change during unsuccessful fertility treatment? Fertility and Sterility 2011;95:1759-63.

Schmidt L. Infertility and assisted reproduction in Denmark. Epidemiology and psychosocial consequences. [Disputats]. København: Copenhagen: University of Copenhagen, Lægeforeningens Forlag, 2006.

Frederiksen ME, Christensen U, Tjørnhøj-Thomsen T, Schmidt L. Solo mother by donor – the plan B of motherhood. A perspective on person centered reproductive medicine. The International Journal of Person Centered Medicine 2011;1:800-807

Further collaborative research projects

1. Stress and infertility

Stress and infertility are linked in complex ways. Infertility is in itself a stressor, and stress is a risk factor for unsuccessful fertility treatment. The aims of the following four projects are to study the pattern between stress, infertility, and outcome of medically assisted reproductive treatment, and further to explore whether an intervention with expressive writing can reduce fertility-related stress.

Protective and risk factors in couples facing infertility

Contact: Mariana Veloso Martins, Post.doc., PhD, Porto University, Portugal

From pre-conception to adulthood

Contact: Anastasia Iliodu, Associate Professor, PhD, Karolinska Institute, Stockholm, Sweden

Fertility-specific stress and psychosocial outcomes

Contact: Arthur L. Greil, Professor, PhD, Alfred University, Alfred, New York, US

Publications

Greil AL, Shreffler KM, Schmidt L, McQuillan J. Variation in distress among women with infertility: evidence from a population-based sample. Human Reproduction 2011;26:2101-2112.

Stress management and involuntarily childlessness among couples in IVF-treatment. The effect of an Expressive Writing Intervention

Contact: Yoon Frederiksen, PhD-student, Institute of Psychology, Aarhus University, Denmark

Publications

Matthiesen SMS, Klonoff-Cohen H, Zachariae R, Johansen MB, Nielsen BK, Frederiksen Y, Schmidt L, Ingerslev HJ. The effect of an expressive writing intervention (EWI) on stress in infertile couples undergoing Assisted Reproductive Technology (ART) treatment – a randomised controlled pilot study. British Journal of Health Psychology 2011; E-pub ahead of print 18 July.

2. Solo mothers - family formation without a father

An increasing number of single women seek fertility treatment in the public health care system. The aim of this project is to explore the single women's motives for motherhood and consideration about seeking fertility treatment with the use of anonymous semen donation. The project includes a qualitative interview study among 6 heterosexual, single women in donor insemination treatment and a national questionnaire-based study among single women and couples (heterosexual and lesbian) in donor insemination treatment.

Contact: Maria Salomon, the Fertility Clinic, Rigshospitalet, Copenhagen University Hospital, Denmark

Publications

Frederiksen M, Christensen U, Tjørnhøj-Thomsen T, Schmidt L. Solo mother by donor - the plan B of motherhood. A perspective on person centered reproductive medicine. The International Journal of Person Centered Medicine 2011;1:800-807.

3. Prevention of infertility

An increasing number of people postpone family formation and many people seek medically assisted reproductive treatment. Several risk factors for infertility are highly prevalent (e.g., sexually transmitted diseases as Chlamydia, increasing age when trying to achieve child birth, overweight, reproductive harmful substances in the environment and at work). This project is under development. Currently it is including an internet-based survey in UK and Denmark investigating the populations’ attitudes to egg freezing for non-medical reasons. Future projects will contribute to provide the scientific knowledge necessary for increased efforts to prevent infertility, e.g., population-based studies about young adults intentions on family formation and their fertility awareness.

Egg-freezing for non-medical reasons

Contact: Nick Macklon, Professor, Southampton University, UK.

Anders Nyboe Andersen, Professor, Fertility Clinic, Rigshospitalet, Copenhagen University Hospital, Denmark

Peter Humaidan, Professor, University of Southern Denmark, Denmark

Camille Lallement, MD, Southampton University, UK.

Lone Schmidt, Associate Professor, University of Copenhagen

An internet-based survey on men’s and women’s intentions of family formation, their knowledge of female age as infertility risk factor, and their attitudes to egg freezing.