Skip to main content
Top
Published in: Health and Quality of Life Outcomes 1/2013

Open Access 01-12-2013 | Research

Validation of the controlled ovarian stimulation impact measure (COSI): assessing the patient perspective

Authors: Meryl Brod, Hein Fennema

Published in: Health and Quality of Life Outcomes | Issue 1/2013

Login to get access

Abstract

Background

Controlled Ovarian Stimulation (COS) is the first step for in vitro fertilization (IVF) treatment, a treatment often described and experienced as stressful to patients and their partners. COS also requires concerted efforts by the patients in administering medication and general compliance to treatment protocols. Little is known about the impacts on patients that may be specific to this important first step in treatment. The absence of a conceptually sound and well-validated measure assessing patient experience and functioning during ovarian stimulation has been an obstacle to understanding the impacts of ovarian stimulation on women pursuing IVF. To address this gap, the Controlled Ovarian Stimulation Impact Measure (COSI) was developed based upon accepted methods for designing patient reported outcome (PRO) measures. The purpose of this study was to psychometrically validate the COSI.

Methods

267 patients from three countries (Ireland, United Kingdom, United States) were administered the COSI. Psychometric validation was conducted according to an a priori statistical analysis plan.

Results

The final 28-item COSI was found to have robust scale structure with four domains: Interference in Daily Life (Work and Home), Injection Burden, Psychological Health and Compliance Worry. Internal consistency of all domains was adequate (between 0.80 to 0.87) as was test-retest reliability (between 0.72-0.87). All a-priori hypotheses for convergent and known-groups validity tests were met.

Conclusions

There is a measurable impact of COS on patient functioning and well-being. The COSI is a well-developed and validated PRO measure of this impact. Future work should include examination of responsiveness and confirmation of concepts in non-western countries.
Appendix
Available only for authorised users
Literature
1.
go back to reference Verhaak CM, Smeenk JM, Evers AW, Kremer JA, Kraaimaat FW, Braat DD: Women's emotional adjustment to IVF: a systematic review of 25 years of research. Hum Reprod Update 2007, 13: 27–36.PubMedCrossRef Verhaak CM, Smeenk JM, Evers AW, Kremer JA, Kraaimaat FW, Braat DD: Women's emotional adjustment to IVF: a systematic review of 25 years of research. Hum Reprod Update 2007, 13: 27–36.PubMedCrossRef
2.
go back to reference Hynes GJ, Callan VJ, Terry DJ, Gallois C: The psychological well-being of infertile women after a failed IVF attempt: the effects of coping. Br J Med Psychol 1992,65(Pt 3):269–278.PubMedCrossRef Hynes GJ, Callan VJ, Terry DJ, Gallois C: The psychological well-being of infertile women after a failed IVF attempt: the effects of coping. Br J Med Psychol 1992,65(Pt 3):269–278.PubMedCrossRef
3.
go back to reference Slade P, Emery J, Lieberman BA: A prospective, longitudinal study of emotions and relationships in in-vitro fertilization treatment. Hum Reprod 1997, 12: 183–190. 10.1093/humrep/12.1.183PubMedCrossRef Slade P, Emery J, Lieberman BA: A prospective, longitudinal study of emotions and relationships in in-vitro fertilization treatment. Hum Reprod 1997, 12: 183–190. 10.1093/humrep/12.1.183PubMedCrossRef
4.
go back to reference Visser AP, Haan G, Zalmstra H, Wouters I: Psychosocial aspects of in vitro fertilization. J Psychosom Obstet Gynaecol 1994, 15: 35–43. 10.3109/01674829409025627PubMedCrossRef Visser AP, Haan G, Zalmstra H, Wouters I: Psychosocial aspects of in vitro fertilization. J Psychosom Obstet Gynaecol 1994, 15: 35–43. 10.3109/01674829409025627PubMedCrossRef
5.
go back to reference Beaurepaire J, Jones M, Thiering P, Saunders D, Tennant C: Psychosocial adjustment to infertility and its treatment: male and female responses at different stages of IVF/ET treatment. J Psychosom Res 1994, 38: 229–240. 10.1016/0022-3999(94)90118-XPubMedCrossRef Beaurepaire J, Jones M, Thiering P, Saunders D, Tennant C: Psychosocial adjustment to infertility and its treatment: male and female responses at different stages of IVF/ET treatment. J Psychosom Res 1994, 38: 229–240. 10.1016/0022-3999(94)90118-XPubMedCrossRef
6.
go back to reference Salvatore P, Gariboldi S, Offidani A, Coppola F, Amore M, Maggini C: Psychopathology, personality, and marital relationship in patients undergoing in vitro fertilization procedures. Fertil Steril 2001, 75: 1119–1125. 10.1016/S0015-0282(01)01775-7PubMedCrossRef Salvatore P, Gariboldi S, Offidani A, Coppola F, Amore M, Maggini C: Psychopathology, personality, and marital relationship in patients undergoing in vitro fertilization procedures. Fertil Steril 2001, 75: 1119–1125. 10.1016/S0015-0282(01)01775-7PubMedCrossRef
7.
go back to reference Ardenti R, Campari C, Agazzi L, La Sala GB: Anxiety and perceptive functioning of infertile women during in-vitro fertilization: exploratory survey of an Italian sample. Hum Reprod 1999, 14: 3126–3132. 10.1093/humrep/14.12.3126PubMedCrossRef Ardenti R, Campari C, Agazzi L, La Sala GB: Anxiety and perceptive functioning of infertile women during in-vitro fertilization: exploratory survey of an Italian sample. Hum Reprod 1999, 14: 3126–3132. 10.1093/humrep/14.12.3126PubMedCrossRef
8.
go back to reference Klonoff-Cohen H, Chu E, Natarajan L, Sieber W: A prospective study of stress among women undergoing in vitro fertilization or gamete intrafallopian transfer. Fertil Steril 2001, 76: 675–687. 10.1016/S0015-0282(01)02008-8PubMedCrossRef Klonoff-Cohen H, Chu E, Natarajan L, Sieber W: A prospective study of stress among women undergoing in vitro fertilization or gamete intrafallopian transfer. Fertil Steril 2001, 76: 675–687. 10.1016/S0015-0282(01)02008-8PubMedCrossRef
9.
go back to reference Yong P, Martin C, Thong J: A comparison of psychological functioning in women at different stages of in vitro fertilization treatment using the mean affect adjective check list. J Assist Reprod Genet 2000, 17: 553–556. 10.1023/A:1026429712794PubMedCentralPubMedCrossRef Yong P, Martin C, Thong J: A comparison of psychological functioning in women at different stages of in vitro fertilization treatment using the mean affect adjective check list. J Assist Reprod Genet 2000, 17: 553–556. 10.1023/A:1026429712794PubMedCentralPubMedCrossRef
10.
go back to reference Merari D, Feldberg D, Elizur A, Goldman J, Modan B: Psychological and hormonal changes in the course of in vitro fertilization. J Assist Reprod Genet 1992, 9: 161–169. 10.1007/BF01203757PubMedCrossRef Merari D, Feldberg D, Elizur A, Goldman J, Modan B: Psychological and hormonal changes in the course of in vitro fertilization. J Assist Reprod Genet 1992, 9: 161–169. 10.1007/BF01203757PubMedCrossRef
11.
go back to reference Boivin J, Takefman JE: Impact of the in-vitro fertilization process on emotional, physical and relational variables. Hum Reprod 1996, 11: 903–907. 10.1093/oxfordjournals.humrep.a019276PubMedCrossRef Boivin J, Takefman JE: Impact of the in-vitro fertilization process on emotional, physical and relational variables. Hum Reprod 1996, 11: 903–907. 10.1093/oxfordjournals.humrep.a019276PubMedCrossRef
12.
go back to reference Boivin J, Takefman JE: Stress level across stages of in vitro fertilization in subsequently pregnant and nonpregnant women. Fertil Steril 1995, 64: 802–810.PubMed Boivin J, Takefman JE: Stress level across stages of in vitro fertilization in subsequently pregnant and nonpregnant women. Fertil Steril 1995, 64: 802–810.PubMed
13.
go back to reference Verhaak CM, Smeenk JM, Eugster A, van Minnen A, Kremer JA, Kraaimaat FW: Stress and marital satisfaction among women before and after their first cycle of in vitro fertilization and intracytoplasmic sperm injection. Fertil Steril 2001, 76: 525–531. 10.1016/S0015-0282(01)01931-8PubMedCrossRef Verhaak CM, Smeenk JM, Eugster A, van Minnen A, Kremer JA, Kraaimaat FW: Stress and marital satisfaction among women before and after their first cycle of in vitro fertilization and intracytoplasmic sperm injection. Fertil Steril 2001, 76: 525–531. 10.1016/S0015-0282(01)01931-8PubMedCrossRef
14.
go back to reference Lok IH, Lee DT, Cheung LP, Chung WS, Lo WK, Haines CJ: Psychiatric morbidity amongst infertile Chinese women undergoing treatment with assisted reproductive technology and the impact of treatment failure. Gynecol Obstet Invest 2002, 53: 195–199. 10.1159/000064560PubMedCrossRef Lok IH, Lee DT, Cheung LP, Chung WS, Lo WK, Haines CJ: Psychiatric morbidity amongst infertile Chinese women undergoing treatment with assisted reproductive technology and the impact of treatment failure. Gynecol Obstet Invest 2002, 53: 195–199. 10.1159/000064560PubMedCrossRef
15.
go back to reference Gourounti K, Anagnostopoulos F, Vaslamatzis G: The relation of psychological stress to pregnancy outcome among women undergoing in-vitro fertilization and intracytoplasmic sperm injection. Women Health 2011, 51: 321–339. 10.1080/03630242.2011.574791PubMedCrossRef Gourounti K, Anagnostopoulos F, Vaslamatzis G: The relation of psychological stress to pregnancy outcome among women undergoing in-vitro fertilization and intracytoplasmic sperm injection. Women Health 2011, 51: 321–339. 10.1080/03630242.2011.574791PubMedCrossRef
16.
go back to reference Smeenk JM, Verhaak CM, Vingerhoets AJ, Sweep CG, Merkus JM, Willemsen SJ, van Minnen A, Straatman H, Braat DD: Stress and outcome success in IVF: the role of self-reports and endocrine variables. Hum Reprod 2005, 20: 991–996.PubMedCrossRef Smeenk JM, Verhaak CM, Vingerhoets AJ, Sweep CG, Merkus JM, Willemsen SJ, van Minnen A, Straatman H, Braat DD: Stress and outcome success in IVF: the role of self-reports and endocrine variables. Hum Reprod 2005, 20: 991–996.PubMedCrossRef
17.
go back to reference Campagne DM: Should fertilization treatment start with reducing stress? Hum Reprod 2006, 21: 1651–1658. 10.1093/humrep/del078PubMedCrossRef Campagne DM: Should fertilization treatment start with reducing stress? Hum Reprod 2006, 21: 1651–1658. 10.1093/humrep/del078PubMedCrossRef
18.
go back to reference Eugster A, Vingerhoets AJ: Psychological aspects of in vitro fertilization: a review. Soc Sci Med 1999, 48: 575–589. 10.1016/S0277-9536(98)00386-4PubMedCrossRef Eugster A, Vingerhoets AJ: Psychological aspects of in vitro fertilization: a review. Soc Sci Med 1999, 48: 575–589. 10.1016/S0277-9536(98)00386-4PubMedCrossRef
19.
go back to reference Csemiczky G, Landgren BM, Collins A: The influence of stress and state anxiety on the outcome of IVF-treatment: psychological and endocrinological assessment of Swedish women entering IVF-treatment. Acta Obstet Gynecol Scand 2000, 79: 113–118. 10.1034/j.1600-0412.2000.079002113.xPubMedCrossRef Csemiczky G, Landgren BM, Collins A: The influence of stress and state anxiety on the outcome of IVF-treatment: psychological and endocrinological assessment of Swedish women entering IVF-treatment. Acta Obstet Gynecol Scand 2000, 79: 113–118. 10.1034/j.1600-0412.2000.079002113.xPubMedCrossRef
20.
go back to reference Anderheim L, Holter H, Bergh C, Moller A: Does psychological stress affect the outcome of in vitro fertilization? Hum Reprod 2005, 20: 2969–2975. 10.1093/humrep/dei219PubMedCrossRef Anderheim L, Holter H, Bergh C, Moller A: Does psychological stress affect the outcome of in vitro fertilization? Hum Reprod 2005, 20: 2969–2975. 10.1093/humrep/dei219PubMedCrossRef
21.
go back to reference Brod M, Verhaak CM, Wiebinga CJ, Gerris J, Hoomans EH: Improving clinical understanding of the effect of ovarian stimulation on women's lives. Reprod Biomed Online 2009, 18: 391–400. 10.1016/S1472-6483(10)60098-3PubMedCrossRef Brod M, Verhaak CM, Wiebinga CJ, Gerris J, Hoomans EH: Improving clinical understanding of the effect of ovarian stimulation on women's lives. Reprod Biomed Online 2009, 18: 391–400. 10.1016/S1472-6483(10)60098-3PubMedCrossRef
23.
go back to reference Juniper E, Guyatt G, Jaeschke R: How to develop and validate a new health-related quality of life instrument. In Quality of life and pharmacoeconomics in clinical trials. 2nd edition. Edited by: Spilker B. Philadelphia: Lippincott-Raven; 1996:49–56. Juniper E, Guyatt G, Jaeschke R: How to develop and validate a new health-related quality of life instrument. In Quality of life and pharmacoeconomics in clinical trials. 2nd edition. Edited by: Spilker B. Philadelphia: Lippincott-Raven; 1996:49–56.
24.
go back to reference The Netherlands Cancer Institute, Amsterdam: Assessing health status and quality-of-life instruments: attributes and review criteria. Qual Life Res 2002, 11: 193–205. 10.1023/A:1015291021312CrossRef The Netherlands Cancer Institute, Amsterdam: Assessing health status and quality-of-life instruments: attributes and review criteria. Qual Life Res 2002, 11: 193–205. 10.1023/A:1015291021312CrossRef
25.
go back to reference Snoek FJ, Mollema ED, Heine RJ, Bouter LM, van der Ploeg HM: Development and validation of the diabetes fear of injecting and self-testing questionnaire (D-FISQ): first findings. Diabet Med 1997, 14: 871–876. 10.1002/(SICI)1096-9136(199710)14:10<871::AID-DIA457>3.0.CO;2-YPubMedCrossRef Snoek FJ, Mollema ED, Heine RJ, Bouter LM, van der Ploeg HM: Development and validation of the diabetes fear of injecting and self-testing questionnaire (D-FISQ): first findings. Diabet Med 1997, 14: 871–876. 10.1002/(SICI)1096-9136(199710)14:10<871::AID-DIA457>3.0.CO;2-YPubMedCrossRef
26.
go back to reference Endicott J, Nee J, Harrison W, Blumenthal R: Quality of life enjoyment and satisfaction questionnaire: a new measure. Psychopharmacol Bull 1993, 29: 321–326.PubMed Endicott J, Nee J, Harrison W, Blumenthal R: Quality of life enjoyment and satisfaction questionnaire: a new measure. Psychopharmacol Bull 1993, 29: 321–326.PubMed
27.
go back to reference Endicott J, Nee J: Endicott Work Productivity Scale (EWPS): a new measure to assess treatment effects. Psychopharmacol Bull 1997, 33: 13–16.PubMed Endicott J, Nee J: Endicott Work Productivity Scale (EWPS): a new measure to assess treatment effects. Psychopharmacol Bull 1997, 33: 13–16.PubMed
28.
go back to reference Wisniewski SR, Rush AJ, Balasubramani GK, Trivedi MH, Nierenberg AA: Self-rated global measure of the frequency, intensity, and burden of side effects. J Psychiatr Pract 2006, 12: 71–79. 10.1097/00131746-200603000-00002PubMedCrossRef Wisniewski SR, Rush AJ, Balasubramani GK, Trivedi MH, Nierenberg AA: Self-rated global measure of the frequency, intensity, and burden of side effects. J Psychiatr Pract 2006, 12: 71–79. 10.1097/00131746-200603000-00002PubMedCrossRef
29.
go back to reference Carpenter JS: The hot flash related daily interference scale: a tool for assessing the impact of hot flashes on quality of life following breast cancer. J Pain Symptom Manage 2001, 22: 979–989. 10.1016/S0885-3924(01)00353-0PubMedCrossRef Carpenter JS: The hot flash related daily interference scale: a tool for assessing the impact of hot flashes on quality of life following breast cancer. J Pain Symptom Manage 2001, 22: 979–989. 10.1016/S0885-3924(01)00353-0PubMedCrossRef
30.
go back to reference Anderson RT, Skovlund SE, Marrero D, Levine DW, Meadows K, Brod M, Balkrishnan R: Development and validation of the insulin treatment satisfaction questionnaire. Clin Ther 2004, 26: 565–578. 10.1016/S0149-2918(04)90059-8PubMedCrossRef Anderson RT, Skovlund SE, Marrero D, Levine DW, Meadows K, Brod M, Balkrishnan R: Development and validation of the insulin treatment satisfaction questionnaire. Clin Ther 2004, 26: 565–578. 10.1016/S0149-2918(04)90059-8PubMedCrossRef
31.
go back to reference Atkinson MJ, Sinha A, Hass SL, Colman SS, Kumar RN, Brod M, Rowland CR: Validation of a general measure of treatment satisfaction, the Treatment Satisfaction Questionnaire for Medication (TSQM), using a national panel study of chronic disease. Health Qual Life Outcomes 2004, 2: 12. 10.1186/1477-7525-2-12PubMedCentralPubMedCrossRef Atkinson MJ, Sinha A, Hass SL, Colman SS, Kumar RN, Brod M, Rowland CR: Validation of a general measure of treatment satisfaction, the Treatment Satisfaction Questionnaire for Medication (TSQM), using a national panel study of chronic disease. Health Qual Life Outcomes 2004, 2: 12. 10.1186/1477-7525-2-12PubMedCentralPubMedCrossRef
32.
go back to reference Dupuy H: The psychological general well-being (PGWB) index. In Assessment of quality of life in clinical trials of cardiovascular therapies. Edited by: Wender N, Mattson M, Furburg C, Elinson J. New York: Le Jacq; 1984:170–183. Dupuy H: The psychological general well-being (PGWB) index. In Assessment of quality of life in clinical trials of cardiovascular therapies. Edited by: Wender N, Mattson M, Furburg C, Elinson J. New York: Le Jacq; 1984:170–183.
33.
go back to reference Chronbach LJ: Coefficient alpha and the internal structure of tests. Psychometrika 1951, 16: 297–334. 10.1007/BF02310555CrossRef Chronbach LJ: Coefficient alpha and the internal structure of tests. Psychometrika 1951, 16: 297–334. 10.1007/BF02310555CrossRef
34.
go back to reference Boivin J, Domar AD, Shapiro DB, Wischmann TH, Fauser BC, Verhaak C: Tackling burden in ART: an integrated approach for medical staff. Hum Reprod 2012, 27: 941–950. 10.1093/humrep/der467PubMedCrossRef Boivin J, Domar AD, Shapiro DB, Wischmann TH, Fauser BC, Verhaak C: Tackling burden in ART: an integrated approach for medical staff. Hum Reprod 2012, 27: 941–950. 10.1093/humrep/der467PubMedCrossRef
35.
go back to reference Bleil ME, Pasch LA, Gregorich SE, Millstein SG, Katz PP, Adler NE: Fertility treatment response: is it better to be more optimistic or less pessimistic? Psychosom Med 2012, 74: 193–199. 10.1097/PSY.0b013e318242096bPubMedCentralPubMedCrossRef Bleil ME, Pasch LA, Gregorich SE, Millstein SG, Katz PP, Adler NE: Fertility treatment response: is it better to be more optimistic or less pessimistic? Psychosom Med 2012, 74: 193–199. 10.1097/PSY.0b013e318242096bPubMedCentralPubMedCrossRef
36.
go back to reference Verhaak CM, Smeenk JM, van Minnen A, Kremer JA, Kraaimaat FW: A longitudinal, prospective study on emotional adjustment before, during and after consecutive fertility treatment cycles. Hum Reprod 2005, 20: 2253–2260. 10.1093/humrep/dei015PubMedCrossRef Verhaak CM, Smeenk JM, van Minnen A, Kremer JA, Kraaimaat FW: A longitudinal, prospective study on emotional adjustment before, during and after consecutive fertility treatment cycles. Hum Reprod 2005, 20: 2253–2260. 10.1093/humrep/dei015PubMedCrossRef
Metadata
Title
Validation of the controlled ovarian stimulation impact measure (COSI): assessing the patient perspective
Authors
Meryl Brod
Hein Fennema
Publication date
01-12-2013
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2013
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/1477-7525-11-130

Other articles of this Issue 1/2013

Health and Quality of Life Outcomes 1/2013 Go to the issue