The Use of Complementary and Alternative Medicine Among Infertile Women Presenting at The Infertility Outpatient Clinic

Öz

Objectives: The use of Complementary and Alternative Medicine (CAM) is common among infertile women. Many studies in Türkiye and throughout the world have shown that infertile women use CAM methods at high rates to increase the chance of conception. This study aimed to determine the status and characteristics of infertile women using CAM. Method: The study was planned as a cross-sectional study. Infertile women who presented at the Infertility Outpatient Clinic were included in the study. The women were questioned in respect of sociodemographic characteristics, medical characteristics related to infertility, CAM use status and types and frequency of CAM use. Results: Evaluations were made of 311 infertile women, of which 65.3% (n=203) used CAM. Herbal methods were the most frequently used CAM method (26.3%), and the most used herbal product was onion water. A statistically significant relationship was found between CAM use and the duration of marriage, occupation, education level, history of IUI and IVF, belief in the benefits of CAM methods and recommendation status (p<0.005 for all values). A positive correlation was found between the duration of CAM use and age, duration of marriage, duration of desire to have children, duration of infertility treatment, and the number of IUI and IVF attempts. Curiosity was the most common reason for CAM usage. It was determined that 46.9% of the participants who used CAM did not use it regularly, 66.5% did not believe that it would be beneficial, and 88.6% were directed to CAM usage by family or friends. Conclusion: The results of this study showed that infertile women used CAM at a high rate and the most commonly used method was herbal products. Infertile women should be evaluated in a multidimensional way with detailed questioning of any CAM methods used.

Anahtar Kelimeler

• Infertility
• complementary and alternative medicine
• woman

Kaynakça

1. 1.Definition of Infertility: A committee opinion (2023).Practice Committee of the American Society forReproductive Medicine. American Society forReproductive Medicine. October 2023. Access date23.08.2024. https://www.asrm.org/practice-guidance/practice-committee-documents/denitions-of-infertility/.
2. 2.İmamoğlu SH. The freezing and preserving of gametesdue to social reasons (social indication) from the civil lawperspective. ABD. 2019;77:25–46.
3. 3.World Health Organisation Global Report. Infertilityprevalance estimates 1990-2021.(2023). Access date23.08.2024.https://www.who.int/publications/i/item/978920068315.
4. 4.Macaluso M, Wright-Schnapp TJ, Chandra A, et al. Apublic health focus on infertility prevention, detection,and management. Fertil Steril. 2010 Jan;93(1):16.e1-10.doi: 10.1016/j.fertnstert.2008.09.046.
5. 5.Fidler AT, Bernstein J. Infertility: from a personal to apublic health problem. Public Health Rep. 1999 Nov-Dec;114(6):494-511. doi: 10.1093/phr/114.6.494.
6. 6.Dhaliwal LK, Gupta KR, Gopalan S, Kulhara P.Psychological aspects of infertility due to various causes--prospective study. Int J Fertil Womens Med. 2004 Jan-Feb;49(1):44-8.
7. 7.Pasch LA, Holley SR, Bleil ME, et al. Addressing theneeds of fertility treatment patients and their partners:are they informed of and do they receive mental healthservices? Fertil Steril. 2016 Jul;106(1):209-215.e2. doi:10.1016/j.fertnstert.2016.03.006.
8. 8.Chen TH, Chang SP, Tsai CF, Juang KD. Prevalence ofdepressive and anxiety disorders in an assistedreproductive technique clinic. Hum Reprod. 2004 Oct;19(10):2313-8. doi: 10.1093/humrep/deh414. 8. Erratum in: Hum Reprod. 2004 Dec;19(12):2968.

9. 9.Njagi P, Groot W, Arsenijevic J, et al. Financial costs ofassisted reproductive technology for patients in low- andmiddle-income countries: a systematic review. HumReprod Open. 2023 Mar 1;2023(2):hoad007. doi:10.1093/hropen/hoad007.
10. 10.Avcibay Vurgeç B, Kizilkaya Beji N. İnfertilitetedavisinde tamamlayıcı/alternatif tıp uygulamaları.Androloji Bülteni. 2013;15(52):71-74.
11. 11.Balkan E, Selçuklar A, Akpınar C, et al. Attitudes ofinfertile women towards complementary and alternative medicine methods. International Journal of Traditionaland Complementary Medicine Research (Online).2022;3(3):132- 37.
12. 12. Hwang JH, Kim YY, Im HB, Han D. Complementary andalternative medicine use among infertile womenattending infertility specialty clinics in South Korea: doesperceived severity matter? BMC Complement AlternMed. 2019 Nov 6;19(1):301.
13. 13.Babikir SA, Elhassan GO, Hamad-Alneil AI, Alfadl AA.Complementary medicine seeking behaviour amonginfertile women: a Sudanese study. Complement TherClin Pract. 2021 Feb;42:101264. doi:10.1016/j.ctcp.2020.101264.
14. 14. Aylin T, Sezer Er G. Determining the use of traditionaland complementary therapies among infertile women.JEUNF. 2023 Ağustos;39(1):1-9.
15. 15.Dicle Ö.E. Religious-magical beliefs and traditionaltreatments as seeking cure for infertility: the case ofŞIRNAK. Şarkiyat. Ağustos 2022; 14/2: 689-707.
16. 16.National Center of Complemantary and IntegrativeMedicine. complementary, alternative, or integrativehealth: what’s in a name? Acces date: August 23, 2024.https://www.nccih.nih.gov/health/complementary-alternative-or-integrative-health-whats-in-a-name.
17. 17.Miner SA, Robins S, Zhu YJ, et al. Evidence for the useof complementary and alternative medicines duringfertility treatment: a scoping review. BMC ComplementAltern Med. 2018 May 15;18(1):158.
18. 18.Sis Çelik A, Kırca N. Complementary and supportivecare practices used by infertile women. AnadoluHemşirelik ve Sağlık Bilimleri Dergisi. 2018;21(3):178-8.
19. 19.Ataman H, Aba YA, Güler Y. Complementary andalternative medicine methods used by Turkish infertilewomen and their effect on quality of life. Holist NursPract. 2019 Sep/Oct;33(5):303-311.
20. 20.Güner Emül T, Vefikuluçay Yılmaz D, Buldum A.determining complementary and alternative therapiesused in women’s infertility treatment. J Educ Res Nurs.2020; 17(4): 317-321.
21. 21.Kurt G, Arslan H. Use of complementary andalternative medicine among couples receiving infertilitytreatment. Cukurova Medical Journal. 2019;44:329-38.
22. 22.Güner Emül T, Değirmenci F, Vefikuluçay Yılmaz D.Traditional methods known and practiced by infertilewomen for infertility:a descriptive study. MersinÜniversitesi Tıp Fakültesi Lokman Hekim Tıp Tarihi veFolklorik Tıp Dergisi. 2024;14(2):385-92.
23. 23.Edirne T, Arica SG, Gucuk S, et al. Use ofcomplementary and alternative medicines by a sample ofTurkish women for infertility enhancement: adescriptive study. BMC Complement Altern Med. 2010Mar 22;10:11.
24. 24.O'Reilly E, Sevigny M, Sabarre KA, Phillips KP.Perspectives of complementary and alternative medicine(CAM) practitioners in the support and treatment ofinfertility. BMC Complement Altern Med. 2014 Oct14;14:394.
25. 25.Read SC, Carrier ME, Whitley R, et al. Complementaryand alternative medicine use in infertility: cultural andreligious influences in a multicultural Canadian setting. JAltern Complement Med. 2014 Sep;20(9):686-92.
26. 26.von Elm E, Altman DG, Egger M, et al.; STROBEInitiative. The strengthening the reporting ofobservational studies in epidemiology (STROBE)statement: guidelines for reporting observationalstudies. J Clin Epidemiol. 2008 Apr;61(4):344-9.
27. 27.Sönmez S, Öztürk M, Sönmez F, at al. Prevalence andpredictors of the usage of complementary alternativemedicine among infertile patients. J Gynecol Obstet HumReprod. 2021 Jun;50(6):102112. doi:10.1016/j.jogoh.2021.1021.
28. 28.Ghazeeri GS, Awwad JT, Alameddine M, Younes ZM,Naja F. Prevalence and determinants of complementaryand alternative medicine use among infertile patients inLebanon: a cross sectional study. BMC ComplementAltern Med. 2012 Aug 20;12:129.
29. 29.Ayaz S, Efe SY. Traditional practices used by infertilewomen in Turkey. Int Nurs Rev. 2010 Sep;57(3):383-7.
30. 30.Sehgal S, Dyer A, Warren C, Galic I, Jain T. Integrativemedicine utilization among infertility patients. ReprodBiol Endocrinol. 2023 Aug 2;21(1):71.