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