Background: Infertility requires medical attention and treatment. It is also a disturbing life event with implications in dimensions of the individuals' and the infertile couples' lives (personal, relational and social). Research question: What factors influence marital satisfaction in couples with infertility problems? Objectives: Determine the influence of socio-demographic and obstetric variables, as well as personal history in the adjustment to fertility and marital satisfaction; evaluate the influence of infertility and fertility adjustment on marital satisfaction. Methods: It is a quantitative study with a 106 women being followed at the reproductive medicine unit of Center of Portugal. Data collection was through a questionnaire comprising a socio-demographic component, obstetric history, personal history and Fertility Adjustment Scale (Leal, 2010) and Evaluation Scale regarding Marital Life Satisfaction (Narciso & Costa, 1996) scales. Results: The adjustment to fertility is influenced by age and by the existence of previous pregnancies on "Total Adjustment" (p = 0,013 and p = 0,026, respectively) and by the number of services one attends, in "Life on Hold" (p = 0,024). Marital satisfaction, is influenced by education level and the beginning of infertility treatments on "Sexuality" (p = 0,039). Conclusion: In this research, it became clear that the adjustment to fertility may not influence at all marital satisfaction; however it influences very important aspects of the couple's life. Thus, aspects of marital satisfaction will influence determinants of fertility adjustment, such as "Emotional Intimacy", "Sexuality" and "Communication/Conflict" in "Life on Hold" and "Autonomy" in "Parenting".

Background In contrast with the setting of acute myocardial infarction, there are limited data regarding the impact of diabetes mellitus on clinical outcomes in contemporary cohorts of patients with chronic coronary syndromes. We aimed to investigate the prevalence and prognostic impact of diabetes according to geographical regions and ethnicity. Methods and results CLARIFY is an observational registry of patients with chronic coronary syndromes, enrolled across 45 countries in Europe, Asia, America, Middle East, Australia, and Africa in 2009–2010, and followed up yearly for 5 years. Chronic coronary syndromes were defined by ≥1 of the following criteria: prior myocardial infarction, evidence of coronary stenosis >50%, proven symptomatic myocardial ischaemia, or prior revascularization procedure. Among 32 694 patients, 9502 (29%) had diabetes, with a regional prevalence ranging from below 20% in Northern Europe to ∼60% in the Gulf countries. In a multivariable-adjusted Cox proportional hazards model, diabetes was associated with increased risks for the primary outcome (cardiovascular death, myocardial infarction, or stroke) with an adjusted hazard ratio of 1.28 (95% confidence interval 1.18, 1.39) and for all secondary outcomes (all-cause and cardiovascular mortality, myocardial infarction, stroke, heart failure, and coronary revascularization). Differences on outcomes according to geography and ethnicity were modest. Conclusion In patients with chronic coronary syndromes, diabetes is independently associated with mortality and cardiovascular events, including heart failure, which is not accounted by demographics, prior medical history, left ventricular ejection fraction, or use of secondary prevention medication. This is observed across multiple geographic regions and ethnicities, despite marked disparities in the prevalence of diabetes. ClinicalTrials identifier ISRCTN43070564

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