Abstract
Study question
Is there a difference in perceived quality of life (QOL) and prevalence of depression between partners with infertility and to determine whether socio-demographic factors influence the same?
Summary answer
Among infertile couples, there was high degree of congruence in perceived quality of life and prevalence of depression was similar among partners
What is known already
Impairment of Quality of life and psychological ramifications of infertility are often not easy to recognize and are frequently overlooked by couples and clinicians alike. The focus of available studies is largely women’s reaction to infertility and couple-based studies are limited at best especially in developing countries. Impact of socio-demographic factors on QOL and depression prevalence have not been studied in depth in couple-based studies.
Study design, size, duration
A prospective, cross-sectional study of infertile couples in setting of western India over a period of one year. In total, 130 couples (260 participants) attending the fertility clinic at a tertiary level teaching hospital were interviewed cross-sectionally, following due approval from the institutional ethical committee.
Participants/materials, setting, methods
Couples’ socio-demographic and clinical details were recorded. Couples were requested to complete the WHOQOL-BREF instrument and Beck Depression Inventory (BDI). Analysis was performed using the statistical package SPSS, version 21, (International Business Machines Corp., Released 2012, Version 21.0.) and p-value of < 0.05 was considered statistically significant. Data was analyzed using paired t-test, one-way multivariate linear variance analysis and regression and correlation models.
Main results and the role of chance
Out of 130 couples (260 participants), data 214 participants (107 couples) was included in Quality of Life score assessment and from 228 participants (114 couples) were included in the final depression analysis. Mean Quality of life (QOL) scores between men and women showed a strong agreement within psychological, social, environmental domains (r = 0.70, 0.67 and 0.69 likewise) and moderate association for physical domain (r = 0.59). Presence of depressive symptoms was associated with significantly impaired QOL scores through all domains. Depression was present in 30.6% of female partners with 18.4% having mild, 9.6% having moderate and 2.6% having severe depression. Corresponding figures in male partners were 27.2%, 20.2%, 6.1% with 0.9% case of severe depression. Pearson correlation between female partner BDI scores and male partner scores was highly statistically significant with a correlation coefficient of 0.745, significant at 0.01 level (99% confidence interval). Presence of depression was not found to be significantly associated with couples’ age, education status, income status, presence of previous living child in the family and the duration of infertility using multinomial logistic regression model.
Limitations, reasons for caution
Being a questionnaire based study, there is predisposition to certain degree of inaccuracy of responses. The Cross-sectional design of the study allows estimation of variance and association but not causation.
Wider implications of the findings: Screening and psychoeducation should be couple based considering the couple as one unit which is likely to improve the mental wellbeing of the couple as a whole. All infertile couples should be screened and offered counselling irrespective of their socio-demographic background.
Trial registration number
AIIMS/IEC/2018/677
Experiences of Infertile Couples of West Bengal With Male Factor, Female Factor, and Unexplained Infertility Factor: A Qualitative Study
