P–510 Psychological distress and quality of life in infertile women attending Infertility clinic at tertiary care center: a pilot study
Authors: Thyagaraju C , Naidu A 
Published: August 2021

Abstract

Study question
What are the levels of psychological distress (anxiety and depression) and quality of life faced by infertile couple presenting with or undergoing treatment for infertility?

Summary answer
The levels of psychological distress and quality of life seems to be affected more in women than their husbands and may require psychological intervention.

What is known already
Infertility is a biopsychosocial crisis which can cause psychological distress in the form of depression and anxiety, and can impair quality of life .It often has a stressful impact on relationships and can affect a couple’s sex life. Most of the time these aspects are not explored and only medical and surgical treatment is offered depending on the cause. Assessing the psychological distress and quality of life contributes to decrease the stress and helps to improve the outcome of management by improving the relationship of the individual to achieve pregnancy. These women need psychological support, in the form of counselling.

Study design, size, duration
Cross-sectional study .100 infertile couples attending fertility clinics. Previous data indicate that the mean infertility specific QoL in infertile couples is 54.39 for females (nd 60.63 for males .Thus, a minimum sample size of 77 samples per group is needed to be able to reject the null hypothesis with probability 80% power. With a 30% dropout rate, the sample size is 100 samples per group. The study was conducted from Jan 2018 to June 2019.

Participants/materials, setting, methods
Infertile couples aged between 25 to 40years attending the Infertility outpatient clinic in OBG department, JIPMER, Pondicherry, India were recruited in to the study. Presence of a pre-existing major medical illness and presence of a major psychiatric illness were excluded from the study. After written consent, the severity of depression and anxiety was measured using the Hospitol Anxiety and Depression Scale (HADS Scale) and QoL was assessed with the Fertility Quality of Life (FertiQoL) questionnaire.

Main results and the role of chance
The average ages (SD) of men and women were 33.6 (4.29) and 31.3(4.03) years, respectively. Women reported higher levels of depression (p &lt; 0.001) and anxiety (p &lt; 0.001) as compared to their husbands. Depression and anxiety was noted more in women who were more than 32year age and prolonged duration of infertility. There was a significant association between depression, gender, duration of marriage and duration of infertility among the infertile couples.78% women felt that their attention and concentration were impaired and 63% responded that they cannot move towards their life goals . Around 72% and 60% felt drained out and lost, respectively. 57% women had fluctuant thoughts like hope and despair. More women felt were socially isolated and uncomfortable with social situations than men. 45% reported social pressure and 52% were felt angry because of fertility problem. Only 24% women were satisfied with support from friends and 37% of their family can understand them. Overall only 51% of the participants gave positive response to fertiqol questions. The total FertiQoL scores were significantly higher in the husbands than the wives (p &lt; 0.001). Poor Qol were significantly associated with male cause of infertility (p = 0.004), primary infertility (p = 0.022) and previous history of receiving multiple treatments (p = 0.020).

Limitations, reasons for caution
The main limitation of the study is the cross-section study design which cannot detect exact cause of psychological distress and small sample size from single center which did not define entire population. Self reported questionairre was more subjective 5han objective which might be counfounding.
Wider implications of the findings: Couples going through infertility have a varying degree of emotional moods swinging between anxiety and depression impairing QoL.,women being affected more than men.Counselor who can empathize with the couple should form an integral part of the infertility team providing psychological intervention along with infertility treatment.

Trial registration number
NA