P-509 Evolution of quality of life, sexual function and marital agreement in long term infertile couples: a 10-year prospective cohort study
Authors: Kaabia O , Ben Smida A , Abid S , Yousri E.K 
Published: June 2022

Abstract

Study question
Comparing the sexual function, marital adjustment, and quality of life of long-term infertile and parenting couples after a history of ART

Summary answer
Long time infertility alters the sexual function in women but does not impact negatively the quality of life and the marital adjustment of the couples

What is known already
The short-term impact of the diagnosis of infertility and its treatments on heterosexual couples has been investigated. But very little literature exists regarding the evolution of the quality of life, marital agreement, and the sexual function of long-term infertile couples. After ART, parenthood is considered to impact the quality of life and thus the conjugal life of the couples in a short time. But there are very few studies comparing the quality of life of couples who underwent ART in regard to the success or not of their parenthood project in the long term.

Study design, size, duration
This is a prospective, cohort-type analytical study where each patient is their own control over time. Patients were recruited at the Fertility Treatment Unit of our department, over a 10-year period (2009-2018). An interview was held with each partner at the 1st consultation and 10 years later. The recruitment phase took place from January 1st, 2009, and May 31, 2009.

Participants/materials, setting, methods
We included all heterosexual married couples with women under 40 and men under 45. The evaluation of the quality of life was standardized by the Medical Outcomes Study Short Form 36 (SF-36) and the Fertility Quality Of Life (FertiQol). The female sexual function was evaluated with the Female Sexual Function Index (FSFI). The male sexual function was evaluated through the International Index of Erectile Function (IIEF). The marital adjustment Test (MAT) evaluated the conjugal life.

Main results and the role of chance
We included 100 couples (100 women and 100 men) of whom only 44 were still together after 10 years:18 were still childless, 8 had adopted, and 18 had live births. The divorce rate in our study population was 56%. There were no significant differences in the socio-demographic features of the parenting and childless couples. Men's sexual function was not different between fathers and childless men. Childless women's sexual function was impaired compared with mothers either regarding the global function (p = 0.003) or all its components (Desire (p = 0,025), excitation (p = 0,001), lubrification (p = 0,007), orgasm (p = 0,017), pain (p = 0,008), and satisfaction (p = 0,006)). There is no difference in terms of marital adjustment (p = 0.479) and in terms of quality of life when applying the SF36. In the 18 long-term infertile women, the core FertiQol emotional scores and the FertiQol treatment tolerance scores were lower than in men (respectively, p = 0.02 and 0.003).

Limitations, reasons for caution
The small size of the sample of our study is the main limitation of the study. It is mainly related to the high rate of divorce in this specific population and the long period of the study.

Wider implications of the findings
Health care professionals need to emphasize the information of the couples of the potential effects of long-term infertility on the couple's marital life, the sexual life, and the quality of life, especially among women. They also need to help the patients seek the help and counseling they need.

Trial registration number
not applicable