Quality of life in women of reproductive age: a comparative study of infertile and fertile women in a Nigerian tertiary centre

Health-related quality of life and its associated factors among infertile women compared with fertile women in public hospital Addis Ababa, Ethiopia: a comparative cross-sectional study

BACKGROUND

Infertility can have detrimental physical, psychological, and social effects that significantly impact health-related quality of life. Although the impact of infertility on quality of life is well established, there is a lack of research comparing the quality of life between fertile and infertile women in Ethiopia.

METHODS

A hospital-based comparative cross-sectional study was conducted among 287 infertile and 301 fertile women. Participants were selected using systematic random sampling. A structured, validated tool was used to collect data. An independent sample t-test was conducted to determine if there was a difference in the study participants' quality of life domains and the mean total quality of life score. Multiple linear regressions were used to correlate quality of life scores with significant predictor factors for the infertile group.

RESULTS

Infertile women had a mean total Herbal of 66.54 ± 10.18, and fertile women (72.68 ± 7.57) were found to be statistically different between the groups. All domains except the physical domain were significantly different between the groups. Duration of marriage (β = -0.529), number of previous sexual partners (β = -0.410), total number of working hours per day (β = -0.345), types of infertility (β = -0.34), and history of the sexually transmitted disease (β = -0.277), in decreasing order of effect, were found to be associated with the quality of life of infertile women (R2 = 0.725).

CONCLUSIONS

The study found that infertile women had a lower mean HRQoL score compared to fertile women, with all domains except for the physical domain being significantly different between the two groups. This suggests that infertility can have a significant impact on various aspects of a woman's life, including her emotional well-being, social functioning, and psychological health. The factors associated with the quality of life of infertile women were the duration of marriage, the number of previous sexual partners, the total number of working hours per day, the types of infertility, and the history of sexually transmitted diseases, with duration of marriage having the strongest association. These findings highlight the need for healthcare providers to address the psychological and social aspects of infertility.

Anxiety, Depression, and Quality of Life Among Infertile Women: A Case-Control Study

Introduction Pregnancy holds significant cultural and social value for women. However, women facing challenges in conceiving often grapple with emotional distress, including depression and anxiety. The connection between psychological elements (stress, anxiety, and depression) and infertility is complex, influenced by multiple factors, and bidirectional. Infertile women are more likely to develop mental illnesses, marital dissatisfaction, and impaired quality of life compared to the individuals of the fertile group. Thus, the study aimed to assess levels of anxiety, depression, and quality of life among infertile women compared to fertile women. Methods This case-control study conducted at a tertiary care center recruited 100 nulliparous women between the age group of 20 and 38 years with primary or secondary infertility, while those with male factor infertility were excluded. The control group (N=100) comprised normal parous women who had at least one child. The primary objective of the study was to assess the impact of infertility on the mental health and quality of life of women seeking infertility treatment. Outcome measures included standardized tools such as the WHOQOL-BREF questionnaire to assess the quality of life across multiple domains (e.g., physical, psychological, social, and environmental) as well as the Depression Anxiety and Stress Scale (DASS-21) to measure levels of anxiety, depression, and stress. Cronbach's alpha was used to measure the tool's reliability. A P value of <0.05 was considered statistically significant. Results Baseline sociodemographic parameters were comparable between the two groups. The mean age of infertile women was 30.6±3.9 years compared to 31.5±3.2 years in fertile women (P=0.076). Using the WHOQOL-BREF scale, we found that the quality of life was better in the fertile group compared to the infertile group through all the physical, psychological, social, and environmental domains (P<0.001). The infertile group had a significantly higher number of women with anxiety, depression, and stress. The questionnaires showed high internal reliability. Conclusion Infertile women experienced a lower quality of life in various domains, higher levels of anxiety, and increased rates of depression compared to fertile counterparts. The study findings underscore the multidimensional impact of infertility, emphasizing the need for comprehensive healthcare approaches to address the psychosocial challenges faced by women undergoing infertility treatment.

Comparing infertility-related stress, coping, and quality of life among assisted reproductive technology and non-assisted reproductive technology treatments

Women who undergo assisted reproductive technology (ART) treatments experience infertility-related stress and have low quality of life (QOL). However, there is limited understanding of infertility-related stress, coping, or QOL among women who undergo non-ART treatments. The purpose of this study was to examine infertility-related stress, coping, and QOL among women who undergo ART and non-ART infertility treatments. Using a descriptive correlational cross-sectional design, we recruited 200 women who underwent infertility treatments. Participants completed the Copenhagen Multi-centre Psychosocial Infertility (COMPI) Fertility Problem Stress Scale, COMPI Coping Styles Scale, Fertility Quality of Life tool, and a demographic infertility survey. Data analysis included descriptive statistics, independent t-test, chi-square, and hierarchical multiple regression. Women who underwent non-ART had more personal stress, used more active-avoidance coping, and had lower emotional, social, and treatment environment QOL compared to those in ART treatment. Women who underwent ART treatments used more meaning-based coping but had lower treatment tolerability QOL. Stress and coping contribute to core QOL differently among infertility treatment groups. Both treatment groups report low satisfaction with emotional services. Regardless of the treatment type, women who undergo infertility treatments may need care to address their psychological health.

Differences in Fertility-Related Quality of Life and Emotional Status Among Women Undergoing Different IVF Treatment Cycles

Objective

The present study aimed to provide more insight into the possible differences in the fertility-related quality of life (FertiQoL) and emotional status of women undergoing different cycles of in vitro fertilization (IVF) treatments.

Methods

A prospective cohort study was performed, and a total of 432 women undergoing IVF treatment were recruited. FertiQoL scale, self-rating anxiety scale (SAS), self-rating depression scale (SDS), and perceived social support scale (PSSS) were used to analyze fertility-related QoL and emotional status. Data were analyzed comparing women undergoing different cycles of IVF treatments.

Results

A significant decrease in FertiQoL scores occurred in women with increased cycles of IVF treatment. Both anxiety and depression scores significantly increased with increased cycles of attempting IVF treatment. There was no significant difference detected in perceived social support among groups.

Conclusion

With the increase in the number of IVF treatment cycles, women's FertiQoL gradually decreased, while the risk of anxiety and depression gradually increased.

Effects of care given in line with Levine's Conservation Model on the quality of life of women receiving infertility treatment: A single blind randomized controlled trial

Although infertility is not a life-threatening condition, it decreases the quality of life of people. This single blind randomized controlled trial was conducted with 80 women who received infertility treatment in an IVF Center located in a city center in the west of Turkey between May 2020 and February 2021. It was determined that thanks to the holistic care given in line with Levine's Conservation Model (LCM), fatigue levels of the women in the experimental group decreased, their energy levels increased, their structural, personal and social integrity was conserved and thus their quality of life improved compared to the women in the control group (all p < 0.001).

Relationships among type-D personality, fatigue, and quality of life in infertile women

PURPOSE

The objective of the present study was to investigate the prevalence of the type D personality and identify the relationship between type D personality, fatigue and quality of life (QoL) in infertile women.

METHODS

A total of 149 infertile women were recruited between October 2020 and January 2021. The participants were assessed through self-administered questionnaires using the type- D Personality Scale-14, Fatigue Severity Scale, and Fertility QoL Instrumental Questionnaire. Data were analyzed using the independent t-test, chi-square test, Pearson's correlation coefficients, and multiple regression analysis using the SPSS/WIN 25.0 program for Windows.

RESULTS

Approximately 40.9% of infertile women were classified into the type D personality group, which showed significantly higher fatigue and lower QoL than the non-type D personality group. Fatigue was the most influential factor on the QoL of infertile women (β=-.23, p=.003), followed by the duration of infertility treatment (β=-.22, p=.003), type D personality (β=-.18, p=.025), and relationship with spouse (β=-.17, p=.024). These variables account for approximately 22% of the variance.

CONCLUSIONS

Intervention programs that consider fatigue, type D personality, relationship with spouses, and treatment duration may be useful for improving QoL in infertile women.

Psychosocial correlates of fertility-related quality of life among infertile women with repeated implantation failure: The mediating role of resilience

OBJECTIVE

This study aimed to examine associations between psychosocial factors and fertility-related quality of life (FertiQoL) among infertile women with repeated implantation failure (RIF), and to identify the possible role of resilience in mediating the effect of social support on FertiQoL.

MATERIALS AND METHODS

A cross-sectional study was conducted with 234 infertile women with RIF in total. Fertility quality of life scale (FertiQoL), perceived social support scale (PSSS), and Connor-Davidson Resilience Scale (CD-RISC) were used to evaluate the patients. Data were described by univariate and multivariate analyses. Stepwise regression method was performed to analyse the mediating effect of resilience.

RESULTS

Social support had a positive predictive effect on FertiQoL (β = 0.757, P < 0.001), also positive on resilience (β = 0.847, P < 0.001). After both variables were added to the regression equation, resilience was found to have a significant positive predictive effect on FertiQoL (β = 0.798, P < 0.001), while the predictive effect of social support on FertiQoL was no longer significant (β = 0.081, P > 0.05). The results indicated that resilience played a complete mediating role between social support and FertiQoL.

CONCLUSION

This study preliminarily verified the mediating role of resilience between social support and FertiQoL among infertile women with RIF. Interventions that consider enhancing resilience and building social support will likely improve their FertiQoL.

IMPACT OF POLYCYSTIC OVARIAN SYNDROME ON GENERAL HEALTH RELATED-QUALITY OF LIFE AMONG A SAMPLE AT "MATERNITY AND CHILDREN TEACHING HOSPITAL" IN DIWANIYAH CITY-IRAQ

OBJECTIVE

The aim: This study amid to identify and studying the most properties of general health related-quality of life (GHR-QoL) of polycystic ovarian syndrome (PCOS) patients, and to find out relationships among redistribution of an overall evaluation quality of life using the general scale of WHO QoL-BERF questionnaire.

PATIENTS AND METHODS

Materials and methods: A descriptive study of patients with PCOS conducted, and it was starting the data collection from 6th December 2020up to 10thMay 2021from the "Maternity and Children Teaching Hospital" in Diwaniyah city -Iraq". Convenient sampling method of (100) patients who visited to that hospital during the data collection period had been selected.

RESULTS

Results: The findings of the study indicated that (GHR-QoL) for the studied patients are assigned that the observing responses were at moderate response generally, and they are accounted for the contents of studied questionnaire (Physical, Psychological, Social, and Environmental) main domains respectively. As well as, results shows that an overall of the (GHR-QoL) redistribution (under/upper) a cutoff point regarding percentile global mean of score (PGMS) that (SDCv.) has reported weak relationships with no significant at P>0.05.

CONCLUSION

Conclusions: There were weak relationships between GHR-QoL and (SDCv.), and it could be concluded that studied questionnaire could be taken a broad view on studied population even though differences with their (SDCv.) indeed.

Coping strategies mediate the association between stigma and fertility quality of life in infertile women undergoing in vitro fertilization-embryo transfer

BACKGROUND

The mediating role of coping strategies and its relationship with psychological well-being and quality of life has been considered in the literature. However, there is little research to explore the mechanism of coping strategies on stigma and fertility quality of life (FertiQoL) in infertile women undergoing In Vitro Fertilization Embryo Transfer (IVF-ET). The aim of this study was to examine the mediating effect of coping strategies on the relationship between stigma and fertility quality of life (FertiQoL) in Chinese infertile women undergoing In Vitro Fertilization Embryo Transfer (IVF-ET).

METHODS

In this cross-sectional study, a total of 768 infertile women undergoing IVF-ET were recruited from Assisted Reproductive Center of Shaanxi Province, China. The personal information, infertility stigma scale, coping strategy scale and FertiQoL scale were measured using a set of questionnaires. The multiple mediator model was performed using AMOS 21.0.

RESULTS

The model showed a significant negative direct effect between stigma on FertiQoL. There were significantly negative indirect effects of stigma on FertiQoL through active-avoidance, active-confronting and passive-avoidance, respectively. The meaning-based coping played a positive intermediary role. The model explained 69.4% of the variance in FertiQoL.

CONCLUSION

Active-avoidance coping strategy is the most important mediator factor between stigma and FertiQoL in infertile women undergoing IVF-ET treatment. Meaning-based coping strategy plays a positive mediating role between stigma and FertiQoL.

The effect of women's sexual functioning on quality of their sexual life

INTRODUCTION

Considering the high prevalence of sexual dysfunction among women and the role of quality of sexual life in women's life and health, in addition to the important role of sexual function evaluation in measuring quality of life, this study aimed to determine the effect of female sexual function on the quality of sexual life.

MATERIAL AND METHODS

This research was a descriptive and cross-sectional. The population of this study was 420 women from Qazvin in 2020, who were selected by multi-stage sampling. The data collection tool was a demographic questionnaire and Persian version of the Female Sexual Function Assessment questionnaire (FSFI) and Sexual Quality of Life Questionnaire (SQOL-F). Data were analyzed using SPSS 23, and descriptive statistics and logistic regression were applied.

RESULTS

The mean (SD) of sexual function score was 21.56 (4.83) out of 36, therefore, it was at an unfavorable level. Also, the mean (SD) score of sexual quality of life 59.71 (19.21) was out of 108 (moderate). The results of logistic regression test showed that the variables of sexual function, age and level of education of women were the factors affecting the quality of women's sexual life (P < 0.05).

CONCLUSIONS

Young women with lower sexual function, and lower level of education had lower quality of sexual life. Hence, it is necessary to pay more attention to these women in designing educational programs for improving the quality of their sexual life.

Reproductive options for families at risk of Osteogenesis Imperfecta: a review

Background

Osteogenesis Imperfecta (OI) is a rare genetic disorder involving bone fragility. OI patients typically suffer from numerous fractures, skeletal deformities, shortness of stature and hearing loss. The disorder is characterised by genetic and clinical heterogeneity. Pathogenic variants in more than 20 different genes can lead to OI, and phenotypes can range from mild to lethal forms. As a genetic disorder which undoubtedly affects quality of life, OI significantly alters the reproductive confidence of families at risk. The current review describes a selection of the latest reproductive approaches which may be suitable for prospective parents faced with a risk of OI. The aim of the review is to alleviate suffering in relation to family planning around OI, by enabling prospective parents to make informed and independent decisions.

Main body

The current review provides a comprehensive overview of possible reproductive options for people with OI and for unaffected carriers of OI pathogenic genetic variants. The review considers reproductive options across all phases of family planning, including pre-pregnancy, fertilisation, pregnancy, and post-pregnancy. Special attention is given to the more modern techniques of assisted reproduction, such as preconception carrier screening, preimplantation genetic testing for monogenic diseases and non-invasive prenatal testing. The review outlines the methodologies of the different reproductive approaches available to OI families and highlights their advantages and disadvantages. These are presented as a decision tree, which takes into account the autosomal dominant and autosomal recessive nature of the OI variants, and the OI-related risks of people without OI.

The complex process of decision-making around OI reproductive options is also discussed from an ethical perspective.

Conclusion

The rapid development of molecular techniques has led to the availability of a wide variety of reproductive options for prospective parents faced with a risk of OI. However, such options may raise ethical concerns in terms of methodologies, choice management and good clinical practice in reproductive care, which are yet to be fully addressed.

Resilience acts as a moderator in the relationship between infertility-related stress and fertility quality of life among women with infertility: a cross-sectional study

BACKGROUND

Infertility-related stress can seriously impact the fertility quality of life (QoL) of infertile women. Resilience, as a coping resource, can effectively combat psychological stress. This study aimed to evaluate the fertility QoL of infertile women and to examine whether resilience moderates the association of infertility-related stress with fertility QoL.

METHODS

This cross-sectional study was conducted in northeast of China from December 2017 to February 2018. Out of 559 women outpatients with infertility, 498 (89.1%) completed self-reported questionnaires including the FertiQoL Scale, Fertility Problem Inventory (FPI) and Connor-Davidson Resilience Scale (CD-RISC). Hierarchical multiple regression analysis and simple slope analysis were applied to explore the influencing factors related to fertility QoL as well as to examine the moderating effect of resilience on the association of infertility-related stress with fertility QoL.

RESULTS

The mean FertiQoL score was 64.54 ± 16.90 among the participants. Household monthly income and causes of infertility were significantly related to fertility QoL. In addition, infertility-related stress was negatively related to fertility QoL, and resilience was positively associated with fertility QoL, explaining 36.3% of the variance. Resilience moderated the association of infertility-related stress with fertility QoL. Specifically, the effect of infertility-related stress on fertility QoL varied by low(1 SD below the mean, B = - 0.496, β = - 0.714, P < 0.001), mean (B = - 0.293, β = - 0.422, P < 0.001) and high (1 SD above the mean, B = - 0.090, β = - 0.130, P < 0.001) levels of resilience. The higher resilience was, the weaker the effect of infertility-related stress on fertility QoL was.

CONCLUSIONS

Overall, women with infertility in China had relatively low FertiQoL scores. Resilience influenced the association of infertility-related stress with fertility QoL. Infertile patients' psychological status must be addressed and adequate resilience-based interventions such as mindfulness-based skills should be provided to improve fertility QoL of women with infertility.

Measurement and evaluation of quality of life and well-being in individuals having or having had fertility problems: a systematic review

OBJECTIVES

The aims of this study were: (1) to identify which measurement instruments are used in practice to assess the quality of life or well-being of individuals with and without (sub)fertility; (2) to describe the design and outcomes of studies comparing quality of life or well-being of individuals with and without fertility problems; and (3) to determine which of the outcomes of the identified studies could be used in cost-utility studies.

METHODS

A systematic literature review was performed of studies published before July 2018, using multiple databases. Included studies investigated (health-related) quality of life or well-being of individuals with fertility problems. The applied instruments were assessed, as were the outcomes and suitability for use in cost-utility studies.

RESULTS

Twenty-six studies met the inclusion criteria. Twelve distinct instruments of measurement were applied: two generic quality-of-life instruments, five generic well-being instruments and five disease-specific instruments. Most studies found negative associations in one or more domains assessing fertility problems and quality of life or well-being. However, two studies found the opposite. None of the studies reported outcomes relevant for cost-utility studies.

CONCLUSION

Quality of life and well-being related to having fertility problems are regularly studied. However, the reported information is not suitable for use in cost-utility studies. There is a clear need for studies investigating the impact of fertility problems on quality of life in a way that outcomes can be compared across studies and disease areas.

Depression, sexual dysfunction and sexual quality of life in women with infertility

Background

Women suffering from infertility are at higher risk of experiencing psychological problems. Sexual function and sexual related quality of life is not considered as it should be. We designed this study to assess depression, sexual function and sexual quality of life in Iranian women with infertility.

Methods

Two hundred and sixty four individuals participated in the study (115 healthy controls, 78 with primary and 71 with secondary infertility). All participants were asked to fill a valid and reliable Persian versions of BDI (Beck depression inventory), FSFIS (Female Sexual Function Index) and sexual quality of life-Female (SQOL-F) questionnaires.

Results

Mean BDI score was significantly lower in healthy individuals.Individuals with primary infertility suffered more from sexual dysfunction, while BDI score was significantly higher and SQOL-F was significantly lower in cases with sexual dysfunction. There was significant positive correlation between SQOL-F and total FSFI score (r = 0.59, p < 0.001). Linear regression analysis by considering SQOL-F as dependent and age, BDI, duration of marriage, sexual dysfunction (FSFI ≤26.55 or > 26.55) showed that BDI and sexual dysfunction were independent predictors of SQOL-F.

Conclusion

Sexual function and quality of life related to sexual life should be considered in Iranian infertile ones. Depression as a crucial factor should be focused more in infertile women.

Electronic supplementary material

The online version of this article (10.1186/s12905-018-0584-2) contains supplementary material, which is available to authorized users.