Quality of Life of Women with Infertility in Gandaki Province, Nepal

Abstract

Infertility is socially and emotionally challenging for married couples and can lead to significant stress, anxiety, and depression that adversely impact their quality of life. The study aimed to compare the quality of life among infertile and non-infertile women and identify factors associated with their quality of life. A cross-sectional analytical study was conducted among infertile and non-infertile women to compare their quality of life using the WHO Quality of Life-BREF (WHOQOL-BREF) questionnaire. Altogether, 92 married women of reproductive age (20-49) facing infertility/subfertility problems were selected as cases, and controls were selected in a 1:1 ratio with cases after matching. Written and verbal consent was obtained from patients, and ethical approval was obtained from the Nepal Health Research Council. Epi-data was used for data entry, and data was analyzed using SPSS. The data collection in this study was from May 20th, 2019, to June 20th, 2019. Multivariable analysis was applied to the variable after bivariate analysis for the adjustment. Fertile women reported significantly higher perceived stress (28.9±4.6 vs. 25.3±3.4, p<0.001), anxiety (8.7±3.0 vs. 7.8±2.9, p<0.001), and depression (8.1±2.7 vs. 6.9±2.5, p<0.001) compared to non-infertile women. Perceived social support was significantly lower in infertile women (p<0.001). Factors such as perceived stress (AOR 10.1, 95% CI: 3.5–29.2) and perceived social support (AOR 3.4, 95% CI: 1.2–10.1) were key determinants of QoL among infertile women. Among non-infertile women, moderate-to-severe depression (AOR 14.6, 95% CI: 2.4–89.9) and reproductive health problems (AOR 3.5, 95% CI: 1.0–12.5) significantly impacted QoL. The findings of this study revealed that the overall and inter-domain score on the quality of life of infertile women was lower than that of non-infertile women. The majority of the cases perceived social discrimination and violence. From multivariate analysis, perceived stress, and perceived social support were found as important determinants of quality of life among infertile women, and moderate to severe levels of anxiety, depression, perceived social support, and reproductive health problems were found as determinants of quality of life among non-infertile women.