QUALITY OF LIFE AND ITS DETERMINANTS AMONG INFERTILE AND NON-INFERTILE WOMEN: A CASE-CONTROL STUDY IN GANDAKI PROVINCE, NEPAL

Abstract

ABSTRACTIntroductionInfertility is highly stressful to married couple and has various social and psychological problems leading adverse impact on quality of life. The study examined the quality of life and factors associated with quality of life among infertile and non-infertile women.Materials and MethodsCase control study was carried out among infertile and non-infertile women to compare their QoL using the World Health Organisation 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 1:1 ratio with cases after matching.The written and verbal inform consent was taken from patients and ethical approval was taken from NHRC. Epi-data was used for data entry and data was analyzed using SPSS. The data collection in this study was from May 20 2019 to June 20 2019. Multivariable analysis was applied to the variable after bivariate analysis for the adjustment.ResultsThe prevalence of infertility was found 9.1%, among then 43.5% had primary and 56.5% secondary infertility. The mean age of marriage of infertile women was significantly higher than that of non-infertile women (p 0.001).The average BMI score of infertile women was significantly higher than that of non-infertile women (p 0.001). Similarly the average perceived stress score among infertile women (28.9±4.61) and non infertile women (25.27±3.36), average anxiety score among infertile women (8.71±3.0) and among non-infertile (7.78±2.89), and average depression score among infertile women (8.14±2.67) and among non-infertile (6.86±2.49) were significantly higher in infertile women than non-infertile women. The total and subscale wise perceived social support score of infertile women was significantly lower than non-infertile women (p<0.001). The overall and inter-domain QoL score of infertile women was significantly lower than non-infertile women (p<0.001). Family planning methods used before first child (AOR-16.59, p=0.025), occupation (AOR-16.88, p=0.023) and induced abortion (AOR-0.086, p=0.047) were found as significant determinants of infertility at 95% CI. Among infertile women, only two factors, perceived stress (AOR-10.13, 95% CI: 3.52-29.18) and perceived social support (AOR-3.412, 95% CI: 1.15-10.101) found as important determinants of quality of life among infertile women, where as moderate to severe level of depression (AOR-14.61, 95% CI: 2.37-89.96); mild level of depression (AOR-3.42, 95% CI: 1.08-10.86), perceived social support (AOR-4.94, 95% CI: 1.51-16.14) and RH problems (AOR-3.539, 95% CI: 1.01-12.46) found as the determinants of quality of life among control (non-infertile women).ConclusionThe findings of this study revealed that the overall and inter domain quality of life of infertile women were lower than that of non-infertile women. A community-based and multicultural study involving more districts may shed more light on this topic in future research. Health service strengthening, priority to infertility in RH programs and counseling sessions should be incorporated as part of the holistic approach in the day-to-day management of the infertile women.