Korean J Women Health Nurs.  2020 Mar;26(1):49-60. 10.4069/kjwhn.2020.03.08.

Factors influencing infertility-related quality of life in infertile women

• Kim YM
• Nho JH

• KMID: 2501576
• DOI: http://doi.org/10.4069/kjwhn.2020.03.08

Abstract

Purpose
The rate of infertility in South Korea is steadily increasing. Infertile women experience various physical, psychological, and relational problems that affect their infertility–related quality of life (QoL). This study investigated infertile women’s infertility-related QoL with the goal of identifying how it is influenced by fatigue, depression, and marital intimacy.
Methods
A sample of 140 infertile women was surveyed in a cross-sectional study. Data were collected from February to April 2018 using self-report structured questionnaires at three infertility clinics located in Jeonju, Korea. Data were analyzed using the independent t-test, analysis of variance, Pearson correlation coefficients, and stepwise multiple regression analysis in SPSS for Windows version 25.0. The subjects agreed to complete a face-to-face interview, including administration of the Fatigue Severity Scale, Depression Anxiety Stress Scale-21, Marital Intimacy Scale, and the Fertility Quality of Life tool.
Results
The mean age of the participants was 35.6±4.3 years. Infertility-related QoL was negatively correlated with fatigue (r=–.42, p<.001) and depression (r=–.56, p<.001), and positively correlated with marital intimacy (r=.30, p<.001). Multiple regression analysis showed that depression (β=–0.44, p<.001), fatigue (β=–0.27, p<.001), and husband’s attitude (β=–0.19, p=.007) had significant effects on the QoL of infertile women, accounting for 40.5% of the variance in infertility-related QoL.
Conclusion
The study provides insights into how infertile women’s infertility-related QoL was influenced by depression, fatigue, and their husbands’ attitudes regarding infertility treatment. To improve infertile women’s infertility-related QoL, healthcare providers should consider developing strategies to decrease depression and fatigue in infertile women and to address their husbands’ attitudes.

Keyword

Infertility; Fatigue; Depression; Marital relationship; Quality of life; 난임; 피로; 우울; 부부 친밀도; 삶의 질

Reference

References

1. Statistics Korea. 2016 Birth Statistics (Confirmation) [Internet]. Daejeon: Author;2016. [cited 2018 Apr 1]. Available from: http://kostat.go.kr/portal/korea/kor_nw/1/2/1/index.board?bmode=read&aSeq=362574.

2. Balasch J. Ageing and infertility: an overview. Gynecol Endocrinol. 2010; 26(12):855–860.

3. Lee SY, Kim EJ, Park JS, Byun SJ, Oh M, Lee SL, et al. The 2018 national survey on fertility and family health and welfare. Sejong: Korea Institute for Health and Social Affairs; 2018 Dec. 51 p. Report No.: Policy Report 2018-37.

4. Boivin J, Takefman J, Braverman A. The Fertility Quality of Life (FertiQoL) tool: development and general psychometric properties. Fertil Steril. 2011; 96(2):409–415.

5. Ashrafi M, Sadatmahalleh SJ, Akhoond MR, Talebi M. Evaluation of risk factors associated with endometriosis in infertile women. Int J Fertil Steril. 2016; 10(1):11–21.

6. Yokoyama Y. Comparison of child-rearing problems between mothers with multiple children who conceived after infertility treatment and mothers with multiple children who conceived spontaneously. Twin Res Hum Genet. 2003; 6(2):89–96.

7. Namdar A, Naghizadeh MM, Zamani M, Yaghmaei F, Sameni MH. Quality of life and general health of infertile women. Health Qual Life Outcomes. 2017; 15(1):139.

8. Hwang N. Factors related to the depression of infertile women. Health Soc Stud. 2013; 33(3):161–187.

9. Jung YJ, Kim HY. Factors influencing infertility-related quality of life in women undergoing assisted reproductive techniques: focusing on depression and resilience. Korean J Women Health Nurs. 2017; 23(2):117–125.

10. Kim M, Nam H, Youn M. Infertility stress, depression, and resilience in women with infertility treatments. J Korean Public Health Nurs. 2016; 30(1):93–104.

11. Chi HJ, Park IH, Sun HG, Kim JW, Lee KH. Psychological distress and fertility quality of life (FertiQoL) in infertile Korean women: The first validation study of Korean FertiQoL. Clin Exp Reprod Med. 2016; 43(3):174–180.

12. Tao P, Coates R, Maycock B. Investigating marital relationship in infertility: a systematic review of quantitative studies. J Reprod Infertil. 2012; 13(2):71–80.

13. Lee KH. A measure of marital intimacy. J Korean Home Econ Assoc. 1995; 33(4):235–249.

14. Bakhtiyar K, Beiranvand R, Ardalan A, Changaee F, Almasian M, Badrizadeh A, et al. An investigation of the effects of infertility on women's quality of life: a case-control study. BMC Womens Health. 2019; 19(1):114.

15. Chachamovich JR, Chachamovich E, Ezer H, Fleck MP, Knauth D, Passos EP. Investigating quality of life and health-related quality of life in infertility: a systematic review. J Psychosom Obstet Gynecol. 2010; 31(2):101–110.

16. Kim M. Relationship between infertility stress and quality of life of infertile women: based on the moderating and mediating effects of sexual satisfaction. J Korean Soc Matern Child Health. 2016; 20(2):140–151.

17. Krupp LB, LaRocca NG, Muir-Nash J, Steinberg AD. The fatigue severity scale. Application to patients with multiple sclerosis and systemic lupus erythematosus. Arch Neurol. 1989; 46(10):1121–1123.

18. Chung KI, Song CH. Clinical usefulness of fatigue severity scale for patients with fatigue, and anxiety or depression. Korean J Psychosom Med. 2001; 9(2):164–173.

19. Henry JD, Crawford JR. The short-form version of the Depression Anxiety Stress Scales (DASS-21): construct validity and normative data in a large non-clinical sample. Br J Clin Psychol. 2005; 44(Pt 2):227–239.

20. Boivin J, Schmidt L. Infertility-related stress in men and women predicts treatment outcome 1 year later. Fertil Steril. 2005; 83(6):1745–1752.

21. Kim JH, Shin HS. A structural model for quality of life of infertile women. J Korean Acad Nurs. 2013; 43(3):312–320.

22. Maroufizadeh S, Hosseini M, Rahimi Foroushani A, Omani-Samani R, Amini P. The effect of depression on quality of life in infertile couples: an actor-partner interdependence model approach. Health Qual Life Outcomes. 2018; 16(1):73.

23. Li Y, Zhang X, Shi M, Guo S, Wang L. 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. Health Qual Life Outcomes. 2019; 17(1):38.

24. Hwang RH. Self-esteem, body image and factors influencing on depression of infertile women. J Digit Converg. 2017; 15(10):537–549.

25. Murphy S, Niemiec SS. Aging, fatigue, and fatigability: implications for occupational and physical therapists. Current Geriatrics Reports. 2014; 3(3):135–141.

26. Targum SD, Fava M. Fatigue as a residual symptom of depression. Innov Clin Neurosci. 2011; 8(10):40–43.

27. Cserepes RE, Bugán A, Korösi T, Toth B, Rösner S, Strowitzki T, et al. Infertility specific quality of life and gender role attitudes in german and hungarian involuntary childless couples. Geburtshilfe Frauenheilkd. 2014; 74(11):1009–1015.

28. Donarelli Z, Lo Coco G, Gullo S, Salerno L, Marino A, Sammartano F, et al. The Fertility Quality of Life Questionnaire (FertiQoL) relational subscale: psychometric properties and discriminant validity across gender. Hum Reprod. 2016; 31(9):2061–2071.

29. Kim MO, Park JS, Nam HA. Factors associated with marital satisfaction of women under infertility treatments. J Korean Soc Matern Child Health. 2016; 20(3):228–238.