Feeling the Blues of Infertility in a South Asian Context: Psychological Well-Being and Associated Factors Among Sri Lankan Women with Primary Infertility

Abstract

Primary infertility may have a considerable impact on the psychological well-being of women. In the present study, the authors investigated the psychological well-being and its correlates among Sri Lankan women with primary infertility. A total of 177 women with primary infertility were compared with 177 fertile women matched for age and duration of marriage to identify differences in the psychological well-being between the two groups. They were recruited from a prevalence survey conducted in the district of Colombo, Sri Lanka from August 2005 to February 2006. The General Health Questionnaire-30 (GHQ-30) and Mental Health sub-components of the Short Form-36 (SF-36) were used to measure psychological well-being. In addition, infertile women with and without psychological distress were compared to identify the social, marital, treatment, and demographic factors independently associated with psychological distress. A significantly higher proportion of women with primary infertility (66.1%; 95% CI 58.6–73.0%) had psychological distress as compared to fertile women (18.6 %; 95% CI 13.2–25.2%; P < 0.001). After adjustment for confounding factors, infertile women who were psychologically distressed were significantly less educated (OR = 55.3; 95% CI 15.2–201.0), had poor marital communication (OR = 3.5; 95% CI 1.3–9.8), had a higher priority for having children (OR = 4.2; 95% CI 1.3–13.8), and had been previously (OR = 39.1; 95% CI 8.3–185.4) or currently (OR = 11.0; 95% CI 3.0–40.6) investigated/treated for infertility when compared with infertile women without distress. Women with primary infertility reported more distress as compared to fertile women. Psychological distress among infertile women was associated with poorer education, being previously/currently investigated/treated, placing higher importance on having children, and having poor marital communication. The need for psychological intervention targeting infertile women in clinics and community settings is highlighted.

KEYWORDS:

• infertility
• psychological well-being
• GHQ-30
• SF-36
• distress
• South-Asia

Notes

The authors are extremely grateful to all of the women taking part in the study; to Dr. Neil Thalagala Consultant Community Physician, the late Dr. Sarath Wijemanna, Consultant Obstetrician and Gynecologist, Family Health Bureau, Colombo, Sri Lanka who made a scientific contribution to this study.

*Normalized to a total possible score of 100 for each subcomponent of the scales.