男性感知到的不育诊断对其性、婚姻和社会的影响。
Sexual, marital, and social impact of a man's perceived infertility diagnosis.
机构信息
Department of Urology, University of California, San Francisco, CA 94143, USA.
出版信息
J Sex Med. 2009 Sep;6(9):2505-15. doi: 10.1111/j.1743-6109.2009.01383.x. Epub 2009 Jul 10.
INTRODUCTION
Male factor infertility is a relatively common problem. This diagnosis may increase sexual, marital, and relationship strain in male partners of infertile couples.
AIM
To measure the personal, social, sexual, and marital impacts of a male factor infertility diagnosis among men in couples evaluated for infertility.
METHODS
Cross-sectional analysis of 357 men in infertile couples from eight academic and community-based fertility clinics. Participants completed written surveys and face-to-face and telephone interviews at study enrollment. This interview queried each participant's perception of their infertility etiology to determine the primary study exposure (i.e., male factor only, male and female factors, female factor only, unknown).
MAIN OUTCOME MEASURES
Personal Impact, Social Impact, Marital Impact, and Sexual Impact scales.
RESULTS
Among the 357 men, no male factor was reported in 47%, isolated male factor was present in 12%, combined male and female factors were present in 16%, and unexplained infertility was present in 25% of couples. Male factor infertility was independently associated with worse Sexual (mean 39 vs. 30, standard deviation [SD] 2.7, P = 0.004) and Personal (mean 37 vs. 29, SD 3.8, P = 0.04) Impact scores relative to men in couples without male factor infertility. These differences remained statistically significant after controlling for male age, partner age, race, religion, educational level, employment status, prior pregnancy, duration of infertility, and prior paternity.
CONCLUSIONS
Male partners in couples who perceive isolated male factor infertility have a lower sexual and personal quality of life compared with male partners of couples without perceived male factor infertility. Social strain is highest among couples without a clear etiology for infertility. These findings highlight the clinically significant negative sexual, personal, and social strains of a perceived infertility diagnosis for men.
简介
男性因素不孕是一个相对常见的问题。这一诊断可能会增加不孕夫妇中男性伴侣的性、婚姻和关系压力。
目的
测量男性因素不孕诊断对接受不孕评估的夫妇中男性的个人、社会、性和婚姻影响。
方法
对来自 8 家学术和社区生育诊所的 357 名不孕夫妇中的男性进行横断面分析。参与者在研究入组时完成了书面调查以及面对面和电话访谈。这次访谈询问了每个参与者对其不孕病因的看法，以确定主要的研究暴露因素（即，仅男性因素、男性和女性因素、女性因素、未知因素）。
主要观察指标
个人影响、社会影响、婚姻影响和性影响量表。
结果
在 357 名男性中，47%的夫妇报告没有男性因素，12%的夫妇报告存在孤立的男性因素，16%的夫妇报告存在男性和女性因素，25%的夫妇报告存在不明原因的不孕。与无男性因素不孕的夫妇相比，男性因素不孕与较差的性（平均 39 对 30，标准差[SD] 2.7，P = 0.004）和个人（平均 37 对 29，SD 3.8，P = 0.04）影响评分独立相关。这些差异在控制了男性年龄、伴侣年龄、种族、宗教、教育程度、就业状况、既往妊娠、不孕持续时间和既往亲职后仍然具有统计学意义。
结论
与无感知男性因素不孕的夫妇相比，感知孤立性男性因素不孕的夫妇的性生活质量和个人生活质量较低。病因不明的夫妇社会压力最大。这些发现突出了男性感知不孕诊断对其产生的显著的负面性、个人和社会压力。
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