Fatima P, Rahman D, Hossain H B, Hossain H N, Mughi C R
Professor Parveen Fatima, Professor of Infertility Unit, Department of Gynae & Obs., Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh.
Mymensingh Med J. 2015 Oct;24(4):704-9.
This study explores to find out the qualitative and quantitative psychosocial consequences of infertility in women coming for infertility treatment in tertiary infertility center. A total of 400 infertile couples who agreed to participate in the study were asked to fill up the questionnaires and later interviewed to access the psychosocial consequences of infertility on their personal life in a tertiary infertility clinic in Dhaka at Center for Assisted Reproduction (CARe Hospital), Dhaka from June 2011 to December 2011 and agreed to participate in the study were included in the study. The data was analyzed and the quantitative and qualitative psychosocial factors were evaluated. Four hundred infertile couple who filled the questionnaires was included in the study. Sixty three percent of the women belonged to age group >20 30 years at the time of interview. Regarding age at marriage 43.8% of the women were married by 20 years, 51.3% were married between 20 30 years. Mean±SD duration of present married life was 7.20±4.45 (range 1 to 28) years and 74.4% of the women were living with their husbands. Of them 75.5% women were housewife. When asked whether they knew what was the reason of infertility in the couple, 32.5% knew the cause was in the female partner, 14.5%, knew the cause was in the male partner, 10.3% knew the cause was in both partners, 21.5% knew cause of infertility was not in any of the partners, and 21.3% had no idea about the cause of infertility. The male partner's response about the issue of prognosis and outcome of couple's infertility revealed 37.3% believed their wives will conceive someday, 31.3% had no intention for a second marriage, 13% were indifferent, 11.3% blamed their wives for infertility and 4.8% threatened for a second marriage. Only 2.5% of the male partners were suggested on consulting and continuing treatment by specialist. The family pressure by in-laws and relatives towards their infertility was that 57.3% insisted on consulting a good gynaecologist, 29.8% had no family pressure, 11.3% insisted the male partners to remarry, and 1.8% insisted the husbands to divorce their wives. In evaluating the social response it showed that 55.8% was suggested to consult a good gynaecologist, 31% asks embarrassing questions, 13% taunted and 0.3% insisted the husband to divorce the wife. In developing countries, despite overpopulation, unwanted childlessness is also an important psychosocial burden that needs attention. The consequences of infertility have greater impact on woman's life and can be a life time crisis. There is no direct intervention regarding infertility from government or NGO's. National services is lacking because policy makers and donor NGOs are not interested to invest on it and also women want to hide their infertility as long as they can.
本研究旨在探究在三级不孕不育治疗中心接受不孕不育治疗的女性,不孕不育所带来的定性和定量的心理社会后果。共有400对同意参与研究的不孕不育夫妇被要求填写问卷,随后接受访谈,以了解在达卡辅助生殖中心(CARE医院),2011年6月至2011年12月期间,不孕不育对他们个人生活的心理社会影响,且同意参与研究的夫妇被纳入研究。对数据进行了分析,并评估了定性和定量的心理社会因素。400对填写了问卷的不孕不育夫妇被纳入研究。63%的女性在接受访谈时年龄在20至30岁之间。关于结婚年龄,43.8%的女性在20岁之前结婚,51.3%的女性在20至30岁之间结婚。目前婚姻生活的平均时长±标准差为7.20±4.45(范围为1至28)年,74.4%的女性与丈夫同住。其中75.5%的女性是家庭主妇。当被问及是否知道夫妻不孕不育的原因时,32.5%的人知道原因在女性伴侣身上,14.5%的人知道原因在男性伴侣身上,10.3%的人知道双方都有原因,21.5%的人知道不孕不育的原因不在任何一方,21.3%的人对不孕不育的原因一无所知。男性伴侣对夫妻不孕不育的预后和结果问题的回答显示,37.3%的人相信他们的妻子总有一天会怀孕,31.3%的人无意再婚,13%的人漠不关心,11.3%的人将不孕不育归咎于他们的妻子,4.8%的人以再婚相威胁。只有2.5%的男性伴侣被建议咨询专家并继续治疗。公婆和亲戚对他们不孕不育施加的家庭压力是,57.3%的人坚持咨询优秀的妇科医生,29.8%的人没有家庭压力,11.3%的人坚持让男性伴侣再婚,1.8%的人坚持让丈夫与妻子离婚。在评估社会反应时发现,55.8%的人被建议咨询优秀的妇科医生,31%的人问令人尴尬的问题,13%的人嘲讽,0.3%的人坚持让丈夫与妻子离婚。在发展中国家,尽管人口过剩,但意外的无子女状态也是一个需要关注的重要心理社会负担。不孕不育的后果对女性生活有更大影响,可能是一场终身危机。政府或非政府组织没有针对不孕不育的直接干预措施。缺乏国家服务,因为政策制定者和捐助型非政府组织对其投资不感兴趣,而且女性也尽可能长时间地隐瞒自己的不孕不育情况。