Center of Reproductive Medicine, Shengjing Hospital of China Medical University, 110072, Shenyang, China.
Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodelling of Liaoning Province, Shenyang, 110072, China.
Reprod Biol Endocrinol. 2021 Oct 9;19(1):157. doi: 10.1186/s12958-021-00837-7.
Infertility, an important source of stress, could affect sexual life. Extensive studies suggest that the incidence of sexual dysfunction is highly prevalent in infertile women. As the duration of infertility increases, the level of stress is also likely to increase even further, and this could aggravate psychological pain and cause sexual dysfunction. However, the effect of infertility duration on sexual health is unclear.
We conducted a case-control study in which 715 patients participated between September 1,2020 and December 25, 2020. We included patients diagnosed with infertility (aged between 20 to 45), who were divided into four groups according to their infertility durations: ≤ 2 years (Group I, n = 262), > 2 years but ≤ 5 years (Group II, n = 282), > 5 years but ≤ 8 years (Group III, n = 97), and > 8 years (Group IV, n = 74). A questionnaire survey on female sexual functions and psychological depression was administered to participants, and their female sexual functions and depression status were measured using the Female Sexual Function Index (FSFI) and Patient Health Questionnaire (PHQ-9), respectively.
As the number of years of infertility increased, the PHQ-9 score as well as the incidence of psychological depression increased significantly (p < 0.05), but the total score of FSFI and those of its six domains/sub-scales were not significantly different among the four groups. An analysis of the relevant factors affecting sexual functions, using the multivariable logistic regression model, revealed that when the infertility duration was greater than 8 years, there was a significant increase in the incidence of sexual dysfunction [adjusted odds ratios (AOR) = 5.158, 95% confidence interval (CI): 1.935-13.746, P = 0.001], arousal disorder (AOR = 2.955, 95% CI: 1.194-7.314, P = 0.019), coital pain (AOR = 3.811, 95% CI: 1.045-13.897, P = 0.043), and lubrication disorder (AOR = 5.077, 95% CI: 1.340-19.244, P = 0.017).
An increasing infertility duration is a risk factor for the occurrence of sexual dysfunction. Hence, as the infertility duration increases, the incidence of female sexual dysfunction and psychological distress could also increase, especially when the infertility duration is more than 8 years.
不孕是压力的一个重要来源，可能会影响性生活。大量研究表明，不孕女性性功能障碍的发病率很高。随着不孕时间的延长，压力水平也可能进一步升高，这可能会加重心理痛苦并导致性功能障碍。然而，不孕时间对性健康的影响尚不清楚。
我们进行了一项病例对照研究，共有 715 名患者于 2020 年 9 月 1 日至 12 月 25 日参加了研究。我们纳入了诊断为不孕的患者（年龄在 20 至 45 岁之间），并根据不孕时间将他们分为四组：≤2 年（组 I，n=262）、＞2 年但≤5 年（组 II，n=282）、＞5 年但≤8 年（组 III，n=97）和＞8 年（组 IV，n=74）。对参与者进行了女性性功能和心理抑郁的问卷调查，并分别使用女性性功能指数（FSFI）和患者健康问卷（PHQ-9）来测量女性的性功能和抑郁状况。
随着不孕时间的增加，PHQ-9 评分以及心理抑郁的发生率显著升高（p＜0.05），但四组间 FSFI 的总分和六个领域/子量表的得分无显著差异。多变量逻辑回归模型分析影响性功能的相关因素发现，当不孕时间大于 8 年时，性功能障碍的发生率显著增加[校正比值比（AOR）=5.158，95%置信区间（CI）：1.935-13.746，P=0.001]，包括性欲障碍（AOR=2.955，95%CI：1.194-7.314，P=0.019）、性唤起障碍（AOR=3.811，95%CI：1.045-13.897，P=0.043）、性交疼痛（AOR=3.811，95%CI：1.045-13.897，P=0.043）和润滑障碍（AOR=5.077，95%CI：1.340-19.244，P=0.017）。
不孕时间的延长是发生性功能障碍的危险因素。因此，随着不孕时间的延长，女性性功能障碍和心理困扰的发生率也可能增加，特别是当不孕时间超过 8 年时。
