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.

Gender differences in experiences with and adjustments to infertility: A literature review

“…Studies have reported that the state of infertility is psychologically taxing for women, causing such feelings as depression (Herbert et al, 2010;Nelson et al, 2008;Qi et al, 2008), distress (Fido, 2004;Lansakara et al, 2011;Omoaregba et al, 2011), anxiety (Albayrak and Gunay, 2007), sadness (Umezulike and Efetie, 2004), anger, regret, social isolation, and loss of self-esteem (Behboodi-Moghadam et al, 2013). The prevalence of psychiatric disorders and alexithymia has been found to be higher among women experiencing infertility than among fertile women (Lamas et al, 2006;Noorbala et al, 2008).…”

Gender disparity as a threat to the mental well-being of young Sri Lankan women

“…Motherhood is considered an essential component of a woman's social identity. In Sri Lankan couples suffering from infertility, pressure from the extended family, myths about the responsibility of infertility and poor marital communication could lead to significant psychological distress in young women (Lansakara et al , 2011).…”

Rating Scales validated for Sri Lankan populations

“…It yields an 8-scale profile of functional health and well-being scores as well as psychometrically-based physical and mental health summary measures and a preference-based health utility index. The SF-36 has been modified translated and validated in Sri Lanka (86). The mental health sub components have been translated into Sinhala and used in a study of females with infertility (87).…”