Comparative Study To Determine The Prevalence And Psychosocial Consequences Of Infertility In Rural And Urban Field Practice Areas Of Shri B.M.Patil Medical College, Vijayapur

Abstract

Introduction: Infertility is a public health problem affecting people worldwide from all the communities with various causes. It has an impact on their physical, mental and social well- being. It affects approximately 8-10% couples worldwide. The various psychosocial consequences affecting infertility are lowered self- esteem, marital conflict, sexual conflict, social conflict, depression, financial burden. In developing countries the consequences range from economic hardship to social isolation, violence and denial of proper death rites. Infertility is thus an “ice berg” phenomenon where the majority of the couples are undiagnosed, they suffer from easily treatable conditions but most of them don’t seek treatment. Various socio cultural practices like believing infertility as a curse, seeking healing from super natural powers is still predominant in the community. The thrust areas in the research have been on the correlates of increased fertility and various methods to regulate it and the concept of infertility is neglected. However data from community based studies are scarce in India and available estimates are highly variable. Hence the present study is undertaken to know the prevalence and psychosocial consequences of infertility in a socio-economically backward area i.e., urban slum and rural area. Objectives: 1. To determine and compare the prevalence of primary and secondary infertility in rural and urban field practice areas. 2. To assess and compare the socio – demographic factors and psychosocial consequences associated with infertility. Material and methods: A cross sectional study was conducted in the rural and urban field practice area of a tertiary care hospital. Complete enumeration of all the houses XI under RHTC and UHTC area was done to list all the eligible couple residing in the area and among them those at risk of pregnancy were identified so as to find out couples with either primary or secondary infertility. After obtaining the ethical clearance from the Institutional Ethical committee, the study was undertaken. A pretested, predesigned, semi-structured questionnaire and a validated “Fertility problem inventory scale” was used to assess the psychosocial consequences associated with infertility and impact was seen at four levels i.e., personal impact, sexual impact, marital impact and social impact. Results: A total of 180 participants were included in the study. The prevalence of infertility in rural area was 7.6% and in urban slums it was 8.8%. Majority of the couples had duration of infertility less than 5 years. Visiting religious places was the most common socio-cultural practice (58%) among rural subjects and 42% among urban subjects. Only 38% of the participants sought treatment which was higher among rural residents compared to urban couples and majority waited for the spontaneous conception. Conflict within the marriage was highest among both rural and urban study subjects followed by decline in the sexual relationship, social stigma and personal impact. Conclusion: Infertility affects the couples, not the individual hence the burden is on the family. The findings of the present study revealed that infertile couples have poor well- being on all the dimensions. They have negative feelings, low self-esteem, low social support. There is need of awareness generation among couples through health education activities