We enrolled 334 males and 334 females presenting to infertility centre for treatment.
Sociodemographic factors of the study participants
Table I is divided into 3 sections; Demographic factors, Socioeconomic factors and Social religious network among infertile patients presenting to the infertility centre.
The Section A of table 1 describes the demographic factors of the study participants. The mean age was significantly higher among males 35.53 ±6.72 as compared to females 30.87 ± 6.12 ( p value 0.001). A higher proportion of males 93.1% had formal education as compared to their counter part (84.19%) (p -value <0.001) with higher median years of education among males as compared to females. However, a higher proportion of females (62.6%) had informal education as compared to their counter parts 50% (p value=0.001). We observed that a significantly higher proportion of males (46.7%) were the head of the family as compared to females (2.4%) (p value < 0.001). A significantly higher proportion of males (8.7%) had more than one marriage as compared to females (3.9%).
The section B of table 1 describes the socioeconomic status of the study participants and we observed that a significantly higher proportion of females (84.4 %) were not working as compared to males (2.4%) (p value < 0.001). The median monthly household income reported by males was significantly higher i.e PKR 50,000 (30,000-90,000) as compared to females 35,000 (20000-50000) (p value < 0.001). The section C of table 1 presents the social/ religious network of the study participants. We observed that the males had a greater number of meet ups with their friends as compared females (p value < 0.001). Moreover, we observed that a significantly higher proportion of females (99.1%) were involved in religious activities as compared to 92.8% males. (p value <0.001)
Resilience, Depression and QoL among infertile males and females
Table II shows resilience, depression and QoL among infertile males and females. We observed that the mean resilience scores were significantly higher among males 77.64 ± 8.56 as compared to females 76.19 ±8.69 (p value = 0.031). A higher proportion of females i.e. 29.6% had lower resilience scores of < 73 as compared to males 21.3%. However, a significantly higher proportion of females were depressed (13.8%) as compared to males (6%). We observed that the mean QoL scores for the following domains (general health , emotional domain, mind and body domain, relational domain and the total QoL was significantly higher among males as compared to females (p value< 0.001), however, Qol for the social domain was not significantly different in both the groups.
Univariate analysis to assess relationship of depression, resilience and demographic factors with total quality of life among males and females presenting for infertility treatment
Table III presents the univariate analysis to assess relationship of demographic factors, socioeconomic factors, resilience and depression with total quality of life among males and females presenting for infertility treatment.
In demographic factors, we evaluated the relationship of; age, educational status, type of marriage, type of family and role in the family with mean QoL among males and females. We observed that among males with everyone unit increase in age the mean total Qol was decreased by 0.043 units (p value < 0.25), however, age was not significantly associated with the mean total QoL of females. Moreover, mean QoL among males and females who had no formal was 9.051 and 6.101 units lower respectively as compared to those who had formal education.. Years of formal education significantly increased the QoL of males and females. The females who had arranged marriage their mean QoL was 6.122units lower as compared to those who had love marriage. However, there was no significant difference in the type of marriage and mean QoL among males. There was significant negative association of duration of marriage with QoL among males but not among females. The males and females who lived in extended families had better QoL as compared to those who lived in nuclear families. Moreover, females who were not the head of the family but took part in decision making their mean QoL was significantly better as compared to those who didn’t take part in decision making.
We also evaluated the relationship of socioeconomic factors with mean QoL among males and females. We observed that the males who were not working their mean QoL was 7.243 unit lower as compared to those who were working. However, no such difference was observed among females but those who were working outside their house their QoL was 9.143 units higher as compared to those who were working from home. The lower the total household monthly income was the lower was the QoL of both males and females. Moreover, males and females who did not have television, refrigerator in their house, their own cultivated land and vehicle their QoL was significantly lower as compared to those who had it. We observed that the quality of life of males decreased by 0.603 units with increase in number of friends, however it did not have any significant relationship with the QoL of females.
We also evaluated relationship of resilience and depression with QoL among males and females and we observed that males and females who had low resilience their QoL was 12.018 and 13.278 units lower respectively as compared to those who had higher resilience. Moreover, QoL among males and females was 21.490 and 22.369 units less respectively among those with high depression scores as compared to their counter parts
Multivariable analysis to assess relationship of depression, resilience and demographic factors with total quality of life among males and females presenting for infertility treatment
Table IV shows the multivariable analysis to assess relationship of demographic factors, socioeconomic factors, resilience and depression with total quality of life among males and females presenting for infertility treatment.
We observed that among males after adjusting for the covariates, resilience, depression, educational status, monthly income and number of friends had a significant association with QoL. The males who were less resilient their QoL was 8.470 units significantly lower as compared those who were more resilient. Similarly, those males who were depressed their QoL was 17.849 units significantly lower as compared their counterparts. Moreover, males who had no formal education their QoL was 5.374 units lower as compared to those who had formal education. Males whose household monthly income was between 10,000-80000PKR their QoL was lower as compared to those who had it between 80000-10000000 PKR.
Furthermore, the males who had more friends had lower QoL scores.
We observed that among females after adjusting for the covariates , resilience , depression, and monthly income, had a significant association with QoL. The females who were less resilient their QoL was 8.606 units lower as compared those who were more resilient. Similarly, those females who were depressed their QoL was 19.387 units significantly lower as compared their counterparts. Moreover, females whose household monthly income was between 10,000-25000 PKR their QoL was 7.249 units significantly lower as compared to those who had it between 80000-10000000 PKR.