In all, 334 males and 334 females, presenting at the infertility centre for treatment, were enrolled.
Socio-demographic factors of the study participants
Table I is divided into 3 sections: Demographic factors, Socio-economic factors, and Social religious network of the infertile patients presenting at the infertility centre.
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 counterparts (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 counterparts (50%) (p value=0.001). We also observed that a significantly higher proportion of males (46.7%) were heads of the family as compared to females (2.4%) (p value < 0.001). Moreover, a significantly higher proportion of males (8.7%) had more than one marriage as compared to females (3.9%).
Section B of Table 1 describes the socio-economic status of the study participants. 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, PKR 35,000 (20000-50000) (p value < 0.001).
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 to 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 males (92.8%) (p value <0.001).
Resilience, depression, and QoL in infertile males and females
Table II shows resilience, depression, and QoL in 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). The proportion of less resilient females (29.6%) was significantly higher than that of less resilient 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 general health domain, emotional domain, mind and body domain, and relational domain, and the total QoL were significantly higher in 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 the relationship of depression, resilience, and demographic factors with the total quality of life, in males and females presenting for infertility treatment
Table III presents the univariate analysis to assess the relationship of demographic factors, socio-economic factors, resilience, and depression with the total quality of life, in 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 in males and females. We observed that age was not significantly associated with the mean total QoL in males and females. However, mean QoL in males and females who had no formal education was significantly lower, by 9 and 6 units, respectively, as compared to those who had received formal education. Moreover, years of formal education significantly increased the QoL of males and females.
Females who had had arranged marriages their mean QoL was 6 units significantly lower as compared to those who had had love marriages. On the other hand, there was no significant difference in the type of marriage and mean QoL among males. However, there was significant negative association of duration of marriage with QoL among males, but not among females. Moreover, males and females who lived in extended families had significantly higher QoL scores as compared to those who lived in nuclear families. Furthermore, 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 did not take part in decision making.
We also evaluated the relationship of socio-economic factors with mean QoL in males and females. We did not observe any significant association of QoL with working status in males and females. However, in females, those who were working outside their house their QoL was 9 units significantly higher as compared to those who were working from home. Moreover, the QoL was significantly lower among males and females with low total household monthly income. Furthermore, males and females who did not have a television and/or a refrigerator in their house, their own cultivated land, and a vehicle their QoL was significantly lower as compared to those who had any or all of these. Additionally, we observed that the quality of life of males decreased significantly, by 0.6 units, with increase in number of friends; however, this did not have any significant relationship with the QoL of females.
We also evaluated the relationship of resilience and depression with QoL in males and females and we observed that males and females who had low resilience their QoL was 12 and 13 units significantly lower, respectively, as compared to those who had higher resilience. Moreover, QoL in males and females was 21 and 22 units significantly lower, respectively, among those with high depression scores as compared to those with lower scores.
Multivariable analysis to assess the relationship of depression, resilience, and demographic factors with the total quality of life, in males and females presenting for infertility treatment
Table IV shows the multivariable analysis to assess the relationship of demographic factors, socio-economic factors, resilience, and depression with the total quality of life, in males and females presenting for infertility treatment.
We observed that among males resilience and depression had a significant association with QoL, after adjusting for the covariates educational status, monthly income, and number of friends. Males who were less resilient their QoL was 8 units significantly lower as compared to those who were more resilient. Similarly, those males who were depressed their QoL was 17 units significantly lower as compared to those who were not. Moreover, males who had no formal education their QoL was 5 units lower as compared to those who had received formal education. Males whose household monthly income was between 10,000-80,000 PKR their QoL was lower as compared to those who had an income between 80,000-10,000,000 PKR. Furthermore, males who had more friends had lower QoL scores.
We observed that among females resilience and depression had a significant association with QoL, after adjusting for the covariate monthly income. Females who were less resilient their QoL was 8 units lower as compared those who were more resilient. Similarly, those females who were depressed their QoL was 19 units significantly lower as compared to those who were not. Moreover, females whose household monthly income was between 10,000-25,000 PKR their QoL was 7 units significantly lower as compared to those who had an income between 80,000-10,000,000 PKR.