The present study was a descriptive-analytical cross-sectional study which evaluated the relation between infertility factor and sexual function, perceived social support and adherence to treatment in infertile women.
In the present study the most prevalent type of infertility was female infertility (41.3%) and among the female infertility factors, polycystic ovarian syndrome (51.8%) was the most common cause, which was in line with the results of most of the conducted studies (1, 41–43). But in the study by Jannati et al (2019), the most prevalent type of infertility was reported as male infertility, which was different from the results of the present study (28). The difference in these results might be due to the climatic differences of the studied areas and also their cultural and social characteristics. Also, among the studied participants the most common cause of male infertility was varicocele. In a similar study that was conducted by Moridi et al (2019), also, the most common cause of male infertility was reported as varicocele (42). However some other studies have mentioned oligospermia disorder and impaired sperm motility as the most common cause of male infertility (1, 43, 44). In these studies, only spermogram was evaluated to investigate male infertility factor while in the present study other causes of infertility such as anatomical causes like varicocele were also investigated and therefore, the results of the present study has been different from the results of those previous studies.
Results of the present study showed that 174 participants (75.7%) had sexual dysfunction and 56 participant (24.3%) did not have sexual dysfunction meaning that most of the infertile women are suffering from sexual dysfunction. In the study by Karli et al (2019) 93.9% of the individuals with unknown cause of infertility and 89.6% of the participants with ovarian laziness, had sexual dysfunction (45). But in the study by Oindi et al (2019) 31.2% of infertile women had sexual dysfunction and most of them had desirable sexual functionality (46). The difference between the results of this study and the resent study might be due to the differences in study design such as having a control group and smaller sample size in the mentioned study and also cultural differences, since sampling of these studies have been conducted in different countries.
The mean score of perceived social support and adherence to treatment in the present study was similar to most of the previously conducted studies and had a desirable level (28, 30, 47). In the study of Ataman et al (2021) the perceived social support by infertile women who participated in the study was low and undesirable (48). In the study of Ataman studied participants were under IVF treatment while in the present study participated women were receiving all types of infertility treatment. In the study by Li et al (2011), which evaluated the effective factors on adherence to treatment in infertile women suffering from polycystic ovarian syndrome, it was revealed that 25.6% of the participants had a desirable level of adherence to treatment (29). In the mentioned study, only women suffering from ovarian laziness were studied; the sample size was smaller and the questionnaires were also different.
According to the results, among the aspects of sexual function, there was a significant relation only between lubrication and infertility factor in a way that the mean score of lubrication was significantly higher in the group with male infertility in comparison to the group with joint male and female infertility. Also, in the study by Karli et al (2019), no significant relation was observed between the mean of women’s sexual functionality and its aspect with infertility factors (45). However in the study by Baghiani Moghadam et al (2011) (49) and Shuji et al (2014) (50), sexual functionality and sexual satisfaction of infertile women had a lower level than infertile men. In the study by Diamond et al (2017), which evaluated sexual functionality in infertile women suffering from polycystic ovarian syndrome, no significant relation was observed between sexual arousal, orgasm, and satisfaction with infertility factors; but the score of sexual desire was significantly higher in women suffering from polycystic ovarian syndrome and also the score of seual pain as significantly higher in the group suffering from infertility with unknown cause (51). This contradiction between the mentioned results with the present study might be due to the difference in the used data gathering tools and sample size. Also cultural and behavioral differences might be effective on the sexual functionality of the couples.
No significant relation was observed between the perceived social support and adherence to treatment with the infertility factor in the present study. In line with the present study, no significant difference was observed between perceived social support and its aspects with infertility factors in the studies conducted by Ataman et al (2021) and Ozturk et al (2021) (48). Desirable adherence to treatment in the present study despite its costs and problems might be influenced by the love for having a child and the importance of childbearing in Iranian culture (32).
There was a linear positive relation between sexual function, perceived social support and adherence to treatment in the studied infertile women in a way that improvement of perceived social support would led to better sexual functionality and more adherence to treatment in infertile women; some other studies have also reported similar results, revealing that improvement of perceived social support have caused better sexual functionality and even more adherence to treatment (18, 40, 47). In the conducted researches, no studies were found with conflicting results and this indicates a significant relation between these factors and also the importance of supportive factors and the effect of receiving support from the spouse, family and friends on acceptance of and adherence to treatment in infertile women.