Sexual Function of Women with Infertility

Abstract

Objective To assess the sexual function, anxiety, and depression of infertile women relative to a control group.

Methods Infertile women (infertile group, IG) of reproductive age were invited to participate in this controlled study. A control group (CG) of women was recruited from the general population of the same city. Sexual function was assessed by the Female Sexual Function Index (FSFI), and anxiety and depression were measured by the Hospital Anxiety and Depression Scale (HADS).

Results A total of 280 women participated in the present study, 140 in the IG and 140 in the CG. The analysis of the FSFI scores showed that 47 women (33.57%) in the IG and 49 women (35%) in the CG had sexual dysfunction (FSFI ≤ 26.55; p = 0.90). Women with anxiety or depression had a greater risk of sexual dysfunction, and sexual dysfunction increased the risk of anxiety and depression. Married women had a lower risk of depression than single women who were living with their partners.

Conclusion Infertile women had no increased risk of sexual dysfunction relative to controls. Anxiety and depression increased the risk of sexual dysfunction in the studied population.

Resumo

Objetivo Avaliar a função sexual, ansiedade e depressão de mulheres inférteis em relação a um grupo controle.

Métodos Mulheres inférteis (grupo infértil, GI) em idade reprodutiva foram convidadas a participar deste estudo. Um grupo controle (GC) de mulheres foi recrutado da população geral da mesma cidade. A função sexual foi avaliada pelo Índice de Função Sexual Feminina (FSFI, na sigla em inglês), e ansiedade e depressão foram medidas pela Escala Hospitalar de Ansiedade e Depressão (HADS, na sigla em inglês).

Resultados Um total de 280 mulheres participaram deste estudo, sendo 140 no GI e 140 no GC. A análise dos escores do FSFI mostrou que 47 mulheres (33,57%) no GI e 49 mulheres (35%) no GC apresentaram disfunção sexual (FSFI ≤ 26,55; p = 0,90). Mulheres com ansiedade ou depressão tiveram um risco maior de disfunção sexual e a disfunção sexual aumentava o risco de ansiedade e depressão. As mulheres casadas tiveram um risco menor de depressão do que as mulheres amasiadas.

Conclusão As mulheres inférteis não apresentaram risco aumentado de disfunção sexual em relação aos controles. Ansiedade e depressão aumentaram o risco de disfunção sexual na população estudada.

Keywords

Marital Infertility - sexuality - female sexual dysfunction - anxiety - depression - assisted reproduction

Palavras-chave

infertilidade conjugal - sexualidade - disfunção sexual feminina - ansiedade - depressão - reprodução assistida

Contributors

Salomão P. B., Navarro P. A., Romão A. P. M. S., Lerri M. R., and Lara L. A. S. contributed with the project and the interpretation of data, the writing of the article, the critical review of the intellectual content, and with the final approval of the version to be published.

• References

• 1 Boivin J, Bunting L, Collins JA, Nygren KG. International estimates of infertility prevalence and treatment-seeking: potential need and demand for infertility medical care. Hum Reprod 2007; 22 (06) 1506-1512 Doi: 10.1093/humrep/dem046
• 2 Wischmann T, Schilling K, Toth B. , et al. Sexuality, self-esteem and partnership quality in infertile women and men. Geburtshilfe Frauenheilkd 2014; 74 (08) 759-763 Doi: 10.1055/s-0034-1368461
• 3 Hentschel H, Alberton DL, Sawdy RJ, Capp E, Goldim JR, Passos EP. Sexual function in women from infertile couples and in women seeking surgical sterilization. J Sex Marital Ther 2008; 34 (02) 107-114 Doi: 10.1080/00926230701636171
• 4 Keskin U, Coksuer H, Gungor S, Ercan CM, Karasahin KE, Baser I. Differences in prevalence of sexual dysfunction between primary and secondary infertile women. Fertil Steril 2011; 96 (05) 1213-1217 Doi: 10.1016/j.fertnstert.2011.08.007
• 5 Iris A, Aydogan Kirmizi D, Taner CE. Effects of infertility and infertility duration on female sexual functions. Arch Gynecol Obstet 2013; 287 (04) 809-812 Doi: 10.1007/s00404-012-2633-7
• 6 Ferraresi SR, Lara LA, de Sá MF, Reis RM, Rosa e Silva AC. Current research on how infertility affects the sexuality of men and women. Recent Pat Endocr Metab Immune Drug Discov 2013; 7 (03) 198-202
• 7 Domar A, Gordon K, Garcia-Velasco J, La Marca A, Barriere P, Beligotti F. Understanding the perceptions of and emotional barriers to infertility treatment: a survey in four European countries. Hum Reprod 2012; 27 (04) 1073-1079 Doi: 10.1093/humrep/des016
• 8 Kassa M, Abajobir AA, Gedefaw M. Level of male involvement and associated factors in family planning services utilization among married men in Debremarkos town, Northwest Ethiopia. BMC Int Health Hum Rights 2014; 14: 33 Doi: 10.1186/s12914-014-0033-8
• 9 Pacheco Palha A, Lourenço MF. Psychological and cross-cultural aspects of infertility and human sexuality. Adv Psychosom Med 2011; 31: 164-183 Doi: 10.1159/000328922
• 10 Klemetti R, Raitanen J, Sihvo S, Saarni S, Koponen P. Infertility, mental disorders and well-being--a nationwide survey. Acta Obstet Gynecol Scand 2010; 89 (05) 677-682 Doi: 10.3109/00016341003623746
• 11 Revonta M, Raitanen J, Sihvo S. , et al. Health and life style among infertile men and women. Sex Reprod Healthc 2010; 1 (03) 91-98 Doi: 10.1016/j.srhc.2010.06.002
• 12 Galhardo A, Pinto-Gouveia J, Cunha M, Matos M. The impact of shame and self-judgment on psychopathology in infertile patients. Hum Reprod 2011; 26 (09) 2408-2414 Doi: 10.1093/humrep/der209
• 13 Coëffin-Driol C, Giami A. [The impact of infertility and its treatment on sexual life and marital relationships: review of the literature]. Gynecol Obstet Fertil 2004; 32 (7-8): 624-637 Doi: 10.1016/j.gyobfe.2004.06.004
• 14 Prado DS, Mota VP, Lima TI. [Prevalence of sexual dysfunction in two women groups of different socioeconomic status]. Rev Bras Ginecol Obstet 2010; 32 (03) 139-143 Doi: 10.1590/S0100-72032010000300007
• 15 Zegers-Hochschild F, Adamson GD, de Mouzon J. , et al; International Committee for Monitoring Assisted Reproductive Technology; World Health Organization. The International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) Revised Glossary on ART Terminology, 2009. Hum Reprod 2009; 24 (11) 2683-2687 Doi: 10.1093/humrep/dep343
• 16 Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983; 67 (06) 361-370 Doi: 10.1111/j.1600-0447.1983.tb09716.x
• 17 Pacagnella RdeC, Martinez EZ, Vieira EM. [Construct validity of a Portuguese version of the Female Sexual Function Index]. Cad Saude Publica 2009; 25 (11) 2333-2344 Doi: 10.1590/S0102-311 × 2009001100004
• 18 Latorre GFS, Carmona NK, Bilck PA, Berghmans B, Sperandio FF. Cutoff scores for the FSFI. Rev Inspirar Mov Saúde 2015; 7: 23-28
• 19 Hosmer DW, Lemeshow S. Applied logistic regression. 2nd ed. New York, NY: Wiley; 2000. .
• 20 Abdo CH, Oliveira Jr WM, Moreira Jr ED, Fittipaldi JA. Prevalence of sexual dysfunctions and correlated conditions in a sample of Brazilian women--results of the Brazilian study on sexual behavior (BSSB). Int J Impot Res 2004; 16 (02) 160-166 Doi: 10.1038/sj.ijir.3901198
• 21 Nappi RE, Albani F, Valentino V, Polatti F, Chiovato L, Genazzani AR. [Aging and sexuality in women]. Minerva Ginecol 2007; 59 (03) 287-298
• 22 Purifoy FE, Grodsky A, Giambra LM. The relationship of sexual daydreaming to sexual activity, sexual drive, and sexual attitudes for women across the life-span. Arch Sex Behav 1992; 21 (04) 369-385 Doi: 10.1007/BF01542026
• 23 Grøntvedt TV, Kennair LE, Mehmetoglu M. Factors predicting the probability of initiating sexual intercourse by context and sex. Scand J Psychol 2015; 56 (05) 516-526 Doi: 10.1111/sjop.12215
• 24 Carvalheira AA, Brotto LA, Leal I. Women's motivations for sex: exploring the diagnostic and statistical manual, fourth edition, text revision criteria for hypoactive sexual desire and female sexual arousal disorders. J Sex Med 2010; 7: 1454-1463 . Doi: 10.1111/j.1743-6109.2009.01693.x
• 25 Jiann BP, Su CC, Yu CC, Wu TT, Huang JK. Risk factors for individual domains of female sexual function. J Sex Med 2009; 6 (12) 3364-3375 Doi: 10.1111/j.1743-6109.2009.01494.x
• 26 Mirblouk F, Asgharnia DM, Solimani R, Fakor F, Salamat F, Mansoori S. Comparison of sexual dysfunction in women with infertility and without infertility referred to Al-Zahra Hospital in 2013-2014. Int J Reprod Biomed (Yazd) 2016; 14 (02) 117-124
• 27 Mendonça CR, Arruda JT, Amaral WN. [Sexual function in women undergoing assisted reproduction]. Rev Bras Ginecol Obstet 2014; 36 (11) 484-488 Doi: 10.1590/S0100-720320140004952
• 28 Pakpour AH, Yekaninejad MS, Zeidi IM, Burri A. Prevalence and risk factors of the female sexual dysfunction in a sample of infertile Iranian women. Arch Gynecol Obstet 2012; 286 (06) 1589-1596 Doi: 10.1007/s00404-012-2489-x
• 29 Jamali S, Zarei H, Rasekh Jahromi A. The relationship between body mass index and sexual function in infertile women: A cross-sectional survey. Iran J Reprod Med 2014; 12 (03) 189-198
• 30 Herrmann D, Scherg H, Verres R, von Hagens C, Strowitzki T, Wischmann T. Resilience in infertile couples acts as a protective factor against infertility-specific distress and impaired quality of life. J Assist Reprod Genet 2011; 28 (11) 1111-1117 Doi: 10.1007/s10815-011-9637-2