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Quality of life assessment: A cross-sectional cohort study of women availing oocyte donation with poor ovarian reserve
, Kshitiz Murdia2, Shashank Sanagoudar2,, Sandeep Kumar Panigrahi3, Jyotiranjan Sahoo3, Nihar Ranjan Bhoi2, Walmik Mistari1, Isha Suwalka4
*Corresponding author: Dr. Shashank Sanagoudar, Department of Reproductive Medicine, Indira IVF Hospital Private Limited, Udaipur, Rajasthan, India. drsanagoudar@gmail.com
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Received: ,
Accepted: ,
How to cite this article: Chandra V, Murdia K, Sanagoudar S, Panigrahi SK, Sahoo J, Bhoi NR, et al. Quality of life assessment: A cross-sectional cohort study of women availing oocyte donation with poor ovarian reserve. J Reprod Healthc Med. 2025;6:22. doi: 10.25259/JRHM_18_2025
Abstract
Objectives:
This is multi-centric cross-sectional study aimed to assess the quality of life (QOL) in infertile couples with poor ovarian reserve requiring donor oocytes.
Materials and Methods:
A total of 968 participants were included in the study. Various socio-demographic parameters, including gender, religion, residence, occupation, family income, and previous childbirth status, were analyzed. QOL was assessed using the World Health Organization (Quality of life BREF) questionnaire, which evaluates four domains: Physical health, psychological well-being, social relationships, and environment. The questionnaire also included questions related to overall QOL and general health.
Results:
Participants were predominantly females (94.0%), Hindus (85.4%) by belief, and resided in urban areas (66.4%). About 72.6% comprised homemakers. Housewives constituted the most common occupation (72.6%), and a significant proportion had an annual family income ranging between 50K to 2.5L (31.2%). About 61.0% of females were found to be infertile. Female factor infertility was the primary cause of infertility (study was conducted on poor ovarian reserve (POR), causing ovum donation to be featured in the result) (61.0%). The overall QOL mean score was 71.41 ± 23.76, featuring 46.8% rated as good, 24.2% rated as very good, with 46.8% rating it as good and 24.2% as very good. The mean physical health score was 68.56 illustrating moderate level of health conditions affecting health activities (cronbach’s α= 0.75). The mean psychological score was 72.58 ± 18.41, with moderate levels of enjoyment of life and life meaningfulness, but also with frequent reports of negative feelings.
Conclusion:
The study highlights the importance of providing appropriate support and interventions to address the physical, psychological, social, and environmental aspects affecting the QOL of couples.
Keywords
Assisted reproductive technologies
Donor oocyte in vitro fertilization
Psychological well-being
Quality of life
INTRODUCTION
Infertility is a significant reproductive health concern affecting couples worldwide.[1] It is defined as the inability to conceive or carry a pregnancy to term after a year or more of regular unprotected sexual intercourse. While infertility can have various causes, one common factor contributing to fertility challenges is poor ovarian reserve (POR).[2] POR refers to a reduced quantity and quality of oocytes. POR is often associated with advanced maternal age, previous ovarian surgeries, exposure to certain toxins, or genetic factors.[3,4]
Advancements in medical technology have offered assisted reproductive technology (ART) as a ray of hope for couples facing childlessness. ART, such as in vitro fertilization (IVF) and intracytoplasmic sperm injection, has revolutionized infertility treatment and enabled many couples to achieve parenthood. However, couples with poor ovarian reserve may face significant challenges with conventional ART as their impaired ovarian function hinders the production of reproducible oocytes.
For couples with POR who desire to have a child biologically related to them, a donor oocyte is a viable option.[5] Donor oocyte IVF involves retrieving oocytes from a healthy young donor, fertilizing them with the intended father’s sperm (of the commissioning couple), and transferring the resulting embryos into the uterus of the intended mother (or gestational carrier). While this technique offers hope and the possibility of parenthood, it also brings forth various emotional, psychological, and social implications for the couples involved.[6]
The psychological and emotional aspects of infertility, particularly when coupled with the use of donor oocytes, can significantly impact the quality of life (QOL) of the affected couples. QOL is a multidimensional construct that encompasses a couple’s physical health, emotional well-being, social relationships, and overall life satisfaction. Understanding the QOL of couples with POR is crucial as it can provide valuable insights into their experiences, coping mechanisms, and areas where they may need additional support.[7]
Prior research[8-10] has explored the QOL of couples undergoing conventional IVF treatments, but there is a paucity of comprehensive studies focusing specifically on the QOL of those utilizing donor oocytes due to POR. Therefore, this multi-centric cross-sectional study aims to bridge that gap by evaluating the QOL of infertile couples who require donor oocytes for achieving parenthood. Using established QOL assessment tools such as the World Health Organization (WHO) QOL-BREF and fertility QOL (FertiQoL), the study seeks to quantify various aspects of the participants’ QOL and compare them across different demographic subgroups.
There is a substantial body of research examining the psychological and emotional aspects of infertility, including the impact of ART on QOL. There remains a notable research gap when it comes to couples with (POR) who require donor oocytes for fertility treatment.
The findings of this study can have important implications for fertility counseling, support services, and the overall well-being of couples pursuing parenthood through donor oocyte IVF. It may shed light on potential areas where targeted interventions or psychosocial support could be reproductive medicine and assist healthcare providers in delivering more patient-centered and holistic care to this specific population.
Understanding the QOL of couples with POR who require donor oocytes is crucial for several reasons, as there has been research on QOL in the context of infertility and ART; there is a dearth of comprehensive studies focusing specifically on this subgroup. This study aims to fill that gap. The use of donor oocytes is a unique aspect of fertility treatment that can have significant psychological and emotional implications. It is important to explore how this impacts the QOL of those involved. This study is novel as the study exclusively examines the QOL of those utilizing donor oocytes for fertility treatment, shedding light on the specific challenges and experiences associated with this approach.
This study aims to estimate the impact of infertility on the physical, psychological, social, and environmental status of couples choosing donor oocyte as a treatment modality for infertility using the standard tool (WHO QOL and FertiQoL).
MATERIALS AND METHODS
Study design
This is a multi-centric cross-sectional design.
Objective/research question
To assess the QOL in infertile couples with POR who require donor oocytes for ART.
Hypothesis
Is there any impact on physical, psychological, social, and environmental factors of quality of life in infertile couples with POR undergoing ART with donor oocytes.
Selection of participants
Couples diagnosed with POR and planning to undergo ART with donor oocytes are recruited as the study’s participants. A total of 968 participants were recruited from multiple fertility clinics of Indira IVF center across different regions to expedite it.
Ethical considerations
Ethics approval was taken from the Hospital Ethics Committee (ECR/1627/Inst/WB/2021). The researchers obtained ethical approval from relevant institutional review boards before commencing the study. This ensures that the rights, safety, and well-being of the participants are protected.
Informed consent is obtained from all participants, clarifying the study’s purpose, the nature of their participation, and data confidentiality. Study is Clinical Trials Registry-India (CTRI) Registered - CTRI/2022/06/043228.
Data collection
To assess the QOL, the study used established and validated QOL questionnaires such as the WHO QOL-BREF and FertiQoL. The WHO QOL-BREF questionnaire covers four domains – physical, psychological, social, and environmental – to assess overall QOL. The FertiQoL is a fertility-specific questionnaire that evaluates the QOL specifically in the context of infertility and assisted reproductive techniques. All the participants were informed, and a written consent was taken. Either husband or wife was considered as a couple participant. The couple was questioned separately. The responses were recorded by one of the research coordinators trained with the tool. The participants’ demographic data, including age, gender, educational background, marital status, and duration of infertility, are collected. These factors could potentially influence the QOL and need to be controlled for in the analysis.
Questionnaire tool and evaluation
To evaluate the general QOL, we employed the WHO QOL Assessment (WHO QOL-BREF) questionnaire, consisting of 26 items. This instrument encompasses four domains: physical health (seven items), psychological health (six items), social relationships (three items), and environmental health (eight items). It also includes items related to QoL and general health. Each item in the WHO QOL-BREF is rated on a scale from 1 to 5. We calculated the mean score for each domain after summing a couple of item scores. Following the methodology, we transformed these domain scores to a 0-to-100-point scale using the WHO-QoL transformation table. A higher score on these four questionnaires indicates better QoL. FertiQoL is a reliable and sensitive measurement tool specifically designed for assessing the QOL in couples dealing with fertility issues. FertiQoL comprises 36 items, each scored on a 0-to-4 response scale. Higher scores reflect a higher QOL. FertiQoL provides six subscales and three total scales, each ranging from 0 to 100, based on the questionnaire’s orientation. This questionnaire consists of two major components: Core FertiQoL, encompassing emotional, mind/body, relational, and social subscales. Regarding the reliability of each questionnaire utilized, we assessed their reliability using Cronbach’s alpha coefficient analysis. The obtained reliability coefficients were acceptable for all the tools: WHO physical domain (0.75), WHO psychiatric domain (0.80), WHO social domain (0.73), WHO environment domain (0.90), WHO Overall (0.80), and Core FertiQoL (0.89).
Statistical analysis
The WHO QOL-BREF questionnaire consists of 26 items grouped into four domains: Physical health, psychological health, social relationships, and environmental health. Each item is scored from 1 to 5, and domain scores were transformed to a 0-to-100-point scale. Higher scores indicate better QoL. FertiQoL, designed for couples with fertility problems, includes 36 items with a range of 0–4 on the response scale. Higher scores signify higher QoL. Reliability analysis (Cronbach’s alpha) showed acceptable reliability for all questionnaires, including WHO domains and Core (FertiQoL). Results were reported as mean ± SD (standard deviation) for quantitative variables and number (percentages) for categorical variables. Statistical tests such as Mann–Whitney U and Kruskal–Wallis were used for quantitative variable comparisons. All analyses were conducted at a 95% significance level using the Statistical Package for the Social Sciences 28.0 software.
RESULTS
A total of 968 participants were recruited from fertility clinics across diverse geographic locations, and their QOL was assessed using two established tools: The WHO QOLBREF and the FertiQoL questionnaire. The study group predominantly comprised females aged 36–45 years (93.9%). Most participants identified as Hindu (85.8%) and resided in urban areas (66.5%). Educationally, the majority had more than 10 years of schooling (83.5%), while a substantial portion were housewives (72.7%) with an annual family income of ≤5 lakhs (61.5%). Notably, a large proportion had no living children (89.4%), belonged to nuclear families (61.2%), and had a BMI ≥25 (49.5%). Moreover, a minority reported using tobacco (1.1%) or alcohol (2.2%), while 15.6% were affected by chronic diseases.
The assessment of well-being using the WHOQOL questionnaire revealed in Table 1 as moderate to good scores across different domains. Participants scored moderately in physical health (68.56) and social relationships (71.06) while scoring well in psychological (72.69) and environmental (74.39) domains. The overall well-being assessment (WHOQOL BREF) averaged at 71.62, indicating a good perception of well-being among participants.
| Characteristics | Categories | n(%) |
|---|---|---|
| Age | 25–35 years | 399 (41.2) |
| 36–45 years | 569 (58.8) | |
| Gender | Male | 59 (6.1) |
| Female | 909 (93.9) | |
| Religion | Hindu | 831 (85.8) |
| Muslim | 111 (11.5) | |
| Others | 26 (2.7) | |
| Residential status | Urban | 644 (66.5) |
| Rural | 324 (33.5) | |
| Education level | <10 years of education | 160 (16.5) |
| ≥10 years of education | 808 (83.5) | |
| Occupation | Housewife | 704 (72.7) |
| Gainfully employed | 264 (27.3) | |
| Annual family income (INR) | ≤5 lakhs (INR) | 595 (61.5) |
| >5 lakhs (INR) | 373 (38.5) | |
| Any living children | Yes | 103 (10.6) |
| No | 865 (89.4) | |
| Number of children | None | 865 (89.4) |
| One or more | 103 (10.6) | |
| Type of family | Nuclear | 592 (61.2) |
| Joint | 376 (38.8) | |
| Number of family members | ≤5 members | 778 (80.4) |
| >5 members | 190 (19.6) | |
| Body mass index | <18.5 | 48 (5.0) |
| 18.5–22.9 | 239 (24.7) | |
| 23–24.9 | 202 (20.9) | |
| ≥25 | 479 (49.5) | |
| Current use of tobacco | Yes | 11 (1.1) |
| No | 957 (98.9) | |
| Current alcohol consumption history | Yes | 21 (2.2) |
| No | 947 (97.8) | |
| Suffering from any chronic disease | No | 817 (84.4) |
| Yes | 151 (15.6) | |
| Years of infertility | <5 years | 322 (33.3) |
| 5–10 years | 381 (39.4) | |
| >10 years | 265 (27.4) | |
| Cause of infertility | Female factor | 590 (61.0) |
| Male factor | 27 (2.8) | |
| Both | 236 (24.4) | |
| Unknown | 115 (11.9) | |
| History of treatment for infertility | Yes | 679 (70.1) |
| No | 289 (29.9) | |
| Number of medical consultations for infertility | ≤5 consultations | 872 (90.1) |
| >5 consultations | 96 (9.9) | |
| Number of failures after IVF treatment | None | 692 (71.5) |
| <2 | 230 (23.8) | |
| ≥2 | 46 (4.8) |
IVF: In vitro fertilization, INR: Indian rupees
Regarding fertility-related quality of life assessed through the Core FertiQoL questionnaire, emotional aspects scored lower (62.33), while mind/body (69.48), relationship (68.05), and social domains (69.28) were moderately rated [Table 2]. However, the overall assessment of fertility-related quality of life (Core FertiQoL) yielded a high score of 73.34, signifying a positive perception of fertility-related aspects among the study population [Table 3].
| Subscales of WHO QOL | Mean | SD | Cronbach (α) |
|---|---|---|---|
| WHO physical health domain | 68.56 | 17.02 | 0.75 |
| WHO psychological domain | 72.69 | 18.39 | 0.80 |
| WHO social relationship domain | 71.06 | 21.48 | 0.73 |
| WHO environment domain | 74.39 | 18.70 | 0.90 |
| WHO QOL BREF | 71.62 | 23.62 | 0.80 |
SD: Standard deviation, WHO: World Health Organization, QOL: Quality of life
| Subscales of core (FertiQoL) | Mean | SD | Cronbach (α) |
|---|---|---|---|
| FertiI emotional domain | 62.33 | 18.01 | 0.67 |
| FertiI mind/body domain | 69.48 | 18.94 | 0.78 |
| FertiI relationship domain | 68.05 | 15.99 | 0.65 |
| FertiI social domain | 69.28 | 18.62 | 0.67 |
| Core (FertiQoL) | 73.34 | 18.70 | 0.89 |
SD: Standard deviation, FertiQoL: Fertility quality of life
In the analysis of [Table 4], which delves into a comparison of WHO domain mean scores across diverse demographic characteristics from a participant pool of 968 couples, several significant observations emerge. Notably, certain demographic factors exhibit strong associations with QOL scores in various domains. For instance, males tend to score higher than females across all domains, with statistically significant differences. Similarly, urban residents generally exhibit higher scores compared to their rural counterparts. Factors such as education level, occupation, annual family income, presence of living children, and even specific health conditions such as chronic diseases and years of infertility, showcase varying impacts on the WHO QOL scores across different domains [Figures 1-4].
| Characteristics (n=968) | Categories | Total WHO QOL | Physical health | Psychological | |||||
|---|---|---|---|---|---|---|---|---|---|
| Mean | SD | P-value | Mean | SD | P-value | Mean | |||
| Age | 25–35 years | 71.55 | 22.39 | 0.567 | 69.00 | 16.23 | 0.612 | 73.39 | |
| 36–45 years | 71.66 | 24.46 | 68.25 | 17.56 | 72.20 | ||||
| Gender | Male | 88.98 | 18.72 | <0.001 | 80.32 | 14.82 | <0.001 | 88.14 | |
| Female | 70.49 | 23.47 | 67.80 | 16.88 | 71.69 | ||||
| Religion | Hindu | 72.83 | 23.31 | <0.001 | 68.96 | 16.93 | 0.07 | 73.59 | |
| Muslim | 62.61 | 24.51 | 64.95 | 17.36 | 65.93 | ||||
| Others | 71.15 | 22.01 | 71.31 | 17.05 | 72.96 | ||||
| Residential status | Urban | 73.49 | 23.17 | <0.001 | 70.27 | 16.77 | <0.001 | 75.21 | |
| Rural | 67.90 | 24.08 | 65.17 | 17.03 | 67.68 | ||||
| Education level | <10 years of education | 69.69 | 26.65 | 0.561 | 65.24 | 19.11 | 0.010 | 68.99 | |
| ≥10 years of education | 72.00 | 22.97 | 69.22 | 16.51 | 73.42 | ||||
| Occupation | Housewife | 70.56 | 23.34 | 0.012 | 67.98 | 16.72 | 0.063 | 71.13 | |
| Gainfully Employed | 74.43 | 24.17 | 70.10 | 17.72 | 76.86 | ||||
| Annual family income (INR) | ≤5 lakhs (INR) | 72.65 | 23.81 | 0.049 | 70.51 | 16.92 | <0.001 | 72.33 | |
| >5 lakhs (INR) | 69.97 | 23.25 | 65.45 | 16.74 | 73.28 | ||||
| Any living children | Yes | 74.51 | 24.24 | 0.115 | 75.06 | 16.55 | <0.001 | 76.16 | |
| No | 71.27 | 23.53 | 67.79 | 16.92 | 72.28 | ||||
| Number of children | None | 71.27 | 23.54 | 0.115 | 67.79 | 16.92 | <0.001 | 72.28 | |
| One or more | 74.51 | 24.25 | 75.06 | 16.56 | 76.16 | ||||
| Type of family | Nuclear | 72.47 | 24.25 | 0.586 | 68.85 | 17.78 | 0.190 | 73.34 | |
| Joint | 70.28 | 22.56 | 68.11 | 15.75 | 71.67 | ||||
| Number of family members | ≤5 members | 71.72 | 24.21 | 0.506 | 68.34 | 17.15 | 0.394 | 72.82 | |
| >5 members | 71.18 | 21.09 | 69.46 | 16.48 | 72.15 | ||||
| Body mass index (BMI) | <18.5 | 75.52 | 21.56 | 0.657 | 69.19 | 18.07 | 0.362 | 71.67 | |
| 18.5–22.9 | 71.97 | 22.42 | 68.65 | 16.56 | 72.98 | ||||
| 23–24.9 | 70.79 | 23.68 | 66.56 | 17.88 | 72.08 | ||||
| ≥25 | 71.40 | 24.39 | 69.30 | 16.75 | 72.91 | ||||
| Current use of Tobacco | Yes | 79.55 | 24.54 | 0.200 | 71.36 | 13.26 | 0.572 | 79.64 | |
| No | 71.53 | 23.60 | 68.53 | 17.06 | 72.61 | ||||
| Current alcohol consumption history | Yes | 80.95 | 23.59 | 0.046 | 71.38 | 16.19 | 0.446 | 82.67 | |
| No | 71.41 | 23.59 | 68.50 | 17.04 | 72.47 | ||||
| Suffering from any chronic disease | No | 72.34 | 23.02 | 0.076 | 68.61 | 17.23 | 0.936 | 73.08 | |
| Yes | 67.72 | 26.39 | 68.28 | 15.89 | 70.60 | ||||
| Years of infertility | <5 years | 75.85 | 22.17 | <0.001 | 73.66 | 16.52 | <0.001 | 77.81 | |
| 5–10 years | 69.62 | 23.45 | 67.84 | 16.38 | 72.09 | ||||
| >10 years | 69.34 | 24.92 | 63.40 | 16.83 | 67.34 | ||||
| Cause of infertility | Female factor | 74.03 | 22.75 | <0.001 | 70.98 | 16.81 | <0.001 | 75.56 | |
| Male factor | 75.00 | 15.50 | 63.52 | 16.50 | 74.04 | ||||
| Both | 67.69 | 25.30 | 67.30 | 16.71 | 70.63 | ||||
| Unknown | 66.52 | 24.31 | 59.92 | 15.64 | 61.89 | ||||
| History of treatment for infertility | Yes | 69.81 | 23.70 | <0.001 | 66.95 | 16.55 | <0.001 | 71.09 | |
| No | 75.87 | 22.90 | 72.35 | 17.51 | 76.46 | ||||
| Number of medical consultations for infertility before coming to this Center | ≤5 Consultations | 72.16 | 23.47 | 0.036 | 68.78 | 16.94 | 0.269 | 72.94 | |
| >5 Consultations | 66.67 | 24.51 | 66.55 | 17.70 | 70.42 | ||||
| Number of failures to conceive after IVF treatment | None | 73.09 | 23.08 | 0.012 | 69.18 | 17.24 | 0.434 | 74.20 | |
| <2 | 67.93 | 23.98 | 67.11 | 16.45 | 69.14 | ||||
| ≥2 | 67.93 | 27.72 | 66.52 | 16.29 | 67.85 | ||||
| Characteristics (n=968) | Categories | Psychological | Social Relationship | Environment | |||||
| SD | P-value | Mean | SD | P-value | Mean | SD | P-value | ||
| Age | 25–35 years | 16.76 | 0.722 | 71.43 | 19.70 | 0.958 | 74.82 | 16.94 | 0.979 |
| 36–45 years | 19.46 | 70.79 | 22.65 | 74.08 | 19.85 | ||||
| Gender | Male | 13.65 | <0.001 | 87.37 | 19.00 | <0.001 | 90.32 | 13.65 | <0.001 |
| Female | 18.22 | 70.00 | 21.20 | 73.35 | 18.52 | ||||
| Religion | Hindu | 18.15 | <0.001 | 72.02 | 21.14 | <0.001 | 75.32 | 18.53 | <0.001 |
| Muslim | 19.43 | 62.82 | 23.18 | 67.02 | 19.04 | ||||
| Others | 16.10 | 75.31 | 16.79 | 75.85 | 16.21 | ||||
| Residential status | Urban | 17.85 | <0.001 | 74.37 | 20.41 | <0.001 | 77.08 | 18.09 | <0.001 |
| Rural | 18.43 | 64.48 | 22.04 | 69.04 | 18.76 | ||||
| Education level | <10 years of education | 20.80 | 0.032 | 65.92 | 25.38 | 0.012 | 71.17 | 21.97 | 0.137 |
| ≥10 years of education | 17.81 | 72.07 | 20.48 | 75.02 | 17.93 | ||||
| Occupation | Housewife | 18.47 | <0.001 | 68.73 | 21.51 | <0.001 | 72.78 | 18.78 | <0.001 |
| Gainfully Employed | 17.56 | 77.27 | 20.13 | 78.66 | 17.84 | ||||
| Annual family income (INR) | ≤5 lakhs (INR) | 19.37 | 0.634 | 69.01 | 22.78 | <0.001 | 74.03 | 19.63 | 0.640 |
| >5 lakhs (INR) | 16.75 | 74.32 | 18.79 | 74.96 | 17.13 | ||||
| Any living children | Yes | 19.16 | 0.033 | 75.71 | 21.37 | 0.015 | 78.23 | 19.18 | 0.019 |
| No | 18.27 | 70.50 | 21.43 | 73.93 | 18.60 | ||||
| Number of children | None | 18.27 | 0.033 | 70.50 | 21.43 | 0.015 | 79.93 | 18.60 | 0.019 |
| One or more | 19.16 | 75.71 | 21.37 | 78.23 | 19.19 | ||||
| Type of family | Nuclear | 19.15 | 0.320 | 72.22 | 22.00 | 0.049 | 75.18 | 19.51 | 0.029 |
| Joint | 17.12 | 69.22 | 20.51 | 73.13 | 17.30 | ||||
| Number of family members | ≤5 members | 18.76 | 0.494 | 71.38 | 21.79 | 0.216 | 74.44 | 19.07 | 0.747 |
| >5 members | 16.87 | 69.75 | 20.14 | 74.16 | 17.14 | ||||
| Body mass index (BMI) | <18.5 | 19.85 | 0.947 | 68.81 | 22.13 | 0.578 | 75.71 | 18.43 | 0.974 |
| 18.5–22.9 | 18.16 | 70.28 | 20.59 | 74.14 | 18.72 | ||||
| 23–24.9 | 18.67 | 71.53 | 22.18 | 73.99 | 19.36 | ||||
| ≥25 | 18.29 | 71.47 | 21.58 | 74.55 | 18.47 | ||||
| Current use of Tobacco | Yes | 16.88 | 0.224 | 71.27 | 31.50 | 0.577 | 83.29 | 19.32 | 0.208 |
| No | 18.40 | 71.05 | 21.36 | 74.19 | 18.65 | ||||
| Current alcohol consumption history | Yes | 16.07 | 0.010 | 78.24 | 25.78 | 0.049 | 83.29 | 19.32 | 0.015 |
| No | 18.39 | 70.90 | 21.36 | 74.19 | 18.65 | ||||
| Suffering from any chronic disease | No | 18.05 | 0.190 | 71.34 | 21.08 | 0.524 | 74.43 | 18.62 | 0.692 |
| Yes | 20.13 | 69.51 | 23.49 | 74.17 | 19.13 | ||||
| Years of infertility | <5 years | 17.72 | <0.001 | 75.82 | 20.71 | <0.001 | 79.70 | 17.79 | <0.001 |
| 5–10 years | 17.13 | 70.38 | 20.64 | 73.40 | 17.53 | ||||
| >10 years | 19.34 | 66.25 | 22.43 | 69.34 | 19.81 | ||||
| Cause of infertility | Female factor | 18.32 | <0.001 | 74.57 | 20.79 | <0.001 | 77.43 | 18.18 | <0.001 |
| Male factor | 11.57 | 73.70 | 17.71 | 75.33 | 13.07 | ||||
| Both | 17.40 | 65.94 | 21.16 | 72.24 | 17.32 | ||||
| Unknown | 17.67 | 62.93 | 22.29 | 62.94 | 20.28 | ||||
| History of treatment for infertility | Yes | 18.37 | <0.001 | 69.39 | 21.47 | <0.001 | 72.80 | 18.76 | <0.001 |
| No | 17.02 | 74.96 | 21.01 | 78.12 | 18.03 | ||||
| Number of medical consultations for infertility before coming to this Center | ≤5 Consultations | 18.34 | 0.209 | 71.56 | 21.59 | 0.012 | 74.59 | 18.79 | 0.237 |
| >5 Consultations | 18.82 | 66.45 | 19.93 | 72.53 | 17.81 | ||||
| Number of failures to conceive after IVF treatment | None | 17.67 | <0.001 | 71.81 | 21.47 | 0.173 | 75.70 | 18.21 | 0.001 |
| <2 | 19.30 | 68.75 | 21.32 | 70.80 | 19.16 | ||||
| <2 | 21.42 | 71.17 | 22.07 | 72.52 | 21.33 | ||||
SD: Standard deviation, WHO: World Health Organization, QOL: Quality of life, IVF:In vitro fertilization. P-value<0.005 is significant, all bold values are significant.
- Transformed scores of the World Health Organization quality of life-BREF wrt age. WHO QOL: World Health Organization Quality of Life.
- Transformed scores of the World Health Organization quality of life-BREF wrt gender. WHO QOL: World Health Organization Quality of Life.
- Transformed scores of the World Health Organization quality of life-BREF wrt years of infertility. WHO QOL: World Health Organization Quality of Life.
- Transformed scores of the World Health Organization quality of life-BREF wrt cause of infertility. WHO QOL: World Health Organization Quality of Life, IVF: In vitro fertilization.
Furthermore, [Table 5], a multiple linear regression analysis focusing on infertile couples with poor ovarian reserve, sheds light on the factors significantly influencing a poor QOL. This regression model reveals that gender, religion, annual family income, presence of chronic diseases, duration of infertility, causes of infertility, and treatment history are among the factors showing significant associations with the total WHO QOL scores. These findings underscore the multifaceted nature of influences on the QOL among couples, especially those grappling with infertility issues [Figures 5-7].
| Characteristics (n=968) | Total WHOQOL | |||
|---|---|---|---|---|
| β | SE | t-value | P-value | |
| Intercept | 95.3 | 7.58 | 12.56 | <0.001 |
| Gender | −16.55 | 3.53 | −4.67 | <0.001 |
| Religion | −5.91 | 1.66 | −3.55 | 0.0004 |
| Residential status | −3.11 | 1.62 | −1.91 | 0.055 |
| Occupation | 0.81 | 1.83 | 0.45 | 0.65 |
| Annual family income (INR) | −3.33 | 1.57 | −2.11 | 0.034 |
| Number of children | −2.24 | 2.37 | −0.94 | 0.34 |
| Current use of tobacco | −2.46 | 8.5 | −0.29 | 0.77 |
| Current alcohol consumption history | 3.47 | 6.6 | 0.52 | 0.59 |
| Suffering from any chronic disease | −4.33 | 2.03 | −2.12 | 0.033 |
| Years of infertility | −1.77 | 1.01 | −1.75 | 0.07 |
| Cause of infertility | −2.68 | 0.66 | −4.03 | <0.001 |
| History of treatment for infertility | 5.28 | 1.74 | 3.03 | 0.002 |
| Number of medical consultations for infertility before coming to this center | −1.98 | 1.39 | −1.42 | 0.155 |
| Number of failures to conceive after IVF treatment | −2.26 | 2.53 | −0.89 | 0.372 |
SE: Standard errors, WHO: World Health Organization, QOL: Quality of life, IVF:In vitro fertilization. P-value<0.005 is significant, all bold values are significant.
- Transformed scores of the World Health Organization quality of life-BREF wrt History of treatment for infertility. WHO QOL: World Health Organization Quality of Life.
- Transformed scores of the World Health Organization quality of life-BREF wrt in vitro fertilization consultation. WHO QOL: World Health Organization Quality of Life.
- Transformed Scores of the World Health Organization quality of life-BREF wrt history of number of failures to conceive after in vitro fertilization treatment. WHO QOL: World Health Organization Quality of Life.
Figure 8 illustrates the fertiQOl tool score across two subgroup: 25-35years and 36-45 years The emotional domain score was higher in lower age group (25-35years) compared to higher age (36-45 years) . Overall scores across all the domains were between the two groups.
- Transformed scores of Feryi quality of life – with respect to age. QOL: Quality of life.
In Table 6, notable findings emerge across different demographics in FertiQoL scores. For instance, males significantly scored higher than females across all domains (Total FertiQoL, Emotional, Mind/Body, Relationship, and Social), with scores like 92.85 (Male) versus 72.08 (Female) in total FertiQoL, emphasizing gender-based disparities. In addition, religious affiliation demonstrated substantial differences, such as the mean score for the Hindu group (74.2) compared to the Muslim group (66.59) in the total FertiQoL domain, revealing religious influences on perceived QOL.
| Characteristics (n=968) | Categories | Total FertiQoL | Emotional domain | Mind/body | |||||
|---|---|---|---|---|---|---|---|---|---|
| Mean | SD | P-value | Mean | SD | P-value | Mean | |||
| Age | 25–35 years | 72.71 | 17.95 | 0.286 | 63.97 | 17.17 | 0.010 | 69.89 | |
| 36–45 years | 73.79 | 19.97 | 61.18 | 18.50 | 69.20 | ||||
| Gender | Male | 92.85 | 14.10 | <0.001 | 65.44 | 10.22 | 0.111 | 79.41 | |
| Female | 72.08 | 18.76 | 62.13 | 18.39 | 68.84 | ||||
| Religion | Hindu | 74.2 | 18.75 | <0.001 | 62.94 | 17.59 | 0.031 | 70.09 | |
| Muslim | 66.59 | 21.54 | 57.87 | 21.35 | 64.71 | ||||
| Others | 74.73 | 16.25 | 62.04 | 12.98 | 70.46 | ||||
| Residential status | Urban | 76.00 | 18.68 | <0.001 | 63.76 | 17.22 | <0.001 | 71.69 | |
| Rural | 68.06 | 19.03 | 59.49 | 19.23 | 65.10 | ||||
| Education level | <10 years of education | 72.21 | 22.92 | 0.743 | 59.78 | 18.62 | 0.141 | 68.08 | |
| ≥10 years of education | 73.57 | 18.34 | 62.84 | 17.86 | 69.76 | ||||
| Occupation | Housewife | 72.11 | 19.43 | 0.010 | 62.23 | 18.81 | 0.591 | 68.25 | |
| Gainfully Employed | 76.63 | 18.07 | 62.61 | 15.72 | 72.78 | ||||
| Annual family income (INR) | ≤5 lakhs (INR) | 74.13 | 20.33 | 0.054 | 62.54 | 19.28 | 0.858 | 68.94 | |
| >5 lakhs (INR) | 72.09 | 17.10 | 62.00 | 15.81 | 70.35 | ||||
| Any living children | Yes | 78.36 | 19.19 | 0.003 | 70.06 | 16.2 | <0.001 | 74.23 | |
| No | 72.75 | 19.08 | 61.41 | 18.00 | 68.92 | ||||
| Number of children | None | 72.75 | 19.08 | 0.003 | 61.41 | 18.00 | <0.001 | 68.92 | |
| One or More | 78.36 | 19.19 | 70.06 | 16.2 | 74.23 | ||||
| Type of family | Nuclear | 73.96 | 19.96 | 0.205 | 62.81 | 18.89 | 0.224 | 70.14 | |
| Joint | 72.36 | 17.82 | 61.57 | 16.53 | 68.46 | ||||
| Number of family members | ≤5 members | 73.26 | 19.57 | 0.622 | 62.48 | 18.03 | 0.434 | 69.74 | |
| >5 members | 73.67 | 17.47 | 61.74 | 17.95 | 68.46 | ||||
| Body mass index | <18.5 | 75.92 | 18.92 | 0.810 | 63.85 | 19.7 | 0.390 | 68.71 | |
| 18.5–22.9 | 73.45 | 18.42 | 63.85 | 17.59 | 69.61 | ||||
| 23–24.9 | 72.94 | 19.42 | 62.33 | 17.28 | 70.7 | ||||
| ≥25 | 73.20 | 19.48 | 61.43 | 18.34 | 68.99 | ||||
| Current use of Tobacco | Yes | 89.82 | 12.62 | 0.002 | 66.00 | 20.22 | 0.571 | 73.45 | |
| No | 73.15 | 19.15 | 62.29 | 17.99 | 69.44 | ||||
| Current alcohol consumption history | Yes | 88.14 | 14.51 | <0.001 | 63.86 | 16.53 | 0.804 | 74.71 | |
| No | 73.01 | 19.13 | 62.30 | 18.05 | 69.37 | ||||
| Suffering From any chronic disease | No | 73.43 | 18.96 | 0.991 | 62.9 | 18.24 | 0.007 | 70.21 | |
| Yes | 72.85 | 20.26 | 59.27 | 16.47 | 65.56 | ||||
| Years of infertility | <5 years | 77.71 | 18.69 | <0.001 | 65.43 | 19.21 | <0.001 | 72.05 | |
| 5–10 years | 71.84 | 18.44 | 62.19 | 16.58 | 70.01 | ||||
| >10 years | 70.20 | 19.86 | 58.76 | 17.89 | 65.61 | ||||
| Cause of infertility | Female factor | 76.37 | 18.9 | <0.001 | 63.84 | 18.42 | <0.001 | 71.75 | |
| Male factor | 72.00 | 9.41 | 63.93 | 15.84 | 75.56 | ||||
| Both | 70.26 | 18.81 | 60.97 | 18.63 | 66.21 | ||||
| Unknown | 64.45 | 19.30 | 57.04 | 13.50 | 63.18 | ||||
| History of treatment for infertility | Yes | 71.95 | 19.12 | <0.001 | 60.82 | 17.63 | <0.001 | 68.39 | |
| No | 76.62 | 18.9 | 65.9 | 18.43 | 72.06 | ||||
| Number of medical consultations for infertility before coming to this Center | ≤5 consultations | 73.57 | 19.07 | 0.350 | 62.39 | 17.72 | 0.633 | 69.72 | |
| >5 consultations | 71.30 | 19.94 | 61.85 | 20.55 | 67.30 | ||||
| Number of failures to conceive after IVF treatment | None | 74.66 | 18.88 | 0.005 | 64.16 | 18.11 | <0.001 | 71.14 | |
| <2 | 70.16 | 19.07 | 57.52 | 17.27 | 65.10 | ||||
| ≥2 | 69.43 | 21.65 | 58.93 | 15.42 | 66.48 | ||||
| Characteristics (n=968) | Categories | Mind/body | Relationship | Social | |||||
| SD | P-value | Mean | SD | P-value | Mean | SD | P-value | ||
| Age | 25–35 years | 18.25 | 0.676 | 67.87 | 14.97 | 0.776 | 69.05 | 18.29 | 0.690 |
| 36–45 years | 19.42 | 68.17 | 16.68 | 69.44 | 18.54 | ||||
| Gender | Male | 13.56 | <0.001 | 88.76 | 15.20 | <0.001 | 79.12 | 11.21 | <0.001 |
| Female | 19.06 | 66.7 | 15 | 68.64 | 18.82 | ||||
| Religion | Hindu | 18.62 | 0.033 | 68.55 | 15.92 | <0.001 | 70.21 | 18.19 | <0.001 |
| Muslim | 20.47 | 62.82 | 15.32 | 61.69 | 20.81 | ||||
| Others | 19.94 | 74.23 | 16.54 | 71.65 | 14.68 | ||||
| Residential status | Urban | 18.29 | <0.001 | 70.62 | 16.57 | <0.001 | 71.38 | 17.82 | <0.001 |
| Rural | 19.46 | 62.94 | 13.41 | 65.10 | 19.46 | ||||
| Education level | <10 years of education | 19.59 | 0.338 | 67.19 | 19.95 | 0.149 | 66.60 | 18.58 | 0.073 |
| ≥10 years of education | 18.80 | 68.22 | 15.10 | 69.81 | 18.59 | ||||
| Occupation | Housewife | 19.09 | <0.001 | 66.17 | 15.01 | <0.001 | 68.39 | 19.07 | 0.008 |
| Gainfully Employed | 18.15 | 73.03 | 17.43 | 71.65 | 17.15 | ||||
| Annual family income (INR) | ≤5 lakhs (INR) | 18.78 | 0.157 | 68.91 | 16.68 | 0.010 | 70.02 | 19.77 | 0.091 |
| >5 lakhs (INR) | 19.18 | 66.66 | 14.75 | 68.10 | 16.56 | ||||
| Any living children | Yes | 18.81 | 0.003 | 69.94 | 17.48 | 0.218 | 73.9 | 18.72 | 0.006 |
| No | 18.88 | 67.82 | 15.80 | 68.72 | 18.53 | ||||
| Number of children | None | 18.88 | 0.003 | 67.82 | 15.80 | 0.218 | 68.72 | 18.53 | 0.006 |
| One or More | 18.81 | 69.94 | 17.48 | 73.90 | 18.72 | ||||
| Type of family | Nuclear | 19.71 | 0.078 | 68.57 | 16.35 | 0.146 | 69.27 | 19.4 | 0.774 |
| Joint | 17.63 | 67.21 | 15.4 | 69.29 | 17.34 | ||||
| Number of family members | ≤5 members | 19.09 | 0.323 | 68.34 | 16.25 | 0.392 | 68.94 | 18.63 | 0.368 |
| >5 members | 18.32 | 66.85 | 14.87 | 70.65 | 18.54 | ||||
| Body mass index | <18.5 | 19.58 | 0.642 | 65.85 | 15.98 | 0.402 | 68.56 | 21.44 | 0.515 |
| 18.5–22.9 | 18.46 | 68.18 | 15.82 | 71.21 | 17.55 | ||||
| 23–24.9 | 19.36 | 67.14 | 16.33 | 69.04 | 18.15 | ||||
| ≥25 | 18.96 | 68.58 | 15.96 | 68.48 | 19.01 | ||||
| Current use of Tobacco | Yes | 15.78 | 0.559 | 77.00 | 21.73 | 0.117 | 73.18 | 20.14 | 0.489 |
| No | 18.97 | 67.94 | 15.90 | 69.23 | 18.60 | ||||
| Current alcohol consumption history | Yes | 15.65 | 0.209 | 82.52 | 19.15 | <0.001 | 76.19 | 18.61 | 0.037 |
| No | 18.99 | 67.72 | 15.78 | 69.12 | 18.59 | ||||
| Suffering From any chronic disease | No | 19.06 | 0.006 | 67.62 | 15.87 | 0.099 | 69.51 | 18.33 | 0.643 |
| Yes | 17.82 | 70.33 | 16.49 | 67.99 | 20.13 | ||||
| Years of infertility | <5 years | 19.53 | <0.001 | 71.76 | 14.97 | <0.001 | 72.24 | 19.83 | <0.001 |
| 5–10 years | 17.63 | 67.27 | 16.10 | 69.55 | 16.70 | ||||
| >10 years | 19.47 | 64.65 | 16.19 | 65.28 | 19.05 | ||||
| Cause of infertility | Female factor | 18.82 | <0.001 | 71.95 | 15.88 | <0.001 | 72.61 | 18.03 | <0.001 |
| Male factor | 18.87 | 63.00 | 12.49 | 65.74 | 17.42 | ||||
| Both | 18.60 | 64.97 | 14.20 | 65.79 | 20.11 | ||||
| Unknown | 17.86 | 55.50 | 12.33 | 60.18 | 13.67 | ||||
| History of treatment for infertility | Yes | 18.51 | 0.002 | 67.63 | 16.02 | 0.217 | 68.22 | 18.56 | 0.022 |
| No | 19.69 | 69.02 | 15.91 | 71.77 | 18.54 | ||||
| Number of medical consultations for infertility before coming to this Center | ≤5 consultations | 18.93 | 0.141 | 68.30 | 16.13 | 0.208 | 69.31 | 18.55 | 0.686 |
| >5 consultations | 19.03 | 65.77 | 14.59 | 68.98 | 19.29 | ||||
| Number of failures to conceive after IVF treatment | None | 18.79 | <0.001 | 68.32 | 15.82 | 0.652 | 70.34 | 18.14 | 0.081 |
| <2 | 18.62 | 67.28 | 16.24 | 66.35 | 19.84 | ||||
| ≥2 | 19.18 | 67.76 | 17.53 | 67.96 | 18.13 | ||||
SD: Standard deviation, ANOVA: Analysis of variance, FertiQoL: Fertility quality of life, IVF:In vitro fertilization. P-value<0.005 is significant, all bold values are significant
In Table 7, the multiple linear regression analysis underscores crucial factors impacting FertiQoL scores among couples with poor ovarian reserve. Gender appears to be a significant influencer, with a regression coefficient of −17.79, showcasing its substantial negative effect on FertiQoL scores. Religion also holds significance, indicated by the regression coefficient of −4.23, suggesting its impact on reducing the overall QOL perception among couples in the study. Moreover, the years of infertility demonstrate a negative correlation, denoted by the coefficient of −1.91, indicating a decline in FertiQoL scores with increased years of dealing with infertility.
| Characteristics (n=968) | Total WHO QOL | |||
|---|---|---|---|---|
| β | SE | t-value | P-value | |
| Intercept | 108.13 | 5.86 | 18.44 | <0.001 |
| Gender | −17.79 | 2.74 | −6.48 | <0.001 |
| Religion | −4.23 | 1.29 | −3.27 | 0.0011 |
| Residential status | −4.96 | 1.26 | −3.93 | <0.001 |
| Occupation | 0.36 | 1.42 | 0.25 | 0.79 |
| Annual family income (INR) | −2.67 | 1.22 | −2.18 | 0.029 |
| Number of children | −4.63 | 1.84 | −2.51 | 0.012 |
| Current use of tobacco | −8.59 | 6.60 | −1.3 | 0.193 |
| Current alcohol consumption history | 1.86 | 5.13 | 0.36 | 0.716 |
| Years of infertility | −1.91 | 0.77 | −2.47 | 0.013 |
| Cause of infertility | −3.09 | 0.51 | −6.01 | <0.001 |
| History of treatment for infertility | 4.40 | 1.34 | 3.28 | 0.0011 |
| Number of failures to conceive after IVF treatment | −2.32 | 1.07 | −2.16 | 0.030 |
SE: Standard errors, FertiQoL: Fertility quality of life, IVF:In vitro fertilization. P-value<0.005 is significant, all bold values are significant
DISCUSSION
The present study aimed to investigate the multifaceted impact of various variables on the QOL experienced by couples undergoing fertility treatment.
The analysis was conducted across four distinct domains of well-being: Physical health, psychological well-being, social relationships, and environment, as outlined in Tables 3 (WHO QOL) and 4 (FertiQOL).
WHO QOL
Physical health domain
The mean score of 68.56 indicates a moderate level of perceived physical health, with a relatively moderate consistency (Cronbach’s α = 0.75). Gender differences were pronounced, with males consistently reporting higher scores than females, suggesting a potential disparity in perceived physical health related to infertility. Urban residents also tended to rate their physical health higher compared to rural couples. Significant associations exist between perceived physical health and the overall QOL among infertile patients.[4,6] Factors such as gender, religion, income, and chronic diseases impact how patients assess their physical well-being, which consequently influences their overall QOL.
Psychological domain
Participants reported a somewhat higher level of psychological well-being, with a mean score of 72.69 and good internal consistency (Cronbach’s α = 0.80). Gender variations were evident, with males consistently reporting better psychological well-being than females. Hindus and couples from other religious backgrounds generally reported higher psychological well-being compared to Muslims. Gainfully employed couples also tended to report better psychological health. Psychological well-being significantly influences the overall QOL for infertile patients. Elements such as the cause of infertility, treatment history, and potentially gender and religion are linked to how patients perceive their psychological state, impacting their overall QOL assessments.
Social relationship domain
The average score of 71.06 reflects a reasonably satisfactory perception of social relationships, with acceptable reliability (Cronbach’s α = 0.73). Across this domain, gender disparities persisted, with males reporting better social relationship perceptions than females. Urban residents tended to rate their social relationships higher compared to rural couples. Gainfully employed participants also reported stronger social relationships. The quality of social relationships plays a substantial role in determining the overall QOL among infertile patients. Factors such as gender, religion, and aspects related to infertility cause and treatment history influence how patients view their social connections, subsequently impacting their overall well-being assessment.
Environment domain
Gender differences were again noticeable, with males consistently reporting better perceptions of their environment than females. Hindus and couples from other religious backgrounds tended to perceive a more favorable environment compared to Muslims. Urban residents also rated their environment more positively compared to rural couples. Perceptions of the environment, influenced by factors such as gender and religion, also contribute to the overall QOL of infertile patients. How patients perceive their surroundings, potentially influenced by sociocultural factors, contributes to their overall well-being assessment.
FertiQoL
Emotional domain
Emotional well-being significantly differs across age groups, with those aged 25-35 exhibiting higher scores. Gender, religion, residential status, education level, occupation, annual family income, the presence of living children, and the type of family also contribute to variations in emotional well-being.
Mind/body domain
Significant differences are observed in the mind/body domain based on gender, religion, residential status, education level, occupation, annual family income, the presence of living children, the type of family, body mass index (BMI), current use of tobacco, alcohol consumption history, suffering from chronic disease, years of infertility, cause of infertility, history of treatment, and the number of failures to conceive after IVF treatment.
Relationship domain
Relationship well-being is notably affected by age, gender, religion, residential status, education level, occupation, annual family income, the presence of living children, the type of family, BMI, current use of tobacco, alcohol consumption history, suffering from chronic disease, years of infertility, cause of infertility, history of treatment, and the number of failures to conceive after IVF treatment.
Social domain
Social well-being is significantly influenced by age, gender, religion, residential status, education level, occupation, annual family income, the presence of living children, the type of family, BMI, current use of tobacco, alcohol consumption history, suffering from chronic disease, years of infertility, cause of infertility, history of treatment, and the number of failures to conceive after IVF treatment.
Comparing our findings with existing literature, our study provides novel insights into the nuanced relationship between demographic characteristics and QOL among couples experiencing infertility. However, limitations include the study’s cross-sectional nature, which restricts establishing causality, and the reliance on self-reported measures, potentially introducing bias. Nonetheless, the strengths lie in the robust sample size and the comprehensive assessment across multiple domains, contributing significantly to the existing body of knowledge on infertility and QOL.
Previous research underscores the considerable impact of gender disparities on QOL, with females consistently reporting lower scores across emotional, social, and psychological domains compared to males. This echoes the gender-related differences highlighted by Ojo et al.[7] and supports the notion that gender plays a pivotal role in shaping QOL perceptions within the infertility spectrum.
The observations resonate with the results of Wang et al. showing the influence of sociocultural factors, such as religion and residential status, on QOL.[8] These factors contribute significantly to the holistic well-being of couples experiencing infertility, emphasizing the need for tailored interventions sensitive to cultural and residential nuances.[8]
The multiple linear regression analysis presented in Table 5 findings shows the prolonged duration of infertility as a crucial factor adversely affecting QOL among affected couples. The correlation between duration of infertility and poorer QOL underscores the persistent psychological burden associated with prolonged struggles[10-12] to conceive.
Moreover, our study’s exploration of FertiQoL scores in Tables 6 and 7 contributes novel insights, substantiating previous findings by[8] regarding the impact of demographic characteristics on specific domains of QOL related to infertility. This supports the evolving understanding that demographic variables, including religious beliefs, number of living children, and the cause of infertility, intricately shape emotional, relational, and social aspects of couples’ lives affected by infertility.[13,14]
Although the study is multi-centric and observational, the findings do not include certain parameters which avoid generalizable to all infertile couples, especially those outside the geographic or cultural context of the study. Some important factors such as mental health history, partner dynamics, support systems, or cultural attitudes toward infertility may influence QoL but were not included in the regression model. Hence, a proper longitudinal study is required with follow-up.
CONCLUSION
As the journey of infertility can be emotionally and physically challenging, healthcare professionals and support networks should be attuned to these aspects and offer tailored assistance to address the specific needs of these patients. The implications of these findings are crucial for healthcare providers and policymakers involved in ART. The research findings affirm that couples grappling with infertility, who opt for donor oocyte treatment, observe significant improvements across multiple domains of life. These encompass physical, psychological, social, and environmental aspects, as measured by the WHO QOL and FertiQOL tools. This underscores the holistic and positive impact of donor oocyte treatment on the QOL for couples experiencing infertility.
Ethical Approval:
The research/study approved by the Institutional Review Board at Indira IVF Hospital Limited Institutional Ethics Committee, number ECR/1627/Inst/WB/2021, dated 20th February, 2022.
Declaration of patients’ consent:
The authors certify that they have obtained all appropriate patient consent.
Conflicts of interest:
There are no conflicts of interest.
Use of artificial intelligence (AI)-assisted technology for manuscript preparation:
The authors confirm that there was no use of artificial intelligence (AI)-assisted technology for assisting in the writing or editing of the manuscript and no images were manipulated using AI.
Financial support and sponsorship: Nil.
References
- Prevalence of infertility in the United States as estimated by the current duration approach and a traditional constructed approach. Fertil Steril. 2013;99:1324-31.e1.
- [CrossRef] [PubMed] [Google Scholar]
- Managing poor ovarian response in the patient with diminished ovarian reserve. Fertil Steril. 2022;117:655-6.
- [CrossRef] [PubMed] [Google Scholar]
- Depression and quality of life in older persons: A review. Dement Geriatr Cogn Disorg. 2015;40:311-39.
- [CrossRef] [PubMed] [Google Scholar]
- American association of clinical endocrinologists and American college of endocrinology comprehensive clinical practice guidelines for medical care of patients with obesity. Endocr Pract. 2016;22:1-203.
- [CrossRef] [PubMed] [Google Scholar]
- Short-term, low-dose, non-steroidal anti-inflammatory drug application diminishes premature ovulation in natural-cycle IVF. Reprod Biomed Online. 2012;24:308-13.
- [CrossRef] [PubMed] [Google Scholar]
- Differences in fertility-related quality of life and emotional status among women undergoing different IVF treatment cycles. Psychol Res Behav Manag. 2023;16:1873-82.
- [CrossRef] [PubMed] [Google Scholar]
- The effect of enteral tube feeding on patients' health-related quality of life: A systematic review. Nutrients. 2019;11:1046.
- [CrossRef] [PubMed] [Google Scholar]
- Sexual function, self-esteem, and quality of life in infertile couples undergoing in vitro fertilization: A dyadic approach. Psychol Res Behav Manag. 2022;15:2449-59.
- [CrossRef] [PubMed] [Google Scholar]
- Ovarian reserve testing: A user's guide. Am J Obstet Gynecol. 2017;217:129-40.
- [CrossRef] [PubMed] [Google Scholar]
- Factors associated with poor ovarian reserve in young infertile women: A hospital-based cohort study. J Hum Reprod Sci. 2023;16:140-7.
- [CrossRef] [PubMed] [Google Scholar]
- Assessment of quality of life in infertility treated women in Poland. Int J Environ Res Public Health. 2021;18:4275.
- [CrossRef] [PubMed] [Google Scholar]
- A new more detailed stratification of low responders to ovarian stimulation: From a poor ovarian response to a low prognosis concept. Fertil Steril. 2016;105:1452-3.
- [CrossRef] [PubMed] [Google Scholar]
- Reframing QoL assessment in persons with neurodevelopmental disorders. Ann Ist Super Sanita. 2020;56:180-92.
- [Google Scholar]
- The effect of alterations in consciousness on quality of life (QoL) in epilepsy: Searching for evidence. Behav Neurol. 2011;24:83-93.
- [CrossRef] [PubMed] [Google Scholar]