Relation between sexual function, perceived social support, and adherence to treatment with infertility factor in women: A cross-sectional study


Background: In some societies, childbearing is a part of women’s identity and infertile women are under a great amount of pressure from others.

Objective: This study aims to evaluate the relationship between infertility factors and sexual functioning, perceived social support, and adherence to treatment in infertile women.

Materials and Methods: In this cross-sectional study, 230 infertile women who referred to the infertility center of Shahrekord, Iran in 2022 were enrolled. Data were collected using demographic characteristics checklist, female sexual function index, multidimensional scale of perceived social support, and general adherence scale.

Results: No significant relation was observed between the infertility factor and the mean score of sexual function, the mean score of perceived social support, and the mean score of adherence to treatment (p > 0.05). Among the aspects of sexual functioning, only the mean score of lubrication in the group of male factors was significantly higher than the common factors for men and women (p = 0.07). A linear positive relation was observed between sexual functioning (r = 0.189), perceived social support (r = 0.200), and adherence to treatment (r = 0.146) in infertile women.

Conclusion: By providing proper training and counseling to infertile couples, we can improve their social support and sexual function so that they can complete their infertility treatment as a result.

Key words: Infertility, Sexual health, Social support, Treatment adherence.

[1] Deshpande PS, Gupta ASP. Causes and prevalence of factors causing infertility in a public health facility. J Hum Reprod Sci 2019; 12: 287–293.

[2] Sun H, Gong T-T, Jiang Y-T, Zhang S, Zhao Y-H, Wu QJ. Global, regional, and national prevalence and disability-adjusted life-years for infertility in 195 countries and territories, 1990-2017: Results from a global burden of disease study, 2017. Aging (Albany NY) 2019; 11: 10952– 10991.

[3] De D, Mukhopadhyay P, Roy PK. Experiences of infertile couples of West Bengal with male factor, female factor, and unexplained infertility factor: A qualitative study. J Psychosexual Health 2020; 2: 152–157.

[4] Doryanizadeh L, Morshed-Behbahani B, Parsanezhad ME, Dabbaghmanesh MH, Jokar A. Calcitriol effect on outcomes of in vitro fertilization in infertile women with vitamin D deficiency: A double-blind randomized clinical trial. Z Geburtshilfe Neonatol 2021; 225: 226–231.

[5] Akhondi MM, Ranjbar F, Shirzad M, Behjati Ardakani Z, Kamali K, Mohammad K. Practical difficulties in estimating the prevalence of primary infertility in Iran. Int J Fertil Steril 2019; 13: 113–117.

[6] Sheoran P, Sarin J. Infertility in India: Social, religion and cultural influence. Int J Reprod Contracept Obstet Gynecol 2015; 4: 1783–1788.

[7] Mirzaei M, Namiranian N, Dehghani Firouzabadi R, Gholami S. The prevalence of infertility in 20-49 years women in Yazd, 2014-2015: A cross-sectional study. Int J Reprod BioMed 2018; 16: 683–688.

[8] Mansouri M, Heydar Z, Lotfi R, Rahimzadeh Kiwi M, Tahamtan T. [The relationship between sexual and marital satisfaction level and the causes of infertility in infertile couples who referred to Nahal infertility center in Alborz province]. AUMJ 2021; 11: 34. (in Persian)

[9] Karimi FZ, Taghipour A, Latifnejad Roudsari R, Kimiaee SA, Mazloum SR, Amirian M. Psycho-social effects of male infertility in Iranian women: A qualitative study. Iran J Obstet Gynecol Infertil 2016; 19: 20–32.

[10] Bois K, Bergeron S, Rosen N, Mayrand M-H, Brassard A, Sadikaj G. Intimacy, sexual satisfaction, and sexual distress in vulvodynia couples: An observational study. Health Psychol 2016; 35: 531–540.

[11] Karli P, Ozdemir AZ. Sexual dysfunction in in-vitro fertilization (IVF) patients and the effect of ovarian reserve on sexual dysfunction. Ann Med Res 2019; 26: 1610–1614.

[12] Zare Z, Amirian M, Golmakani N, Mazlom R, Ahangar ML. Sexual dysfunction in infertile women. Int J Reprod BioMed 2016; 14: 89–94.

[13] Sahraian K, Jafarzadeh F, Poursamar SL. [The relationship between social support and marital satisfaction in infertile women based on infertility factor]. Nurs Midwif J 2015; 12: 1104–1109. (in Persian)

[14] Jafarkhany ZSM, Shabanian G, Manzary Tavakoly V. [A comparison of marital adjustment, empathy and positive and negative emotions fertile and infertile women in Kerman]. J Woman Stud Family 2017; 10: 119–136. (in Persian)

[15] Maroufizadeh S, Karimi E, Vesali S, Omani Samani R. Anxiety and depression after failure of assisted reproductive treatment among patients experiencing infertility. Int J Gynecol Obstet 2015; 130: 253–256.

[16] Hwu L-J, Hsu M-Y, Chuang H-L, Shih F-F, Lu Y-CA, Lee S-H. Childbearing perceptions among Taiwanese women undergoing in vitro fertilization treatment: A qualitative study. J Transcult Nurs 2022; 33: 569–575.

[17] Gholamaliei B, Karimi-Shahanjarini A, Roshanaei G, Rezapour-Shahkolaei F. [Medication adherence and its related factors in patients with type II diabetes]. J Educ Community Health 2016; 2: 3–12. (in Persian)

[18] Li S, He A, Yang J, Yin T, Xu W. A logistic regression analysis of factors related to the treatment compliance of infertile patients with polycystic ovary syndrome. J Reprod Med 2011; 56: 325–332.

[19] Mahoney DE, Russell CL, Cheng A-L. Medication adherence among women undergoing infertility treatment: A systematic review. Int J Women’s Health Reprod Sci 2019; 7: 141–149.

[20] Swift A, Reis P, Swanson M. Comparing infertility-related stress, coping, and quality of life among assisted reproductive technology and non-assisted reproductive technology treatments. Hum Fertil 2023: 1–8.

[21] Direkvand-Moghadam A, Delpisheh A, Direkvand- Moghadam A. Effect of infertility on sexual function: A cross-sectional study. J Clin Diagn Res 2015; 9: QC01– QC03.

[22] Oindi FM, Murage A, Lema VM, Mukaindo AM. Association of female sexual dysfunction and fertility: A cross sectional study. Fertil Res Pract 2019; 5: 12.

[23] Nazarpour S, Simbar M, Ramezani Tehrani F, Alavi Majd H. Exercise and sexual dysfunction among postmenopausal women in Iran. Sci J School Public Health 2015; 13: 17–32.

[24] Cheraghi MA, Davari Dolatabadi E. [Development and psychometric evaluation of the heart failure patients’ perceived social support inventory]. J Rafsanjan Univ Med Sci 2016; 15: 195–208. (in Persian)

[25] Bruwer B, Emsley R, Kidd M, Lochner C, Seedat S. Psychometric properties of the multidimensional scale of perceived social support in youth. Compr Psychiatrry 2008; 49: 195–201.

[26] Ozturk A, Aba YA, Sik BA. The relationship between stigma, perceived social support and depression in infertile Turkish women undergoing in vitro fertilizationembryo transfer. Arch Psychiatr Nurs 2021; 35: 434–440.

[27] Avşar B, Emul TG. The relationship between social support perceived by infertile couples and their mental status. Research square 2021.

[28] Hays RD, Kravitz RL, Mazel RM, Sherbourne CD, DiMatteo MR, Rogers WH, et al. The impact of patient adherence on health outcomes for patients with chronic disease in the medical outcomes study. J Behav Med 1994; 17: 347–360.

[29] Bashiri Nejadian A, Bayazi MH, Johari Fard R, Rajaei AR. [The relationship between ambivalence over emotional expression and health-related quality of life and adherence to treatment in cancer patients: The mediating role of depression and social support: A descriptive study]. J Rafsanjan Univ Med Sci 2021; 20: 163–186. (in Persian)

[30] Moridi A, Roozbeh N, Yaghoobi H, Soltani Sh, Dashti S, Shahrahmani N, et al. Etiology and risk factors associated with infertility. Int J Women’s Heal Reprod Sci 2019; 7: 346– 353.

[31] Aramesh Sh, Diba E, Hassanzadeh S, Taghavi SA. [Prevalence of infertility in Boyer-Ahmad city based on SIB system in 2016-2018: A cross sectional Study]. Armaghan Danesh 2020; 25: 487–502. (in Persian)

[32] Janati S, Poormoosavi SM, Tirkesh F. [Survey of the causes of infertility in patients referred to Dezful infertility center from 1393 to 1396]. Jundishapur Sci Med J 2019; 18: 347– 354. (in Persian)

[33] Besharat MA, Lashkari M, Rezazadeh MR. [Explaining adjustment to infertility according to relationship quality, couples’ beliefs and social support]. J Family Psychol 2015; 1: 41–54. (in Persian)

[34] Ataman H, Aygun O, Pekcan N, Dogan Merih Y. The relationship between the perceived social support levels and levels of adjustment to the infertility problem of women who received infertility treatment. Izmir Democracy Univ Health Sci J 2021; 4: 285–301.

[35] Baghiani Moghadam MH, Aminian AH, Abdoli AM, Seighal N, Falahzadeh H, Ghasemi N. Evaluation of the general health of the infertile couples. Iran J Reprod Med 2011; 9: 309–314.

[36] Diamond MP, Legro RS, Coutifaris C, Alvero R, Robinson RD, Casson PA, et al. Sexual function in infertile women with polycystic ovary syndrome and unexplained infertility. Am J Obstet Gynecol 2017; 217: 191. e1–e19.