الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Infertility is a traumatic process that negatively affects the lives of women in social-emotional and psychosocial aspects. Infertility is defined as ―a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse‖ according to the World Health Organization (WHO).Patients experiencing infertility have more stress in relationships, thus, a holistic approach integrating quality of life (QOL) into the clinical practice is the best method of treatment for infertility. Consequences of infertility may include psychosocial problems, higher risks of breast, ovarian cancer and high financial costs for those trying infertility treatment. An increased number of studies have evidenced the physical, psychological, ethical, sociocultural, emotional, and financial effects of infertility. Infertile couples or individuals frequently demonstrate signs of stress, anxiety, depression, financial hardships, guilt feeling, fear, loss of social status, despondence, and social labeling. Yet a good number of infertile couples or individuals choose to hide the problem and avoid sharing fertility problem with their families and relatives, which then leave them unsupported. Quality of life (QOL) is an overarching term for the quality of the various domains in life. It is a standard level that consists of the expectations of an individual or society for a good life. These expectations are guided by the values, goals and socio-cultural context in which an individual life. It is a subjective, multidimensional concept that defines a standard level for emotional, physical, material and social well-being. It serves as a reference against which an individual or society can measure the different domains of one‘s own life. Aim of the Study: The study aimed to identify the relation between infertility of women and their quality of life. Subjects and Methods: Research design: A descriptive design was used to conduct this study. Setting: The study was conducted in the infertility and gynecologic outpatient clinic in El Shatby University hospital in Alexandria, It was chosen for conducting this study for many reasons: Firstly it provides services for infertile women in Alexandria as well as El Behera and Kafr Elsheikh governorates secondly; it has the highest attendance rate of infertile women. Subject: A convenient sample of 400 infertile women was chosen from the previous mentioned settings for conducting this study.
Inclusion criteria for infertile women:- Women aged 20-45 years old. Married for more than 12 months. Women experiencing primary or secondary infertility. Not having any chronic disease that can adversely affect quality of life as cancer or liver disease. Women willing to participate in the study. Tools for data collection: In order to collect the necessary data from the study subject, two tools was used to assess the quality of life among infertile women: • Tool 1: Women’s profile structured interview schedule: this tool was developed by the researcher after reviewing the recent literature in order to collect data from the participants. It included the following parts: Part I: Socio-Demographic Data This section consisted of socio-demographic characteristics which include age, duration of marriage, religion, residence (urban, rural), family income, occupation, education Part II: Health History A- Family history as presence of hereditary diseases or genetic disorders. B- Reproductive history as age of menarche, duration of the menstrual cycle & interval between the menstrual cycles, regularity of menstrual period, and presence of any type of gynecological infections, previous fertility testing or treatment, duration of infertility treatment and infertility diagnosis. C- Past medical history as thyroid dysfunction, surgical history, infection as measles or German measles, previous medication and current medications. D- Present history as any complaints (onset & duration). • Tool 2: fertility specific quality of life (FertiQoL tool). The fertiQoL is an internationally developed and validated questionnaire measuring infertility specific quality of life. It consists of 34 items covering two modules (the core module and the treatment module), in addition to two general items measuring overall satisfaction of physical health and QOL. FertiQoL is available in many languages.
It includes the following 1- The two general items: to assess the overall physical health and quality of life satisfaction 2- The core module (24 items) i. Personal quality of life a) The emotional domain (6 items) b) The mind body domain (6 items) ii. Interpersonal quality of life a) The relational domain (6 items) b) The social domain: (6 items) 3- The treatment module (10 items) Administrative Design An official permission to conduct the study obtained from the medical director outpatient clinic and gynecologic outpatient clinic in El Shatby university hospital in Alexandria. The researcher met the hospital director to explain the purpose and the methods of the data collection. Ethical Considerations The research approval was obtained from the Faculty Ethical Committee before starting the study. The ethical research considerations include the following: - Written informed consent was obtained from every woman included in the study after the explanation of the aims of the study and assures them that collected data will be used only for the study purpose and informs them about their voluntary participation. - Confidentiality, privacy and anonymity of individual response were guaranteed by statement in the cover page. - A code number was used instead of names. This helped a lot to ensure their cooperation and gaining their confidence Pilot Study A Pilot study was carried out on 10 % of the selected subject which was composed of 40 women who was chosen randomly and was not be included in the study sample in order to assure the clarity, applicability and comprehension of the tool and identify obstacles and problems that might be encountered during data collection to estimate the time needed for data collection. Accordingly, the necessary modification was done. Some questions were changed, and others were added.
Collection of data: o Establishment of relationship with women was the first step done before data collection o The data was collected individually by interviewing every women fulfilling the inclusion criteria attended the infertility and gynecologic outpatient clinic in El Shatby University hospital after a brief explanation of the purpose and the nature of the research. o Each interview took approximately from 40-60 minutes. o Data was collected over a period of 6 months (from September 2017 to April 2018). Results The findings of the current study can be summarized as: • The mean age of women was 30.55 ± 5.920 years, nearly two fifths (42.3%) of them were illiterate, 54.5% of the studied women were house wives. • The mean age of their husband was 35.32 ± 5.041 years. More than one third (37.3%) of the husbands were illiterate, less than two thirds (59.7%) of them had skilled work, also, more than half (54.5%) of them reported that their husbands weren’t smokers. • Pertaining to family history of infertility, it is clear that, the majority (82.3%) didn’t have history of infertility, less than three quarters (72.0%) of them reported that they had family history of diabetes, more than two thirds (67%) of them had family history of hypertension. • Regarding the obstetric history, about three quarters (74.3%) of the studied women did not have history of vaginal infection. • Relating to the body mass index, less than half (43.5%, 42.5%) were normal and overweight respectively. • The majority (88%) of the studied women didn’t use contraceptives immediately after marriage. Additionally, the majority (98.3%) of the studied women used traditional methods for treating infertility • Regarding the general domain, similar percent of nearly half (45.3%, 44.3%) of the studied women had poor and fair quality of life respectively. Concerning the core module, less than one fifth (16.3) of them had good QOL. The personal QOL represents that more than one fifth (20.5%) had good QOL and more than one tenth (14.0%) of them had poor QOL.