Assessment of socio-demographic factors associated with depression among couples attending a tertiary-care infertility clinic

Background: Infertility rates vary amongst countries from 5%-30%. Data extrapolated from WHO by the Indian council of medical research suggest that approximately 13-19 million couples are likely to be infertile in India at any given time. Many studies give evidence that depression is highly prevalent among infertile couples, especially women. Demographic and social factors are expected to impact the fertility behaviours. It is estimated that psychological factors have an important role in the pathogenesis of infertility. Aim of this study was to assess socio-demographic factors associated with depression among couples attending a tertiary-care infertility clinic. Methods: This cross-sectional study was conducted among 126 infertile couples attending the infertility clinic of government medical college, Thiruvananthapuram, Kerala, India. We used descriptive design as the research design and purposive sampling as sampling technique. PHQ9 depression tool and an interviewer administered semi-structured questionnaire were used in study. Qualitative variables were expressed as frequency and percentages. Chi-square test of independence and Fisher's exact test used to test association between categorical variables as applicable. Results: Among the infertile couples the prevalence of depression was 51.6% (n=65). Depression was more prevalent in females (48.4%, n=61) than in males (33.3%, n=42) and when the reason for infertility was female related. The differences were not statistically significant (p>0.05). The risk of development of depression was significantly high when the other partner had depression (p=0.001, odds ratio=25.196). Presence of children in the family had a significant association with development of depression in infertile couples who belonged to joint or extended family (p=0.020). Depression was significantly associated with social pressure (p=0.021) in female participants and with impaired concentration in both females (p=0.013) and males (p=0.001). Causal relationships could not be established between depression and socio demographic as well as fertility variables due to cross sectional design. Conclusions: Prevalence of depression is comparatively high among infertile females. Support from spouse, family, friends and society have been estimated to have an impact on prevalence of depression. Interventions like counseling and supportive psychotherapy to decrease and prevent development of severe depression among these patients should be considered.