Title

Quality of life and its determinants in subfertile patients seeking fertility care at two urban fertility Centres in Nairobi

Date of Award

2019

Document Type

Dissertation

Degree Name

Master of Medicine (MMed)

First Supervisor/Advisor

Dr. Mukaindo Mwaniki

Second Supervisor/Advisor

Dr. Alfred Murage

Third Supervisor/Advisor

Dr. Angela Koech

Department

Obstetrics and Gynaecology (East Africa)

Abstract

Introduction: Subfertility affects one in six couples worldwide with devastating psychosocial consequences impacting on quality of life (QoL). Assessment of QoL and institution of appropriate interventions in subfertility patients complements clinical management by reducing the psycho-social effects of subfertility and its treatment. No local or regional data exist on impact of subfertility on QoL using a fertility-specific QoL assessment tool.

Objective: The study sought to determine the QoL of subfertile patients seeking fertility care at two urban fertility centres in Nairobi using the Fertility Quality of Life (FertiQoL) tool.

Methods: This was a cross sectional study. Subfertile women of reproductive age (18-49 years) and their partners attending fertility clinics were recruited. Study participants completed the self-administered FertiQoL questionnaire, an internationally validated subfertility-specific tool consisting of 36 questions each on a five-point Likert scale. It assessed QoL in four core subscales (emotional, relational, social and mind/body) and two treatment subscales (tolerability and environment) with higher scores denoting better QoL. Mean FertiQoL scores and standard deviation (SD) were calculated for the total FertiQoL and subscales. Univariate analysis was used to examine association between age, sex, education status, comorbid conditions, duration of subfertility and cause of subfertility with QoL.

Results: A total of 104 participants were recruited. The mean total FertiQoL score was 65.7 (SD=14.5). The mean Core FertiQoL score was 63.9 (SD=16.7). The emotional domain had the lowest mean score (57.5) while the relational domain had the highest mean score (72.5). Age less than 35 years was associated with lower emotional (P<0.04) and mind/body (P<0.03) scores. Previous live birth was associated with higher mind/body score (P<0.01). University education and previous pregnancy were associated with higher treatment environment (P<0.01) and treatment tolerability (P<0.005) scores respectively. Sex, cause of subfertility and type of treatment had no impact on QoL domain scores. No factor showed significant association with the total FertiQoL score.

Conclusion: Study provided baseline QoL for the study population which is similar to that seen in other regions. Age more than 35 years, university education, previous live birth and previous v pregnancy had positive impact on FertiQoL subscales. There is need to assess QoL in subfertility patients using a reliable disease-specific tool such as FertiQoL.

This document is available in the relevant AKU library

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