Journal of Reproduction & Infertility

Journal of Reproduction & Infertility

Depression Among Infertile Men in the Gaza Strip, Palestine: The Neglected Aspect of Fertility Care

Authors
1 Reproductive Health Department, Nursing and Midwifery School, Tehran University of Medical Science, Tehran, Iran; Midwifery Department, Nursing School, Islamic University of Gaza, Gaza Strip, Gaza Strip, Palestine
2 Faculty of Medical Sciences, Israa University-Gaza, Gaza Strip, Palestine; Unit of Planning and Policy Formulation, Palestinian Ministry of Health, Gaza, Palestine
3 Shifa Medical Compound, Palestinian Ministry of Health, Gaza, Palestine
4 Directorate General of Primary Healthcare, Ministry of Health, Gaza Strip, Palestine
5 Reproductive Health Department, Nursing and Midwifery School, Tehran University of Medical Science, Tehran, Iran
6 Directorate General of Mental Health, Ministry of Health, Gaza Strip, Palestine
Abstract
Background: Infertility is a worldwide public health problem and affects psychological aspects of males’ and females’ life. However, the problem has not been well investigated in Palestine. Therefore, the purpose of this study was to determine prevalence and predictors of depression among infertile men in the Gaza strip. Methods: A cross-sectional study was carried out among three hundred eighty five infertile males from January to December 2019. Participants were selected from three main in-vitro fertilization (IVF) centers following simple random sampling. The Arabic version of Beck Depression Inventory was used. Descriptive and inferential analyses were performed using the SPSS V22. Binary analysis was done to determine independent variables and t-test and one-way ANOVA were conducted afterwards. Logistic regression was performed to determine independent factors associated with depression symptoms. The p-value of 0.05 or less was considered statistically significant. Results: Findings showed that 42.6% (164/385) of infertile men had at least one type of depression. Severe depression was presented in 16.6% (64/164) of participants, while 13.2% (51/164) and 12.7% (49/164) showed moderate and mild depression, respectively. Predictors for depression were duration of marriage (>8 years) (CI 95%: 1.099-2.615) and at least one IVF attempt (CI 95%: 0.373-0.873). Conclusion: It has been revealed that depression is prevalent among infertile men. Marriage of long duration and several failures in IVF attempts are predictors for depressions. Psychological counseling besides medical interventions seems to be an optimal strategy to alleviate psychological distress associated with infertility.
Keywords

  1. Pozzilli P, Lenzi A, Clarke L, Young WF. Imaging in Endocrinology. 1st ed. USA:Wiley; 2014. 248 p.
  2. Rowe PJ, Comhaire FH, Hargreave TB, Mahmoud AM. WHO manual for the standardized investigation and diagnosis of the infertile male. 1st ed. UK: Cambridge University Press; 2000. 102 p.
  3. Punab M, Poolamets O, Paju P, Vihljajev V, Pomm K, Ladva R, et al. Causes of male infertility: a 9-year prospective monocentre study on 1737 patients with reduced total sperm counts. Hum Reprod. 2017;32(1):18-31.
  4. Shindel AW, Nelson CJ, Naughton CK, Ohebshalom M, Mulhall JP. Sexual function and quality of life in the male partner of infertile couples: prevalence and correlates of dysfunction. J Urol. 2008;179(3):1056-9.
  5. Donarelli Z, Lo Coco G, Gullo S, Marino A, Volpes A, Allegra A. Are attachment dimensions associated with infertility-related stress in couples undergoing their first IVF treatment? a study on the individual and cross-partner effect. Hum Reprod. 2012;27(11):3215-25.
  6. Fassino S, Piero A, Boggio S, Piccioni V, Garzaro L. Anxiety, depression and anger suppression in infertile couples: a controlled study. Hum Reprod. 2002;17(11):2986-94.
  7. Péloquin K, Brassard A, Arpin V, Sabourin S, Wright J. Whose fault is it? blame predicting psychological adjustment and couple satisfaction in couples seeking fertility treatment. J Psychosom Obstet Gynaecol. 2018;39(1):64-72.
  8. El Kissi Y, Romdhane AB, Hidar S, Bannour S, Idrissi KA, Khairi H, et al. General psychopathology, anxiety, depression and self-esteem in couples undergoing infertility treatment: a comparative study between men and women. Eur J Obstet Gynecol Reprod Biol. 2013;167(2):185-9.
  9. Gourounti K, Anagnostopoulos F, Vaslamatzis G. Primary appraisal of infertility: evaluation of the psychometric properties of a Greek version of the appraisal of life events scale (ALE) in a sample of infertile women undergoing fertility treatment. Women Health. 2010;50(7):688-704.
  10. Boivin J, Griffiths E, Venetis CA. Emotional distress in infertile women and failure of assisted reproductive technologies: meta-analysis of prospective psychosocial studies. BMJ. 2011;342:d223.
  11. Jongbloed-Pereboom M, Middelburg K, Heineman M, Bos A, Haadsma M, Hadders-Algra M. The impact of IVF/ICSI on parental well-being and anxiety 1 year after childbirth. Hum Reprod. 2012;27(8):2389-95.
  12. Yang B, Zhang J, Qi Y, Wang P, Jiang R, Li H. Assessment on occurrences of depression and anxiety and associated risk factors in the infertile Chinese men. Am J Mens Health. 2017;11(3):767-74.
  13. Chiaffarino F, Baldini MP, Scarduelli C, Bommarito F, Ambrosio S, D'Orsi C, et al. Prevalence and incidence of depressive and anxious symptoms in couples undergoing assisted reproductive treatment in an Italian infertility department. Eur J Obstet Gynecol Reprod Biol. 2011;158(2):235-41.
  14. Drosdzol A, Skrzypulec V. Depression and anxiety among Polish infertile couples--an evaluative prevalence study. J Psychosom Obstet Gynaecol. 2009;30(1):11-20.
  15. Volgsten H, Skoog Svanberg A, Ekselius L, Lundkvist O, Sundström Poromaa I. Prevalence of psychiatric disorders in infertile women and men undergoing in vitro fertilization treatment. Hum Reprod. 2008;23(9):2056-63.
  16. Issa Y, Sallmén M, Nijem K, Bjertness E, Kristensen P. Fecundability among newly married couples in agricultural villages in Palestine: a prospective study. Hum Reprod. 2010;25(8):2132-8.
  17. Abdel-Khalek A. Beck depression inventory: the Arabic version. Cairo, Anglo-Egyptian Bookshop, 1996.
  18. Warchol-Biedermann K. The risk of psychiatric morbidity and course of distress in males undergoing infertility evaluation is affected by their factor of infertility. Am J Mens Health. 2019;13(1):1557988318823904.
  19. Dooley M, Dineen T, Sarma K, Nolan A. The psychological impact of infertility and fertility treatment on the male partner. Hum Fertil (Camb). 2014;17(3):203-9.
  20. Khosravi Z. Mental health predictive factors in in-fertile couples. Med J Reprod Infertil. 2002;3(1):56-64.
  21. Muller MJ, Schilling G, Haidl G. Sexual satisfaction in male infertility. Arch Androl. 1999;42(3):137-43.
  22. Ahmadi H, Montaser-Kouhsari L, Nowroozi MR, Bazargan-Hejazi S. Male infertility and depression: a neglected problem in the Middle East. J Sex Med. 2011;8(3):824-30.
  23. Carney PR, Berry RB, Geyer JD. Clinical sleep disorders. 2nd ed. USA: Lippincott Williams & Wilkins (LWW); 2011. 544 p.
  24. Pook M, Krause W, Drescher S. Distress of infertile males after fertility workup: a longitudinal study. J Psychosom Res. 2002;53(6):1147-52.
  25. Pook M, Krause W. The impact of treatment experiences on the course of infertility distress in male patients. Hum Reprod. 2005;20(3):825-8.
  26. Volgsten H, Ekselius L, Poromaa IS, Svanberg AS. Personality traits associated with depressive and anxiety disorders in infertile women and men undergoing in vitro fertilization treatment. Acta Obstet Gynecol Scand. 2010;89(1):27-34.
  27. Volgsten H, Skoog Svanberg A, Ekselius L, Lundkvist O, Sundstrom Poromaa I. Risk factors for psychiatric disorders in infertile women and men undergoing in vitro fertilization treatment. Fertil Steril. 2010;93(4):1088-96.
  28. Li L, Zhang Y, Zeng D, Li F, Cui D. Depression in Chinese men undergoing different assisted reproductive technique treatments: prevalence and risk factors. J Assist Reprod Genet. 2013;30(9):1161-7.
  29. Gao J, Zhang X, Su P, Liu J, Shi K, Hao Z, et al. Relationship between sexual dysfunction and psychological burden in men with infertility: a large observational study in China. J Sex Med. 2013;10(8):1935-42.
  30. Tüzer V, Tuncel A, Göka S, Bulut SD, Yüksel FV, Atan A, et al. Marital adjustment and emotional symptoms in infertile couples: gender differences. Turkish J Med Sci. 2010;40(2):229-37.
  31. Koochaksaraei FY, Mirghafourvand M, Hasanpoor S, Bani S. Mental health and its socio-demographic predictors in male partner of Iranian infertile couples. Issues Ment Health Nurs. 2016;37(8):563-8.
  32. Kazandi M, Gunday O, Mermer TK, Erturk N, Ozkınay E. The status of depression and anxiety in infertile Turkish couples. Iran J Reprod Med. 2011;9(2):99-104.