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Factors Influencing the Depression Level of Couples Participating in the National Supporting Program for Infertile Couples

Article information

Res Community Public Health Nurs. 2015;26(3):179-189
Publication date (electronic) : 2015 September 30
doi : https://doi.org/10.12799/jkachn.2015.26.3.179
Nami Hwang1, Insun Jang2
1Korea Institute for Health and Social Affairs, Sejong, Korea.
2Department of Nursing, Korea Bible University, Seoul, Korea.
Corresponding author: Jang, Insun. Department of Nursing, Korea Bible University, 32 Dongil-ro(st), 214-gil, Nowon-gu, Seoul 139-791, Korea. Tel: +82-2-950-5485, Fax: +82-2-950-5484, agape90@korea.com
Received 2015 February 03; Revised 2015 March 19; Accepted 2015 September 09.

Abstract

Purpose

The purpose of this study was to identify factors influencing depression of participants in the National Supporting Program for Infertile Couples (NSPI) who received a treatment of IVF (in vitro fertilization) or IUI (intra-uterine insemination).

Methods

Using the 2013 NSPI Satisfaction On-line Survey data, secondary data analyses were conducted on 830 cases of IVF and 706 cases of IUI. Descriptive statistics, independent t-test, χ2 test, and logistic regression were performed using SPSS/WIN 21.0.

Results

Logistic regression analysis showed that non-pregnancy status (OR=3.05), unexplained infertility (OR=4.29), relationship trouble with spouse (OR=3.57), and relationship trouble with the in-law family (OR=2.78) were significant factors predicting the depression level in the IUI treatment group. Non-pregnancy status (OR=5.28), childlessness (OR=1.92), financial support helpful hardly or not at all (OR=2.63), relationship trouble with spouse (OR=3.28), relationship trouble with the in-law family (OR=2.83), and unemployment (OR=1.60) were significant factors in the IVF treatment group.

Conclusion

To reduce infertile women's depression, adequate attention and care need to be paid to these psychological symptoms. It is suggested to develop counseling and couple-therapy along with methods to enhance social support (including that from the in-law's family).

Keywords: Infertility; Depression; Insemination; In vitro fertilization

References

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Article information Continued

© 2015 Korean Academy of Community Health Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Table 1

Comparison of Socio-demographic Characteristics of Respondents

Characteristics Categories IUI (n=706) IVF (n=830) χ2 or t p
n (%) n (%)
Wife age (year) 25~29 43 (6.9) 32 (4.3) 48.05 <.001
30~34 324 (52.3) 286 (38.6)
35~39 209 (33.7) 298 (40.2)
40~45 44 (7.1) 125 (16.9)
M±SD 34.2±3.47 35.6±3.91 -7.14 <.001
Husband age (year) 25~29 15 (2.4) 16 (2.2) 40.68 <.001
30~34 218 (35.1) 156 (21.2)
35~39 284 (45.7) 364 (49.5)
40~45 104 (16.7) 199 (27.1)
M±SD 36.0±3.59 37.2±3.93 -5.99 <.001
Employment status Unemployed 239 (38.5) 303 (41.0) 1.02 .599
Employed 329 (53.1) 372 (50.3)
Part-time 52 (8.4) 64 (8.7)
Education ≤High school 89 (14.2) 140 (18.9) 5.29 .071
University 432 (69.1) 482 (65.0)
≥Graduate school 104 (16.6) 119 (16.1)
Pregnancy status (now) Yes 145 (23.3) 98 (13.4) 22.60 <.001
No 477 (76.7) 635 (86.6)
Child (number) 0 417 (67.1) 435 (58.7) 11.43 .003
1 180 (29.0) 279 (37.7)
≥2 24 (3.9) 27 (3.6)

Note. Missing data excluded; IUI=intrauterine insemination; IVF=in vitro fertilization.

Table 2

Comparison of Infertility related Characteristics and Family Support of Respondents

Characteristics Categories IUI (n=706) IVF (n=830) χ2 or t p
n (%) n (%)
Causes of infertility Unexplained 488 (70.7) 401 (49.3) 86.13 <.001
Female 100 (14.5) 273 (33.6)
Male 68 (9.9) 83 (10.2)
Both 34 (4.9) 56 (6.9)
Infertility duration (month) <12 13 (2.3) 20 (3.0) 69.79 <.001
12~23 71 (12.6) 57 (8.5)
24~35 143 (25.3) 113 (16.9)
36~47 175 (31.0) 143 (21.4)
48~59 83 (14.7) 121 (18.1)
≥60 80 (14.2) 214 (32.0)
M±SD 38.2±18.10 50.2±43.36 -6.53 <.001
Treatment result Fail 489 (75.8) 448 (58.6) 47.12 <.001
Sucess only pregnancy 48 (7.4) 84 (11.0)
Sucess delivery 108 (16.7) 232 (30.4)
Distance to hospital (hour) <1 491 (79.1) 498 (67.1) 28.88 <.001
1~2 106 (17.1) 173 (23.3)
≥2 24 (3.9) 71 (9.6)
Financial support Very helpful 378 (60.6) 365 (49.3) 19.05 <.001
Moderate helpful 240 (38.5) 358 (48.4)
Not helpful 6 (1.0) 17 (2.3)
Attendance of health program Wife No 290 (41.1) 324 (39.0) 0.70 .403
Yes 415 (58.9) 506 (61.0)
Husband No 345 (48.9) 405 (48.8) 0.00 .956
Yes 360 (51.1) 425 (51.2)
Depression Yes (≥4) 125 (20.5) 177 (24.3) 2.83 .093
No (≤3) 486 (79.5) 551 (75.7)
Total number of IVF before 1.55±1.12 2.54±1.18 -13.27 <.001
Total number of IUI before 2.42±2.93 2.05±1.22 2.52 .012
Relationship with spouse Get better 143 (23.2) 165 (22.5) 5.85 .054
Not change 452 (73.4) 521 (71.2)
Get worse 21 (3.4) 46 (6.3)
Relationship with in-laws' house Get better 71 (11.6) 86 (12.0) 7.22 .027
Not change 505 (82.4) 561 (78.0)
Get worse 37 (6.0) 72 (10.0)

Note. Missing data excluded; IUI=intrauterine insemination; IVF=in vitro fertilization.

Table 3

Depression according to Socio-demographic Characteristics of Respondents

Characteristics Categories IUI (n=706) χ2 (p) IVF (n=830) χ2 (p)
Yes No Yes No
n (%) n (%) n (%) n (%)
Wife age (year) 25~29 16 (13.1) 24 (5.0) 10.66 (.014) 6 (3.4) 24 (4.4) 5.83 (.120)
30~34 62 (50.8) 256 (53.1) 80 (45.2) 200 (36.6)
35~39 36 (29.5) 167 (34.6) 69 (39.0) 221 (40.5)
40~45 8 (6.6) 35 (7.3) 22 (12.4) 101 (18.5)
Husband age (year) 25~29 5 (4.0) 10 (2.1) 2.15 (.542) 5 (2.9) 10 (1.8) 3.09 (.377)
30~34 45 (36.0) 167 (34.7) 36 (20.6) 118 (21.8)
35~39 57 (45.6) 219 (45.5) 93 (53.1) 257 (47.4)
40~45 18 (14.4) 85 (17.7) 41 (23.4) 157 (29.0)
Employment status Unemployed 55 (44.4) 177 (36.9) 4.08 (.130) 88 (50.3) 209 (38.3) 8.00 (.018)
Employed 56 (45.2) 265 (55.2) 73 (41.7) 288 (52.7)
Part-time 13 (10.5) 38 (7.9) 14 (8.0) 49 (9.0)
Education ≤High school 21 (16.9) 66 (13.6) 0.99 (.610) 40 (23.0) 94 (17.1) 3.87 (.144)
University 84 (67.7) 336 (69.3) 111 (63.8) 360 (65.6)
≥Graduate school 19 (15.3) 83 (17.1) 23 (13.2) 95 (17.3)
Pregnancy status (now) Yes 13 (10.5) 126 (26.1) 13.68 (<.001) 9 (5.2) 89 (16.4) 13.70 (<.001)
No 111 (89.5) 356 (73.9) 163 (94.8) 455 (83.6)
Child (number) 0 95 (76.0) 314 (65.4) 6.64 (.036) 135 (76.3) 293 (53.6) 28.68 (<.001)
1 24 (19.2) 148 (30.8) 39 (22.0) 230 (42.0)
≥2 6 (4.8) 18 (3.8) 3 (1.7) 24 (4.4)

Note. Missing data excluded; IUI=intrauterine insemination; IVF=in vitro fertilization.

Table 4

Depression according to Infertility related Characteristics and Family Support of Respondents

Characteristics Categories IUI (n=706) χ2 or t (p) IVF (n=830) χ2 or t (p)
Yes No Yes No
n (%) n (%) n (%) n (%)
Causes of infertility Unexplained 79 (64.8) 353 (72.8) 11.18 (.011) 75 (43.1) 275 (50.3) 13.76 (.003)
Female 25 (20.5) 65 (13.4) 76 (43.7) 169 (30.9)
Male 7 (5.7) 48 (9.9) 9 (5.2) 65 (11.9)
Both 11 (9.0) 19 (3.9) 14 (8.0) 38 (6.9)
Infertility duration (month) <12 3 (2.6) 9 (2.0) 6.27 (.281) 3 (1.9) 17 (3.4) 15.73 (.008)
12~23 9 (7.7) 60 (13.6) 9 (5.6) 47 (9.4)
24~35 26 (22.2) 115 (26.1) 19 (11.8) 91 (18.2)
36~47 42 (35.9) 132 (29.9) 29 (18.0) 113 (22.6)
48~59 22 (18.8) 60 (13.6) 31 (19.3) 89 (17.8)
≥60 15 (12.8) 65 (14.7) 70 (43.5) 143 (28.6)
Treatment result Fail 100 (82.0) 356 (74.2) 3.25 (.197) 130 (75.1) 291 (53.4) 31.52 (<.001)
Sucess only pregnancy 7 (5.7) 37 (7.7) 19 (11.0) 58 (10.6)
Sucess delivery 15 (12.3) 87 (18.1) 24 (13.9) 196 (36.0)
Distance to hospital (hour) <1 90 (72.6) 389 (80.9) 4.20 (.123) 97 (55.7) 385 (70.0) 12.40 (.002)
1~2 27 (21.8) 75 (15.6) 53 (30.5) 119 (21.6)
≥2 7 (5.6) 17 (3.5) 24 (13.8) 46 (8.4)
Financial support Very helpful 62 (50.4) 307 (63.4) 7.21 (.027) 55 (31.1) 302 (55.4) 33.46 (<.001)
Moderate helpful 59 (48.0) 173 (35.7) 114 (64.4) 234 (42.9)
Not helpful 2 (1.6) 4 (0.8) 8 (4.5) 9 (1.7)
Attendance of health program Wife No 39 (31.2) 168 (34.6) 0.52 (.469) 43 (24.3) 192 (34.8) 6.82 (.009)
Yes 86 (68.8) 317 (65.4) 134 (75.7) 359 (65.2)
Husband No 53 (42.4) 206 (42.5) 0.00 (.988) 68 (38.4) 247 (44.8) 2.24 (.134)
Yes 72 (57.6) 279 (57.5) 109 (61.6) 304 (55.2)
Total number of IVF before 1.53±1.16 1.63±0.98 -0.71 (.476) 2.46±1.15 2.85±1.23 -3.80 (<.001)
Total number of IUI before 2.33±2.41 2.76±4.49 -1.40 (.164) 2.05±1.21 2.06±1.24 -0.07 (.942)
Relationship with spouse Get better 21 (16.8) 121 (25.0) 30.31 (<.001) 30 (17.0) 135 (24.7) 50.58 (<.001)
Not change 90 (72.0) 356 (73.6) 115 (65.3) 396 (72.5)
Get worse 14 (11.2) 7 (1.4) 31 (17.6) 15 (2.7)
Relationship with in-laws' house Get better 5 (4.0) 66 (13.7) 42.36 (<.001) 11 (6.4) 75 (14.0) 60.80 (<.001)
Not change 98 (78.4) 400 (83.2) 119 (68.8) 434 (81.0)
Get worse 22 (17.6) 15 (3.1) 43 (24.9) 27 (5.0)

Note. Missing data excluded; IUI=intrauterine insemination; IVF=in vitro fertilization.

Table 5

Factors related to Depression

Variables IUI IVF
β p OR 95% CI β p OR 95% CI
(Constant) -0.473 .701 0.623 -4.845 <.001 0.008
Pregnancy status (1=No) 1.117 .001 3.054 1.61~5.81 1.663 <.001 5.277 2.32~12.00
Child (number) (1=0) 0.431 .089 1.539 0.94~2.53 0.652 .039 1.919 1.03~3.57
Causes of infertility
 Unexplained† - .065 - - .026 -
 Female -0.844 .063 0.430 0.18~1.05 -0.725 .085 0.484 0.21~1.11
 Male -0.470 .352 0.625 0.23~1.68 -0.141 .738 0.868 0.38~1.99
Both -1.455 .018 0.233 0.07~0.78 -1.081 .059 0.339 0.11~1.04
Financial support (1=Moderate or not helpful) 0.349 .119 1.418 0.91~2.20 0.969 <.001 2.634 1.67~4.16
Relationship with spouse (1=Get worse) 1.272 .023 3.569 1.20~10.66 1.189 .006 3.284 1.40~7.71
Relationship with in-laws' house (1=Get worse) 1.023 .015 2.783 1.22~6.33 1.038 .004 2.825 1.40~5.71
Wife age -0.048 .140 0.953 0.89~1.02
Employment status (1=Unemployed) 0.469 .036 1.599 1.03~2.48
Infertility duration 0.001 .801 1.001 1.00~1.01
Treatment result (1=Fail) 0.575 .057 1.777 0.98~3.21
Distance to hospital (1=≥1 hours) 0.452 .142 1.571 0.86~2.87
Attendance of health program (Wife) (1=Yes) 0.448 .070 1.565 0.96~2.54
Total number of IVF before 0.184 .700 1.202 0.99~1.47

†Causes of infertility-Unexplained: Reference group; IUI=intrauterine insemination; IVF=in vitro fertilization.