Care seeking behaviour of infertile couples attending a government infertility clinic in Delhi

Authors

  • Janender S. Negi National Institute of Health and Family Welfare (NIHFW), New Delhi, India
  • Renu Shahrawat National Institute of Health and Family Welfare (NIHFW), New Delhi, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20213556

Keywords:

Care seeking, Infertility, Behavior of infertile couples, Infertility management, Primary infertility, Secondary infertility

Abstract

Background: Childbearing is the reproductive right of every infertile couple. Infertility brings with it, multi-dimensional implications like social, economic and psychological. Care seeking by infertile couples is poorly understood as infertility services are deficient at grass-root level. We aimed to examine treatment seeking behaviour among infertile couples.

Methods: A descriptive study was carried from 15 October 2019 to 15 March 2020. Primary data was collected by interviewing 196 married couples seeking care from an infertility clinic in Delhi. Data was tabulated and analyzed using statistical package for the social sciences (SPSS) version 23.

Results: Majority of the couples had primary infertility (73%). In 47% of the couples, care seeking was advised by the household members. Most of the couples (82%) took decision to seek care themselves. Treatment was initiated within 3 years of marriage in 45% of couples. For first consultation, infertility treatment was sought from private sector (73%), public sector (16%) and informal sector (11%). Among public sector consultations, Government Medical College was preferred by 44% of couples while in private sector, 80% of them preferred private clinics. Infertility care was sought in 79% of couples from allopathic specialists. Mean duration of treatment and visits per consultation was 5 months and 10 visits respectively. Main source of information for treatment were friends and close relatives. Females (98%) faced more pressure from family to seek treatment than the males (72%).

Conclusions: Main source of infertility care was from private sector. Females faced more pressure to seek treatment. Services in the public sector needs to be developed and strengthened to make infertility care accessible, equitable and affordable.

Author Biographies

Janender S. Negi, National Institute of Health and Family Welfare (NIHFW), New Delhi, India

POST GRADUATE RESIDENT 

MD (COMMUNITY HEALTH ADMINISTRATION)

Renu Shahrawat, National Institute of Health and Family Welfare (NIHFW), New Delhi, India

Professor, 

The National Institute of Health and Family Welfare Clinic

References

Boivin J, Bunting L, Collins JA, Nygren KG. International estimates of infertility prevalence and treatment-seeking: potential need and demand for infertility medical care. Human Reproduction. 2007;22(6):1506-12.

Mascarenhas MN, Flaxman SR, Boerma T, Vanderpoel S, Stevens GA. National, Regional, and Global Trends in Infertility Prevalence Since 1990: A Systematic Analysis of 277 Health Surveys. PLOS Med. 2012;9(12):1001356.

Kumar D. Prevalence of female infertility and its socio-economic factors in tribal communities of Central India. Rural Remote Health. 2007;7(2):456.

Sarkar S, Gupta P. Socio-Demographic Correlates of Women's Infertility and Treatment Seeking Behavior in India. J Reprod Infertil. 2016;17(2):123-32.

Katole A, Saoji AV. Prevalence of Primary Infertility and its Associated Risk Factors in Urban Population of Central India: A Community-Based Cross-Sectional Study. Indian J Comm Med. 2019;44(4):337-41.

Singh K, Kumari R, Ranjan A, Bharti G. Analysis of causes and clinical pattern of infertility in couples coming to a tertiary care centre in Bihar, India. 2017. Int J Reprod Contracept Obstet Gynaecol. 2017;6(6):5.

Ganguly S, Unisa S. Trends of Infertility and Childlessness in India: Findings from NFHS Data. Facts, Views & Vision in ObGyn. 2010;2(2):131-8.

Somigliana E, Paffoni A, Busnelli A, Filippi F, Pagliardini L, Vigano P, et al. Age-related infertility and unexplained infertility: an intricate clinical dilemma. Hum Reprod. 2016;31(7):1390-6.

Anderson K, Nisenblat V, Norman R. Lifestyle factors in people seeking infertility treatment – A review. Australian and New Zealand Journal of Obstetrics and Gynaecology. 2010;50(1):8-20.

UN. World Fertility Report 2013: Fertility at Extremes. United Nations, New York: Department of Economic and Social Affairs, Population Division. 2014.

Campana A. Training Course in Sexual and Reproductive Health Research. 2009.

Mahey R, Gupta M, Kandpal S, Malhotra N, Vanamail P, Singh N, et al. Fertility awareness and knowledge among Indian women attending an infertility clinic: a cross-sectional study. BMC women's health. 2018;18(1):177.

Inhorn, Marcia C. Quest for Conception: Gender, Infertility and Egyptian Medical Traditions: University of Pennsylvania Press. 1994.

Van Balen F, Verdurmen J, Ketting E. Choices and motivations of infertile couples. Patient Education and Counseling. 1997;31(1):19-27.

Papreen N, Sharma A, Sabin K, Begum L, Ahsan SK, Baqui AH. Living with infertility: Experiences among urban slum populations in Bangladesh. Reproductive Health Matters. 2000;8(15):33-44.

Inhorn MC. Umm Il-ghayyib, Mother of the Missing One: A Sociomedical Study of Infertility in Alexandria, Egypt: University of California, Berkeley with University of California, San Francisco. 1991.

Gerrits T. Social and cultural aspects of infertility in Mozambique. Patient Educ Couns. 1997;31(1):39-48.

Bhatti LI, Fikree FF, Khan A. The quest of infertile women in squatter settlements of Karachi, Pakistan: a qualitative study. Soc Sci Med. 1999;49(5):637-49.

Chauhan S, Unisa S, Joshi B, Kulkarni R, Singh A, Subramanian T, et al. Capacity Assessment of District Health System in India on Services for Prevention and Management of Infertility. Indian J Comm Med. 2018;43(1):19-23.

Widge A, Cleland J. The public sector's role in infertility management in India. Health Policy and Planning. 2009;24(2):108-15.

Sengupta A, Nundy S. The private health sector in India. BMJ. 2005;331(7526):1157-8.

Katz P, Showstack J, Smith JF, Nachtigall RD, Millstein SG, Wing H, et al. Costs of infertility treatment: Results from an 18-month prospective cohort study. Fertility and sterility. 2011;95(3):915-21.

Sharma N, Ghai S. An Exploratory Study on Treatment Seeking Behavior and Pathways of Care Followed by Couples Attending Infertility Clinic. Int J Infertility Fetal Med. 2019;9:1-5.

Kulkarni G, Mohanty NC, Mohanty IR, Jadhav P, Boricha BG. Survey of reasons for discontinuation from in vitro fertilization treatment among couples attending infertility clinic. Journal of Human Reproductive Sciences. 2014;7(4):249-54.

Zegers-Hochschild F, Adamson GD, de Mouzon J, Ishihara O, Mansour R, Nygren K, et al. International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) revised glossary of ART terminology, 2009. Fertil Steril. 2009;92(5):1520-4.

Vidya P, Rekha U. Treatment seeking pattern among infertile couple in Rural and Urban areas of Vijayapur district, Karnataka. Nat J Res Comm Med. 2019;8(3):226.

Chethana R, Shilpa. Treatment seeking pattern among infertile couples in a rural area. Int J Comm Med Public Health. 2016;3(10):7.

Tripathi N. Infertility among Indian women: Emerging evidence and need for policy measures. Presented at the annual conference of the population Association of America. 2011.

Widge A. Seeking conception: Experiences of urban Indian women with in vitro fertilisation. Patient Education and Counseling. 2005;59(3):226-33.

Unisa S. Childlessness in Andhra Pradesh, India: Treatment-Seeking and Consequences. 1999.

Patel A, Sharma P, Kumar P. In cycles of dreams, despair, and desperation: Research perspectives on infertility specific distress in patients undergoing fertility treatments. Journal of Human Reproductive Sciences. 2018;11(4):320-8.

Zargar AH, Wani AI, Masoodi SR, Laway BA, Salahuddin M. Epidemiologic and etiologic aspects of primary infertility in the Kashmir region of India. Fertil Steril. 1997;68(4):637-43.

Greil A. Infertility and psychological distress: A critical review of the literature. Social Science & Medicine. 1997;45:1679-704.

Downloads

Published

2021-08-27

How to Cite

Negi, J. S., & Shahrawat, R. (2021). Care seeking behaviour of infertile couples attending a government infertility clinic in Delhi. International Journal Of Community Medicine And Public Health, 8(9), 4480–4486. https://doi.org/10.18203/2394-6040.ijcmph20213556

Issue

Section

Original Research Articles