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Prevalence and risk factors of the female sexual dysfunction in a sample of infertile Iranian women

  • Reproductive Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Background

Infertility has a major impact on women’s quality of life and emotional well-being. The resulting interpersonal problems extend to women’s sexual relationships, with a high proportion of infertile women reporting sexual problems.

Aim

To determine the prevalence and identify the potential risk factors of female sexual dysfunction (FSD) among infertile Iranian women.

Methods

Using a cross-sectional study design including 12 infertility clinics in five Iranian cities, FSD was assessed in 604 infertile women using the culturally adapted, multidimensional Female Sexual Function Index (IV-FSFI). Depression, anxiety and health-related quality of life (HRQL) were also assessed for all infertile patients. Depression and anxiety were assessed with the Hospital Anxiety and Depression Scale (HADS) while HRQL was measured using the Short Form 36 (SF-36).

Main outcome measure

Prevalence of FSD in infertile women and associated factors.

Results

Infertile women reported significantly lower scores on the FSFI domains in comparison with healthy women. Risk factors for FSD as determined by multilevel analyses were older age and self-reported depression. Furthermore, secondary infertility, lower educational level and higher partner education put women at increased risk for FSD.

Conclusions

Among infertile women, sexual dysfunctions seem to be prevalent higher than previously published in Iran. This finding may have implications on the clinical assessment of sexual function and the role of demographic and psychological factors in infertile women.

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Conflict of interest

The author does not have any conflict of interest, including financial and personal relationship with people or organizations that could inappropriately influence this work.

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Correspondence to Amir H. Pakpour.

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Pakpour, A.H., Yekaninejad, M.S., Zeidi, I.M. et al. Prevalence and risk factors of the female sexual dysfunction in a sample of infertile Iranian women. Arch Gynecol Obstet 286, 1589–1596 (2012). https://doi.org/10.1007/s00404-012-2489-x

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  • DOI: https://doi.org/10.1007/s00404-012-2489-x

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