Sexual Function of Women with Infertility

Infertile women (infertile group, IG) of reproductive age were invited to participate in this controlled study. A control group (CG) of women was recruited from the general population of the same city. Sexual function was assessed by the Female Sexual Function Index (FSFI), and anxiety and depression were measured by the Hospital Anxiety and Depression Scale (HADS).

Results

A total of 280 women participated in the present study, 140 in the IG and 140 in the CG. The analysis of the FSFI scores showed that 47 women (33.57%) in the IG and 49 women (35%) in the CG had sexual dysfunction (FSFI ≤ 26.55; p = 0.90). Women with anxiety or depression had a greater risk of sexual dysfunction, and sexual dysfunction increased the risk of anxiety and depression. Married women had a lower risk of depression than single women who were living with their partners.

Conclusion

Infertilewomenhadno increased riskof sexual dysfunction relativetocontrols. Anxiety and depression increased the risk of sexual dysfunction in the studied population.

Keywords:
Marital Infertility; sexuality; female sexual dysfunction; anxiety; depression; assisted reproduction

Variable		IGn (%)	CGn (%)	p-value
Age (years)	< 40	130 (92.86)	125 (89.29)	0.40
Age (years)	≥40	10 (7.14)	15 (10.71)	0.40
Marital status	Living together	34 (24.29)	46 (32.86)	0.15
Marital status	Married	106 (75.71)	94 (67.14)	0.15
Partner's age (years)	< 40	99 (70.71)	100 (71.43)	0.99
Partner's age (years)	≥40	41 (29.29)	40 (28.57)	0.99
Time of relationship(years)	< 5	10 (7.14)	27 (19.29)	< 0.01
Time of relationship(years)	≥5	130 (92.86)	113 (80.71)	< 0.01
Schooling	Elementary	19 (16.38)	16 (11.43)	0.29
	High school	46 (39.66)	50 (35.72)
	Higher education	51 (43.97)	74 (52.85)
BMI (kg/m2)*	Low weight	2 (1.44)	2 (1.43)	0.72
	Normal weight	63 (45.32)	72 (51.43)
	Overweight	44 (31.65)	42 (30)
	Obese	30 (21.58)	24 (17.14)
Sexarche	< 18 years	70 (50)	64 (45.71)	0.35
Sexarche	≥18 years	70 (50)	76 (54.28)	0.35
Frequency of intercourse	Every 2 months	1 (0.71)	1 (0.71)	0.41
	Once a month	0	3 (2.14)
	Twice a month	4 (2.86)	1 (0.71)
	Three times a month	3 (2.14)	2 (1.43)
	1–3 days a week	111 (79.29)	108 (77.14)
	4–6 days a week	21 (15)	24 (17.14)
	Every day	0	1 (0.71)
Number of partners	< 5	118 (84.28)	106 (75.71)	0.71
	≥5	16 (11.43)	33 (23.57)
	Doesn't know	6 (4.28)	1 (0.71)

Variable	Group	Median (Q1-Q3)	p-value*
Desire	IG	3.60 (3.00–4.20)	0.51
Desire	CG	3.60 (3.00–4.20)	0.51
Excitation	IG	4.20 (3.60–4.80)	0.04
Excitation	CG	4.50 (3.60–5.10)	0.04
Lubrication	IG	5.40 (4.20–6.00)	0.94
Lubrication	CG	5.40 (4.20–6.00)	0.94
Orgasm	IG	4.80 (4.00–5.60)	0.58
Orgasm	CG	4.80 (4.00–5.60)	0.58
Satisfaction	IG	5.20 (4.80–6.00)	0.52
Satisfaction	CG	5.60 (4.00–6.00)	0.52
Pain	IG	5.60 (4.40–6.00)	0.90
Pain	CG	5.60 (4.40–6.00)	0.90

Variable	Sexual dysfunction		p-value
Variable	Yes, n (%)	No, n (%)	p-value
Anxiety (n= 107)	52 (54.2)	55 (29.9)	< 0.01
Depression (n= 34)	24 (25)	10 (5.4)	< 0.01

Variable	OR crude	95% CI crude	p-value	OR adjusted	95% CI adjusted	p-value
Age (≥40 years old vs< 40 years old)	1.03	0.40–2.67	0.95	1.09	0.37–3.21	0.88
BMI* (OW vs UW + N)	0.91	0.49–1.71	0.77	0.90	0.44–1.86	0.78
BMI* (O vs UW + N)	0.77	0.37–1.63	0.50	0.66	0.27–1.64	0.37
Marital status (married vs unmarried)	1.66	0.89–3.09	0.11	1.84	0.83–4.05	0.13
Time of relationship, years ( ≥5 vs< 5 years)	2.06	0.86–4.98	0.11	1.36	0.47–3.96	0.57
Schooling (high school vs elementary)	1.98	0.82–4.78	0.13	2.49	0.91–6.83	0.08
Schooling (complete high school vs complete elementary)	0.88	0.37–2.12	0.78	0.96	0.35–2.61	0.94
Pregnancy (yes vs no)	2.01	1.14–3.54	0.02	0.89	0.26–3.02	0.85
Contraception (yes vs no)	1.23	0.71–2.13	0.46	0.84	0.40–1.76	0.65
Parity (yes vs no)	1.82	1.05–3.17	0.03	1.79	0.46–6.98	0.40
Psychotherapy (yes vs no)	1.03	0.34–3.12	0.96	1.96	0.56–6.78	0.29
Cigarette smoking (yes vs no)	0.66	0.23–1.90	0.44	0.54	0.14–2.10	0.37
Alcohol (yes vs no)	2.04	0.40–10.47	0.39	3.31	0.45–24.23	0.24
Alcohol (social vs no)	0.92	0.51–1.67	0.78	1.08	0.52–2.22	0.84
Partner's age (≥40 vs< 40 years)	1.11	0.61–2.02	0.75	1.20	0.60–2.43	0.61
Risk of anxiety (yes vs no)	2.87	1.63–5.05	< 0.01	2.53	1.34–4.81	< 0.01
Risk of depression (yes vs no)	7.10	2.83–17.78	< 0.01	6.85	2.37–19.75	< 0.01
Group (case vs control)	0.77	0.44–1.36	0.37	0.86	0.35–2.09	0.73

Variable	OR crude	95% CI crude	p-value	OR adjusted	95% CI adjusted	p-value
Age (≥40 years old vs< 40 years old)	0.79	0.31–2.03	0.62	0.81	0.29–2.27	0.68
BMI* (OW vs UW + N)	0.91	0.50–1.68	0.77	0.98	0.49–1.93	0.95
BMI* (O vs UW + N)	1.05	0.52–2.13	0.89	1.19	0.53–2.66	0.68
Marital Status (married vs unmarried)	1.33	0.74–2.38	0.34	1.47	0.72–3.00	0.29
Time of relationship years (5 or more vs <5)	1.59	0.72–3.51	0.25	1.25	0.50–3.11	0.63
Schooling (high school vs elementary)	1.02	0.44–2.35	0.97	0.90	0.35–2.30	0.82
Schooling (complete high scholl vs complete elementary)	1.06	0.47–2.39	0.88	1.17	0.47–2.91	0.73
Pregnancy (yes vs no)	1.06	0.62–1.80	0.83	1.62	0.51–5.13	0.41
Contraception (yes vs no)	0.82	0.48–1.39	0.46	0.85	0.43–1.68	0.64
Parity (yes vs no)	0.85	0.50–1.44	0.54	0.41	0.12–1.46	0.17
Psychotherapy (yes vs no)	0.79	0.26–2.40	0.68	0.81	0.24–2.73	0.73
Cigarette smoking (yes vs no)	1.08	0.42–2.75	0.87	1.05	0.35–3.16	0.93
Alcohol (yes vs no)	3.53	0.63–19.88	0.15	5.23	0.75–36.43	0.10
Alcohol (social vs no)	1.20	0.68–2.13	0.53	1.41	0.74–2.69	0.30
Partner's age (≥40 years old vs< 40 years old)	1.03	0.57–1.84	0.93	1.00	0.52–1.94	0.99
Sexual Dysfunction (yes vs no)	2.86	1.63–5.05	< 001	2.44	1.29–4.62	< 0.01
Risk of depression (yes vs no)	4.28	1.77–10.32	< 0.01	3.60	1.35–9.61	0.01
Group (case vs control)	1.23	0.72–2.11	0.46	1.01	0.45–2.27	0.98

Variable	OR crude	95% CI crude	p-value	OR adjusted	95% CI adjusted	p-value
Age (≥40 years old vs < 40 years old)	0.33	0.04–2.55	0.29	0.27	0.03–2.62	0.26
BMI* (OW vs UW + N)	0.88	0.37–2.10	0.77	0.69	0.23–2.09	0.52
BMI* (O vs UW + N)	0.63	0.20–1.99	0.43	0.44	0.11–1.73	0.24
Marital Status (married vs unmarried)	0.52	0.24–1.16	0.11	0.21	0.07–0.60	< 0.01
Time of relationship, years (5 or more vs< 5)	2.31	0.52–10.17	0.27	2.37	0.43–12.97	0.32
Schooling (high school vs elementary)	1.02	0.34–3.09	0.97	0.53	0.14–1.96	0.34
Schooling (complete high scholl vs complete elementary)	0.53	0.17–1.66	0.27	0.53	0.13–2.09	0.36
Pregnancy (yes vs no)	2.82	1.20–6.63	0.02	4.61	0.87–24.36	0.07
Contraception (yes vs no)	1.50	0.69–3.26	0.31	1.31	0.46–3.67	0.61
Parity (yes vs No)	2.10	0.96–4.61	0.06	0.63	0.09–4.28	0.64
Cigarette smoking (yes vs no)	1.42	0.39–5.17	0.60	1.24	0.23–6.74	0.80
Partner's age (≥40 years old vs< 40 years old)	0.74	0.30–1.81	0.51	0.51	0.17–1.54	0.23
Sexual dysfunction (yes vs no)	7.62	3.11–18.69	< 0.01	7.59	2.72–21.14	< 0.01
Risk of anxiety (yes vs no)	4.14	1.80–9.51	< 0.01	3.51	1.36–9.06	< 0.01
Group (case vs control)	0.72	0.32–1.59	0.41	0.93	0.23–3.72	0.91

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[1] Address for correspondence Priscilla Bianchini Salomão, Master, Faculdade de Medicina, Universidade de São Paulo de Ribeirão Preto, Av. Bandeirantes, 3900, Monte Alegre, 14040-900, Ribeirão Preto, SP, Brazil (e-mail: pri_salomao@hotmail.com).