Article

Infertility and domestic violence: Cause, consequence and management in Indian scenario

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Abstract

Infertility is worldwide problem affecting people of all communities, though the cause and magnitude may vary with geographical location and socioeconomic status. Approximately 8-10 percent of couples within the reproductive age group present for medical assessment, generally following two years of failed efforts to reproduce. Evidences suggest that infertility is becoming a public health problem in India. It is estimated that globally 60-80 million cou-ples suffer from infertility every year, of which probably between 15-20 millions (25%) are in India alone. Globally studies show that, at least one in three women and / or girls have been beaten or sexually abused in their lifetime. National Family Health Survey 3 (NFHS-3) shows that approximately 21 percent of women who has been interviewed have experienced physical or sexual violence in last 12 months. It is now becoming more and more evident that Infertility and Gender-based Violence (GBV) are emerging health problems of India. The present analysis was carried out with objective to study the association between Infertil-ity and GBV. Data collected by NFHS-3 from 23,722 women in reproductive age group by household survey shows that 2,023 (8.5%) women were infertile and 21,699 (91.5%) women were having at least one child. Out of total 2,023 infertile women 1,574 (77.8%) have experi-enced physical and/or sexual violence in last 12 months. Out of total 21,699 women having at least one child, only 1,332 (6.1%) have experienced physical and/or sexual violence in last one year. This shows that there is significant association between Infertility and GBV (p<0.001). Based on the study findings the recommendations are: (i) Infertility management should be coupled with counseling on GBV; (ii) Appointing a professional counselor in infer-tility management team; (iii) Infertility management specialist should be sensitized about the GBV.

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... Ameh et al. report a physical violence rate of 17.5% for infertile women, which they state is similar to the general population (19). In contrast, Pasi et al. (22) have reported that infertile women experienced physical or sexual violence more frequently than fertile women, although these researchers assessed physical and sexual violence together. ...
... Similarly, Ardabily et al. have demonstrated that 61.8% of infertile women experience marital violence because of their infertility (12). Pasi et al. (22) have also reported that 76.3% of infertile women and 65.9% of those who have at least one child have experienced violence. In their study there was a highly significant association between infertility and domestic violence. ...
... Pasi et al. have reported that approximately three quarters of either infertile or fertile women have experienced emotional violence. Although the rate of emotional violence in infertile women was higher than in fertile women, it was not statistically significant (22). Totally, these findings indicated that infertile women have been subjected to high rates of emotional, sexual and economic violence. ...
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The aim of this descriptive study was to evaluate the level of marital violence among Turkish women and to determine whether infertility was a risk factor for marital violence. This descriptive study was conducted during January-July 2009 at a training hospital. The study groups comprised 204 fertile and 228 infertile women. We administered the Descriptive Information Questionnaire and Scale for Marital Violence against Women (SDVW) to obtain data. There was a statistically significant difference between infertile and fertile women for the total score of violence in marriage. The emotional, economic and sexual violence scores were higher in the infertile group. However, the verbal violence score was lower. We performed a detailed study aimed at uncovering the presence of any violence from the data collection stage to the end of treatment in infertile couples with the intent to include questions to this effect in the care plan.
... The Declaration on the elimination of violence against women, adopted by the United Nation in 1992, defines violence against women as ''any act of gender based violence that results or likely to result in physical, sexual or psychological harm or suffering to women including threats of such harm, coercion or arbitrary deprivation of liberty whether occurring in public or private life [7]. The World Health Organization (WHO) estimates that at least one in five women have experienced violence in their lives [8]. ...
... Violence against infertile women is an important health problem with serious consequences for their physical and mental health. The prevalence of domestic violence against women with infertility in this study was 31.6% which is lower than 41.8% reported in a similar study carried out among women with infertility in Northern Nigeria by Ameh et al. [10] and 61.8% from infertile couples in an Iranian setting by Ardabily et al. [6] but higher than 1.8% reported among infertile women in India by Pasi et al. [8]. ...
... Psychological violence was the commonest form of domestic violence experienced in this study accounting for more than 50% cases among the women who had experienced violence ever, since infertility was diagnosed or in the past 1 year and this is similar to the findings in previous studies [2,3,6,10] but in contrast to finding by Pasi et al. [8] who reported that physical and sexual violence accounted for about 78% of forms of violence experienced in an Indian study. The psychological violence could be in form of verbal abuse, economic deprivation, threats or ridicule. ...
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The study evaluated the prevalence and predictors of intimate partner violence among infertile women attending infertility clinic of Ekiti State University Teaching Hospital, Ado-Ekiti. A cross sectional study of infertile women presenting at the clinic between 1st November 2012 and 31st October 2013 was done. A semi-structured questionnaire on violence was administered to 170 consecutive women who consented to participate. The data were analysed using SPSS 17 and significances test were performed on variables associated with violence with Student's t test and Chi square test. Logistic regression was done to determine predictive factors associated with intimate partner violence. The prevalence of intimate partner violence associated with infertility among the women was 31.2%. There were no significant differences in the age of the women, duration of marriage and duration of infertility between the women who had experienced violence and those who had not experienced it; p>0.05. Unemployment, polygamous marriage, husbands' social habits, primary infertility and prolonged duration of infertility were associated with violence in these women; p<0.05. Education of the women and their husbands, their religion and ethnicity were not significantly associated with violence; p>0.05. However with logistic regression, the unemployment status of the women and prolonged duration of infertility were the predictors of violence against women with infertility in this study, p value<0.05. More than 50% of the women reported psychological violence as the commonest form of violence experienced by them ever, since the diagnosis of infertility was made and in the past one year. All forms of violence experienced were aggravated by infertility in these women. Women with infertility are prone to intimate partner violence and this would further aggravate the challenges of infertility being faced by these women. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
... 7,9,16,17 İNFERTİL KADINLARDA ŞİDDET PREVELANSI Şiddet, tüm dünyada sosyoekonomik ve eğitim düzeylerine bakılmaksızın "infertil" milyonlarca kadının hayatını etkilemektedir. 18 İnfertilitenin yaklaşık üçte biri kadından, üçte biri erkekten, üçte biri her ikisinden kaynaklanmaktadır. 9 İnfertilite, erkek ve kadın her ikisini de etkilemesine rağmen, cinsiyet farklılıkları gözlenmektedir. ...
... 17 Kadın infertilitesi varlığında, kadınların eş yada partnerden gördüğü şiddet yaygınlığı, Nijerya'da %41,6, Türkiye'de %33,6, Pakistan'da %64, İran %61,8, Hindistan'da %77,8, Hong Kong'da %1,8 olarak bildirilmiştir. 2,9,[18][19][20] Ardabily ve ark.nın Tahran'da infertilite merkezinde yaptığı çalışmada, infertil kadınların %61,8'nin infertilite sorunu nedeniyle aile içi şiddet maruz kaldıkları bildirilmiştir. ...
... İnfertil kadınların, fiziksel veya cinsel şiddete fertil kadınlara oranla daha yüksek düzeyde maruz kalmış oldukları belirtilmiştir. 18 Farzadi ve ark.nın (2014) İran'da yapmış olduğu çalışmada, katılımcıların %45'inin fiziksel şiddete, %82'sinin ise en az bir kez psikolojik şiddete maruz kaldıklarını belirtilmiştir. İnfertil kadınlarda psikolojik şiddetin en yaygın türü; küfür, aşağılama ve bağırma olduğu, fiziksel şiddetin en yaygın türünün tokat atma (%37), herhangi bir objeyi fırlatma (%26,5) olarak belirtilmiştir. 1 Sami'nin Pakistan'da yaptığı çalışmada (2012) infertil kadınların, en fazla sözle şiddete (60,8) maruz kaldığını, bunu şiddet tehditi (42,1), evden ayrılma yada boşanma izlediğini (38,8) belirtmiştir. ...
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Dünya genelinde kadın yönelik şiddet giderek artmaktadır ve önemli bir halk sağlığı sorunu olarak görülmektedir. Değişen toplumsal yapı ile birlikte kadının doğurganlığının ertelenmesi vb. nedenlerden infertilite de yaygınlaşmaktadır. İnfertilite kadını psikolojik, fizyolojik ve sosyal olarak etkileyen çok yönlü bir sağlık sorunudur. Özellikle ataerkil toplumlarda infertiliteden kadının sorumlu tutulduğu görülmektedir. İnfertil kadınların şiddete maruz kalma oranlarının, bu sebeple daha yüksek olduğu düşünülmektedir. Bu nedenle, infertilite tedavisi gören kadınların, infertilite tedavisi sırasında şiddet yönünden de rutin olarak taranması önerilmektedir. Bu derleme de, sağlık personelinin infertil hastalarda şiddete maruz kalma olasılıkları konusunda farkındalığının artırılması, şiddete yönelik erken müdahalenin geliştirilmesi konusunda eğitim programlarının oluşturulması, infertilite kliniklerinde bu konuda da danışmanlık verilmesinin öneminin vurgulanması amaçlanmaktadır.
... A growing body of research, primarily conducted in low and middle-income countries (LMICs), indicates that infertility is associated with intimate partner violence, regardless of socioeconomic and educational levels (Pasi et al., 2011;Stellar et al., 2016). Especially in patriarchal societies and those with pronatalist assumptions (i.e. ...
... those that advocate a high birth rate), if a woman cannot bear children, they may experience violence from their partner (Onat, 2014). For example, previous studies have shown that 1.8% of infertile women in Hong Kong,41.6% in Nigeria,64% in Pakistan,61.8% in Iran,33.6% in Turkey,and 77.8% in India experienced domestic violence in their marriages (Ardabily et al., 2011;Leung et al., 2003;Pasi et al., 2011;Yildizhan et al., 2008), suggesting intimate partner violence (IPV) may be common among infertile women in low-and middle-income countries. ...
... The National Intimate Partner and Sexual Violence Survey (NISVS) reported that the prevalence of lifetime IPV in the US was 37.3% (Smith et al., 2017). Previous studies have reported the prevalence of IPV among infertile women ranged from 1.8% to 77.8% in the worldwide (Ardabily et al., 2011;Leung et al., 2003;Ozturk et al., 2017;Pasi et al., 2011). Surprisingly, we found a significantly smaller percentage of infertile women who had been emotionally or physically abused compared with fertile women, whereas the percentages of being physically hurt and sexual violence are quite small for both fertile and infertile women and there were no differences between groups. ...
Article
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Objectives: Previous studies investigated the physical, psychological and sociological effects of infertility; however, stigma and violence experiences of infertile women haven’t yet been studied in the US. The objective of the study is to examine the perceived stress, stigma, violence experiences, and social support of US infertile women and to compare with fertile women in order to understand the effects of infertility on stress levels, violence exposures, and support. Methods: The descriptive, cross-sectional study was conducted with fertile and infertile women who use social media for an online support group. A convenience sample of 786 women completed an online survey. Results: In the study, 41.6% of participants were fertile and 58.4% were infertile. We found infertile women experienced high levels of stigma and moderate stress. One in five infertile women has been exposed to emotional or physical violence. Compared to fertile women, infertile women had significantly higher perceived stress levels and were less likely to experience emotional or physical violence. Conclusion: These findings highlight that infertile women have experienced stigma and high levels of stress in a developed country. They are also exposed to emotional or physical violence, but surprisingly infertile women are less likely to report violence than fertile women.
... 1,3 Violence affects the lives of millions of infertile women worldwide, regardless of their socioeconomic and educational level. 4 Bibi et al. (2014) found that 20% of women who suffered from violence were subjected to violence due to infertility; Kaur (2014) found that 7% of women considered infertility a factor contributing to ...
... 5,6 Previous studies have reported that in the presence of infertility, the prevalence of violence toward women from their husbands or partners ranged between 1.8% and 77.8% in the world. 3,4,7 Psychological violence was the most frequently seen type of violence in infertile women. 3,7 Because of the cultural perception that infertility is the problem of women alone, violence against women is more common in the male-dominated social structure. ...
... It has been reported that women who are exposed to domestic violence as a result of infertility are two times more defenseless than those having children. 3,4,7,8,10 Previous studies have shown that 1.8% of women in Hong Kong, 41.6% in Nigeria, 64% in Pakistan, 61.8% in Iran, and 77.8% women in India experienced domestic violence in their marriages. 3,4,7,11,12 In a study carried out in Turkey (2009), 33.6% of infertile women reported domestic violence because of infertility. ...
Article
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Background & Objective Violence against women is a widespread problem and has serious implications on women’s health. Infertility, in many ways, is a very stressful condition that affect social and marital life of a couple; moreover, compared to fertile women, infertile women are twice as vulnerable against violence. Our objective was to determine the prevalence of violence and define the effect of infertility on violence on women receiving infertility treatment. Methods Descriptive and cross-sectional study was carried out 301 infertile women between November 2015 and August 2016 in a state hospital, Izmir. Data were collected as “Sociodemographic Characteristics Form” and “Infertile Women’s Exposure to Violence Determination Scale”. Results The mean age of women was 31.77±5.46 years; the average duration of marriage was 6.93±4.53 years. About 32.5% of women stated that they have suffered from violence throughout their lives and 4.7% of women were still suffering from violence, while 5.0% of women were subjected to violence after infertility was diagnosed. Conclusion It is an encouraging finding that infertile women have a low exposure to violence. However, despite a low violence rate, there is an increase in violence toward women who have been diagnosed with infertility.
... The psychological and social consequences associated with childlessness include but not limited to marital conflict [17]; psychiatric morbidity [18]; psychological distress [19]; sexual dysfunction [20]; and spousal violence [21,22]. ...
... However, in spite of increasing studies linking childlessness and spousal violence across the world [21][22][23][24][25][33][34][35], only few studies have been able to determine whether the likelihood of spousal violence is higher or lower among childless women compared with women who have children. Two reasons account for this knowledge gap. ...
... This finding was contradicted by two Indian studies based on 2005/2006 National Family Health Survey (NFHS-3) data. The first study reported 77.8% prevalence of spousal physical/sexual violence among childless women compared with 6.1% among women who have children [22], while the second study reported the same 9.6% prevalence of forced sex among women who have children and childless women, though other types of violence were slightly higher among childless women in the study [39], but the differences were marginal. In a recent Nigerian study, it was reported that childlessness was not a significant predictor of spousal abuse [34]. ...
Article
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Background: Few studies have been able to determine whether the likelihood of spousal violence is higher or lower among childless women compared with women who have children. This is because most studies linking childlessness and spousal violence were either qualitative or were conducted among childless women attending fertility clinics. In the fewer quantitative studies that linked childlessness and spousal violence, results are mixed and yet to be verified in Nigeria using nationally representative sample data. The current study addresses this knowledge gap by raising the research question: is the likelihood of spousal violence lower or higher among childless women? Methods: The study analysed data from 2008 and 2013 Nigeria Demographic and Health Surveys. Only women aged 35-49 years are included in the analysis. The outcome variable was spousal violence, while the key explanatory variable was parity status categorised into childless, have only one child, and have two or more children. Selected individual-level and community-level variables were included as additional explanatory variables. The multilevel mixed-effects logistic regression analysis was applied in four nested models using Stata 12. Results: In Model 1, result show 57% more likelihood of spousal violence among women who have two or more children compared with childless women (OR = 1.570: CI: 1.074-2.294). In Model 2, women who have two or more children were 52.3% more likely to experience spousal violence compared with childless women (OR = 1.523; CI: 1.037-2.247). In Model 3, the likelihood of spousal violence was 67.2% higher among women who have two or more children compared with childless women (OR = 1.672; CI: 1.140-2.452). In the full model, women who have two or more children were 50.8% more likely to experience spousal violence compared with childless women (OR = 1.508; CI: 1.077-2.234). The Intra-Class Correlation (ICC) provides evidence to support community contributions to prevalence of spousal violence. Conclusions: The likelihood of spousal violence is lower among childless women in Nigeria. Causes of spousal violence against women cut across individual, family, and community characteristics irrespective of childlessness or number of children. Current Behaviour Change Communication should be strengthened by adequate enforcement of the newly enacted Violence Against Persons (Prohibition) Act of 2015.
... -72.0% in Turkey, 31. 64% in Pakistan,77.8% in India; in Iran and in 45.7% -96.3% Egypt (Aduloju et al., 2015;Akpinar et al., 2019;Alijani et al., 2018;Ardabily et al., 2011;Celik and Kırca, 2018;Ghaly et al., 2019;Iliyasua et al., 2016;Ozgoli et al., 2016;Pasi et al., 2011;Rahebi et al., 2019;Sahin et al., 2018;Sami and Ali, 2012;Yildizhan et al.,2009). ...
... In societies such as that of Turkey, where patriarchy is still present and gender equality not fully realized, the inability of the woman, whose role and fertility are deemed important, to provide a child for the family, may lead to an increased risk of violence to her. (Baydar and Yanikkerem, 2016;Potur et al., 2019;Sami and Ali, 2012). When the literature is analyzed, it is seen that the prevalence of studies related to violence and its forms in women with infertility is quite high (Aduloju et al., 2015;Akpinar et al., 2019;Alijani et al., 2018;Ardabily et al., 2011;Celik and Kırca, 2018;Ghaly et al., 2019;Iliyasua et al., 2016;Ozgoli et al., 2016;Pasi et al., 2011;Rahebi et al., 2019;Sahin et al., 2018;Sami and Ali, 2012;Yildizhan et al.,2009). However, there are very few studies in the literature examining the relationship between the level of violence experienced by infertile women exposure to violence from husband and families, and SD (Dhont et al., 2011;Moghaddam et al., 2016;Poornowrooz et al., 2019;Potur et al., 2019;Sami and Mete, 2012). ...
Article
Objective: The aim of this study was to investigate the relationship between exposure to violence from husband, and their families and relatives, and sexual dysfunction in women with infertility. Methods: This cross-sectional study was conducted on 202 women with infertility at an Assisted Reproductive Techniques Center of a state university located in the west of Turkey. Infertile Women's Exposure to Violence Determination Scale, Index of Female Sexual Function, and information form were used for obtaining data. Results: The Infertile Women's Exposure to Violence Determination Scale total score was 40.5 ± 9.9. The Index of Female Sexual Function score was 34.9 ± 6.4, and 36 women (17.8%) had sexual dysfunction. The Infertile Women's Exposure to Violence Determination Scale total score of the women with sexual dysfunction (47.8 ± 14.7) was significantly higher than the total score of the women without sexual dysfunction (38.9 ± 7.7) (p < 0.001). Total score of the Infertile Women's Exposure to Violence Determination Scale was negatively correlated with total score of the Female Sexual Function of Index (r = - 0.268; p < 0.001). Conclusion: In this study was found that women with infertility level of exposure to violence were low. However, sexual dysfunction increases as the level of exposure to violence increases. Of the infertile women should be determined exposure to violence and sexual dysfunction levels. ÖZ Amaç: Bu çalışmanın amacı, infertil kadınlarda eş ve yakın şiddetine maruziyet ile cinsel işlev bozukluğu arasındaki ilişkiyi incelemektir. Yöntemler: Kesitsel tipte ki bu çalışma, Türkiye'nin batısında yer alan bir devlet üniversitesinin Yardımcı Üreme Teknikleri Merkezi'nde infertil 202 kadın ile gerçekleştirildi. Verilerin elde edilmesinde İnfertil Kadınların Şiddete Maruz Kalma Durumunu Belirleme Ölçeği, Kadın Cinsel İşlev İndeksi ve bilgi formu kullanıldı. Bulgular: İnfertil Kadınların Şiddete Maruz Kalma Durumunu Belirleme Ölçeği toplam puanı 40.5 ± 9.9 idi. Kadın Cinsel İşlev İndeksi puanı 34.9 ± 6.4 olup 36 kadında (% 17.8) cinsel işlev bozukluğu vardı. Cinsel işlev bozukluğu olan kadınların, İnfertil Kadınların Şiddete Maruz Kalma Durumunu Belirleme Ölçeği toplam puanı (47,8 ± 14,7), cinsel işlev bozukluğu olmayan kadınların toplam puanından (38,9 ± 7,7) anlamlı düzeyde yüksekti (p <0,001). İnfertil Kadınların Şiddete Maruz Kalma Durumunu Belirleme Ölçeği toplam puanı ile Kadın Cinsel İşlev İndeksi toplam puanı arasında negatif korelasyon vardı (r = - 0.268; p <0.001). Sonuç: Bu çalışmada infertil kadınların şiddete maruz kalma düzeylerinin düşük olduğu tespit edilmiştir. Ancak şiddete maruz kalma düzeyi arttıkça cinsel işlev bozukluğu da artmaktadır. İnfertil kadınların şiddete maruz kalma düzeyleri ve cinsel işlev bozuklukları belirlenmelidir.
... 5 DV is the most common form of violence against women globally, 6 and 1-3 of 5 women will experience a form of violence in their lifetime. 7 According to the WHO report in 2013, almost a third (30%) of women in the world experienced DV, and in some areas it reached 38%. 5 In Iran, the overall prevalence of DV against women is estimated to be 48.9%. 8 According to Sahraian et al., social violence is more than 80%; 73% of wives were regularly beaten by their husbands, and the rate of humiliation was estimated to be 77.2%. ...
... 34 However, a study from India using a standard violence questionnaire showed a higher prevalence of physical and sexual violence (78%) than emotional violence (1.8%). 7 Another large population-based cross-sectional survey in married women residing in urban Rasht (northern Iran) showed that 57.1% suffered psychological aggression, 27.6% physical abuse, 26.6% sexual abuse and 6.9% injury. 26 Another systematic review and meta-analysis in Iran showed that the prevalence of IPV was 66%. ...
Article
Background: . WHO has identified intimate partner violence (IPV) as a health priority as it has considerable consequences on the physical and psychological health of women. We aimed to evaluate the prevalence of IPV in women of one of the central cities of Iran in addition to examining the effect of a women's job and spousal addiction on IPV. Methods.: We did a cross-sectional study on 240 homemakers and nurse women, selected by a multistage random sampling method. Data were collected by a modified version of domestic violence CTS-2 of Straus questionnaire and were analysed by chi-square test and t test. Multivariate logistic regression was used to assess the predictors of physical IPV as the most important type of violence. Results.: The mean (SD) age of the women and their husbands was 33.1 (8) and 37.8 (8.7) years, respectively. Verbal (95.4%) and psychological (80.8%) violence were the most common while injury (14.6%) was the least prevalent. The prevalence of physical violence was 28.8%. Based on the regression model, economic problems, history of divorce in the woman's family and spousal addiction were the highest predictors of violence (p<0.05). Discussion.: Spousal addiction was related to higher violence against women in physical, psychological and injury dimensions. Increase of family support, removal of economic disparities and tackling drug addiction could be effective in decreasing violence.
... The presence of infertility is signaled, not by the presence of pathological symptoms, but by the absence of a desired state of 'non-event transition', in the words of Koropatnick. 1 Infertility is a worldwide problem affecting people of all communities, though the cause and magnitude may vary with geographical location and socioeconomic status. 2 So far the definition of infertility has not been really consistent and defined differently by various disciplines. Infertility primarily refers to the biological inability of a person to contribute to conception. ...
... 36 According to the results from some studies, several types of violence had been expressed simultaneously. 25,39,42 Additionally, there was also an increase in economic violence (for example, economic deprivation) according to some reports [ Table 2]. 18,31,32,36 Five studies reported the comparison of DV in fertile and infertile women. ...
Article
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Domestic violence (DV) against infertile women is an important health concern, which affect their well-being. This systematic review and meta-analysis investigated the prevalence of DV against infertile women. The study was done based on the preferred reporting items for systematic reviews and meta-analysis (PRISMA) on international electronic databases. Inclusion criteria were cross-sectional studies published in English and Persian journals, which investigated the prevalence of DV against infertile women up to May 2020. Out of 634 studies, 26 cross-sectional studies were systematically reviewed, from which 16 studies were included in the meta-analysis. Violence varied widely in infertile women, from 14.987 to 88.918%. The results of meta-analysis showed that the prevalence of violence was equal to 47.163% (95% CI 34.660 to 59.850%). Psychological and emotional violence was the most common types of violence. Considering high rate of DV, policymakers are recommended to address the problem by providing supportive cares including educational and counseling services. Keywords: Women's Infertility, Violence, Domestic Violence, Intimate Partner Violence
... Female infertility, male infertility or a combination of the two, affects millions of couples in the world each year. It is estimated that globally 60-80 million couples suffer from infertility every year , this approximately equals 10 to 15 percent of couples that have trouble getting pregnant or getting to a successful delivery (Pasi et al., 2011) . ...
Research
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A graduate research of the 4th stage of the college of nursing, supervised by Dr. Ali A. Al-fahham
... Female infertility, male infertility or a combination of the two, affects millions of couples in the world each year. It is estimated that globally 60-80 million couples suffer from infertility every year (Pasi et al., 2011) 1 . ...
Article
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Recently, a great attention has been paid to the role of hormones as a diagnostic too in the evaluation of female infertility. The purpose of this study was to identify the association between female infertility and hormonal imbalance (FSH, LH and Prolactin) and what is the relationship between these hormones and the woman's socio-demographic and clinical characteristics. The study was carried out at the Fertility Center in Al-Sadr Medical City, which is located in Najaf province, Iraq, during the period from Dec, 2014 to Apr, 2015. The study involved (44) infertile women who attended the Fertility Center. In accordance to the socio-demographic data, the majority of the studies women were from urban regions (81.18%), while all them were housewives. The clinical history revealed a relatively high percentage (56.82%) of vaginitis, and UTI (50%) among the studies women, while most of them were either overweight (40.91%) or obese (22.73%). The results showed that the majority of studies women had normal hormonal levels according to the standard reference limits for FSH, LH and Prolactin. The study also showed that there was a significant positive correlation between the level of FSH and the age of the studies infertile women. It was concluded that hormonal imbalance for (LH, FSH and prolactin) is just a minor suspected etiologic factor in causing infertility in the studies women the level of FSH increases with age, while the level of prolactin slightly decreases with age. It was recommended to achieve a comprehensive case-control study for evaluating hormonal imbalance of (FSH, LH, prolactin, estrogens, progesterone, thyroid and inhibit) hormones in the infertile women.
... Different studies have reported 33.6-77.8% of infertile women to experience marital violence. [9,[16][17][18][19][20] Psychological violence reported in our study is 34%, whereas in other studies it was observed to be 33.8-74.3%. [19,[21][22][23] Physical violence in our study was 11%, whereas in the studies by Farzadi et al. [22] and Ardabily et al. [17] it was 45% and 14%, respectively. ...
Article
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Background and Aim In Asian countries, child bearing is a social obligation. Experience of infertility profoundly affects the personal well-being of women. Women with infertility are at a higher risk of anxiety, depression, and Intimate partner violence (IPV). In this background the present study was carried out to determine IPV and psychiatric comorbidity in women with infertility. Methods Hundred consecutive women with primary infertility in the age group of 18 years to 45 years were included in the study. Psychiatric diagnosis was made according to DSM-5. Hamilton Anxiety Rating Scale (HAM-A) and Hamilton Depression Rating Scale (HAM-D) were used to assess the severity of the anxiety and depressive symptoms. IPV was assessed using WHO violence against women instrument. Results The mean age of the 100 women was 26.73 ± 4.23 years, duration of marriage was 7.11 ± 4.177 years and duration of infertility treatment in years was 5.56 ± 3.89. The prevalence of IPV among patients was 50% and psychiatric comorbidity was 46%. When we compared the women who experienced IPV and who did not, the prevalence of anxiety disorder and depressive disorder was high among IPV group. Anxiety, depressive scores in HAM A, HAM D were higher in IPV group compared to the other group and was statistically significant. Conclusion A significant number of women who had infertility reported IPV. This emphasizes the importance of screening for IPV in these women. It is observed that women with IPV had higher psychiatric comorbidity and may require psychotherapeutic intervention.
... [1,2] Annually, an estimated 60-80 million couples are affected by infertility worldwide. [3] Infertility is an unpleasant and stressful occasion in the life of a person and may lead to psychological disorders such as depression and anxiety in both men and women. [4] Generalized anxiety disorder (GAD) is one of the psychological disorders which is often happening in GAD commonly experience lower levels of two dimensions of physical and psychological aspects of health-related quality of life, including physical functioning, role physical, role emotional, bodily pain, general health, vitality, social functioning, and mental health. ...
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Background: Generalized anxiety disorder (GAD) is a common disorder in infertile people. The aim of this study was the identification of associated risk factors for the severity of GAD in infertile people using an ordinal model with a flexible link function. Materials and methods: This cross-sectional study was conducted on 1146 individuals with a couple's infertility problem selected from an infertility center in Tehran, Iran. Data collected using self-administered questionnaires include demographic/clinical information and GAD-7. We used a Bayesian-ordered symmetric power logit (splogit) model to identify the risk factors for the severity of GAD. Furthermore, we implemented standard ordinal models to compare with the ordered splogit model. Results: Female gender (B coefficient 0.48, 95% credible interval [CrI]: 0.34-0.62), longer duration of infertility (B coefficient 0.03, 95% CrI: 0.01-0.04), previous treatment failure (B coefficient 0.17, 95% CrI: 0.03-0.30), and self-cause of infertility (B coefficient 0.12, 95% CrI: 0.01-0.23) were associated factors with the severity of GAD. The splogit model had a better fit and performance to determine the associated risk factor for the severity of GAD as compared to standard models. It provided more precise estimates of risk factors and one more significant risk factor. Conclusion: Infertile people with female gender, longer duration of infertility, failure in previous treatments, and self-cause infertility are more likely to experience higher severity levels of GAD and require additional psychological, and support interventions. Furthermore, it can be argued that the ordinal splogit model is more powerful to identify the associated risk factors for the severity of GAD.
... It affects millions of couples in the world each year. It is estimated that globally 60-80 million couples suffer from infertility every year (1) . Female infertility affects estimated 48.5million women in the world with the highest prevalence of infertility affecting people in South-Asia, Sub-saharan Africa, North Africa/Middle east, Central or Eastern Europe or central Asia (2) . ...
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The prevalence of infertility is estimated to be between 12 and 14%. It thus represents a common condition, with important medical, economic and psychological implications. The aim of the study was to determine the studies follicle stimulating hormone (FSH), luteinizing hormone (LH) and prolactin (PRL) levels in infertile women. The study was carried out at the El-Beyda City, during the period from April to December 2017.The details pertaining to the patients regarding age, number of childbirth is furnished. The blood was collected during mid cycle, serum decanted and used for analysis. FSH, LH and PRL were estimated by Immuno enzymatic assay by Elisa Reader. The study involved (140) women. The results showed that the majority of studies women had normal hormonal levels according to the standard reference limits for FSH, LH and PRL. The study also showed that there was a significant positive correlation between the change in level of FSH, LH, PRL and the age of the studies infertile women. It was concluded that hormonal imbalance for (FSH, LH and PRL) is just an importance suspected etiologic factor in causing infertility.
... found a lower domestic violence rate of 11.3% among infertile women. However, a study by Pasi et al. [20] gave higher domestic violence rates of 76.3% and 65.9% among infertile women and their fertile counter parts respectively. ...
... The quoted prevalence of DV from different countries is 31.6% in Turkey 28 64% in Pakistan 29 and 77.8% in India. 30 As per the WHO multi-country study on health of women and family violence, those who had ever been in an intimate partnership, 13-61% ever experienced physical violence by a partner; 4-49% cases reported having experienced severe physical violence; 6-59% reported sexual violence by a partner at some point of time in their lives; and 20-75% reported experiencing one emotionally abusive act, or more, from a partner in their lifetime. 12 In the WHO multi-country study, 19-51% of women who had ever been physically abused by their partner had left home for at least one night, and 8-21% had left two to five times. ...
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Introduction: Infertility is the failure of a sexually active pair to conceive within 12 months of unprotected coitus. For a couple, experiencing infertility is profoundly stressful and affects the personal well-being of married women. Infertility is usually associated with psychological disturbances in the form of depression, anxiety, and psychosomatic symptoms. Intimate partner violence (IPV) is not uncommon in this group therefore the present study was initiated to study psychiatric morbidity and IPV in infertile women. Material and methods: One hundred consecutive infertile women in the age group of 20-45 years who gave written informed consent were included in the study. Psychiatric morbidities were diagnosed according to DSM-5. Hamilton Anxiety Rating Scale and the Hamilton Depression Rating Scale were used to determine the severity of the anxiety and depression. Intimate Partner Violence was assessed using WHO violence against women instrument. Results: The mean age of studied participants was 30.63±3.17 years. The mean duration of marriage was 6.20±0.92 years and the mean duration of infertility treatment was 4.147±0.83 in years. The prevalence of psychiatric morbidity was 70%. 51% of the patients gave a history of IPV: 56.86% had psychological violence, 31.37% had physical and 11.76% had sexual violence. In comparison to patients who didn’t have IPV, duration of the marriage, duration of infertility treatment, HAM-D scores, and suicidal ideation was more in the IPV group and the difference was statistically significant. Conclusion: Significant portion of married infertile women have psychiatric morbidity and IPV. The relationship between infertility and IPV should be investigated in different cultural contexts.
... Conflicting results exist regarding the rates of IPV among infertile women. 24,25,26 The prevalence of IPV among infertile women is hard to estimate accurately. This would be rendered to variable definitions for infertility and IPV used among studies. ...
Article
Objective: To evaluate domestic violence and sexual dysfunction in infertile women. Materials and methods: We recruited women complaining of infertility (primary or secondary infertility). A control group of fertile women attending the outpatient clinic for any concern was recruited. Domestic violence was evaluated using the Arabic validated NorVold Domestic Abuse Questionnaire (NORAQ). Female sexual function was evaluated using the Arabic validated female sexual function index. Results: There was no significant difference between both groups in rates of exposure to violence (p-value 0.830). Primary infertility was a significant contributing factor in infertile women's exposure to violence (p-value 0.001). All the studied population had female sexual dysfunction, with more dysfunction was reported by the infertile women (total score 18.87 ± 5.92, 19.51 ± 5.42, p-value 0.072). They differed significantly in arousal (2.83 ± 1.33, 3.13 ± 1.29, p-value 0.001) and satisfaction (3.98 ± 1.27, 4.28 ± 1.28, p-value 0.003) which were impaired in infertile women. Conclusions: The recruited infertile women were exposed to violence. Emotional abuse was the most common reported type of violence. Sexual dysfunction was reported in the entire studied population with no significant difference relating to fertility.
... Female infertility affects millions of couples in the world each year. It is estimated that globally 60-80 million couples suffer from infertility every year [8]. Many infertility cases are attributable to other medical circumstances. ...
... Female infertility affects millions of couples in the world each year. It is estimated that globally 60-80 million couples suffer from infertility every year [8]. Many infertility cases are attributable to other medical circumstances. ...
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This study carried out to investigate the relationship between prolactin, LH, FSH, TSH hormones and female infertility. The results demonstrated high significant of prolactin (P<0.01) between infertile women as contrasted with an intact group. The outcomes additionally indicated a significant difference at (P<0.01) of TSH of infertile women as contrasted and unblemished and demonstrated a significant difference at (P<0.05) of infertile women as contrasted and with intact. There were no significant differences of (FSH) level between infertile women and intact. The investigation shows the part of prolactin hormone was the most impact of the female infertility.
Article
Objective Our objective was to estimate the prevalence and risk factors for domestic violence among women seeking infertility treatment at an IVF center. Study design This cross-sectional study was conducted with 423 infertile women who referred to the IVF Center in the southwest of Turkey between 1 January and 31 July 2016. The women were interviewed without their male partners by using the questionnaire and Infertile Women’s Exposure to Violence Determination Scale. Results A total of 306 participants (72%) declared having experienced domestic violence. It was found that 30% of the women exposed to violence stated that they were subject to physical violence, 6% to sexual violence, 62% to emotional violence, and 19% to economic violence. It was determined that the total mean score obtained by the women exposed to violence from Infertile Women’s Exposure to Violence Determination Scale was 120.04 ± 12.69 and when it was evaluated based on the total mean scores to be obtained from the scale, level of violence experienced by the women was found to be severe. Conclusions The rate of exposure to violence was determined to be high in women included in the study. The most common type of domestic violence is psychological violence.
Article
While it is estimated that 15% of couples worldwide are infertile, this figure hinges critically on the quality, inclusiveness and availability of infertility data sources. Current infertility data and statistics fail to account for the infertility experiences of some social groups. We identify these people as the invisible infertile , and refer to their omission from infertility data and statistics-whether intentional or unintentional-as the process of invisibilization . We identify two processes through which invisibilization in survey data is produced: sampling, with focus on exclusionary definitions of the population at-risk, and survey instrument design, with focus on skip patterns and question wording. Illustrative examples of these processes are drawn from the Integrated Fertility Survey Series and the Demographic and Health Surveys. Empirical research is not designed in an objective vacuum. Rather, survey instruments and sampling techniques are shaped and influenced by the sociocultural norms and geopolitical context of the time and place in which they are created and conducted, reflecting broader social beliefs about family building and reproduction. Furthermore, population policy singularly aimed at curbing overpopulation in high fertility parts of the world limits the type of reproduction data collected, effectively rendering the infertility of some groups epidemiologically unfathomable. In light of these sociocultural and geopolitical forces, many marginalized groups are missing from reproductive health (RH) statistics. The omission of entire groups from the scientific discourse casts doubt on the quality of research questions, validity of the analytic tools, and accuracy of scientific findings. Invisibility may also misguide evidence-based RH and family planning policies and deter equitable access to reproductive healthcare for some social groups, perpetuating social inequalities.
Chapter
In many countries globally, intentional self-injury has become a frequent reaction to emotional distress, particularly among young adults. In high-income countries, the substances ingested are analgesics, antidepressants and sedatives, all of which are relatively harmless. However, the scenario is quite different in low- and middle-income countries (LMICs), especially in rural areas where agricultural pesticides are used to attempt self-harm. All across the world countries have accrued tremendous benefits from pesticide use. Pesticides have enhanced agricultural production dramatically in most countries thereby ensuring food for the increasing population. They have been instrumental in effectively controlling vector-borne diseases. In the 1950s and 1960s there was much glorification about the advantages of pesticides in reducing world hunger, increasing crop productivity, controlling pest infestation and crop damage and so on. However, recent evidence suggests that pesticides have considerable deleterious impact on the environment and human health. Moreover, accidental poisoning and pesticide-related self-harm/suicide is emerging as a grave public health issue in several nations, particularly in LMICs. The present chapter aims to highlight the issue of easy availability of pesticides in an agrarian region in India, the aggressive marketing by pesticide companies, the limited role of the local administration in the sale of pesticides, and specific sociocultural contexts such as dowry and domestic violence, in which pesticides are consumed.
Article
Globally, the research has consistently found that at least one-third and as many as three-quarters of women report a history of sexual coercion and associated cause for mental-health problem. The majority of the research on sexual coercion comes from developed countries. Women in India are 'taught' to be inferior to men, are expected to serve, obey and satisfy their husband’s sexual needs. Research exploring the subjective experience of coercion, the context in which it occurs and its consequences among women living in Indian society with a psychiatric disorder are urgently needed. Therefore, the current study uses a qualitative research design and phenomenological approach to explore the issues related to sexual coercion among Indian women living with a psychiatric disorder. Results illustrated psychiatric women (n = 168) reported that their husbands were the prime (50%) perpetrator. Further, teachers (25%), blood relatives (19%) and their friends (6.5%) followed the numbers of perpetrators. About 40% of respondents reported a history of sexual abuse before the age of 18, and 62% of women experienced marital rape. The childlessness of women also causes for sexual coercion. About three-fifth women never report such incidence of sexual coercion. Many women in India, with mental disorders, have been and continue to be exposed to sexual coercion. Interestingly, all women were facing this because they were women in a patriarchal society. In summary, concerted efforts at social, emotional and legal levels can bring change in the lives of Indian women and contribute to the improvement of the mental health of these women. The findings can be used in structuring culturally appropriate, but valid programs aimed at reducing both sexual coercion and the respective mental disorders. Further mixed method research is recommended to enrich and quantify our understanding.
Article
Background: Infertility/subfertility could be a formerly unrecognized risk factor for intimate partner violence (IPV). Objectives: To review the evidence on the association between infertility/subfertility in women and the risk of IPV. Search strategy: Seven databases were searched for articles published in English or Spanish between January 2000 and July 2015. Selection criteria: Studies were included if they analyzed the relationship between infertility/subfertility and IPV in a quantitative manner. Data collection and analysis: A systematic search was completed by one author, and articles meeting the inclusion/exclusion criteria were chosen by two authors. It was not possible to pool the data because of heterogeneity in the study design, the methods, and the definitions of IPV and infertility/subfertility found across the studies. Instead, a narrative report was completed. Main results: Twenty-one papers met the inclusion/exclusion criteria. The available evidence indicated that infertility/subfertility is associated with IPV in low- and middle-income countries (LMICs). Conclusions: Infertility/subfertility is associated with an increased risk of experiencing IPV in LMICs. Future research should focus on studies with a homogenous design, rigorous methodology, and appropriately selected study and control groups. Qualitative research would also be invaluable to assess the impact of relevant social variables on outcomes.
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Background: The aim of this descriptive study was to evaluate the level of marital violence among Turkish women and to determine whether infertility was a risk factor for marital violence. Materials and Methods: This descriptive study was conducted during January-July 2009 at a training hospital. The study groups comprised 204 fertile and 228 infertile women. We administered the Descriptive Information Questionnaire and Scale for Marital Violence against Women (SDVW) to obtain data. Results: There was a statistically significant difference between infertile and fertile women for the total score of violence in marriage. The emotional, economic and sexual violence scores were higher in the infertile group. However, the verbal violence score was lower. Conclusion: We performed a detailed study aimed at uncovering the presence of any violence from the data collection stage to the end of treatment in infertile couples with the intent to include questions to this effect in the care plan
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There has been very little documentation of the social meaning given to infertility in many developing countries, including Nigeria, where the prevalence of infertility is known to be high. We have conducted a number of qualitative studies aimed at exploring socio-cultural issues associated with infertility in Ile-Ife, Southwestern Nigeria. Twentyfive focus-group discussions were held with knowledgeable persons in the rural and urban parts of the community to ascertain their attitudes towards infertility. The results show that community members accord great significance to childbearing, but, they have incorrect knowledge of the causes and appropriate treatment of infertility. Focus-group participants mentioned several traditional beliefs regarding the causes of infertility from which they derived a variety of traditional and religious methods for its treatment; many affected couples use these methods of treatment, sometimes singly but most often in combination. Orthodox treatments are less often used because of perceptions of the causes of infertility and lack of confidentiality at the treatment centres. Women are more likely to suffer the social consequences of infertility; they suffer physical and mental abuse, neglect, abandonment, economic deprivation and social ostracism as a result of their infertile status. These findings have profound implications for reproductive health and reproductive rights of women in the area. Measures recommended to ameliorate the adverse consequences of infertility in the community include provision of broad reproductive health education and appropriate services; integration of infertility treatment and prevention into primary health care and the traditional system of health care delivery; and programs aimed at the empowerment of women in the area.
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