Psychiatric aspects in infertile women seen at the gynaecology clinic in Kenyatta National Hospital

Abstract

The main objective for this study was to survey and show the nature and magnitude of psychiatric morbidityassociated with infertility. Literature review revealed that research work in this field is scanty and often difficult to interprete. However, there is universal agreement that infertility causes considerable emotional distress. This prospective study covered 52 cases of infertility, from the gynaecology clinic at Kenyatta National Hospital (KNH). Twenty seven of these had primary infertility while twenty five had secondary infertility. Thirty five controls matched for age, education, occupation and number of cowives were selected from the family planning clinic at the same hospital. Using a two-stage screening procedure the subjects were interviewed by the author. (appendix i). The data thus collected was analysed using SL-MICRO computer programme. Psychiatric morbidity among the infertile women was 80.2% compared to 5.7% among the control group. There was no statistical,difference in psychiatric morbidity between patients with primary and secondary infertility. More infertile women had visited traditional healers (42.3%) than their fertile counterparts (5.7%). This difference was statistically significant. There was a higher number of polygamous marriages among the infertile women compared to controls. This observation is important although it did not reach statistical significance (p >_0.05 < 0.2). The co-wives would have been acquired after the other wife had "failed" or "ceased" to give birth. The gynaecology clinic in knh handles about 50 patients on a typical clinic day. Twenty to thirty percent of these are infertile. Thus infertility assumes such a magnitudethat one cannot afford to ignore it. In this study, the author found that the psychological component of infertility was not attended to due to various reasons. A holistic approach that integrates psychological support into the total patient care is formulated and recommended.