Association between interpersonal relational factors in couples with tubal infertility and delayed decision-making on definitive treatment: a case control study

Authors

  • Dr. Koigi PK The Nairobi Hospital ,Department of Obstetrics and Gynaecology, University of Nairobi
  • Dr. Kamau RK Department of Obstetrics and Gynaecology, University of Nairobi
  • Dr. Wanjala SM Department of Obstetrics and Gynaecology, University of Nairobi
  • Dr. Maranga ISO Kenyatta National Hospital

DOI:

https://doi.org/10.59692/jogeca.v28i2.337

Keywords:

Relational factors, Delayed decision-making, Definitive treatment, Tubal infertility

Abstract

Background: Infertility affects about 10% of couples and is often characterized by delay in initializing seeking of  treatment, which culminates in delay in appropriate decision-making on definitive management. This creates a  need for understanding the determinants of delay in order to strategize on corrective intervention.

Objective: To determine the association between interpersonal relational factors among couples with tubal  infertility and delayed decision-making on definitive treatment. 

Method: This was an unmatched case-control study at Kenyatta National Hospital Infertility Clinic amongst women  with tubal infertility in who decisions on definitive treatment had been made. Cases were patients with delayed  decision-making (≥4 years), whereas controls were patients without delayed decision-making (<4 years).

Results: Age >35 years (OR 15.93, OR 95% CI 5.36-47.38, p <0.001), low education level (OR 8.56, OR 95% CI 2.98- 24.58, p <0.001) and rural residence (OR 8.74, OR 95% CI 2.89-26.48, p<0.001) were associated with delay. Formal  marriage was negatively associated with delay (OR 0.17, OR 95% CI 0.05 – 0.50, p <0.001). Prolonged duration to  effective communication on difficulty in conception (≥ 25 months), (OR 20.3, OR 95% CI 2.52 – 162.83, p <0.001) and  being blamed by the male spouse (OR 12.73, OR 95% CI 4.54 – 35.62, p <0.001) were significantly associated with  delay. Support by the male spouse, including performance of semen analysis (OR 0.17, 95% CI 0.06 – 0.49, p <0.001)  was negatively associated with delayed decision-making on definitive management. In relation to marital conflict,  the strongest associations with delay were noted with threats of divorce (OR 47.31, OR 95% CI 9.93 – 225.45,  p <0.001), sexual constraints (OR 42.46, OR 95% CI 8.96 – 201.29, p <0.001) and physical violence (OR 27.46, OR  95%CI 3.44 – 218.78, p < 0.001). 

Conclusion: Adverse inter-relational factors among couples with infertility are significantly associated with delay  in decision-making on appropriate treatment of tubal infertility. It is recommended that adequate education on  preparedness for infertility as a possible outcome be encouraged, in order to minimize delay in seeking treatment.

Author Biographies

Dr. Koigi PK, The Nairobi Hospital ,Department of Obstetrics and Gynaecology, University of Nairobi

The Nairobi Hospital

Department of Obstetrics and Gynaecology, University of Nairobi 

Dr. Kamau RK, Department of Obstetrics and Gynaecology, University of Nairobi

Department of Obstetrics and Gynaecology, University of Nairobi

Dr. Wanjala SM, Department of Obstetrics and Gynaecology, University of Nairobi

Department of Obstetrics and Gynaecology, University of Nairobi

Dr. Maranga ISO, Kenyatta National Hospital

Kenyatta National Hospital

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Published

2016-12-01

How to Cite

KOIGI, P., KAMAU, R., WANJALA, S., & MARANGA, I. (2016). Association between interpersonal relational factors in couples with tubal infertility and delayed decision-making on definitive treatment: a case control study. Journal of Obstetrics and Gynaecology of Eastern and Central Africa, 28(2), 9–14. https://doi.org/10.59692/jogeca.v28i2.337