INTRODUCTION:

Back ground of the study:

Parenthood is a fundamental human need. The urge to reproduce is universal. Every human being has a desire to become a parent and look after his or her children. The very desire for parenthood is a step in the direction of creating a family¹.

The WHO has defined infertility as the inability to achieve a pregnancy after 0ne year of unprotected int6ercourse. When a woman has never conceived, despite sexual relation for a period of one year, it is primary infertility. When a woman has previously conceived and is subsequently unable to conceive, despite sexual relation for a period of one year, it is secondary infertility. According to this criterion 20% of couples are infertile though this falls to 10% after 18 months².

It is estimated that about 8%–10% of couples experience some sort of infertility in their reproductive lives. In India, primary and secondary infertility figures, as given in WHO studies, are 3% and 8%, respectively. A report available at the WHO library explains primary and secondary infertility affects 8-12% couples (50-80 million) worldwide ³.

ART is an option for those who fail to conceive with expected management. ART encompasses all the procedures that assist the process of reproduction by retrieving oocytes from the ovary or sperm from the testis or epidydimis. The first assisted reproductive technology was non-coital insemination, which may be intrauterine insemination, or intra vaginal insemination using sperm of a donor or from the woman’s partner.

Evidence from a village-level study in the state of Maharashtra in India puts the level of infertility at 6%–7% ⁷. According to the recent National Family Health Survey in India, 3.8% of women between the ages of 40 and 44 years have not had any children and 3.5% of currently married women are declared in fecund ⁴.

An estimated one in ten couples around world has difficulty conceiving at some point in their reproductive lives. Nearly 5.3 million American women are infertile; representing 9.1% of all women aged 15 to 44. Infertility affects 15 to 20% of all couples who are trying to conceive. The problem may be associated with male factors (40%) or both (10-15%) are unexplained⁵.

Utilization of ART is low compared to the rate of infertility. About 10% of infertile couple only seeks ART of 50-80 million couples throughout the world⁹. The male is directly responsible for infertility in about 30-40%; the female in about 40-505 and both are responsible in about 10% cases. The remaining 10% is unexplained in spite of thorough investigations with modern technical know how⁶.

The investigator observed that though treatments are available, many factors inhibit women from obtaining such treatment. They include misconceptions, malpractices and of course their cost effectiveness. It was felt that many women though they are aware of available ART; they abstain from opting for it. Hence, the investigator felt the need to assess the knowledge of infertile women regarding ART and also to appraise how far these attitudes are influencing utilization of ART.

Objectives:

· To assess the knowledge of infertile women regarding ART.

· To assess the attitude of infertile women regarding ART.

· To correlate the knowledge and attitude of infertile women regarding ART.

· To associate the level of knowledge of infertile women regarding ART with demographic variables.

· To associate the level of attitude of infertile women regarding ART with demographic variables.

MATERIALS AND METHODS:

Research approach and Research design:

A descriptive survey approach, Descriptive and co relational design was adopted for the study. The structured interview schedule was used to assess the knowledge and 5 point Likert scale to assess the attitude of the infertile women regarding ART.

Setting of the study:

The study was conducted in the Gunasheela IVF centre, Basavangudi, Bangalore.

Sample and sampling technique:

The samples for the study included 50 infertile women who had attended Gunasheela IVF centre by non-probability convenient sampling technique.

Plan for data analysis:

Descriptive statistics:

· Frequency and percentage distribution were used to study the demographic variables of the infertile women.

· Mean and standard deviation were used to determine the level of knowledge and attitude of infertile women on ART.

Inferential statistics:

· Spearman’s co relation was used to correlate the knowledge and attitude of infertile women on ART.

· Chi square test was used to find out the association between demographic variables and level of knowledge and attitude of infertile women on ART.

· Level of significance was fixed at 5% level.

RESULTS:

The characteristics of the infertile women were, majority 56% were in the age group of ≤ 25 years, 68% were attained the puberty in the age group of 14 -16 years, maximum number that is 84% were married between the age of 18 and 21 years, 42% of them had 2-4 years of marital life, 48% were graduates, 58% were house wives, majority 68% were Hindus, 54% of infertile women’s monthly income of the family was Rs. 5-10,000 per month, majority 72% got information about ART through health personnel, majority of infertile women 39% of them were never conceived, 78% were diagnosed as primary infertile and 48% of infertile women were infertile for 2-4 years and 74% of them had source of information from health personnel.

Out of 50 subjects assessment of knowledge regarding ART revealed that majority 32 (64%) of them had moderately adequate knowledge, 10 (20%) had inadequate knowledge and remaining 8 (16%) had adequate knowledge regarding ART.

The mean for overall knowledge of infertile women was 18.26 (SD=3.9). The highest mean knowledge score was for general information on anatomy and physiology, pregnancy 7.64 (SD=1.93), the lowest mean score was for infertility 3.7 (SD=1.4) and mean core for ART was 6.84 (SD=1.4). This decrease in total knowledge indicates that the infertile women need more information on infertility and ART.

The assessment of attitude of infertile women revealed that majority 40 (80%) of infertile women had neutral attitude regarding ART and 10 (20%) had favorable attitude. The mean score of overall attitude was 63.52 (SD=8.94).

The correlation between knowledge and attitude showed that there was a positive correlation between knowledge and attitude regarding ART among infertile women. The obtained ‘r’ value was 0.498.

Association of knowledge with demographic variables revealed that there is statistically significant association found between knowledge and demographic variables such as education{ X² = 8.92 (2 df)}, occupation{X² =8.37 (2 df)}, past obstetrical history {X² = 8.67 (2 df)} and type of infertility {X²8=.67 ( 2 df)}at p < 0.05 level. Association of demographic variables with attitude of infertile women revealed that there is statistically significant association found between attitude and demographic variables such as occupation {X²=4.03 (1 df)} and monthly income of the family {X²=5.81 (2 df)}, at p <0.05 level.

DISCUSSION:

The research hypothesis H₁stated, “There is a significant correlation between knowledge and attitude of infertile women regarding ART” was accepted. This shows that efforts can be undertaken by the maternity health nurse to educate the infertile women regarding ART, which may increase their knowledge and improve positive attitude towards ART.

The research hypothesis H₂stated “there is a significant association of knowledge regarding ART with demographic variables” was accepted. This indicates that the level of knowledge is influenced by demographic variables.

The research hypothesis H₃stated “there is a significant association of attitude regarding ART with demographic variables” was accepted. This indicates that the level of attitude is influenced by demographic variables.

Recommendations:

On the basis of the findings of the study it is recommended that

1. A similar study can be undertaken with a large sample for better generalization of findings.

2. A similar study can be undertaken by adopting an experimental design.

3. A study can be done among infertile couples.

4. A study can be done among and families of infertile couple.

5. A comparative study can be done between fertile and infertile women.

6. A comparative study can be done between rural and urban women.

Limitations

1. The study was limited to selected hospital. Therefore the possibility for wider generalization is limited.

2. The study was limited to infertile women.

3. Many women were not willing to reveal their views about ART.

REFERENCES:

1. Fluer Heylinger. Realities in Childbearing. Clinical Obstet and Gynecol. 2001 Mar; 42(1): 164-168.

2. Bennet, R. V. Myles. Textbook for Midwives. New York; International Student Education Publication: 1998; 156-160.

3. Usha Anand. Infertility prevalence etiology of infertility. Central statistical office; 1998.

4. National Family Health Survey 1998–99, India. Mumbai: Inter- national Institute for Population Sciences; 2000.

5. Rezia Koromi, Parthak K. B. Unisas. Estimation of Infertility from Children ever born. B. R. Publishing Corporation 1993; 195-213.

6. World Health Report. New York. Report of the Director General. 2000.

Received on 08.01.2011 Modified on 02.02.2011

Asian J. Nur. Edu. & Research 1(1): Jan.-March 2011; Page 06-08