Prevalence and predictors of sexual problems, relationship stress, and depression in female partners of infertile couples

Christian J. Nelson, Alan W Shindel, Cathy K. Naughton, Michael Ohebshalom, John P. Mulhall

Research output: Contribution to journalArticlepeer-review

121 Scopus citations


Introduction. Infertility has been associated with anxiety, stress, and sexual problems in both men and women. Aim. To assess quality of life, sexual health, and depression in the female partner of infertile couples. Methods. Couples presenting for the evaluation of infertility at two tertiary care medical centers were invited to participate in a survey study. Main Outcome Measures. Female partners completed the Female Sexual Function Index (FSFI) and a modified Self-Esteem and Relationship (SEAR) Questionnaire. Male partners completed the SEAR and the International Index of Erectile Function (IIEF). Both partners completed the Center for Epidemiological Studies Depression Scale (CES-D) for depression and the Short Form-36 (SF-36) for general quality of life. Demographic, fertility, and comorbidity information was recorded. Results. One hundred and twenty-one couples constitute the study population. Mean female and male age was 32 ± 5 and 35 ± 7 years, respectively. Most (92%) couples were married. Mean duration of relationship and marriage were 6.4 ± 3.9 and 3.8 ± 3.2 years, respectively. Mean duration of attempted conception was 24 ± 24 months. On CES-D, 19% of women had moderate and 13% had severe depression. Women reported significantly worse SF-36 Mental Health subscale scores (mean = 47.8, P < 0.05) compared with normative values. The mean total FSFI score was 28 ± 7 (maximum score of 36), with 26% of the women scoring below 26.55, an established cut-off for high risk of female sexual dysfunction. FSFI scores had a modest positive correlation with male IIEF scores (r = 0.37, P < 0.01), and there was a trend toward a negative correlation with female CES-D scores (r = -0.16, P < 0.06). These relationships were maintained on multivariate analysis. Conclusions. Depression and sexual dysfunction are prevalent in female partners of infertile couples. Female sexual function is positively correlated with male partner sexual function in this population.

Original languageEnglish (US)
Pages (from-to)1907-1914
Number of pages8
JournalJournal of Sexual Medicine
Issue number8
StatePublished - Aug 2008
Externally publishedYes


  • Depression
  • Infertility
  • Sexual dysfunction

ASJC Scopus subject areas

  • Urology
  • Obstetrics and Gynecology


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