Comment on "Disability, Psychiatric Symptoms, and Quality of Life in Infertile Women: A Cross-Sectional Study In Turkey".

The aim of this work is to comment on the study about disability, psychiatric symptoms and quality of life in infertile women of Turkey that was published in this Journal. We suggest that future studies use larger samples, consider the influence of factors such as cause of infertility and assisted reproductive techniques (ARTs) and, last but not least, exclude other comorbidities which may influence the data analysis.

Dear Editor,

We read with great interest the article by Sezgin and colleagues[ about psychiatric symptoms, disability and quality of life in fertile and infertile women in Turkey. We agree that infertility is a very stressful experience for women and it can also be influenced by socio-cultural factors. For this reason, it is important to investigate the role of these factors in order to better understand the effects of infertility both in women and couples.

Although we appreciated the methodology used by the authors, we take the opportunity to point out several elements which would let us further realize the results of this study.

First of all, the authors could have used a larger sample in order to increase the validity of their data analysis. Moreover, the study enrolled women who had a diagnosis of infertility but authors did not specify the type of infertility nor the cause (primary infertility, male factor infertility/female factor infertility or both, unexplained infertility). Indeed, many studies about this topic have underlined that the causes of infertility have a different impact on emotional and psychological wellbeing of women affected.[ So, we think that authors should have considered this element in their study.

Also, it is not clear what the type of infertility treatment discussed in the study is and if enrolled women are on their first attempt at treatment or not. Literature underlines that the different types of assisted reproductive techniques (ARTs) differently affect the emotional state of both women and couples. In addition, the failure of treatment may influence the quality of life and the relationship within the couple so it is important to consider this variable as well .[

We would like to know if women with a history of anxiety and depression or with organic pathologies that may affect psychological well-being were excluded from the sample. If these women were not excluded, it would not be possible to conclude that the results registered among the women of this study were related to their infertility condition rather than to other pathologies.

As regards the tests used by the authors, the results are based on the use of self-report psychometric measures. According to our opinion, it is important to consider that these results may have been influenced by a series of individual factors which may limit the validity of self-evaluation instruments. Moreover, it would be interesting to use a test more specific to people suffering from infertility such as the Fertility Quality of Life questionnaire (FertiQoL)[.

Finally, it is important to investigate the consequences of infertility for the partners of the affected women. Indeed, many studies have demonstrated that the experience of infertility may affect sexual function, partner relational satisfaction and general well-being within the couple.[

In conclusion, based on these data and our experience, we strongly suggest that future studies use larger samples, consider the influence of factors such as cause of infertility and assisted reproductive techniques (ARTs) and, last but not least, exclude other comorbidities which may influence the data analysis.