Predictive factors of sexual dysfunction in infertile Tunisian Women

 

Aim

 To assess sexual function in a sample of infertile Tunisian woman and to identify the potential risk factors of female sexual dysfunction (FSD).

Design This was a descriptive and analytical cross-sectional study.

Methods

We used an online survey distributed on social-media (infertility groups) from September 2021 to December 2022.

We included all infertile women who had given their clear consent to participate.

Female Sexual Function Index (FSFI) was used to evaluate sexual function. A FSFI score ≤ 26.55 indicated sexual dysfunction.  

Results

102 patients were enrolled. The mean age of women was 32 years (range. 21-46). Most of them (63%) had completed their university studies.  Eleven patients (10.7%) had history of tubal catheterization, 3 patients had a myomectomy and 3 others a laparoscopic cystectomy.

More than half of patients (52.4%) suffered primary infertility. Oral contraception was noted in 23.4% of patients, most of them with secondary infertility.

 As for the partners, the mean age was 37 years (range. 26-57). Half of them (51.5%) had higher education. 11 male partners suffered from premature ejaculation and 9 others from erectile dysfunction.

All couples were married with a frequency of sexual intercourse distributed as follows: ≥3 /week (30%) – 2 /week (46%) – once /week (18%).

The average duration of marriage was 3.8 years (range 1-12 years) with an average duration of infertility of 3.2 years (range 1-11 years)

Infertility was of female origine in 27.2% of cases, male nature (12.6%), mixed (21.4%) and unexplained in 37.9% of cases.   Forty two patients had at least one previous attempt of medically assisted procreation. The procedure had failed in 81% of cases.  The initiation of the sexual act was made by the spouse in 40.8% of cases and by both partners equally in 49.5% of cases.

The mean FSFI score was 20.38 (range. 2-35.4). A sexual dysfunction was observed in 84 patients (81.6%).

Lower educational level, secondary infertility, contraceptive use and a long history of fertility treatment as well as the presence of sexual dysfunction in the male partner, were found to be associated with sexual dysfunction in women suffering from infertility , yet no significant correlation was established. 

 

Conclusion

Infertility is associated with high rates of sexual dysfunction. Thorough counseling and continuing support of infertile women is therefore indicated.