Comparison of self-esteem and depression among fertile and infertile women in a low resource setting

This study aimed to explore the effect of infertility on self-esteem and depression, and to identify the sociodemographic and infertility characteristics associated with self-esteem and depression among infertile women in Ekiti State, Nigeria. Self-esteem and depression were assessed in 100 infertile women and 100 women seeking family planning (controls) using the Rosenberg Self-Esteem Scale (RSES) and Patient Health Questionnaire (PHQ-9), respectively. Infertile women had significantly lower RSES score (19.4 ± 4.5 vs. 20.7 ± 4.4, p=.038) and higher PHQ-9 score (5.1 ± 4.1 vs. 3.8 ± 3.5, p=.023) compared to controls. Among infertile women, marital status, being remarried, duration of infertility, and RSES score were associated with PHQ-9 score on simple linear regression. On multiple linear regression analysis, the RSES score had a negative association with the PHQ-9 score (β= -0.32, p<.001). In conclusion, infertile women have lower self-esteem and higher depression scores. Mental health screening and management should be an integral part of care administered to infertile women.Impact StatementWhat is already known on this subject? Infertility is a global health problem with negative effects on the mental health and quality of life of couples, especially women.What the results of this study add? Infertile women have lower self-esteem and higher depression scores. The prevalence of major depressive disorder (MDD) is higher among infertile women. Longer duration of infertility, older age, ≤6 years of formal education, and low self-esteem are significant associations of MDD among infertile women.What the implications are of these findings for clinical practice and/or further research? Mental health screening and management should be included in the care given to women undergoing evaluation and treatment for infertility. Larger community-based studies evaluating other aspects of mental health among infertile couples are encouraged.