Psychological Morbidity (Stress, Anxiety and Depression) and Fertility Quality of Life amongst Infertile Women with and without Polycystic Ovary Syndrome (PCOS): A Cross-sectional Study

Background: PCOS is associated with substantial psychological morbidity related to its clinical features and associated infertility. Aim: To compare psychological morbidity and fertility quality of life (FertiQoL) amongst infertile women with and without PCOS and to correlate the psychological parameters with clinical, socio-demographic, endocrine and metabolic parameters. Settings and Design: Analytical cross-sectional study. Materials and Methods: Psychological assessment was done using validated questionnaires for Stress (Perceived Stress Scale); Anxiety (Hamilton Anxiety Rating Scale); depression (Patient Health Questionnaire-9) and quality of life (FertiQoL tool [core]). The main outcome measure was psychological morbidity and FertiQoL scores and correlation of these with clinical, socio-demographic, endocrine and metabolic parameters. Statistical Analysis Used: The categorical data were analysed using the Chi-square or Fisher’s exact test. Shapiro–Wilk test/ t -test was used to assess the normality and Spearman’s rank correlation was applied for correlation analysis. A two-tailed P < 0.05 was considered statistically significant. Results: Stress and anxiety were significantly higher in non-PCOS women. Depression and FertiQoL scores were comparable between the two groups. Amongst PCOS women, longer infertility duration and obesity were associated with the lower quality of life based on FertiQ_E, FertiQ_MB and total FertiQoL scores. In non-PCOS women, obese women were more likely to have depression and lower quality of life. Longer duration of infertility led to depression and poor FertiQ_E scores. On regression analysis in PCOS women, BMI was independent factor having positive association with depression, anxiety and negative association with individual and total FertiQoL scores. Conclusions: PCOS women had comparable depression and FertiQoL scores and lower levels of anxiety and stress when compared to non-PCOS women. Longer duration of infertility and obesity were associated with depression and lower quality of life irrespective of cause.