PROFORMA FOR REGISTRATION OF
SUBJECT FOR DISSERTATION
Submitted to:
Mrs. Lovera Suresh
Head of the Department
Paediatriac Nursing
Sarvodaya College of Nursing,
Bangalore – 560 079
Submitted by:
Ms. G. SHANTHI
1st year M. Sc. Nursing
Dept. of Maternity Nursing
2007-2009
Sarvodaya College of Nursing,
Bangalore – 560 079
 RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,
KARNATAKA BANGALORE

PERFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION

Ms. Shanthi.G
1. NAME OF THE CANDIDATE & 1st year M.Sc.,(Nursing)
ADDRESS Sarvodaya College Of Nursing
#11|2,Agrahara Dasarahalli
Magadi Main Road ,
Bangalore-560079
2. NAME OF THE INSTITUTION Sarvodaya College Of
Nursing,Vijayanagar , Bangalore-
560040
3. COURSE OF STUDY AND SUBJECT First year M.Sc.,(Nursing)
Obstetrics and Gynecological
Nursing
4. DATE OF ADMISSION OF COURSE 06-10-2007

5. TITLE OF THE STUDY “A Study to Assess The

Knowledge and Attitude
Regarding Infertility Among
Women in a Selected Rural
Community , Bangalore with a
view to develop an information
booklet ”
6. BRIEF RESUME OF THE INTENDED
WORK
6.1 Introduction Enclosed
6.2 Need for the Study Enclosed
6.3 Statement of the problem Enclosed
6.4 Objectives of the study Enclosed
6.5 Operational definitions Enclosed
6.6 Assumption Enclosed
6.7 (1)Inclusion &(2)exclusion criteria Enclosed
6.8 Review of related literature Enclosed
7. MATERIALS AND METHODS
7.1 Source of Data
Data will be collected from women in the reproductive age of 15-45.
7.2 Methods of Data Collection –Structured interview method.
7.3 Does the study require any investigation or intervention to be conducted on the
patient or other human beings or animals.
No
7.4 Has ethical clearance has been obtained from your institution.
Yes.
 RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,
KARNATAKA BANGALORE

PERFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION

Ms. Shanthi.G
1st year M.Sc.,(Nursing)
1. NAME OF THE CANDIDATE &
Sarvodaya College Of Nursing
ADDRESS
#11|2,Agrahara Dasarahalli
Magadi Main Road ,
Bangalore-560079

2. NAME OF THE INSTITUTION Sarvodaya College Of

Nursing,Vijayanagar , Bangalore-
560040

3. COURSE OF STUDY AND SUBJECT First year M.Sc.,(Nursing)

Obstetrics and Gynecological
Nursing

4. DATE OF ADMISSION OF COURSE 06-10-2007

5. TITLE OF THE STUDY “A Study to Assess The

Knowledge and Attitude
Regarding Infertility Among
Women in a Selected Rural
Community , Bangalore with a
view to develop an information
booklet ”
6.1 INTRODUCTION

“A baby is a well spring of pleasure

A messenger of peace and love

A resting place for innocence on earth

A link between angels and men”

-Martin Frquhar

It is the dream of every married couple to have a child which will bring happiness

and joy into their life. Most people assume they can have children when they choose after

twenty or thirty years of assuming that they will have children when wanted and spending

time and energy trying to get pregnant, they feel frustrated when they find that to have a

baby when wanted is not so simple.1

The WHO (1992) defines infertility is the inability of a couple to achieve

conception or to bring a pregnancy to term after a year or more of regular unprotected

intercourse (WHO).4

Infertility is a global health issue, affecting approximately 8-10% of couples

worldwide. In India one out of six couples suffer from inability to procreate while

infertility is estimated to have around 7% among Indian women in past 3 years according

to organon fertility survey.1

Women from rural population are likely to be illiterate and employed in the

agriculture. The cause of infertility can rest in the women or the men, or can be from

unknown factors or a combination of factors. Infertility does not have a single cause
because successful pregnancy is a multi step chain of events. But in India, infertility has

devasting consequence for women because the blame for infertility is squarely late only

on the women. It results as a threat to the women’s identity and may influence their self

concept in terms of their inability to conceive, but 40% of couple infertility is due to the

male. The most common cause of male infertility are impaired sperm count, undesended

testicles, testosterone deficiency, blockage of epididymis, retrograde ejaculation. The

cause of female infertility includes polycystic ovarian syndrome, hormonal imbalance,

fallopian block, hereditary, fibroids, early menopause and pelvic adhesions.2

Through ongoing research in the fields of pregnancy induction there are many

ways to treat infertility, it has allowed couples to bear healthy children successfully. In

Bangalore, there are super specialty hospitals and infertility clinic mainly for the mothers

and new born, the aim is to provide best possible care at par with the world’s standards,

infertility clinics includes the Gunashela Surgical and maternity hospital, hope infertility

clinic and research foundation and BACC (Bangalore Assisted Conception Centre). The

first infertility clinic in the country to be designated ISO was set up in the team of healthy

child for healthy couple. Today it is one of the best equipped and most advanced

infertility centers in India offering tertiary care facilities under the stewardship of Dr.

Kamini Rao. Reproduction is the most important event in women’s life. Committed to

make motherhood a reality for every women.2

Women are the bearers and nurtures of the next generation. Birth is as ancient as

life itself and as natural process as breathing.3

6.2 NEED FOR STUDY

Motherhood is the ultimate dream in a women life. To be able to experience this

wonderful feeling, one has to be endowed with the female reproductive organ. If a

woman lacks any of these organs her dream will remain unfulfilled.3

So infertility can happen to any age group between 15-45 years, to any person and

no one thinks it will happen to them.3

Prevalence of infertility affects approximately 8-10% world wide, in India

infertility rate estimated to be 6-7%. The population of infertile couples in India is 15

million compared to six million in the USA according to organon fertility survey.6

Infertility has been relatively neglected as a health problem in South Asia, but

these figures are more significant in a country like India where children are

accepted as an integral part of the cultural and social fabric.6

A global review of infertility from the world fertility survey, the estimated

rates in south Asia are 4% - Bangladesh, 6% - Nepal, 5% - Pakistan, 4% - Srilanka, and

7% - India.6

Infertility risk increases with reproductive age group between 15-45 years are

4.1% of 15-24 years old, 31.1% of 25-35 years old, 21.4% of 35-44 years old.6

Kumar D, conducted a study on prevalence of female fertility in sidhi district of

Madhya Pradesh in Central India. The objective of the study was to determine the

prevalence of infertility in two tribal groups. The data were collected from 1305 people
through structured interview schedule in April 2002. The results they found that the

infertility was significantly higher among Khairwars than non Khairwars.6

Some causes of infertility are pelvic inflammatory disease, sexually transmitted

disease, ovulatory dysfunction, hormonal imbalance, uterine fibroids, endometriosis,

pelvic adhesions and polycystic ovarian disease there are easily correctable, but a

diagnosis is needed before treatment. Before making a decision regarding the kind of

treatment the client should be given proper information and guidance. Arming oneself

with information, resources and support can make them a better infertility patient.

Prakash Trivedi, conducted a study on fibroids major cause of infertility among

Indian women, he studied 2,142 women and found that who are red meat eaters or

overweight and have hypertension tend to get fibroids. Researcher came to an conclusion

that fibroids which are responsible for infertility can be operated and increase the chance

of pregnancy.7

From the experience the researcher felt that infertility can be treated with proper

guidance and treatment, and every couple can have fruitful life. Infertility is not merely a

health problem, it is a matter of social injustice and Inequality for the rural population, as

they are having high levels of child and maternal mortality and morbidity arising from

poor nutrition, economically disadvantage, socially undeveloped and have low levels of

literacy. Knowledge is virtue and knowledge is power therefore the more learned a person

is the more she is educated. Knowledge is gained by educating oneself. It is not necessary

to undergo formal education, although it is the most commonly used method to gain

knowledge.7
6.3 STATEMENT OF THE PROBLEM:

“A Study To Assess The Knowledge And Attitude Regarding Infertility

Among Women in a Selected Rural Community at Bangalore with a view to

develop an information booklet.”

6.4 OBJECTIVES OF THE STUDY:

1) To assess the knowledge and attitude of women regarding infertility.

2) To find out the correlation between knowledge and attitude of women

regarding infertility.

3) To determine the association between the knowledge and attitude among

women regarding infertility in selected variables.

4) To provide information booklet.

6.5 OPERATIONAL DEFINITIONS:

1) KNOWLEDGE: Refers to awareness of information given by mothers on

items of knowledge regarding infertility as assessed by the proper

response to items of the knowledge questionnaire.

2) ATTITUDE : Refers to the opinion of women regarding infertility as

assessed by the proper response to items of the attitude questionnaire.

3) WOMEN : It refers to females in the age group of 15-45 years.

4) INFERTILITY: Refers to a woman’s inability to conceive and give birth

to a living child with regular unprotected intercourse after one year.

5) INFORMATION BOOKLET: It is a list of information which includes

definitions, causes, diagnosis and treatment of infertility.

6.6 ASSUMPTION

Women may have some level of knowledge and indifferent opinion about

infertility.

6.7 (1) INCLUSION CRITERIA:

1) Who are willing to participate

2) Who are available at the time of study

6.7(2) EXCLUSION CRITERIA:

- Who are taking treatment

6.8 REVIEW OF LITERATURE

Review of the literature is an integral component of any study or research project.

It enhances the depth of the knowledge and inspires a clean insight into the cruse of the

problem. Literature review throws light on the studies and their finding reported about the

problems under study.

Review of literature following under sub-headings.

Studies related to incidence of Infertility

Vite Vargas JA, Ortiz Nunez DA, Hernandez Marin I, Tovar Rodriquez JM,

Ayala AR. Conducted a study on epidemiological analysis of infertility in Mexican

population. The objective of the study is to gain knowledge of general characteristics

from patients with infertility. Data were collected from 116 infertile patients through

descriptive, observational, situational and retrospective indagatory study in 1999. They

found that altered ovarian endocrine factor is 82.7%, cervical factor is 80%, maculine

factor is 39%, tuboperitonial factor is 29%. The percentage successful pregnancy is

31.88%.8

Larson U, Masenga G, Mlay J. Conducted a study on infertility in community

and clinic based samples of couples. The objective of the study is to determine the type

and etiology of infertility in a community and clinic based samples. Data were collected

from 2019 women aged 20-44 years through cross-sectional survey in a community based

setting in Moshi. They found that the percentage of primary infertility was 37.1% and

secondary infertility was 62.9% and female factor is 65.9% and male factor is 6.8%, male

and female factor is 15.2% and unexplained infertility is 12.1%. they came to a
conclusion that etiology of infertility were same in the community and clinic based

sample and tubal factor infertility was the commonest cause.9

Singh AJ, Dhaliwal LK. Conducted a study on identification of infertile couples

in a rural area of Northern India. The purpose of the study is to identify infertile couples

through a three stage screening of the cases were done with the help of the health worker

records with the total population of 28839 in 40 villages of PHC, out of 4453 eligible

couples in the PHC, 129 (2.9%) were infertile. (46.5% primary infertile and 53%

secondary infertility). The study revealed that key informants and existing information

structure can be utilized to identify infertility in rural areas.10

Zargar A H, Waxi AI, Masoodi S R, Laway B A, Salahuddin M conducted a

study on epidiomological and etiologic aspects of primary infertility. The objective of the

study is to assess the magnitude of primary infertility and etiologic aspects, the data were

collected from 10063 married couples in Kashmir valley of India. They found that 15%

of the couples had primary infertility and 4.6% had unresolved fertility, etiology of

infertility in female factor is 57.6% and male factor is 22.4%. They came to a conclusion

that primary infertility is as common and distressing problem in India.11

Trent M, Millstein SG, Ellen JM. Conducted a study on gender based

differences in fertility believes and knowledge among adolescents and high sexually

transmitted disease – prevalence communities. The purpose of the study was to examine

gender based differences data were collected from adolescents health study and

population based telephone survey. They found that female adolescents are able to

identify the chlamydia and pelvic inflammatory diseases are causes fertility than male
adolescents. Through this they decided that health education is needed to motivate

adolescents to participate in asymptomatic STD screening programme. 12

Studies related to Etiological and Epidemiological Risk factors regarding

infertility

Kelly – Weeder S, Cox C L. conducted a study on the impact of life style risk

factors on female infertility. The objective of the study were to identify the life style

factors associated with infertility in women and to offer recommendations to women’s

health providers. The data were collected from 824 women between the age of 15 – 45

years through the reexamination of National Survey of Family Growth (NSFG) in 1995.

They found that the infertility is directly related to increasing age, a history of ectopic

pregnancy, current smoking, obesity and self reported health status. They came to

conclusion that women with routine visit can give an appropriate intervention and

reinforcing messages on fertility risk. 13

Trokoudes KM, Skordis N, Picolos MK. Conducted a study on infertility and

thyroid disorders. The objective of the study is thyroid dysfunction affects many organs

including the male and female gonads interferes with human reproduction. They found

that thyroid auto immunity increase the miscarriage rate and came to an conclusion that

awareness of the thyroid status in the infertile couple is crucial because of its significant,

frequent and often reversible or preventable effect on infertility. 14

 Studies related to treatment of infertility

Widge A, conducted a study on experience of urban Indian women with invitro

fertilization. The objective of the study is the social context of infertility and women’s

perception and experiences with IVF. Data were collected from 22 childless women /

couples who sought IVF from two major cities – New Delhi and Mumbai. They found

that infertility affects women’s status and stigmatization and isolation. They came to a

conclusion that in Indian society fertility defines womanhood and motherhood and

infertility is stigmatized and women undergo all kinds of treatment to produce a

biological child. 15
7. Material Methods

7.1 Source of data

Data will be collected from women in a rural community, Bangalore.

7.2 Methods of collecting data

1) Research design - Descriptive design.

2) Setting - Rural area.

3) Sampling technique - Purposive Sampling Method.

4) Sample size - 100.

5) Method of data collection - Interview method.

6) Tool for data collection - Structured interview schedule..

7) Duration of the study - 6 Weeks.

8) Method of data analysis and interpretation - The researcher will use appropriate

statistical technique for data analysis and present in the form of table and diagrams.

9) Variables - Research variables- Knowledge and Attitude.

- Demographic variables

o Age

o Age at menarche

o Source of information

o Education

o Occupation

10) Projected outcome:

Women with increase knowledge and positive attitude can cope with the disease

condition and its consequences.

8. BIBLIOGRAPHY

1. Holistic online com (online). 2000 [cited 2007 Aug 10]; Available from

URL:http://www.holisticonline.com/remedies/infertility/inf_introduction.htm

2. Mayoclinic.com tools for healthier lives [cited on 2008, Feb.12]; Available from

www.myoclinic.com/health/infertility

3. www.ehealthmed.com/library/infertility/ink - causes html - 42K.

4. Fraser Diane M, Cooper Margaret A, Myles Textbook for Midwives. 14th ed. New

York; Churchill Livingstone, 2003.

5. Adele Pillitteri, Maternal and Child Health Nursing, 2nd edition, chapter 6, page 116.

6. Kumar D. Prevalence of female infertility and its socio-economic factors in tribal

communities, 2007 May:8, 7:456. Available from: http://www.rrh.org.au

7. Prakash Trivedi. Fibroids major cause of infertility 2008, Feb 7. New Delhi. Available

from www.bihertimes.com

8. Vite Vargas JA, Ortiz DA, Hernandez Marin I, Tovar Rodriquez JM, Ayala AR,

epidiological analysis of infertility, 1999, Available from PMID:17081929,

pubmed indexed for Medline.

9. Larsen U, Masenga G, Mlay J. Infertility in a community and clinic based sample of

couples. 2006 Jan; 83(1):10-7 Available from PMID:8262584 pubmed-indexed

for MEDLINE.
10. Singh AJ, Dhaliwal LK, Identification of infertile couples in a rural area. 1993.

Aug:98:206-8. Available from PMID 15850324 pubmed-indexed for

MEDLINE.

11. Zargar AH, Waxi AI, Masoodi SR, Laway BA, Salahuddin M. Epidemiologic and

etiologic aspect of primary infertility. 1997 Oct: 68(4):637-43. Available from

PMID:17590841 pubmed-inprocess.

12. Trent M, Millstein SG, Ellen JM. Gender based differences in fertility belief and

knowledge among adolescents, 2006 Mar:38(3):282-7, Available from

PMID:16580364 pubmed_indexed for MEDLINE.

13. Kelly Weeder S, Con CL. Life style risk factors on female infertility, 2006; 44(4): 1–

23, Available PMID:17786646 pubmed indexed for medline.

14. Trokoudes KM, Skordis N, Picolos MK. Infertility and thyroid disorders, 2006 Aug

18(4): 446-51. Available from PMID:16827825 pubmed_indexed for

MEDLINE

15. Widge A. experience of urban Indian women with in vitro fertilization. 2005, Dec:

59(3): 226-33. Available from PMID:1648882 pubmed_indexed for MEDLINE

9. Signature of Candidate :

10. Remarks of the Guide :

11. Name & designation of (in block letters) :

11.1 Guide :

11.2 Signature :

11.3 Head of the Department :

11.4 Signature :

12. 12.1 Remarks of the Chairman & Principal :

12.2 Signature :