INTRODUCTION

1.1 Background Of The Study

Infertility can result in significant psychosocial impairment due to the fact that reproduction is considered an essential human desire [Khodakarami and Hashemi, 2019]. Infertility, as defined by the World Health Organisation, is a condition of the reproductive system characterised by the failure to conceive after one year of continuous sexual activity [Masearenhas and Flaxma, 2021]. Infertility is a matter of international concern that has far-reaching implications for individuals of all ages and genders [Masearenhas and Flaxma, 2021]. Globally, the incidence can affect as many as 186 million individuals [Rajashekar & Krishna, 2019]. The emotional toll of infertility can be excruciating [Dural & Yasa, 2018]. It has the potential to induce a variety of psychological complications, such as anxiety, depression, tension, low self-esteem, decreased sexual satisfaction, and compromised quality of life. The adverse impact of the resulting psychosocial issues is greater on the female gender compared to her spouse [Rajashekar & Krishna, 2019], particularly in societies where biases against women are prevalent [Dural & Yasa, 2018]. Due to this, an infertile woman may exhibit anger and frustration to a relatively high degree, which may negatively impact her relationships with family, acquaintances, and even her spouse. Similarly, compared to members of the fertile group, infertile women have a higher propensity to experience mental maladies, marital discontentment, and a diminished quality of life [Farrokh and Eslamlou, 2020]. Cultural and ethnic groups frequently impact perspectives on infertility. The prevailing societal expectation in eastern societies is that women fulfil the role of the mother. The absence of pregnancy, regardless of the underlying cause, can give rise to a plethora of psychosocial issues and additional difficulties (Choobfroushzadeh,et al.., 2019). 

Moreover, although infertility does not qualify as a disease, its management can have far-reaching effects on couples' lives, potentially leading to a range of psychological, emotional, and physical disorders or repercussions such as despair, anxiety, distress, hopelessness, shame, and a sense of personal insignificance (Maroufizadeh, 2020). As an illustration, infertility treatment is one of the most stressful factors for infertile couples, according to a quantitative research conducted in Iran (Biovin et al. 2021). On the contrary, (Namujju, 2018) argues that infertility can be fully embraced and dealt with by the couple as a marital obstacle within the context of their enduring affection; however, societal and extended family pressures undermine the bond. In line with the above, this study is focused on unveiling the causes of infertility and attitude of couples towards infertility in Vaden Clinic And Fertility Center Owerri Imo State.

1.2 Statement Of The Problem

Possessing a child, who will offer them joy and happiness, is the aspiration of each married couple. Infertility, a malady of the reproductive system, has an almost equal incidence among men and women (Callahan et al. 2018). A worldwide issue, infertility impacts between 50 and 80 million couples, or 8 to 12 percent, at some point in their reproductive existence (WHO, 2015). Women with infertility have been stigmatised since the beginning of time. Feminine individuals who are considered to be infertile frequently encounter social obstacles such as exclusion from religious observances. Additionally, male factor infertility is a taboo and infrequently discussed topic in society. Couples' relationships are thereby constrained, leading to the occurrence of divorces. Despite couples seeking treatment, women are frequently held responsible for childlessness, and they are expected to endure diagnostic procedures alone in order to determine the cause of infertility (Namujju, 2018). 

A worldwide survey of nearly 17,500 women (the majority of whom were of reproductive age) from ten countries unveiled a dearth of understanding and perspective concerning the biology of reproduction and infertility. Obesity, advanced maternal age, menstrual irregularities, sexually transmitted infections, smoking, alcohol consumption, and numerous others are all risk factors for infertility. 

Enhancing understanding of these variables could potentially reduce the prevalence of infertility by enabling couples to circumvent specific risk factors that are associated with it (Biovin et al. 2021). Additionally, this information may facilitate societal comprehension and compassion towards the infertile couple, thereby potentially alleviating the psychological strain experienced by those impacted. Even more so, it has been discovered that patient education is a critical component of patient satisfaction with infertility care. 

1.3 Objectives Of The Study

The overall aim of this study is to critically assess the causes of infertility and attitude of couples towards infertility in Vaden Clinic And Fertility Center Owerri Imo State. Hence, the study will be channeled to the following specific objectives;

1. Determine prevalence of infertility challenges among couples attending Vaden Clinic And Fertility Center Owerri Imo State. 

2. Assess the knowledge of couples on possible causes of infertility.

3. Ascertain the implications of infertility on couples marital relationship.

4. Determine the attitude of couples towards the management of infertility.

1.4 Research Question

This study will be guided by the following questions;

a. What is the prevalence of infertility challenges among couples attending Vaden Clinic And Fertility Center Owerri Imo State?

b. What are the possible causes of infertility among couples?

c. What are the implications of infertility on couples marital relationship?

d. What is the attitude of couples towards the management of infertility?

1.5 Research Hypothesis

Ho: Couples do not have negative attitude towards infertility

Ha: Couples do have negative attitude towards infertility.

1.6 Significance Of The Study

This study will serve as a material for enlightenment for mostly married couples, and the society at large. To a very great extent, this study will educate families on the need and how to manage family and societal pressures which are associated with the issue of infertility especially among women. The study will further caution the society on the implications of intruding into family matters as delicate as infertility, and the need to offer relevant support to victims of infertility not to add fire to the smoke. This study will add to the existing body of knowledge on medical sociology. It will create room for further research on the challenges associated with infertility among married women.

1.7 Scope Of The Study

This study is structured but delimited to the the causes of infertility and attitude of couples towards infertility in Vaden Clinic And Fertility Center Owerri Imo State.

1.8 Limitation of the Study

Like in every human endeavour, the researcher encountered slight constraints while carrying out the study. Insufficient funds tend to impede the efficiency of the researcher in sourcing for the relevant materials, literature, or information and in the process of data collection, which is why the researcher resorted to a limited choice of sample size. More so, the researcher simultaneously engaged in this study with other academic work. As a result, the amount of time spent on research will be reduced.

Moreover, the case study method utilized in the study posed some challenges to the investigator including the possibility of biases and poor judgment of issues. However, the investigator relied on respect for the general principles of procedures, justice, fairness, objectivity in observation and recording, and weighing of evidence to overcome the challenges. 

1.9 Definition Of Terms

Childless: The absence of children in a family resulting from the inability to conceive a child by married couple or death of existing children.

Couples: This refers to a man and woman united and legally bounded in marriage.

Culture: The arts, customs, beliefs, values, behavior and material objects that constitute peoples’ way of life.

Fertility: The condition, or the degree of being fertile 

Infertility: The inability to conceive after a period of 12 months of uncontrollable and unprotected sexual intercourse.