INTRODUCTION:

Infertility is a global health issue affecting millions of people of reproductive age worldwide. Available data suggests that globally one in six people experience infertility in their lifetime. Infertility is a disease of the male or female reproductive system defined by the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse. Primary infertility is the inability to have any pregnancy, while secondary infertility is the inability to have a pregnancy after previously successful conception. WHO’s International Classification of Diseases provides more information on the many primary and secondary causes of infertility in both women and men. Globally, most infertile couples suffer from primary infertility.¹

Infertility affects approximately 15 percent of Indian couples. Late marriages, stressful lifestyles, obesity, high junk food intake, smoking, alcoholism, and drug addiction contribute to the problem.²The common problems that cause infertility in women include polycystic ovary syndrome, which is found in a high percentage of women nowadays. The syndrome has several stages and is often curable through medication and treatment. Other issues faced by women include a diminished ovarian reserve, where the eggs in a woman reduce with each menstrual cycle, and endometriosis, a condition where the growth of the tissue inside the uterus is moved outside. Due to these problems about 85,000 women undergo IVF treatments on a yearly basis.³

Childbirth is the most joyous event in every woman's life. Parenthood is viewed in most cultures as an entry into adulthood, and also an important part of status. Some couple delay pregnancy due to the changing lifestyle and career involvement. At the same time, many couples’ experience difficulty in conceiving and carrying a child. Infertility may be perceived as a tragedy in the lives of many women in developing countries. It is considered as the responsibility of the females to give birth to their own children. Women without children may be stigmatized and isolated from the society. Childlessness leads to an increased incidence of domestic violence in female partner and remarriage in male partner. The desire for children is strong in many couples. If a couple did not achieve pregnancy or produce a living child as expected, the man and woman often experience psychological distress. They may feel unlovable or unappealing to their mates. The main factors contributing to infertility in males are defective spermatogenesis, failure to deposit sperm high in the vagina due to erectile dysfunction. ejaculatory defect and hypospadiasis. Sperm abnormality like loss of sperm motility. abnormal sperm morphology, errors in the seminal fluid may also lead to male infertility. The female factors contributing to infertility are ovulatory dysfunctions, tubal obstruction. anatomical and physiological defects in the cervix and uterine factors like fibroid uterus, endometritis etc. Advanced age beyond 35 especially of wife, infrequent intercourse. lack of knowledge of coital technique and timing of coitus to utilize the fertile period. Apareunia or dyspareunia, anxiety and apprehension.use of spermicidal lubricants and immunological factors may also cause infertility. The modern treatment modalities like artificial insemination, assisted reproductive technology, Ovum and sperm donor program and surrogacy are also available for the correction of fertility problem in infertile couples.⁴

According to WHO - April 2023, 1 in 6 people globally affected by infertility: Large numbers of people are affected by infertility in their lifetime, according to a new report published by WHO. Around 17.5% of the adult population – roughly 1 in 6 worldwide – experience infertility, showing the urgent need to increase access to affordable, high-quality fertility care for those in need.⁵With advances in medical science, infertile couples can now have a biological child using advanced procedures like In Vitro Fertilization (IVF), which has shown to be successful in about 90 per cent of cases, making it a popular choice for infertile couples. Fertility treatments necessitate a high level of attention and insurance coverage. Experts recommend that insurers include intrauterine insemination (IUI), in vitro fertilization (IVF), or frozen embryo transfer (FET) in their policies. comprehensive care and coverage for fertility therapy would open up a new vision for all stakeholders in the fertility industry.²

NEED FOR THE STUDY:

According to WHO, in the year 2023-Infertility affects millions of people of reproductive age worldwide – and has an impact on their families and communities. Estimates suggest that between 48 million couples and 186 million individuals live with infertility globally.⁶

Infertility affects up to 15% of reproductive-aged couples worldwide. According to World Health Organization estimate the overall prevalence of primary infertility in India is between 3.9 to 16.8%. In Indian states prevalence of infertility varies from state to state such as 3.7 per cent in Uttar Pradesh, Himachal Pradesh, and Maharashtra, to 5 per cent in Andhra Pradesh, and 15 per cent in Kashmir and prevalence varies in same region across tribes and caste. Globally, most infertile couples suffer from primary infertility.⁷

Figure 1: Prevalence of Infertility

June 2021, Marital Duration, and Fertility-Related Stress as Predictors of Quality of life: Gender Differences among Primary Infertile Couples-The study aimed to understand the gender differences of psychological factors related to infertility in couples with primary infertility. Furthermore, an attempt was also made to understand gender-specific associations that could interact with the fertility-related quality of life. This cross-sectional hospital-based study included 100 married couples with the diagnosis of primary infertility, irrespective of the cause of infertility. The fertility problem inventory and fertility-related quality of life these factors were used to measure the couple’s fertility-related stress and fertility-related quality of life, respectively. The result of study shows that Fertility stress was a significant mediating factor between marital duration and global fertility-related quality of life in men. However, women showed a direct negative association between marital duration and fertility-related quality of life. The study provides important insights into the couple's experiences with various infertility problems that may potentially be addressed during psychotherapy or during infertility counseling.⁸

March 2022, Fertility treatments cannot be a one-sided process, both partners have to be fully invested: Fertility treatments and new techniques have recently become much more common as compared to earlier times and they have helped a lot of childless couples conceive and experience the joy of parenting. Couples who have been trying for over a year are ideally recommended fertility treatments in order to conceive. At times, they may also be recommended to women, who are nearing the end of their reproductive potential, have blocked fallopian tubes, endometriosis, advanced maternal age or fibroids. In the case of men, it is generally because of a falling sperm count and quality, erectile dysfunctions due to psychological issues, diabetes, blocked vas deferens or varicocele, hydrocele in the scrotum that can lead to sperm damage.⁹

With the previous statistical analysis 27 million of couples are suffering from primary infertility in India out of that 40-50% attributed to female factors, 30-40% attributed to male factors, globally, most infertile couples suffer from primary infertility, also with my clinical experience most of them couples are ambiguous and anxious about what is going to happen in future. They may be aware but have less information regarding causes, risk factors, prevention, home remedial measures and treatment modalities. So as a researcher taught to give in-depth information through the media as a means of imparting knowledge about infertility. Hence, researcher planned to conduct the research study to broaden the horizon of their lives by providing them adequate knowledge regarding primary infertility and its treatment modalities available. For this purpose, a video assisted teaching has been chosen as a means of conveying knowledge to reach out to the couples, and create a positive attitude towards the treatment and improve the pregnancy rate.

OBJECTIVES OF THE STUDY:

Primary Objective:

● To evaluate the effectiveness of video assisted teaching on knowledge regarding primary infertility and its treatment modalities among married couples.

Secondary Objective:

● To assess the pre-test knowledge score regarding primary infertility and its treatment modalities among married couples before giving Video Assisted teaching program.

● To assess the post-test knowledge score regarding primary infertility and its treatment modalities among married couples after giving Video Assisted teaching program.

● To compare the pre-test and post-test level of knowledge score regarding primary infertility and its treatment modalities among married couples before and after giving Video Assisted teaching program.

● To find out the association of pre-test knowledge score of married couples regarding infertility and its treatment modalities with their selected demographic variables.

Hypotheses

H₀: There will be no significant difference between the pre-test and post test knowledge score after providing video assisted teaching programme among married couples regarding primary infertility and its treatment modalities.

H₁: There will be significant difference between the pre-test and post- test knowledge score among married couples after providing video assisted teaching programme regarding primary infertility and its treatment modalities.

METHODOLOGY:

Research Approach:

Research approach indicates the procedure for conducting the study to accomplish the objective of the study. The selection of research approach is the basic procedure for the research enquiry.¹⁰ In the present study, a quantitative research approach was adopted to assess the effectiveness of video assisted teaching program for improving knowledge about primary infertility and its treatment modalities among married couples attending selected obstetrical and gynecological clinics.

Research Design:

A design is used to structure the research, to show how all of the major parts of the research project work together to try to address the central research questions.¹¹ In this study, pre-experimental one group pre-test post- test design was used. This design is used to assess the effect of an intervention over a period of time.

Group	Pretest	Intervention	Post test
Married Couples	O1	X	O2

Keys:

O1 = Pre-test knowledge score.

X = video assisted teaching.

O2 = Post-test knowledge score.

SETTING OF THE STUDY:

The research study was conducted in selected obstetrical and gynecological clinics in the metropolitan city.

VARIABLES UNDER STUDY:

1. Study Variables:

Independent Variables:

Video assisted teaching

Dependent variables:

knowledge

2. Demographic Variables:

Age, education, occupation, habits, menstrual cycle, duration of menstrual cycle, type of family, sources of information.

Sample:

Sample may be defined as representative unit of a target population which is to be worked upon by researchers during their study.¹²In this study, sample is married couples attending Obstetrical and Gynecology clinics in the metropolitan city and those are fulfilling the inclusion criteria of the study.

Sampling Technique:

Sampling is the process of selecting a representative part of population.¹³

In this study, non-probability purposive sampling technique is used.

Sample Size:

Sample size was determined using the expected proportion of event/outcome values in each time interval of which are estimated from literature¹⁴and using the formula, in this study, the sample consists of 60 married couples.

Sampling Criteria:

Eligibility criteria are the characteristics that delimit the population of interest.

In this study, the sample was selected according to the following criteria:

Inclusion Criteria:

Married couples who are;

● Willing to attend video-assisted teaching programme sessions conducted by the investigator.

● Available at the time of data collection.

● Between the age group 21-45 years.

● Not having child.

● Able to understand English/Marathi/Hindi

Exclusion Criteria:

Married couples who are

● Diagnosed with secondary infertility.

● Not willing to participate in the study.

● Receiving treatment from infertility clinic.

● Not able to read and write.

Withdrawal criteria:

● Married couples who want to withdraw from the study at any given point of time.

Table 1: The Frequency and Percentage Distribution of Married Couples According to Their Selected Demographic Variables N=60

Demographic Variables	No. of Cases	Percentage
Husband
Age Group (yrs)
20 to 25 Years	3	5.0
26 to 30 Years	20	33.3
31 to 35 Years	16	26.7
36 to 40 Years	19	31.7
41 to 45 Years	2	3.3
Education
Primary	5	8.3
Secondary	6	10.0
Higher secondary	23	38.3
Graduate and above	26	43.3
Occupation
Business	11	18.3
Private employee	22	36.7
Government employee	11	18.3
Any other	16	26.7
Habits
Smoking	12	20.0
Tobacco chewing	8	13.3
Alcohol	8	13.3
Addicted to Drugs	0	0.0
Nil	32	53.3
Wife
Age Group (yrs)
20 to 25 Years	17	28.3
26 to 30 Years	36	60.0
31 to 35 Years	5	8.3
36 to 40 Years	2	3.3
41 to 45 Years	0	0.0
Education
Primary	10	16.7
Secondary	12	20.0
Higher secondary	31	51.7
Graduate and above	7	11.7
Occupation
Business	37	56.7
Private employee	12	20.0
Government employee	1	1.7
Any other	13	21.7
Habits
Smoking	0	0.0
Tobacco chewing	1	1.7
Alcohol	0	0.0
Addicted to Drugs	0	0.0
Nil	59	98.3
Menstrual Cycle
Regular	32	53.3
Irregular	28	46.7
Duration of menstrual Cycle
Less than 28 Days	3	6.0
28 Days	10	16.7
1 month	22	36.7
More than 1 month	25	41.7
Common
Types of Family
Nuclear	26	43.3
Joint	34	56.7
Sources of Information
Mass media	13	21.7
Books	2	3.3
Friends	13	21.7
Relative	15	25.0
Any other	17	28.3

Table 4: Association of pre-test knowledge score of married couples regarding primary infertility and its treatment modalities with their selected demographic variables.

Husband
Demographic Variables of Husband	Pre-test: Level of Knowledge				Chi- square Test	P-Value	Sig. at 5% level
Demographic Variables of Husband	Inadequate (0 – 8)	Moderate (9-16)	Adequate (17-25)	Total	Chi- square Test	P-Value	Sig. at 5% level
Age Group (yrs)
20 to 25 Years	1	2	0	3	6.296	0.614	Not significant
26 to 30 Years	4	16	0	20
31 to 35 Years	1	14	1	16
36 to 40 Years	5	14	0	19
41 to 45 Years	1	1	0	2
Total	12	47	1	60
Education
Primary	0	5	0	5	7.273	0.296	Not significant
Secondary	2	4	0	6
Higher secondary	2	21	0	23
Graduate and above	8	17	1	26
Occupation
Business	3	8	0	11	2.907	0.820	Not significant
Private employee	3	18	1	22
Government employee	3	8	0	11
Any other	3	13	0	16
Habits
Smoking	2	10	0	12	3.741	0.712	Not significant
Tobacco chewing	0	8	0	8
Alcohol	2	6	0	8
Addicted to Drugs	0	0	0	0
Nil	8	23	1	32
WIFE
Demographic Variables of Wife	Pre Test: Level of Knowledge				Chisquare Test	P-Value	Sig. at 5% level
Demographic Variables of Wife	Inadequate (0 – 8)	Moderate (9-16)	Adequate (17-25)	Total	Chisquare Test	P-Value	Sig. at 5% level
Age Group (yrs)
20 to 25 Years	4	13	0	17	2.740	0.841	Not Significant
26 to 30 Years	8	27	1	36
31 to 35 Years	0	5	0	5
36 to 40 Years	0	2	0	2
41 to 45 Years	0	0	0	0
Total	12	47	1	60
Education
Primary	2	8	0	10	9.429	0.151	Not Significant
Secondary	1	11	0	12
Higher secondary	7	24	0	31
Graduate and above	2	4	1	7
Occupation
Business	5	28	1	34	4.360	0.628	Not Significant
Private employee	2	10	0	12
Government employ	0	1	0	1
Any other	5	8	0	13
Habits
Smoking	0	0	0	0	0.281	0.869	Not Significant
Tobacco chewing	0	1	0	1
Alcohol	0	0	0	0
Addicted to Drugs	0	0	0	0
Nil	12	46	1	59
Menstrual Cycle
Regular	8	23	1	32	2.097	0.350	Not Significant
Irregular	4	24	0	28			Not Significant
Duration of Menstrual Cycle
Less than 28 Days	0	3	0	3	3.568	0.735	Not Significant
28 Days	3	7	0	10
1 month	5	16	1	22
More than 1 month	4	21	0	25
COMMON
Demographic Variables	Pre Test: Level of Knowledge				Chisquare Test	P-Value	Sig. at 5% level
Demographic Variables	Inadequate (0 – 8)	Moderate (9-16)	Adequate (17-25)	Total	Chisquare Test	P-Value	Sig. at 5% level
Types of Family
Nuclear	7	19	0	26	2.026	0.363	Not significant
Joint	5	28	1	34			Not significant
Total	12	47	1	60
Sources of Information
Mass media	3	10	0	13	3.780	0.876	Not significant
Books	0	2	0	2
Friends	3	10	0	13
Relative	3	11	1	15
Any other	3	14	0	17
Total	12	47	1	60

The data present in the table no 5 reveals the association of pre-test knowledge score of married couples regarding primary infertility and its treatment modalities with their selected demographic variables. So, there was no significant association found between pre-test knowledge score of primary infertility and its treatment modalities among married couples with their selected demographic variables. Hence, null hypothesis (H₀₂)is accepted and research hypothesis (H₂) is rejected.

LIMITATIONS:

The study was limited to:

· Married couples in reproductive age from 21 to 45 years.

· Sample size of 60 married couples.

· The study was conducted only among married couples attending obstetrical and gynaecological clinics.

· Time duration of 4 weeks.

RECOMMENDATIONS:

On the basis of the findings of the study, it is recommended that,

· A similar study can be replicated on large sample with diverse setting like community.

· A comparative study can be done among women in urban and rural area to assess their knowledge and attitude.

· A study can be conducted among nursing students about latest treatment modalities.

· A research study can be conducted to determine the attitude of the married couples.

· A quasi-experimental study can be conducted on latest treatment modalities of primary infertility among staff nurses.

· A similar study can be conducted to assess the practice and attitude of the health care professionals.

· A study can be conducted about preventive home remedial measures of infertility.

· A study can be conducted to assess the effect of stress on infertility among both men and women.

· A descriptive study on attitudes of men and family members regarding treatment about infertility.

CONCLUSION:

Investigator concluded that providing video assisted teaching is an effective teaching strategy in increasing the knowledge of primary infertility and its treatment modalities among married couples. Because many of the couples who attended clinics were not aware of preventive measures and treatment modalities of primary infertility. All participants under study properly responded to self-structured questionnaire in both pre-test and post test phase was interested for the couple to gain adequate knowledge about infertility which was explicated by them while watching the video. The video assisted teaching programmed was successful in providing adequate knowledge to the couples.

ETHICAL CLEARANCE:

Obtained from the Ethical Clearance Committee of Terna Nursing College, Nerul.

CONFLICT OF INTEREST:

Nil.

REFERENCE:

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Received on 01.07.2025 Revised on 18.07.2025

Accepted on 02.08.2025 Published on 14.08.2025

Available online from August 23, 2025

Int. J. of Advances in Nursing Management. 2025;13(3):185-191.

DOI: 10.52711/2454-2652.2025.00036

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Creative Commons License.

Test	N	Mean	SD	Median	Wilcoxon Signed rank test	P-Value	Sig. at 5% level
Pre Test	60	10.37	2.58	10.00	6.762**	0.000	Yes
Post Test	60	17.82	2.61	18.00

Married Couples	Level of Knowledge				Chisquare Test	P-Value	Sig. at 5% level
Married Couples	Poor (0 – 8)	Good (9-16)	Excellent (17-25)	Total	Chisquare Test	P-Value	Sig. at 5% level
Pre Test (%)	12 (20.0%)	47 (78.3%)	1 (1.7%)	60 (100.0%)	64.031**	0.000	Yes
Post Test (%)	0 (0.0%)	18 (30.0%)	42 (70.0%)	60 (100.0%)
Total	12	65	43	120