Prevalence of depression Among Infertile Women in Aden, Yemen: A Cross-Sectional Study

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M. Gubran, Hanan A. A. Mohammed, Lama Gamal Abdalqawi Awadh, and 7 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9706961/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background : No empirical study has evaluated the prevalence of depression or its severity among infertile women seeking reproductive treatment in Yemen. Objectives : This study aimed to determine the prevalence of depression and its severity among infertile women in Aden, Yemen. Methods : This was a cross-sectional study conducted among infertile women attending different infertility centers and clinics in Aden, Yemen, and the score of depressive symptoms was evaluated using the PHQ-9 scale. The data was collected via face-to-face interviewing using a structured questionnaire, and then SPSS was used to analyze the data. Results: Among 101 infertile women who were enrolled in our study, the overall prevalence of depression among infertile women was 71 (70.3%). Those women who had primary school education and housewives had the highest significant rates, with 75% (p = 0.034) each. The significant borderline highest rate was also shown among women in the age groups >36 years (84%, p=0.057). Out of 71 depressed women, 56.3%, 25.4%, and 18.3% of them had mild, moderate, and severe depression, respectively. The severe depression was significantly associated with women who lived in rural areas, had low income, whose duration of infertility was more than 10 years, and those with chronic diseases (p=0.004, 0.036, 0.037, and 0.015), respectively. Conclusion : The prevalence of depression among infertile women in Aden, Yemen, was higher compared to most related global studies. The age groups >36 years, primary school education, and housewives were associated with depression. Depression severity was significantly correlated with rural background residence, low income, duration of infertility over 10 years, and the presence of chronic diseases. Severity Depression Infertility mental health PHQ-9 Aden Yemen Figures Figure 1 Figure 2 Introduction Depression is one of the most frequent mental health problems in the world, accounting for a significant portion of disability, impaired functioning, and lower quality of life, particularly among women [ 1 , 2 ]. Depression is widespread in this demographic, with rates ranging from 30% to 50% and even higher in low- and middle-income countries [ 3 , 4 , 5 , 6 ]. Depression is particularly prevalent among women of reproductive age, as it can have a severe impact on interpersonal interactions, health-seeking behaviours, and medical treatment adherence. [ 7 , 8 ]. Infertility, defined as the inability to conceive after 12 months of regular unprotected sexual contact, is widely acknowledged as a major global public health concern [ 9 ]. Infertility is a major emotional and psychological stressor, in addition to its biological and medical aspects [ 10 ]. Women with infertility frequently describe emotions of guilt, humiliation, inadequacy, low self-esteem, social withdrawal, and isolation. [ 7 , 11 , 12 ]. In many communities, infertility is viewed as a life crisis that destroys identity, marital stability, and personal aspirations, especially if motherhood is a fundamental societal role for women. [ 10 , 13 , 14 ]. A considerable body of evidence suggests a strong link between infertility and poor mental health outcomes. Infertile women had persistently high levels of depression, anxiety, and stress, according to global systematic reviews and meta-analyses. [ 3 , 4 , 5 ]. Infertile women are significantly more likely than fertile women to have depressive symptoms, which can continue even after fertility treatment [ 15 , 16 , 17 ]. Psychosocial therapies have been found to improve psychological outcomes among infertile people, while availability remains limited in many situations [ 18 ]. According to qualitative evidence, infertility is a "silent grief" characterized by emotional distress and unmet psychosocial demands [ 12 ]. Broader social variables, cultural expectations, and gender conventions around reproduction also influence psychological discomfort. [ 7 , 13 ]. In Yemen, several studies were conducted among general women in Aden and hemodialysis patients in Hodeida, and two of them among medical students revealed the rates of depression were 83.3%, 63%, 73.67%, and 48.4%, respectively [ 19 , 20 , 21 , 22 ]. There is still a lack of context-specific study in Yemen on the psychological impact of infertility, especially among infertile women. Understanding the prevalence of depression and related variables among infertile women in Aden is critical. Examining how socio-demographic features, infertility-related issues, and larger social situations interact can aid in early detection, clinical management, and culturally relevant therapies. Therefore, this study was aimed to determine the prevalence of depression and its severity among infertile women in Aden, Yemen, and to determine the associated factors that may contribute to increasing the prevalence of depression among those women. Methodology This study was a cross-sectional design that was conducted during the period from October 2025 to April 2026 on infertile women attending different infertility centers and clinics in Aden, Yemen. The score of depressive symptoms was evaluated using the PHQ-9 scale. The study population included infertile women attending the different health facilities during the data collection period. The study focused on women of reproductive age. Women were included if they were married, diagnosed with infertility, and agreed to participate. Women were excluded if they were single, if the duration of their marriage was less than 12 months, if they had a known history of psychiatric disorders, or if they refused to give consent. The sample size was calculated using the standard formula for cross-sectional studies: n = Z² × p(1-p) / d² Where: n = required sample size Z = standard normal value at 95% confidence level (1.96) p = estimated prevalence of depression among infertile women d = margin of error (0.09) A margin of error of 9% (d = 0.09) was used due to feasibility and resource limitations. A study conducted among infertile women in Saudi Arabia reported that 53.8% of them had a depression [ 23 ]. Based on this prevalence (p = 0.538), the sample size was calculated as follows: The calculation was performed as follows: (1.96)² × 0.538 × (1–0.538) / (0.09)² = 3.8416 × 0.538 × 0.462 / 0.0081 = 0.954 / 0.0081 = 117.8 ≈ 118 women. After adding a 10% non-response rate, the target sample size was 130 women. However, due to time constraints, limited accessibility of participants, and non-response during data collection, a total of 101 infertile women were eventually enrolled. Of 130 eligible infertile women approached, 101 agreed to participate, yielding a response rate of 77.7%. Data Collection Data was collected by using face-to-face interviewing using a previously designed structured questionnaire with some modifications [ 23 , 24 , 25 ]. The questionnaire (File S1) included socio-demographic information such as age, education, occupation, and income; and clinical and infertility-related data such as duration of infertility and treatment of infertility, menopause, and presence of chronic diseases. as well as other data related to sporting status and smoking status. The depressive symptoms were evaluated using the Patient Health Questionnaire-9 (PHQ-9), a validated tool consisting of nine items scored from 0 to 3. The total score ranges from 0 to 27, with scores less than 5 (0–4) indicating no depression and scores 5–9, 10–14, 15–19, and 20–27 indicating mild, moderate, moderately severe, and severe depression, respectively [ 25 ]. The internal consistency of the PHQ-9 scale in our study sample was assessed using Cronbach's alpha, which yielded a value of 0.87, indicating good reliability. Bias reduction To minimize information bias, all interviewers were trained on the administration of the PHQ-9 and the structured questionnaire. Selection bias was reduced by approaching all eligible women attending the participating clinics during the study period. Data Analysis Data were entered and analyzed using the Statistical Package for the Social Sciences (SPSS) version 23. Descriptive statistics such as frequencies, percentages, means, and standard deviation (SD) were used. The chi-square test was applied to assess associations between variables. A p-value of less than 0.05 was considered statistically significant. Missing data was handled by listwise deletion, as the proportion of missing values was less than 5% for all variables except duration of infertility (9.9%), which was reported separately. Reporting guideline This study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines for cross-sectional studies. The completed STROBE checklist is available as File S3. Results A total of 101 infertile women were enrolled in our study on the basis of the inclusion and exclusion criteria. The mean ± SD of age was 31.0 ± 8.11 years. The highest frequencies of infertile women were 43 (42.6%) aged 26–36 years, 99 (98.0%) married, 80 (79.2%) who had primary school education, 81 (80.2%) who lived in urban areas, 80 (79.2%) who were housewives, and 70 (69.3%) who had medium socioeconomic status (Table 1 ). Table 1 Socio-demographic characteristics of infertile women in Aden, Yemen (n = 101) Item Frequency Percent (%) Age 36 years 25 24.8 Marital status Married 99 98.0 Divorced 1 1.0 widowed 1 1.0 Education level Illustrate 9 8.9 Primary 80 79.2 Secondary 12 11.9 Residence Urban 81 80.2 Rural 20 19.8 Occupation Housewife 80 79.2 Daily Laborer 9 8.9 Employment 12 11.9 Income Low 20 19.8 Medium 70 69.3 High 11 10.9 Infertility period 10 years 23 22.8 The overall prevalence of depression among infertile women in this study was 71 (70.3%) (Fig. 1 ). The highest significant rates for depressed women were 60 (75%) among those who had a primary school education and 60 (75%) among housewives (p = 0.034), each. The highest rate was among 21 (84%) in the age groups > 36 years but without significant association (p = 0.057). Other variables had no significant effect on depression (Table 2 ). Table 2 The association between depression and different variables among infertile women in Aden, Yemen (𝑛 = 101) Item Depression p No % Age 36 years (n = 25) 21 84.0 Marital status Married (n = 99) 70 70.7 0.276 Divorced (n = 1) 1 100.0 Widowed (n = 1) 0 0.0 Education level Illiterate (n = 9) 4 44.4 0.034 Primary(n = 80) 60 75.0 Secondary(n = 12) 7 58.3 Residence Urban (n = 81) 56 69.1 0.414 Rural(n = 20) 15 75.0 Occupation Housewife (n = 80) 60 75.0 0.034 Daily Laborer(n = 9) 4 44.4 Employed (n = 12) 7 58.3 Income Low (n = 20) 17 85.0 0.267 Medium (n = 70) 47 67.1 High (n = 11) 7 63.6 Duration of infertility ≤ 5 years (n = 41) 25 61.0 0.233 6–10 years (n = 37) 28 75.7 > 10 years(n = 23) 18 78.3 Menopause Yes (n = 5) 4 80.0 0.532 No (n = 96) 67 69.8 Sport status Yes (n = 8) 4 50.0 0.180 No (n = 93) 67 72.0 Smoking status Yes (n = 7) 3 42.9 0.114 No (n = 94) 58 72.3 Chronic disease Yes (n = 12) 8 66.7 0.503 No (n = 89) 63 70.8 Treatment of infertility Yes (n = 88) 64 72.7 0.144 No (n = 13) 7 53.8 Of 71 depressed infertile women, 40 (56.3%) had mild depression, 18 (25.4%) had moderate depression, and 13 (18.3%) had severe depression (Fig. 2 ). The significant highest prevalence rates for severe depression were 7 (46.7%) among women who live in rural areas, 8 (47.1%) among women who had a low income, 7 (38.9%) among women whose duration of infertility was more than 10 years, and 2 (50%) among women who had chronic diseases (p = 0.004, 0.036, 0.037, and 0.015), respectively. Other results had no significant association with severe depression (Table 3 ). Table 3 The association between severity of depression and different variables among infertile women in Aden, Yemen (𝑛 = 71) Item Severity of depression p - value Mild Moderate Severe No % No % No % Age group 36 years (n = 21) 12. 57.1 5 23.3 4 19.0 Marital status Married (n = 70) 39 55.7 18 25.7 13 18.6 0.424 Divorced (n = 1) 1 100.0 0 0.0 0 0.0 Education level Illiterate (n = 4) 4 100.0 0 0.0 0 0.0 0.217 Primary(n = 60) 33 55.0 15 25.0 12 20.0 Secondary (n = 7) 3 42.9 3 42.9 1 14.3 Residence Urban (n = 56) 35 62 15 26.8 6 10.7 0.004 Rural(n = 15) 5 33.3 3 20.0 7 46.7 Occupation Housewife (n = 60) 33 55.0 15 25.0 12 20.0 0.217 Daily Laborer(n = 4) 4 100.0 0 0.0 0 0.0 Employed (n = 7) 3 42.9 3 42.9 1 14.3 Income status Low (n = 17) 5 29.4 4 23.5 8 47.1 0.036 Medium (n = 47) 33 70.2 10 21.3 4 8.5 High (n = 7) 2 28.6 4 57.1 1 14.3 Duration of infertility ≤ 5 years (n = 25) 17 68.0 4 16.0 4 16.0 0.037 6–10 years (n = 28) 15 53.6 11 39.3 2 7.1 > 10 years (n = 18) 8 44.4 3 16.7 7 38.9 Menopause Yes (n = 4) 1 25.0 1 25.0 2 50.0 0.097 No (n = 67) 39 58.2 17 25.0 11 16.4 Sporting status Yes (n = 4) 2 50.0 1 25.0 1 25.0 0.731 No (n = 67) 38 56.7 17 25.4 12 17.9 Smoking status Yes (n = 3) 1 33.3 1 33.3 1 33.3 0.389 No (n = 68) 39 57.4 17 25.0 12 17.6 Chronic disease Yes (n = 7) 2 25.0 2 25.0 2 50.0 0.015 No (n = 63) 38 60.3 16 25.4 9 14.3 Treatment of infertility Yes (n = 64) 36 56.3 16 25.0 12 18.8 0.863 No (n = 7) 4 57.1 2 28.6 1 14.3 Discussion Absence of children and loss of identity are vital factors for depression among infertile females. In Islamic countries, the occurrence of infertility in females is experienced with marital problems or instability due to multiple marriages, where the men can marry more than one woman [ 26 ]. The present study was the first in Yemen to determine the depression among infertile women, in which the overall prevalence was 70.3%. This finding was consistent with that conducted among Iraqi infertile women, which was 68.9% in [ 27 ]. Our result was higher than various global studies, such as 62.3% in Egypt [ 24 ], 62.0% in Ghana [ 28 ], 57.1% in India [ 29 ], 55% in Morocco [ 30 ], 53.8% in Saudi Arabia [ 23 ], 52.7% in Southwest Nigeria [ 31 ], 44.8% in Hungary [ 32 ], 42.1% in Ethiopia [ 25 ], 41% in Iran [ 26 ], 40.3% in Tanzania [ 33 ], 35.44% in Poland [ 34 ], 25.6% in Nigeria [ 35 ], and 12.2% in Vietnam [ 36 ]. In contrast, two studies conducted among Pakistani infertile women reported higher than our rate, which was 78.4% and 79% [ 37 , 38 ]. One of the highest rates was 95% in Pakistan [ 39 ]. Our finding was also lower than that reported among general women (not specifically infertile) in Aden, Yemen, which was 83.3% [ 22 ], highlighting that infertility is not the sole contributor to depression among women in this context. The differences in sample size, the assessment tests and scoring techniques for depression, culture and religion, and the absence of social support from husbands and family members may be attributed to discrepancies in the prevalence rates in different communities. In the present results, 84% of the women in the age groups > 36 years had depression. It was in agreement with that which was conducted in China [ 40 ]. Age over 35 years is another risk factor for the occurrence of depression among infertile women because hope and the probability of successful medical intervention will be decreased gradually with the increasing age of infertile women, especially with the failure of previously repeated trials for treatment [ 41 ]. Regarding the education level, those women who had a primary school education had the highest significant rates (p = 0.034). Benbella et al. showed that illiterate women had the highest main score of depression [ 30 ]. Fatima et al. noticed that secondary school-educated women had the highest depression rate [ 38 ]. Three studies conducted in Saudi Arabia, Morocco, and Turkey found that the score of depression decreased with the increasing level of education of women [ 23 , 30 , 42 ]. The majority of women in our study had primary school education, and there were no differences between illiterate and primary school-educated women regarding getting work or employment to increase their income to overcome the high cost of success in treatment for infertility. In the current data, the housewives had the highest significant rate of depression (p = 0.034). Two studies agreed with our finding [ 26 , 28 ]. Beyene et al. showed a significant association between unemployed women and detection of depression [ 25 ]. No significant association was found in the report from Pakistan, despite the highest prevalence of depression among housewives [ 38 ]. The increased depression rate among housewives is due to financial issues that may limit access to successful treatment, especially the high cost and expenses of medical care. Staying at home increases feelings of loneliness and social isolation as well as exposing those women to pressure, criticism, and neglect from family members. Employment acts as a protective element against depression, as having employment may give the women self-esteem and confidence, and they may participate in the management of infertility [ 30 ]. In addition, employment might distract a woman from thinking about infertility issues, and occasionally, those women may meet the emotional support from friends and colleagues that may be lacking at home. The current results showed that marital status, residence, income, menopause, smoking status, presence of chronic disease, and treatment of infertility had no significant effect on depression. No previous literature had evaluated these variables among infertile women. The lacking associations may be due to the small sample size of our studied group. According to the severity of depression in the present data, 18.3% of women had severe depression, and 25.4% of them had moderate depression. A study among Iraqi infertile women revealed that more than half of women (50.3%) had moderate to severe depression, and 7.5% had severe depression [ 27 ]. Research from South Africa showed that 45% of women had moderate to moderately severe depression [ 43 ]. A study conducted among Pakistani infertile women noticed that 33.3% and 27.4% of women had moderate and severe depression, respectively [ 38 ]. The discrepancy may be due to differences in scoring assessment techniques for depression and sociodemographic contexts of women. Our study demonstrated that the severity of depression was significantly associated with rural residence of infertile women (p = 0.004). Verma & Baniya found similar results [ 29 ]. In the rural societies, the increasing of severe depression is due to the differences in cultural expectations resulting from family pressures and social stigmas because in those societies, having children is highly valued [ 30 ]. The women living in urban areas have better social support and health care compared to those living in rural areas [ 44 ]. The infertile and childless women may lead to marital instability such as polygamy or divorce, which increases the psychological problems among those women [ 30 ]. Regarding the income of women in the present data, there was a significant association between low income and severe depression (p = 0.036). Several studies reported similar findings [ 30 , 45 , 46 ]. A different result was reported among Pakistani infertile women [ 47 ]. The psychological burden is increased among infertile females due to facing a combination of low income and infertility. The financial problems exacerbate the feelings of hopelessness about obtaining successful treatment for fertility. There is a lack of good facilities and advanced treatment intervention in our country, resulting in seeking those interventions by traveling to other countries, which increases the cost burden. The severity of depression was significantly associated with a duration of infertility over 10 years (p = 0.037). Two studies conducted among infertile women revealed consistent results [ 25 , 30 ]. Increasing the duration of infertility means increasing the repeated treatment intervention combined with a high-cost burden and decreasing the hope for childbearing in the near future [ 48 ]. The results of this study demonstrated that the presence of chronic diseases such as diabetes and cancer was significantly correlated to severe depression (p = 0.015). There was no previous study that had assessed this variable, so this association was reported as the first finding among our study group. The presence of chronic diseases along with infertility increases the risk of depression among women. Our data revealed no statistically significant difference between severity of depression and age group, marital status, education level, occupation, menopause, sporting status, smoking status, chronic disease, or treatment of infertility. The small sample size is the main factor for the lack of associations between the severe depression and these variables. The main limitations of the present study were the type of study, a cross-sectional study that cannot determine the real causation of depression, and the small sample size of infertile women. This study also involved those women who were seeking medical care in fertility centers and clinics, but those who did not seek medical care or those attending to psychological distress were not enrolled. Conclusion The prevalence of depression among infertile women in Aden, Yemen, is higher compared to most global studies. The age groups > 36 years, primary school education, and housewives are associated with depression. Other variables were not significantly associated with the presence of depression among infertile women. Depression severity was significantly correlated with rural background residence, low income, duration of marriage and infertility over 10 years, and the presence of chronic diseases. Lacking associations with other different variables and severity of depression. Future studies should be conducted with a large sample size and involve the fertility centers and psychological centers in Aden and other governorates of Yemen. Abbreviations PHQ-9 Patient Health Questionnaire-9 SPSS Statistical Package for the Social Sciences SD standard deviation Declarations Acknowledgments The authors gratefully thank the infertile women who consented to participate in this study. They also thank the student's team for their contributions to data collection from women. Authors' contributions ANMG, and NTA supervision and revision and final editing of manuscript. HAAM, LAJ, and AIM contributed in writing of introduction and methodology. SMMD inserted the data into SPSS software and analyzed the data. ANMG and HAAM also preparing of tables and figures and discussing of results. LGAA, BA, SR, and MAA collect the data from the infertile women. NTA also arranged the references according the referencing style of journal. All authors contributed the same. Funding The authors declare that no funds, grants, or other support were received during the preparation of this manuscript. Availability of data and materials All data were presented in the manuscript; no further data are available, and they will be available from the corresponding authorupon request. Ethics approval and Consent to Participate The ethical approval of this study was obtained from Faculty’s Medical Research Ethics Committee (MREC), University of Science and Technology, Aden, Yemen, MEC No. (MEC/AD0166). Our research was conducted in accordance with the Declaration of Helsinki. Written informed consent forms were obtained from all infertile women before collection of data (File S2). Consent for publication Not applicable Competing interests The authors have no competing interests to declare that are relevant to the content of this article. References Yan G, Zhang Y, Wang S, Yan Y, Liu M, Tian M, Tian W. Global, regional, and national temporal trend in burden of major depressive disorder from 1990 to 2019: An analysis of the global burden of disease study. Psychiatry Res. 2024;337:115958. Jia Y, Zhou Z, Xiang F, Hu W, Cao X. Global prevalence of depression in menopausal women: A systematic review and meta-analysis. 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Depression, anxiety and stress among female patients of infertility; A case control study. Pakistan journal of medical sciences. 2016 Nov;32(6):1340. Fatima S, Choudhary ZI, Haider N, Minhas FA, Yasir S, Naheed A. Prevalence and determinants of depression in females with primary infertility. The Professional Medical Journal. 2021 Mar 10;28(03):372-6. Qayyum M, Ahmed S, Kanwal S, Ishfaq Y, Hassan H, Ali W, Waheed N, Shoaib K. Frequency of depression among fertile and infertile women. Pakistan Armed Forces Medical Journal. 2014 Dec 1(4):581. Wang L, Tang Y, Wang Y. Predictors and incidence of depression and anxiety in women undergoing infertility treatment: A cross-sectional study. PLoS One. 2023 Apr 13;18(4):e0284414. Dinelli L, Courbiere B, Achard V, Jouve E, Deveze C, Gnisci A, Grillo JM, Paulmyer-Lacroix O. Prognosis factors of pregnancy after intrauterine insemination with the husband's sperm: conclusions of an analysis of 2,019 cycles. Fertility and sterility. 2014 Apr 1;101(4):994-1000. Kazandi M, Gunday O, Mermer TK, Erturk N, Ozkınay E (2011) The status of depression and anxiety in infertile Turkish couples. Iran J Reprod Med 9: 99-104. Mulondo T, Baloyi S, Sempa JB. Prevalence and severity of depression and anxiety in infertile female patients attending an academic hospital in central South Africa. South African Journal of Obstetrics and Gynaecology. 2024 Jun 1;30(1):21-6. Cyr ME, Etchin AG, Guthrie BJ, Benneyan JC. Access to specialty healthcare in urban versus rural US populations: a systematic literature review. BMC health services research. 2019 Dec 18;19(1):974. Teklemicheal AG, Kassa EM, Weldetensaye EK. Prevalence and correlates of infertility related psychological stress in women with infertility: a cross-sectional hospital based survey. BMC psychology. 2022 Apr 7;10(1):91. Rufai AI, Grema BA, Bello MM, Michael GC. Association between family functionality, sociodemographic factors, and severity of depression in women with infertility attending a gynecology clinic in northwest Nigeria. Journal of neurosciences in rural practice. 2022 Mar 10;13(2):246. Ali HS, Shams H, Kessani LV, Ali R. Depression: prevalence and predicators among Pakistani infertile women. The Professional Medical Journal. 2015 Nov 10;22(11):1480-4. Albayrak E, Günay O. State and trait anxiety levels of childless women in Kayseri, Turkey. The European Journal of Contraception & Reproductive Health Care. 2007 Jan 1;12(4):385-90. Additional Declarations No competing interests reported. Supplementary Files FileS1Questionnaire.docx FileS2InformedConsentForm.docx FileS3STROBEChecklist.docx SampleSizecalculation.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9706961","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":640127060,"identity":"0fba6122-0a7c-426c-9fa2-381b6d53c9a5","order_by":0,"name":"Ali N. M. 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M","lastName":"Darwiesh","suffix":""},{"id":640127068,"identity":"ad238518-a0a6-410a-900c-ee34d55f7a26","order_by":8,"name":"Lyan Abdulrahman Jamel","email":"","orcid":"","institution":"University of Science and Technology","correspondingAuthor":false,"prefix":"","firstName":"Lyan","middleName":"Abdulrahman","lastName":"Jamel","suffix":""},{"id":640127069,"identity":"cfbeed0a-a601-4d5f-8839-2c5ce9980157","order_by":9,"name":"Abrar Ibrahim Mohamed","email":"","orcid":"","institution":"University of Science and Technology","correspondingAuthor":false,"prefix":"","firstName":"Abrar","middleName":"Ibrahim","lastName":"Mohamed","suffix":""}],"badges":[],"createdAt":"2026-05-13 18:08:56","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9706961/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9706961/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":109289271,"identity":"98cc813f-8d7b-4d80-9a49-98cccd6f7dd2","added_by":"auto","created_at":"2026-05-15 06:17:06","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":6536,"visible":true,"origin":"","legend":"\u003cp\u003eThe prevalence depression among infertile women in Aden, Yemen (𝑛= 101)\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-9706961/v1/e58f53805ece711270df523d.png"},{"id":109289272,"identity":"ae04fbc8-ef7b-408a-a78a-69471a0af61e","added_by":"auto","created_at":"2026-05-15 06:17:06","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":9322,"visible":true,"origin":"","legend":"\u003cp\u003eSeverity of depression among infertile women in Aden, Yemen (𝑛 = 71)\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-9706961/v1/c1258b8f0c530d54a480a3bc.png"},{"id":109454639,"identity":"bafe10f5-1c1d-447a-911e-f3aee249570a","added_by":"auto","created_at":"2026-05-18 09:41:55","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":429302,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9706961/v1/bd14174d-6ecc-4efc-871d-26e7afeab54c.pdf"},{"id":109289275,"identity":"ae0e3601-ee7d-46d6-abc1-2312907b55e1","added_by":"auto","created_at":"2026-05-15 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08:47:09","extension":"docx","order_by":3,"title":"","display":"","copyAsset":false,"role":"supplement","size":29571,"visible":true,"origin":"","legend":"","description":"","filename":"FileS3STROBEChecklist.docx","url":"https://assets-eu.researchsquare.com/files/rs-9706961/v1/14e8955f7943e83a9c24e09e.docx"},{"id":109405242,"identity":"df67536f-11d2-496e-9d15-2752123cf4a9","added_by":"auto","created_at":"2026-05-17 13:05:43","extension":"docx","order_by":4,"title":"","display":"","copyAsset":false,"role":"supplement","size":13877,"visible":true,"origin":"","legend":"","description":"","filename":"SampleSizecalculation.docx","url":"https://assets-eu.researchsquare.com/files/rs-9706961/v1/843e2771f69acf423fdb8d5f.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Prevalence of depression Among Infertile Women in Aden, Yemen: A Cross-Sectional Study","fulltext":[{"header":"Introduction","content":"\u003cp\u003eDepression is one of the most frequent mental health problems in the world, accounting for a significant portion of disability, impaired functioning, and lower quality of life, particularly among women [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Depression is widespread in this demographic, with rates ranging from 30% to 50% and even higher in low- and middle-income countries [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Depression is particularly prevalent among women of reproductive age, as it can have a severe impact on interpersonal interactions, health-seeking behaviours, and medical treatment adherence. [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Infertility, defined as the inability to conceive after 12 months of regular unprotected sexual contact, is widely acknowledged as a major global public health concern [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Infertility is a major emotional and psychological stressor, in addition to its biological and medical aspects [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Women with infertility frequently describe emotions of guilt, humiliation, inadequacy, low self-esteem, social withdrawal, and isolation. [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. In many communities, infertility is viewed as a life crisis that destroys identity, marital stability, and personal aspirations, especially if motherhood is a fundamental societal role for women. [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eA considerable body of evidence suggests a strong link between infertility and poor mental health outcomes. Infertile women had persistently high levels of depression, anxiety, and stress, according to global systematic reviews and meta-analyses. [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Infertile women are significantly more likely than fertile women to have depressive symptoms, which can continue even after fertility treatment [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Psychosocial therapies have been found to improve psychological outcomes among infertile people, while availability remains limited in many situations [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. According to qualitative evidence, infertility is a \"silent grief\" characterized by emotional distress and unmet psychosocial demands [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Broader social variables, cultural expectations, and gender conventions around reproduction also influence psychological discomfort. [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn Yemen, several studies were conducted among general women in Aden and hemodialysis patients in Hodeida, and two of them among medical students revealed the rates of depression were 83.3%, 63%, 73.67%, and 48.4%, respectively [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. There is still a lack of context-specific study in Yemen on the psychological impact of infertility, especially among infertile women. Understanding the prevalence of depression and related variables among infertile women in Aden is critical. Examining how socio-demographic features, infertility-related issues, and larger social situations interact can aid in early detection, clinical management, and culturally relevant therapies. Therefore, this study was aimed to determine the prevalence of depression and its severity among infertile women in Aden, Yemen, and to determine the associated factors that may contribute to increasing the prevalence of depression among those women.\u003c/p\u003e"},{"header":"Methodology","content":"\u003cp\u003eThis study was a cross-sectional design that was conducted during the period from October 2025 to April 2026 on infertile women attending different infertility centers and clinics in Aden, Yemen. The score of depressive symptoms was evaluated using the PHQ-9 scale.\u003c/p\u003e \u003cp\u003eThe study population included infertile women attending the different health facilities during the data collection period. The study focused on women of reproductive age. Women were included if they were married, diagnosed with infertility, and agreed to participate. Women were excluded if they were single, if the duration of their marriage was less than 12 months, if they had a known history of psychiatric disorders, or if they refused to give consent.\u003c/p\u003e \u003cp\u003eThe sample size was calculated using the standard formula for cross-sectional studies:\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003en\u0026thinsp;=\u0026thinsp;Z\u0026sup2; \u0026times; p(1-p) / d\u0026sup2;\u003c/h2\u003e \u003cp\u003eWhere:\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003e \u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;required sample size\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003e \u003cem\u003eZ\u003c/em\u003e\u0026thinsp;=\u0026thinsp;standard normal value at 95% confidence level (1.96)\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003e \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;estimated prevalence of depression among infertile women\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003ed\u0026thinsp;=\u0026thinsp;margin of error (0.09)\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003eA margin of error of 9% (d\u0026thinsp;=\u0026thinsp;0.09) was used due to feasibility and resource limitations. A study conducted among infertile women in Saudi Arabia reported that 53.8% of them had a depression [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. Based on this prevalence (p\u0026thinsp;=\u0026thinsp;0.538), the sample size was calculated as follows: The calculation was performed as follows: (1.96)\u0026sup2; \u0026times; 0.538 \u0026times; (1\u0026ndash;0.538) / (0.09)\u0026sup2; = 3.8416 \u0026times; 0.538 \u0026times; 0.462 / 0.0081\u0026thinsp;=\u0026thinsp;0.954 / 0.0081\u0026thinsp;=\u0026thinsp;117.8\u0026thinsp;\u0026asymp;\u0026thinsp;118 women. After adding a 10% non-response rate, the target sample size was 130 women. However, due to time constraints, limited accessibility of participants, and non-response during data collection, a total of 101 infertile women were eventually enrolled. Of 130 eligible infertile women approached, 101 agreed to participate, yielding a response rate of 77.7%.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eData Collection\u003c/h3\u003e\n\u003cp\u003eData was collected by using face-to-face interviewing using a previously designed structured questionnaire with some modifications [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. The questionnaire (File S1) included socio-demographic information such as age, education, occupation, and income; and clinical and infertility-related data such as duration of infertility and treatment of infertility, menopause, and presence of chronic diseases. as well as other data related to sporting status and smoking status. The depressive symptoms were evaluated using the Patient Health Questionnaire-9 (PHQ-9), a validated tool consisting of nine items scored from 0 to 3. The total score ranges from 0 to 27, with scores less than 5 (0\u0026ndash;4) indicating no depression and scores 5\u0026ndash;9, 10\u0026ndash;14, 15\u0026ndash;19, and 20\u0026ndash;27 indicating mild, moderate, moderately severe, and severe depression, respectively [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe internal consistency of the PHQ-9 scale in our study sample was assessed using Cronbach's alpha, which yielded a value of 0.87, indicating good reliability.\u003c/p\u003e\n\u003ch3\u003eBias reduction\u003c/h3\u003e\n\u003cp\u003eTo minimize information bias, all interviewers were trained on the administration of the PHQ-9 and the structured questionnaire. Selection bias was reduced by approaching all eligible women attending the participating clinics during the study period.\u003c/p\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eData Analysis\u003c/h2\u003e \u003cp\u003eData were entered and analyzed using the Statistical Package for the Social Sciences (SPSS) version 23. Descriptive statistics such as frequencies, percentages, means, and standard deviation (SD) were used. The chi-square test was applied to assess associations between variables. A p-value of less than 0.05 was considered statistically significant.\u003c/p\u003e \u003cp\u003eMissing data was handled by listwise deletion, as the proportion of missing values was less than 5% for all variables except duration of infertility (9.9%), which was reported separately.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eReporting guideline\u003c/h3\u003e\n\u003cp\u003eThis study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines for cross-sectional studies. The completed STROBE checklist is available as File S3.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eA total of 101 infertile women were enrolled in our study on the basis of the inclusion and exclusion criteria. The mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD of age was 31.0\u0026thinsp;\u0026plusmn;\u0026thinsp;8.11 years. The highest frequencies of infertile women were 43 (42.6%) aged 26\u0026ndash;36 years, 99 (98.0%) married, 80 (79.2%) who had primary school education, 81 (80.2%) who lived in urban areas, 80 (79.2%) who were housewives, and 70 (69.3%) who had medium socioeconomic status (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSocio-demographic characteristics of infertile women in Aden, Yemen (n\u0026thinsp;=\u0026thinsp;101)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eItem\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercent (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;26 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e26\u0026ndash;36 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e42.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;36 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMarital status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e98.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDivorced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ewidowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEducation level\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIllustrate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrimary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e79.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSecondary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eResidence\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e80.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOccupation\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHousewife\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e79.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDaily Laborer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmployment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eIncome\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLow\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedium\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e69.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInfertility period\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e40.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5\u0026ndash;10 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;10 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe overall prevalence of depression among infertile women in this study was 71 (70.3%) (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). The highest significant rates for depressed women were 60 (75%) among those who had a primary school education and 60 (75%) among housewives (p\u0026thinsp;=\u0026thinsp;0.034), each. The highest rate was among 21 (84%) in the age groups\u0026thinsp;\u0026gt;\u0026thinsp;36 years but without significant association (p\u0026thinsp;=\u0026thinsp;0.057). Other variables had no significant effect on depression (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe association between depression and different variables among infertile women in Aden, Yemen (\u0026#119899; = 101)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eItem\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eDepression\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;26 years\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e60.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.057\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e26\u0026ndash;36 years (n\u0026thinsp;=\u0026thinsp;43)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e69.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;36 years (n\u0026thinsp;=\u0026thinsp;25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e84.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMarital status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;99)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e70.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.276\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDivorced\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWidowed (n\u0026thinsp;=\u0026thinsp;1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEducation level\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIlliterate (n\u0026thinsp;=\u0026thinsp;9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e44.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.034\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrimary(n\u0026thinsp;=\u0026thinsp;80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e75.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSecondary(n\u0026thinsp;=\u0026thinsp;12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e58.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eResidence\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUrban (n\u0026thinsp;=\u0026thinsp;81)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e69.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.414\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRural(n\u0026thinsp;=\u0026thinsp;20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e75.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOccupation\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHousewife (n\u0026thinsp;=\u0026thinsp;80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e75.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.034\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDaily Laborer(n\u0026thinsp;=\u0026thinsp;9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e44.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmployed (n\u0026thinsp;=\u0026thinsp;12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e58.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eIncome\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLow (n\u0026thinsp;=\u0026thinsp;20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e85.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.267\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedium (n\u0026thinsp;=\u0026thinsp;70)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e67.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh (n\u0026thinsp;=\u0026thinsp;11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e63.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDuration of infertility\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026le;\u003c/span\u003e\u0026thinsp;5 years (n\u0026thinsp;=\u0026thinsp;41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e61.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.233\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e6\u0026ndash;10 years (n\u0026thinsp;=\u0026thinsp;37)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e75.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;10 years(n\u0026thinsp;=\u0026thinsp;23)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e78.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMenopause\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes (n\u0026thinsp;=\u0026thinsp;5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e80.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.532\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo (n\u0026thinsp;=\u0026thinsp;96)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e69.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSport status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes (n\u0026thinsp;=\u0026thinsp;8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e50.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.180\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo (n\u0026thinsp;=\u0026thinsp;93)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e72.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSmoking status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes (n\u0026thinsp;=\u0026thinsp;7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e42.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.114\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo (n\u0026thinsp;=\u0026thinsp;94)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e72.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eChronic disease\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes (n\u0026thinsp;=\u0026thinsp;12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e66.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.503\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo (n\u0026thinsp;=\u0026thinsp;89)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e70.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTreatment of infertility\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes (n\u0026thinsp;=\u0026thinsp;88)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e72.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.144\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo (n\u0026thinsp;=\u0026thinsp;13)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e53.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eOf 71 depressed infertile women, 40 (56.3%) had mild depression, 18 (25.4%) had moderate depression, and 13 (18.3%) had severe depression (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). The significant highest prevalence rates for severe depression were 7 (46.7%) among women who live in rural areas, 8 (47.1%) among women who had a low income, 7 (38.9%) among women whose duration of infertility was more than 10 years, and 2 (50%) among women who had chronic diseases (p\u0026thinsp;=\u0026thinsp;0.004, 0.036, 0.037, and 0.015), respectively. Other results had no significant association with severe depression (Table \u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe association between severity of depression and different variables among infertile women in Aden, Yemen (\u0026#119899; = 71)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eItem\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"6\" nameend=\"c7\" namest=\"c2\"\u003e \u003cp\u003eSeverity of depression\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e- value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eMild\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eModerate\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003eSevere\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge group\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;26 years\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e50.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e30.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e20.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.746\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e26\u0026ndash;36 years (n\u0026thinsp;=\u0026thinsp;30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e60.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e23.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e16.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;36 years (n\u0026thinsp;=\u0026thinsp;21)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e57.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e23.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e19.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMarital status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;70)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e55.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e25.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e18.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.424\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDivorced\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEducation level\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIlliterate (n\u0026thinsp;=\u0026thinsp;4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.217\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrimary(n\u0026thinsp;=\u0026thinsp;60)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e55.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e25.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e20.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSecondary (n\u0026thinsp;=\u0026thinsp;7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e42.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e42.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e14.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eResidence\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUrban (n\u0026thinsp;=\u0026thinsp;56)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e26.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e10.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.004\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRural(n\u0026thinsp;=\u0026thinsp;15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e33.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e20.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e46.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOccupation\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHousewife (n\u0026thinsp;=\u0026thinsp;60)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e55.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e25.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e20.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.217\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDaily Laborer(n\u0026thinsp;=\u0026thinsp;4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmployed (n\u0026thinsp;=\u0026thinsp;7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e42.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e42.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e14.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eIncome status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLow (n\u0026thinsp;=\u0026thinsp;17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e23.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e47.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.036\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedium (n\u0026thinsp;=\u0026thinsp;47)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e70.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e21.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e8.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh (n\u0026thinsp;=\u0026thinsp;7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e57.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e14.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDuration of infertility\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026le;\u003c/span\u003e\u0026thinsp;5 years (n\u0026thinsp;=\u0026thinsp;25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e68.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e16.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e16.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.037\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e6\u0026ndash;10 years (n\u0026thinsp;=\u0026thinsp;28)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e53.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e39.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e7.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;10 years (n\u0026thinsp;=\u0026thinsp;18)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e44.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e16.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e38.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMenopause\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes (n\u0026thinsp;=\u0026thinsp;4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e25.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e50.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.097\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo (n\u0026thinsp;=\u0026thinsp;67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e58.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e25.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e16.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSporting status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes (n\u0026thinsp;=\u0026thinsp;4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e50.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e25.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e25.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.731\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo (n\u0026thinsp;=\u0026thinsp;67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e56.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e25.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e17.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSmoking status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes (n\u0026thinsp;=\u0026thinsp;3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e33.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e33.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e33.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.389\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo (n\u0026thinsp;=\u0026thinsp;68)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e57.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e25.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e17.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eChronic disease\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes (n\u0026thinsp;=\u0026thinsp;7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e25.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e50.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.015\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo (n\u0026thinsp;=\u0026thinsp;63)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e60.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e25.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e14.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTreatment of infertility\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes (n\u0026thinsp;=\u0026thinsp;64)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e56.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e25.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e18.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.863\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo (n\u0026thinsp;=\u0026thinsp;7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e57.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e28.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e14.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eAbsence of children and loss of identity are vital factors for depression among infertile females. In Islamic countries, the occurrence of infertility in females is experienced with marital problems or instability due to multiple marriages, where the men can marry more than one woman [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. The present study was the first in Yemen to determine the depression among infertile women, in which the overall prevalence was 70.3%. This finding was consistent with that conducted among Iraqi infertile women, which was 68.9% in [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. Our result was higher than various global studies, such as 62.3% in Egypt [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e], 62.0% in Ghana [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e], 57.1% in India [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e], 55% in Morocco [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e], 53.8% in Saudi Arabia [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e], 52.7% in Southwest Nigeria [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e], 44.8% in Hungary [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e], 42.1% in Ethiopia [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e], 41% in Iran [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e], 40.3% in Tanzania [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e], 35.44% in Poland [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e], 25.6% in Nigeria [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e], and 12.2% in Vietnam [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]. In contrast, two studies conducted among Pakistani infertile women reported higher than our rate, which was 78.4% and 79% [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]. One of the highest rates was 95% in Pakistan [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e]. Our finding was also lower than that reported among general women (not specifically infertile) in Aden, Yemen, which was 83.3% [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e], highlighting that infertility is not the sole contributor to depression among women in this context. The differences in sample size, the assessment tests and scoring techniques for depression, culture and religion, and the absence of social support from husbands and family members may be attributed to discrepancies in the prevalence rates in different communities.\u003c/p\u003e \u003cp\u003eIn the present results, 84% of the women in the age groups\u0026thinsp;\u0026gt;\u0026thinsp;36 years had depression. It was in agreement with that which was conducted in China [\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e]. Age over 35 years is another risk factor for the occurrence of depression among infertile women because hope and the probability of successful medical intervention will be decreased gradually with the increasing age of infertile women, especially with the failure of previously repeated trials for treatment [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eRegarding the education level, those women who had a primary school education had the highest significant rates (p\u0026thinsp;=\u0026thinsp;0.034). Benbella et al. showed that illiterate women had the highest main score of depression [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. Fatima et al. noticed that secondary school-educated women had the highest depression rate [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]. Three studies conducted in Saudi Arabia, Morocco, and Turkey found that the score of depression decreased with the increasing level of education of women [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e]. The majority of women in our study had primary school education, and there were no differences between illiterate and primary school-educated women regarding getting work or employment to increase their income to overcome the high cost of success in treatment for infertility.\u003c/p\u003e \u003cp\u003eIn the current data, the housewives had the highest significant rate of depression (p\u0026thinsp;=\u0026thinsp;0.034). Two studies agreed with our finding [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. Beyene et al. showed a significant association between unemployed women and detection of depression [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. No significant association was found in the report from Pakistan, despite the highest prevalence of depression among housewives [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]. The increased depression rate among housewives is due to financial issues that may limit access to successful treatment, especially the high cost and expenses of medical care. Staying at home increases feelings of loneliness and social isolation as well as exposing those women to pressure, criticism, and neglect from family members. Employment acts as a protective element against depression, as having employment may give the women self-esteem and confidence, and they may participate in the management of infertility [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. In addition, employment might distract a woman from thinking about infertility issues, and occasionally, those women may meet the emotional support from friends and colleagues that may be lacking at home.\u003c/p\u003e \u003cp\u003eThe current results showed that marital status, residence, income, menopause, smoking status, presence of chronic disease, and treatment of infertility had no significant effect on depression. No previous literature had evaluated these variables among infertile women. The lacking associations may be due to the small sample size of our studied group.\u003c/p\u003e \u003cp\u003eAccording to the severity of depression in the present data, 18.3% of women had severe depression, and 25.4% of them had moderate depression. A study among Iraqi infertile women revealed that more than half of women (50.3%) had moderate to severe depression, and 7.5% had severe depression [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. Research from South Africa showed that 45% of women had moderate to moderately severe depression [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e]. A study conducted among Pakistani infertile women noticed that 33.3% and 27.4% of women had moderate and severe depression, respectively [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]. The discrepancy may be due to differences in scoring assessment techniques for depression and sociodemographic contexts of women.\u003c/p\u003e \u003cp\u003eOur study demonstrated that the severity of depression was significantly associated with rural residence of infertile women (p\u0026thinsp;=\u0026thinsp;0.004). Verma \u0026amp; Baniya found similar results [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. In the rural societies, the increasing of severe depression is due to the differences in cultural expectations resulting from family pressures and social stigmas because in those societies, having children is highly valued [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. The women living in urban areas have better social support and health care compared to those living in rural areas [\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e]. The infertile and childless women may lead to marital instability such as polygamy or divorce, which increases the psychological problems among those women [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eRegarding the income of women in the present data, there was a significant association between low income and severe depression (p\u0026thinsp;=\u0026thinsp;0.036). Several studies reported similar findings [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e, \u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e]. A different result was reported among Pakistani infertile women [\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e]. The psychological burden is increased among infertile females due to facing a combination of low income and infertility. The financial problems exacerbate the feelings of hopelessness about obtaining successful treatment for fertility. There is a lack of good facilities and advanced treatment intervention in our country, resulting in seeking those interventions by traveling to other countries, which increases the cost burden.\u003c/p\u003e \u003cp\u003eThe severity of depression was significantly associated with a duration of infertility over 10 years (p\u0026thinsp;=\u0026thinsp;0.037). Two studies conducted among infertile women revealed consistent results [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. Increasing the duration of infertility means increasing the repeated treatment intervention combined with a high-cost burden and decreasing the hope for childbearing in the near future [\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe results of this study demonstrated that the presence of chronic diseases such as diabetes and cancer was significantly correlated to severe depression (p\u0026thinsp;=\u0026thinsp;0.015). There was no previous study that had assessed this variable, so this association was reported as the first finding among our study group. The presence of chronic diseases along with infertility increases the risk of depression among women.\u003c/p\u003e \u003cp\u003eOur data revealed no statistically significant difference between severity of depression and age group, marital status, education level, occupation, menopause, sporting status, smoking status, chronic disease, or treatment of infertility. The small sample size is the main factor for the lack of associations between the severe depression and these variables.\u003c/p\u003e \u003cp\u003eThe main limitations of the present study were the type of study, a cross-sectional study that cannot determine the real causation of depression, and the small sample size of infertile women. This study also involved those women who were seeking medical care in fertility centers and clinics, but those who did not seek medical care or those attending to psychological distress were not enrolled.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe prevalence of depression among infertile women in Aden, Yemen, is higher compared to most global studies. The age groups\u0026thinsp;\u0026gt;\u0026thinsp;36 years, primary school education, and housewives are associated with depression. Other variables were not significantly associated with the presence of depression among infertile women. Depression severity was significantly correlated with rural background residence, low income, duration of marriage and infertility over 10 years, and the presence of chronic diseases. Lacking associations with other different variables and severity of depression. Future studies should be conducted with a large sample size and involve the fertility centers and psychological centers in Aden and other governorates of Yemen.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003ePHQ-9\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ePatient Health Questionnaire-9\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003eSPSS\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eStatistical Package for the Social Sciences\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003eSD\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003estandard deviation\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors gratefully thank the infertile women who consented to participate in this study. They also thank the student\u0026apos;s team for their contributions to data collection from women.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eANMG, and NTA supervision and revision and final editing of manuscript. HAAM, LAJ, and AIM contributed in writing of introduction and methodology. SMMD inserted the data into SPSS software and analyzed the data. \u0026nbsp;ANMG and HAAM also preparing of tables and figures and discussing of results. LGAA, BA, SR, and MAA collect the data from the infertile women. NTA also arranged the references according the referencing style of journal. All authors contributed the same.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that no funds, grants, or other support were received during the preparation of this manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll data were presented in the manuscript; no further data are available, and they will be available from the corresponding authorupon request. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and Consent to Participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe ethical approval of this study was obtained from Faculty\u0026rsquo;s Medical Research Ethics Committee (MREC), University of Science and Technology, Aden, Yemen, MEC No. (MEC/AD0166). Our research was conducted in accordance with the Declaration of Helsinki. Written informed consent forms were obtained from all infertile women before collection of data (File S2).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors have no competing interests to declare that are relevant to the content of this article.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eYan G, Zhang Y, Wang S, Yan Y, Liu M, Tian M, Tian W. Global, regional, and national temporal trend in burden of major depressive disorder from 1990 to 2019: An analysis of the global burden of disease study. \u003cem\u003ePsychiatry Res.\u003c/em\u003e 2024;337:115958.\u003c/li\u003e\n \u003cli\u003eJia Y, Zhou Z, Xiang F, Hu W, Cao X. 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Prognosis factors of pregnancy after intrauterine insemination with the husband\u0026apos;s sperm: conclusions of an analysis of 2,019 cycles. Fertility and sterility. 2014 Apr 1;101(4):994-1000.\u003c/li\u003e\n \u003cli\u003eKazandi M, Gunday O, Mermer TK, Erturk N, Ozkınay E (2011) The status of depression and anxiety in infertile Turkish couples. Iran J Reprod Med 9: 99-104.\u003c/li\u003e\n \u003cli\u003eMulondo T, Baloyi S, Sempa JB. Prevalence and severity of depression and anxiety in infertile female patients attending an academic hospital in central South Africa. South African Journal of Obstetrics and Gynaecology. 2024 Jun 1;30(1):21-6.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eCyr ME, Etchin AG, Guthrie BJ, Benneyan JC. Access to specialty healthcare in urban versus rural US populations: a systematic literature review. BMC health services research. 2019 Dec 18;19(1):974.\u003c/li\u003e\n \u003cli\u003eTeklemicheal AG, Kassa EM, Weldetensaye EK. Prevalence and correlates of infertility related psychological stress in women with infertility: a cross-sectional hospital based survey. BMC psychology. 2022 Apr 7;10(1):91.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eRufai AI, Grema BA, Bello MM, Michael GC. Association between family functionality, sociodemographic factors, and severity of depression in women with infertility attending a gynecology clinic in northwest Nigeria. Journal of neurosciences in rural practice. 2022 Mar 10;13(2):246.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eAli HS, Shams H, Kessani LV, Ali R. Depression: prevalence and predicators among Pakistani infertile women. The Professional Medical Journal. 2015 Nov 10;22(11):1480-4.\u003c/li\u003e\n \u003cli\u003eAlbayrak E, G\u0026uuml;nay O. State and trait anxiety levels of childless women in Kayseri, Turkey. The European Journal of Contraception \u0026amp; Reproductive Health Care. 2007 Jan 1;12(4):385-90.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Severity, Depression, Infertility, mental health, PHQ-9, Aden, Yemen","lastPublishedDoi":"10.21203/rs.3.rs-9706961/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9706961/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e: No empirical study has evaluated the prevalence of depression or its severity among infertile women seeking reproductive treatment in Yemen.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eObjectives\u003c/strong\u003e: This study aimed to determine the prevalence of depression and its severity among infertile women in Aden, Yemen.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e: This was a cross-sectional study conducted among infertile women attending different infertility centers and clinics in Aden, Yemen, and the score of depressive symptoms was evaluated using the PHQ-9 scale. The data was collected via face-to-face interviewing using a structured questionnaire, and then SPSS was used to analyze the data.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eAmong 101 infertile women who were enrolled in our study, the overall prevalence of depression among infertile women was 71 (70.3%). Those women who had primary school education and housewives had the highest significant rates, with 75% (p = 0.034) each. The significant borderline highest rate was also shown among women in the age groups \u0026gt;36 years (84%, p=0.057). Out of 71 depressed women, 56.3%, 25.4%, and 18.3% of them had mild, moderate, and severe depression, respectively. The severe depression was significantly associated with women who lived in rural areas, had low income, whose duration of infertility was more than 10 years, and those with chronic diseases (p=0.004, 0.036, 0.037, and 0.015), respectively.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e: The prevalence of depression among infertile women in Aden, Yemen, was higher compared to most related global studies. The age groups \u0026gt;36 years, primary school education, and housewives were associated with depression. Depression severity was significantly correlated with rural background residence, low income, duration of infertility over 10 years, and the presence of chronic diseases.\u003c/p\u003e","manuscriptTitle":"Prevalence of depression Among Infertile Women in Aden, Yemen: A Cross-Sectional Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-05-15 06:17:01","doi":"10.21203/rs.3.rs-9706961/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"3394ed37-90cf-4f82-80c4-beda8858bc36","owner":[],"postedDate":"May 15th, 2026","published":true,"recentEditorialEvents":[{"type":"decision","content":"Rejected","date":"2026-05-18T09:24:50+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-05-14T07:04:18+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-05-14T07:03:49+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Women's Health","date":"2026-05-13T17:57:40+00:00","index":"","fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-05-18T09:41:19+00:00","versionOfRecord":[],"versionCreatedAt":"2026-05-15 06:17:01","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9706961","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9706961","identity":"rs-9706961","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}