Turk J Urol 2018; 44(2): 153-61 • DOI: 10.5152/tud.2018.78861 153 GENERAL UROLOGY Original Article Investigating knowledge levels of university students about infertility Diğdem Müge Siyez1 , Seçil Seymenler2 , Erol Esen2 , Ender Siyez3 , Yelda Kağnıcı4 , Bahar Baran5 , Barışcan Öztürk6 Cite this article as: Siyez DM, Seymenler S, Esen E, Siyez E, Kağnıcı Y, Baran B, et al. Investigating knowledge levels of university students about infertility. Turk J Urol 2018; 44(2): 153-61. ABSTRACT Objective: The aim of this study was to determine the knowledge levels of university students about infertil- ity and investigate the differences in knowledge levels according to sociodemographic variables and some lifestyle factors. Material and methods: The sample of the study consisted of 9693 undergraduate students (5002 females, 4691 males) from 12 regions. Regions were determined according to Statistical Region Units Classifica- tion-1 criteria. Infertility Knowledge Test (IKT) was used as a data collection tool. 1Department of Counseling and Guidance, Dokuz Eylül University Results: It was found that university students’ IKT scores significantly differed according to gender School of Education, İzmir, Turkey (p<0.01); age (p<0.05); body mass index (p<0.05); reproductive health education status (p<0.001), presence 2Department of Counseling of infertile individuals around (p<0.001); having sexual intercourse (p<0.001); smoking (p<0.001) and alco- and Guidance, Celal Bayar hol consumption frequency (p<0.05). University School of Education, Manisa, Turkey Conclusion: University students’ lack of knowledge about family planning, effects of age and sexual inter- 3Clinic of Urology, Seyfi Demirsoy course timing on infertility was remarkable. However, it was determined that the knowledge level of infertil- State Hospital, İzmir, Turkey ity risk factors related to substance use and body mass index was high. It is believed that increasing the level 4 Department of Counseling and of knowledge about infertility among individuals will positively effect their awareness of risk factors and Guidance, Ege University School of Education, İzmir, Turkey facilitate their search for timely medical assistance. Sexual health education can be effective in increasing 5Department of Computer and university students' knowledge of infertility. Teaching Technologies, Dokuz Eylül University School of Keywords: Infertility; knowledge level; university students. Education, İzmir, Turkey 6Institute of Educational Sciences, Dokuz Eylül University, İzmir, Turkey Introduction professional targets.[4,5]. Though considered This study was presented at the as a health problem, infertility may bring 20th Euro Congress Psychiatrists and Psychologist (Rome, Italy, Infertility which is accepted as one of the most with it both individual, and social concerns. August 7 to 8, 2017). important problems of reproductive health has It may cause psychological problems in both Submitted: been defined as the couple’s inability to have partners as decreased self-respect, isolation, 30.09.2017 a child despite unprotected and regular sexual loneliness, loss of self control, and feeling Accepted: intercourse for ≥1 year.[1] Although the num- of sexual insufficiency. Having a child is the 03.11.2017 ber of infertile couples is not known exactly, basic cultural, and sexual norm of many com- Available Online Date: 05.01.2018 it is estimated that globally 13-15% of the munities. Therefore, couples experiencing the couples are affected by infertility.[2] Because problem of infertility may be marginalized Correspondence: Diğdem Müge Siyez of the lack of fundamental knowledge about under social pressure, excluded from the E-mail: infertility, its causes, and possible treatment society, and become isolated.[6] Especially [email protected] alternatives, it has reportedly higher inci- in traditional societies having a child is the ©Copyright 2018 by Turkish dence rates in underdeveloped countries[3], in determinative factor of the women’s social Association of Urology developed countries risk of infertility incre- status, therefore infertile women may feel the Available online at ases owing to predetermined academic, and social stigma more strongly.[7] www.turkishjournalofurology.com Turk J Urol 2018; 44(2): 153-61 154 DOI:10.5152/tud.2018.78861 Lifestyle related factors as smoking, and alcohol use, insufficient Material and methods exercise, sexually transmitted diseases, advanced age, caffein consumption, obesity, and stress appear to occupy an important Patient population, and sampling place among risk factors of infertility.[8,9] Interestingly, these The population of this survey consisted of university students behaviours or conditions which adversely affect reproductive who continue their undergraduate education in state universities potential are modifiable or preventable factors.[9,10] Knowledge in Turkey. In the selection of sampling Statistical Region Units level has a key role for preventive measures. Lack of knowledge Classification-1 (IBBS-1) was used. Based on Level 1 criteria together with some fallacies delays search for medical help.[11,12] Turkey is divided into 12 regions as follows: Istanbul, West Findings which reveal that ignorance about infertility-related risk Anatolia, East Marmara Region, Aegean Region, West Marmara factors, and possible treatment methods are directly associated Region, Central Anatolian Region, East Black Sea Region, with the incidence of infertility also underline the key role of Southeast Anatolia, Central East Anatolia, and Northeast Anatolia. being knowledgeable.[11] It has been suggested that increase in the knowledge levels about infertility will allow these infertile For the determination of samples, first of all state universities couples to refrain from these risk factors which will contribute were listed based on the regions. The ratio between the number to decrease in the prevalence of infertility.[12] Besides, it has been of universities in each region and the overall population was cal- predicted that increase in the level of knowledge about inferti- culated, and the number of universities to be selected from each lity will enable the larger section of society to understand, and region was determined being as close as to this predetermined emphatize with the couples that experience infertility problems ratio. Universities from each region were selected using random alleviating psychological, and social distress of these couples.[8] number tables. Then sample size suitable to overall population was calculated. According to Higher Education Information Limited number of studies mostly performed abroad about the Management System data, a total of 1,622,336 students were knowledge level of university students about infertility who are educating during the 2014-2015 academic year in the four-year at a higher risk of being infertile despite their desire to have a faculties, and high schools of state universities in Turkey. Using child when compared with other groups due to their intensive sample size calculation programs, appropriate sample size was attempts at attaining their academic, and professional targets found to be 9.547 students within a 95% confidence interval, and are available.[8,13] Findings indicate that the university students an error margin of 1 percent. In consideration of the ratio of the plan to have a child when their reproductive potential starts to number of university students included in the study to the overall decline, and they have not possessed adequate awareness about population, the number of students from each university who decrease in this age related decrease, and knowledge about would provide their data were calculated. For the selection of stu- infertility, and relevant risk factors.[14,15] We have encountered dents from their respective universities. simple random sampling, only one study which evaluated beliefs, and risky behaviours and cluster sampling methods were used. For the determination of university students on infertility, while any study on their of faculties to be selected for simple random sampling method, knowledge levels about infertility has not been encountered yet. random number table was used. For the selection of samples from [10] In Turkey infertility means more than a problem of repro- within faculties cluster sampling method was used to relieve the ductive health. For example not having a child is considered a issue of “traveling” which might create problems when simple deficiency, and fault on behalf of especially women, and child- random method were used. During the process of determining less marriages are believed to be short-lived. Cultural inheritan- the clusters within faculties, expert opinion was obtained, and ce together with lack of knowledge is thought to be effective in the most suitable subjects in the clusters were determined. Before the persistence of this perspective.[16] analyzing data, the data of the 528 students who could not res- pond more than 10% of the questions in the measurement tool The determination of knowledge levels of university students were excluded from the analysis, and sample of the investigation regarding infertility, and investigation of its relationship with consisted of 9693 undergraduate students (5002 female, 4691 sociodemographic, and lifestyle changes will fill the gap in the male). The mean age of the female students was 20,46 (SD=1.90) literature, and conceivably contribute to infertility-preventive while the mean age of the males was