DR.NTR UNIVERSITY OF HEALTH SCIENCES

VIJAYAWADA,ANDHRA PRADESH

ASSESS THE KNOWLEDGE OF POST GRADUATE STUDENTS REGARDING

INFERTILITY BEFORE AND AFTER STRUCTURED TEACHING

PROGRAMME AT SELECTED POST GRADUATE COLLEGES,HYDERABAD.

PROFORMA FOR THE REGISTRATION OF

SUBJECT FOR DISSERTATION

Ms. VIJAYA JAHSSE

1 YEAR M Sc NURSING,

OBSTETRICAL & GYNECOLOGICAL NURSING,

2011-2013

EASHWARI BAI MEMORIALCOLLEGEOFNURSING,

WEST MAREDPALLY,

SECUNDERABAD-26,

ANDHRA PRADESH.

1

DR.NTR UNIVERSITY OF HEALTH SCIENCES

VIJAYAWADA,ANDHRA PRADESH

PROFORMA FOR THE REGISTRATION OF

SUBJECT FOR DISSERTATION

1 NAME OF CANDIDATE

AND ADDRESS

Ms. VIJAYA JAHSSE

1 YEAR M Sc NURSING,EASHWARI

BAI

MEMORIALCOLLEGEOFNURSING,H.N

O.10-1-5/C,ROADNO-4,WEST

MAREDPALLY,

SECUNDERABAD-26,ANDHRA

PRADESH.

2 NAME OF THE

INSTITUTION

EASHWARI BAI MEMORIALCOLLEGE

OF NURSING

3 COURSE STUDY AND

SUBJECT

I YEAR M.SC. NURSING

OBSTETRICAL&GYNECOLOGICAL

NURSING

4 DATE OF ADMISSION

TO COURSE

1/10/2011

5 TITLE OF THE TOPIC ASSESS THE KNOWLEDGE OF POST

GRADUATE STUDENTS REGARDING

INFERTILITY BEFORE AND AFTER

STRUCTURED TEACHING PROGRAMME

AT SELECTED POST GRADUATE

COLLEGES,HYDERABAD.

2

INTRODUCTION

“Pain during labour is tolerable but…emotional pain due to infertility is

intolerable -

FRIEDRICH NIETZSCHE

In all societies the obvious biological difference between

men and women is used as a justification for forcing them into different social roles

which limit and shape their attitudes and behavior. That is to say, no society is content

with the natural difference of sex, but each insists on adding to it a cultural difference of

gender. The simple physical facts therefore always become associated with complex

psychological qualities.

Reproduction is a device that has evolved for the survival of

the living organisms of different species by producing continuous streams of new

generation of the specific species. Reproduction is an organism's way of creating a new

generation of its species. Reproduction is essential for preserving a species (carrying on

with the species), and replenishing the number of organisms in it to compensate for dead

organisms. Without reproduction, a species would die out in one generation.

Failure to this process results in infertility. Infertility is a tragic condition. Though

infertility does not claim an individual life, it inflicts devastating emotional trauma on the

individual for being unable to fulfil the biological role of parenthood for no fault of

his/her own.

Most experts define infertility as not being able to get

pregnant after at least one year of trying. Women who are able to get pregnant but then

have repeat miscarriages are also said to be infertile. It is accepted that the terms

infertility, childlessness or sterility all refer to the incapacity of couples to conceive or

bear children when desired. Primary infertility refers the couple had never conceived

despite cohabitation and exposure to the risk of pregnancy (absence of contraception) for

a period of 2 years. Secondary infertility refers the couple failed to conceive following a

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previous pregnancy, despite cohabitation and exposure to the risk of pregnancy (in the

absence of contraception, breastfeeding or postpartum amenorrhoea) for a period of

2 years.

The common causes of fertility problems in women

include: blocked fallopian tubes due to pelvic inflammatory disease, endometriosis,

physical problems with the uterus, uterine fibroids and many things can affect a woman's

ability to have a baby such as age, stress, poor diet, being over weight or under weight,

tobacco chewing, smoking, alcohol, sexually transmitted diseases and health problems

that cause hormonal changes.

Infertility is not always a woman's problem. In only about

one-third of cases is infertility due to the woman (female factors). In another one third of

cases, infertility is due to the man (male factors). The remaining cases are caused by a

mixture of male and female factors or by unknown factors. Infertility may have profound

psychological effects. Partners may become more anxious to conceive, ironically

increasing sexual dysfunction. Marital discord often develops in infertile couples,

especially when they are under pressure to make medical decisions. Women trying to

conceive often have clinical depression rates similar to women who have heart disease or

cancer. Emotional stress and marital difficulties are greater in couples where the

infertility lies with the man.

Infertility can be treated with medicine, surgery, artificial

insemination, or assisted reproductive technology. Many times these treatments are

combined. In most cases infertility is treated with drugs or surgery.

Adopting a  healthier lifestyle through simple lifestyle

changes in diet, maintaining body weight or staying up to date with regular health checks

and tests,  may help to prevent infertility.

NEED FOR THE STUDY

Parenthood is undeniably one of the most universally desired

goals in adulthood, and most people have life plans that include children. However, not

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all couples who desire a pregnancy will achieve one spontaneously and a proportion of

couples will need medical help to resolve underlying fertility problems.

Infertility has been recognized as a public health issue

worldwide by the World Health Organization (WHO). “According to the World Health

Organization (WHO), the worldwide incidence of infertility is about 10 per cent. The

WHO data further concludes that in most developing countries, one of four couples in the

reproductive age is infertile because of primary or secondary infertility.”

WHO estimates that approximately 8-10% of couples

experience some form of infertility. On a worldwide scale, this means that 60-80 million

people suffer from infertility with men and women in almost identical proportion.

Infertility is exclusively a female problem in 30-40% of cases and male in 10-30% of

cases.

One of the factors that leads to increasing infertility

amongst women is that most of them do not want to get married before 30 and even if

they get married in their 20s they don’t usually plan their baby soon enough. Doctors say

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that women’s infertility rate is 10 to 15 percent when they are in their 20s and goes up

25% in their 30s.

A global review of infertility from the World Fertility Survey

and others estimated similar rates of infertility in other settings in South Asia, such as 4%

in Bangladesh, 6% in Nepal, 5% in Pakistan and 4% in SriLanka. One estimate of overall

primary and secondary infertility in South Asia, on the basis of women at the end of their

reproductive lives in the age group 45-49 years, suggests an infertility rate of

approximately 10%: 8% in India, 10% in Pakistan, 11% in Sri Lanka, 12% in Nepal and

15% in Bangladesh.

Supporting the statement, Dr P Rama Devi, founder

& medical director, Dr Rama’s Institute for Fertility, says, “Today, infertility has

become a global health issue and in 40 percent of the cases, problem lies exclusively with

the male, 40 per cent with the female, 10 percent with both partners and in another 10 per

cent of the cases, the cause is idiopathic in nature.” In India, the incidence and prevalence

of infertility also seems to be increasing steadily.

The report said that in India, 13 percent of ever-

married women aged 15-49 years were childless in 1981 (rural 13.4 percent and urban

11.3 percent) which increased to 16 percent in 2001 (rural 15.6 percent and urban 16.1

percent). Over half of married women aged 15-19 years were childless in 1981, which

increased to 70 percent in 2001.

"Out of 250 million individuals conservatively estimated

to be attempting parenthood at any given time...13 to 19 million couples are likely to be

infertile," the Union minister of health had sounded the alarm in 2010. It is estimated that

globally 60-80 million couples suffer from infertility every year, of which probably

between 15-20 millions (25%) are in India alone according to the statistics of 2011 in

which both male and female are affecting in equal proportions.

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STATEMENT OF THE PROBLEM

ASSESS THE KNOWLEDGE OF POST GRADUATE STUDENTS REGARDING

INFERTILITY BEFORE AND AFTER STRUCTURED TEACHING PROGRAMME

AT SELECTED POST GRADUATE COLLEGES,HYDERABAD.

OBJECTIVES OF THE STUDY

To assess the knowledge of post graduate students regarding infertility .

To assess the effectiveness of planned teaching programme among post graduate

students regarding infertility .

To find out the significant association between the knowledge scores with their

selected demographic variables regarding infertility.

OPERATIONAL DEFINITIONS

Assess :the process of finding out the effectiveness of structured teaching

programme among post graduates .

Knowledge: In this study, knowledge refers to correct responses given by the

postgraduate students regarding infertility using a structured questionnaire.

Post graduates: students who are doing a two year post graduate course at a

selected college in Hyderabad.

Infertility : Failure to conceive after one year of regular intercourse without

contraception.

Structured teaching programme :A teaching programme related to infertility

which is structured by the investigator,which includes definition, types,risk

factors& causes, management..

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LIMITATIONS OF THE STUDY

The study is limited to the post graduate students at selected colleges in

Hyderabad..

Post graduate students who are willing to participate in the study.

Post graduate students who are available at the time of data collection.

CRITERIA FOR SAMPLE SELECTION:

Inclusion Criteria:

Post graduate students who are willing to participate in study.

Post graduate students who are available at the time of study.

Post graduate students who are able to speak /read English.

Exclusion Criteria:

Post graduate students who are not willing to participate in the study.

Post graduate students who are not available at the time of study.

Post graduate students who are not able to speak/read English.

RESEARCH HYPOTHESIS

H1: There will be significant difference between the pre and post test knowledge of

post graduate students regarding infertility.

H2: There will be significant association between the knowledge scores of

postgraduate students with their selected demographic variables.

REVIEW OF LITERATURE

Every piece of ongoing research needs to be connected with the work already done, to

attain an overall relevance and purpose. The review of literature thus becomes a link

between the research proposed and the studies already done. It tells the reader about

aspects that have been already established or concluded by other authors, and also gives a

chance to the reader to appreciate the evidence that has already been collected by

previous research, and thus projects the current research work in the proper perspective.

Review of literature extensive,exhaustive and systematic examination of publications

relevant to the research project.(Basavanthappa,B.T,2003).

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REVIEW OF LITERATURE

The review of literature is divided into the following sections.

Section-I :Literature related to knowledge assessment of infertility

Section-II : Literature related to risk factors and etiology of infertility.

Section-III : Literature related to prevalence of infertility.

Section-IV : Literature related to treatment modalities of infetility.

Section-I :Literature related to knowledge assessment of infertility

A prospective study was conducted by Chhabra S., Srujana D. and Annapurna M.A

(2012) Obstetrics and Gynaecology, Mahatma Gandhi Institute of Medical Sciences,

Sewagram, Wardha, Maharashtra, India, over two years to findout the advice-seeking

scenario of women with infertility. A total of 1000 infertile women from culturally

diverse, urban and rural communities, attending outpatient care were the study subjects

were interviewed with the help of a semi-structured questionnaire in the women's first

language, about their awareness of conception events, and advice seeking practices; and

the information collected were analysed. Results showed that 76.8% of women had little

knowledge about conception events, possible treatment options for infertility .

Section-II: Literature related to prevalence of infertility

A descriptive study was conducted by Tracey Bushnik, Jocelynn L. Cook, A. Albert

Yuzpe (2011) to estimate the the prevalence of infertility in Canada. Data from the

infertility component of the 2009–2010 Canadian Community Health Survey were

analyzed for married and common law couples with a female partner aged 18–44 by

randomized sampling. The three definitions of the risk of conception were derived

sequentially starting with birth control use in the previous 12 months, adding reported

sexual intercourse in the previous 12 months, then pregnancy intent. Prevalence and odds

ratios of current infertility were estimated by selected characteristics. The results showed

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that the prevalence of current infertility ranged from 11.5% (95% CI 10.2, 12.9) to 15.7%

(95% CI 14.2, 17.4). The present study suggests that the prevalence of current infertility

has increased in Canada, and is associated with the age of the female partner and parity.

Couples with lower parity (0 or 1 child) had significantly higher odds of experiencing

current infertility when the female partner was aged 35–44 years versus 18–34 years.

A descriptive study was conducted by Sule J.O., P. Erigbali, L. Eruom (2008) to assess

the prevalence of infertility in Women in a Southwestern Nigerian Community . The

study was conducted in women aged between 15 and 55 years was assessed in four

hospital centers in Osun State, located in the SouthWestern part of Nigeria. A survey of a

consecutive sample of 200 cases of infertility were carried out in four hospital centers

with a total of 50 cases of infertility evaluated in each of the centers between 2001 –

2003. The incidence of high infertility in women was established in all the centers;

(Obafemi Awolowo University Teaching Hospital, Ile-Ife), 59.4%, (Obafemi Awolowo

University Teaching Hospital, Ilesa), 47.7%, (Ladoke Akintola University Teaching

Hospital, Oshogbo), 54.8% and (General Hospital, Ikire), 44.2%. 77.5% was recorded for

a high rate of secondaryInfertility, while Primary Infertility was 22.5%.

A retrospective study was conducted by Rajvi H Mehta, Sanjay MakwanaGeetha

M Ranga, R J Srinivasan,etal., (2006) to determine whether there was any regional

variation in the prevalence of azoospermia, oligozoospermia and mean sperm counts in

male partners of infertile couples from different parts of India. 16 714 semen samples

were collected an analyzed over the past five years from six different laboratories located

in five cities of India. Results revealed that there was a regional variation in the

prevalence of azoospermia. The prevalence of azoospermia was extremely high in

Kurnool and Jodhpur (38.3 % and 37.4 %, respectively). There was also a regional

variation in the prevalence of oligozoospermia (51 %) in Kurnool.

Section-III: Literature related to risk factors and etiology of infertility.

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A descriptive study was conducted by Kristi L. Lenz, Amy W. Valley(2011) conducted

to know the incidence of infertility after chemotherapy. A Medlines search of articles

from 1998 conducted using the terms infertility, antineoplastics, amenorrhea, azospermia,

oogenesis, and spermatogenesis. Additional references were identified using review

articles and pharmacology textbooks. All human studies reported in English language

were included. The incidence and severity of antifertility effects are dependent on the

total dosage delivered, duration of therapy, and age at exposure were taken as criteria for

the study. The results found that infertility is a common late complication of cancer

chemotherapy that is receiving increasing attention as the number of cancer survivors

increases.

A descriptive study was conducted by Laura Bunting and Jacky Boivin(2008) to

assess the fertility knowledge more broadly in young people and investigated three areas

of knowledge, namely risk factors associated with female infertility (e.g. smoking),

beliefs in false fertility myths (e.g. benefits of rural living) and beliefs in the illusory

benefits of healthy habits (e.g. exercising regularly) on female fertility.149 samples

consisted of 110 female and 39 male postgraduate and undergraduate university students

(average age 24.01, SD = 7.81) were selected by nonrandomized method. Knowledge

scores were based on a simple task requiring the participants to estimate the effect a

factor would have on a group of 100 women trying to get pregnant. Items (n = 21) were

grouped according to three categories: risk factors (e.g. smoking; 7 items), myths (e.g.

living in countryside; 7 items) and healthy habits (e.g. being normal weight; 7

items).Results revealed that young people were significantly better at correctly

identifying the effects of risks compared with null effects of healthy habits (P < 0.001) or

fertility myths (P < 0.001). Young people are aware that the negative lifestyle factors

reduce fertility but falsely believe in fertility myths and the benefits of healthy habits.

A case-control study of was conducted by Friday Okonofua, Uche Menakaya, S

O Onemu, etal., (2006) in Nigeria to evaluate the association between selected potential

socio-demographic and behavioral risk factors and infertility in Nigerian men. There

were two groups in this study. One group consisted of 150 men with proven male

infertility, and the other consisted of 150 fertile men with normal semen parameters. Both

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were matched for age, place of residence and key socio-demographic variables. They

were compared for sexual history, past medical and surgical history, past exposures to

sexually transmitted infections and treatment, past and current use of drugs as well as

smoking and alcohol intake history. Results of the study found that infertile men were

significantly more likely than fertile men to report having experienced penile discharge,

painful micturition and genital ulcers, less likely to seek treatment for these symptoms

and more likely to seek treatment with informal sector providers.

A prospective study was conducted by Chhabra S., Srujana D. and Annapurna M.A

(2012) over two years to find out the advice-seeking scenario of women with infertility.

A total of 1000 infertile women from culturally diverse, urban and rural communities,

attending outpatient care were the study subjects.They were interviewed with the help of

a semi-structured questionnaire about the causes of infertility. Results found that in

10.79% couples, male factor was the obvious cause; in 32.21% female factors, and in

20% couples, both male and female had obvious reasons responsible for infertility. In

37% cases, infertility appeared unexplained. Out of female factors, around 40% women

had tubal factors, 30% had anovulation, endocrine disorders (thyroid disorders,

hyperprolactinemia, polycystic ovarian disorders, luteal phase defect, diabetes etc.) were

in 13%, and uterine causes (hypoplasia, malformed uterus, tuberculous endometritis,

fibroid uterus, synechiae etc.,) in 10% cases. There were other pelvic causes (pelvic

inflammatory disease, endometriosis) and cervical mucous problems in 5% of the cases

and 2% had coital problems. Male factors (10.79%) included aspermia, azoospermia,

oligospermia, teratospermia, erectile dysfuction, premature ejaculation, hypoactive sexual

desire, etc.

A descriptive study was conducted by Sule J.O., P. Erigbali, L. Eruom (2008)

Department of Physiology, Niger Delta University., Bayelsa State, Nigeria regarding

common causes of infertility in women aged between 15 and 55 years was assessed in

four hospital centers in South Western part of Nigeria. A survey of a consecutive sample

of 200 cases of infertility were carried out in four hospital centers with a total of 50 cases

of infertility evaluated in each of the centers between 2004 –2006. The commonest

causes of infertility in this environment were, the tubal factor, uterine factor, and ovarian

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factor representing 39.5%, 30% and 13% respectively. The least common cause were

cervical factor, Pelvic Infection Disease (PID), and endometriosis which was seen in 3%,

5.5% and 2.5% of the subjects respectively.

Section-IV: Literature related to treatment modalities of infertility.

An experimental study was conducted by Sinikka Nuojua-Huttunen, Leena

Tuomivaara(2004) to evaluate the effectiveness of intrafollicular insemination (IFI) for

the treatment of non-tubal infertility was investigated in a pilot study. A total of 50

infertility patients with normal tubal function verified by laparoscopy or

hysterosalpingography were stimulated with clomiphene citrate/human menopausal

gonadotrophin. Washed spermatozoa were injected into one to three pre-ovulatory

follicles via vaginal puncture 12 or 30 hrs after human chorionic gonadotrophin

administration. Natural progesterone was given for luteal support. One normal intra-

uterine pregnancy resulted. The results indicate that by comparison with other assisted

reproductive technologies IFI is very inefficacious for treating non-tubal infertility. Our

data suggest that the intrafollicular environment in the pre-ovulatory period is not

favourable for fertilization.

A prospective study was conducted by A M Clark, B Thornley, L Tomlinson,etal.,

(2004) to assess the Weight loss in obese infertile women results in improvement in

reproductive outcome for all forms of fertility treatment. A weight loss programme was

assessed to determine whether it could help obese infertile women, irrespective of their

infertility diagnosis, to achieve a viable pregnancy, ideally without further medical

intervention. 150 subjects were taken as samples by convenient sampling method who

underwent a weekly programme aimed at lifestyle changes in relation to exercise and diet

for 6 months those that did not complete the 6 months were treated as a comparison

group. Results showed that women in the study lost an average of 10.2 kg/m2, with 60 of

the 67 anovulatory subjects resuming spontaneous ovulation, 52 achieving a pregnancy

(18 spontaneously) and 45 a live birth. Thus weight loss should be considered as a first

option for women who are infertile and overweight.

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A prospective randomized study was conducted by Jan Gerris1, Diane De Neubourg,

Kathelijne Mangelschots,(2003) comparing single embryo transfer with double embryo

transfer after in-vitro fertilization or intra cytoplasmic sperm injection (IVF/ICSI) was

carried out. First, top quality embryo characteristics were delineated by retrospectively

analysing embryos resulting in ongoing twins after double embryo transfer. A top quality

embryo was characterized by the presence of 4 or 5 blastomeres at day 2 and at least 7

blastomeres on day 3 after insemination, the absence of multinucleated blastomeres and

<20% cellular fragments on day 2 and day 3 after fertilization. Using these criteria, a

prospective study was conducted in women <34 years of age, who started their first

IVF/ICSI cycle. Of 194 eligible patients, 110 agreed to participate of whom 53 produced

at least two top quality embryos and were prospectively randomized. In all, 26 single

embryo transfers resulted in 17 conceptions, 14 clinical and 10 ongoing pregnancies

[implantation rate (IR) = 42.3%; ongoing pregnancy rate (OPR) = 38.5%] with one

monozygotic twin; 27 double embryo transfers resulted in 20 ongoing conceptions with

six (30%) twins (IR = 48.1%; OPR = 74%). We conclude that by using single embryo

transfer and strict embryo criteria, an OPR similar to that in normal fertile couples can be

achieved after IVF/ICSI, while limiting the dizygotic twin pregnancy rate to its natural

incidence of <1% of all ongoing pregnancies.

RESEARCH METHODOLOGY

Research methodology is a systematic way to solve a problem.It is a blue print of how

the research activities should be carried out.It is a set of methods and principles used to

perform a particular activity.The researcher must carefully select the research design as it

has an important role in conducting the study.The research design determines how the

study should be organized,when the data should be collected,and when interventions are

to be implemented.

RESEARCH APPROACH

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The research approach is a broad based procedure for stydying the selected problem and

drawing conclusions.The research approach refers to a general set of ordinary disciplined

procedure used to acquire dependable and useful information.

RESEARCH DESIGN

Research design is the conceptual structure with in which the research should be

conducted. It provides the back bone of the study. The research design is a platform from

which the researcher explores new knowledge in an effort to better describe and

understand phenomena, clarify plausible explanations and identify potential factors. In

this study, pre experimental design i.e.,one group pretest-post test design will be used.

O1 X O2

Pre-test planned teaching post-test

RESEARCH VARIABLES

Variable is a measurable factor, characteristic, or attribute of an individual or a system

that varies and which takes on different values.

1) INDEPENDENT VARIABLE

In this study, planned teaching programme on infertility is the independent

variable. The planned teaching programme contains prevalence, risk factors&

etiology, management.

Planned teaching programme will be prepared after referring text books and other

references.

2) DEPENDENT VARIABLE

The knowledge of the post graduate students in the selected post graduate colleges

regarding infertility.

DEMOGRAPHIC VARIABLES

The demographic variables are age, educational qualifications, gender,

SETTING OF THE STUDY

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The setting refers to the area /place where the study will be conducting. The researcher

selects a post graduate colleges in Hyderabad.

POPULATION

In this study, the population consist of postgraduate students at selected post graduate

colleges at Hyderabad.

SAMPLE AND SAMPLE SIZE

A sample is a selected proportion of the defined population.The samples will be the

postgraduate students in selected postgraduate college at Hyderabad and the sample size

is 40.

CRITERIA FOR SAMPLE SELECTION

Inclusion criteria

a) Postgraduate students in selected postgraduate colleges at Hyderabad.

b) Postgraduate students who are willing to participate in the study.

c) Postgraduate students who are able to understand and read English.

Exclusion criteria

a) Postgraduate students who are absent at the time of data collection.

b) Postgraduate students who donot know to read and speak English.

SAMPLING TECHNIQUE

The sampling technique is the non-probability convenient sampling .

TOOL FOR DATA COLLECTION

SectionA; structured questionnaire regarding demographic data.

SectionB: It is divided into subparts like.

Part(A): structured questionnaire on definition, prevalence, etiology&risk factors of

infertility.

Part(B):structured questionnaire on types and treatment modalities.

METHOD OF DATA COLLECTION

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Phase1: After obtaining permission from concerned authorities, informed consent from

the samples , the researcher will collect the data pertaining to the demographic variables

and assess the existing knowledge with the structured questionnaire.

Phase2: Planned teaching programme will be conducted.

Phase3; After five days self administered,structured questionnaire will be administered to

assess the post test knowledge of the postgraduate students.

SCORE INTERPRETATION

Each correct answer will be given a score of one and wrong answer as zero.Score

interpretation will be based on knowledge score in terms of percentages.The knowledge

score will be considered into three classes;

Below 33.33% - below average knowledge.

33.33% -66.66%- average knowledge.

Above 66.66% - above average knowledge.

VALIDITY

To evaluate the content validity,the tool will be given to the experts in related fields like

obstetrics, gynaecology, and nursing.

RELIABILITY

The reliability of the tool will be tested by test retest method with a time gap of five days

and the correlation co-efficient will be calculated by Karl Pearson formula.

PILOT STUDY

The pilot study will be conducted to assess the practicability, feasibility and

appropriateness of the tool.

PLANS FOR DATA ANALYSIS

The collected data will be analysed by using descriptive and inferential statistics.In

descriptive statistics frequency, percentage, distribution, means and standard deviation.

Inferential statistics Paired “t” test to compare the pre test and the post test

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knowledge,chi-square test to assess the association between the knowledge of post

graduate students with their selected demographic variables will be assessed.

PROJECT OUTCOME

The study will help the postgraduate students to have better knowledge regarding

infertility in selected postgraduate colleges at Hyderabad.

ETHICAL CLEARANCE

Informed consent will be obtained from the hospital authorities and subjects privacy,

confidentiality, and anonymity will be guaranteed. Scientific objectivity of the study will

be maintained with honesty and impartiality.

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Sample Registration System (SRS) Estimates of Total Fertility Rate (TFR)

in Andhra Pradesh from 1981-2010.

Name 1981 1991 2001 2007 2010

Andhra

pradesh 4.0 3.0 2.4 1.9 1.8

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India 4.5 3.8 3.5 3.4 3.3 3.2 3.2 3.0 3.0 2.9 2.9 2.8 2.7 2.6 2.6 2.5

Source : Family Welfare Statistics in India - 2006-2010; MoH&FW, GoI; SRS - 2010

(April, 2012)

http://planningcommission.nic.in/data/datatable/0904/tab_207.pdf

Read more at: http://indiatoday.intoday.in/story/infertility-on-the-rise/1/103037.html

http://humrep.oxfordjournals.org/content/14/10/2581.abstract

http://www.rightdiagnosis.com/f/female_infertility/stats-country.htm

http://www.bioline.org.br/pdf?md08031

http://www.nature.com/aja/journal/v7/n4/abs/aja200563a.html

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3237240

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