title: Knowledge, attitude, and practices of infertility among Saudi couples.
abstract: BACKGROUND
  Infertility places a huge psychological burden on infertile couples, especially for women. Greater knowledge of the factors affecting fertility may help to decrease the incidence of infertility by allowing couples to avoid certain risk factors. The aim of our study was (1) to assess the knowledge and attitudes of infertile and fertile Saudi participants on infertility, possible risk factors, and social consequences; and (2) to determine the practices of infertile Saudi couples to promote their fertility before having them attend an in vitro fertilization (IVF) clinic.
  
  
  METHODS
  We conducted a cross-sectional study on 277 fertile participants from outpatient clinics and 104 infertile patients from the IVF clinic at King Abdulaziz Medical City between June 24, 2012 and July 4, 2012, using a previously validated interview questionnaire. Descriptive and analytical statistics were applied with a significance threshold of P ≤ 0.05.
  
  
  RESULTS
  A generally poor level of knowledge (59%) and a neutral attitude (76%) toward infertility were reported by participants. Mistaken beliefs commonly held by the study participants regarding the causes of infertility were Djinns and supernatural causes (58.8%), black magic (67.5%), intrauterine devices (71.3%), and contraceptive pills (42.9%). The healer/Sheikh was reported as the primary and secondary preference for infertility treatment by 6.7% and 44.2% of IVF patients, respectively. Compared with fertile patients, IVF patients were significantly less likely to favor divorce (38.5% versus 57.6%; P = 0.001) or marriage to a second wife (62.5% versus 86.2%; P < 0.001), if the woman could not have a baby. The patients with infertility had more favorable attitudes toward fertility drugs (87.5% versus 68.4%; P = 0.003) and having a test tube baby (92.4% versus 70.3%; P < 0.001). Child adoption was accepted as an option for treatment by the majority of IVF patients (60.6%) and fertile outpatients (71.5%). Alternative treatments previously practiced by the IVF patients to improve fertility include practicing Ruqia (61%), using alternative medicine (42%), engaging in physical exercise (39%), eating certain foods (22%), and quitting smoking (12%).
  
  
  CONCLUSIONS
  These findings have implications for health care providers regarding the reluctance that couples experiencing fertility problems may have, at least initially, to accept some interventions required for the couple to conceive.
authors.affiliation: King Abdullah International Medical Research Center (KAIMRC), King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
authors.forename: Mostafa A
authors.initials: MA
authors.lastname: Abolfotouh
authors.forename: Abdullah A
authors.initials: AA
authors.lastname: Alabdrabalnabi
authors.forename: Rehab B
authors.initials: RB
authors.lastname: Albacker
authors.forename: Umar A
authors.initials: UA
authors.lastname: Al-Jughaiman
authors.forename: Samar N
authors.initials: SN
authors.lastname: Hassan
keywords: KAP; attitude; infertility; knowledge; misconceptions; practice