Psychological Impact of Infertility on Couples: A Cross-Sectional Study of Coping Strategies

Psychological Impact of Infertility on Couples

Authors

  • Munazza Yousaf Department of Gynecology and Obstetrics, Maqsood Medical Complex, General Hospital, Peshawar, Pakistan
  • Unzila Umer Department of Gynecology and Obstetrics, Maqsood Medical Complex, General Hospital, Peshawar, Pakistan
  • Naila Raziq Department of Gynecology and Obstetrics, Maqsood Medical Complex, General Hospital, Peshawar, Pakistan
  • Laila Shinwari Department of Gynecology, Kabir Medical College, Peshawar, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v7i3.3730

Keywords:

Infertility, Psychological Distress, Anxiety, Depression, Coping Strategies

Abstract

Infertility is not only a biomedical concern but also a source of considerable psychological stress for both partners, affecting emotional health and relationship functioning. The distinct emotional and coping processes of infertile couples necessitate understanding emotional distress for the planning of structured psychosocial support. Objective: To evaluate the psychological effect of infertility and find the coping mechanisms employed by infertile couples attending Maqsood Medical Complex and General Hospital, Peshawar. Methods: This cross-sectional descriptive study was carried out from April 1st, 2025, to September 30, 2025, on 130 infertile couples. Data were gathered on sociodemographic characteristics, the Hospital Anxiety and Depression Scale (HADS), and the Brief COPE inventory. The means ± SD were calculated for continuous variables, the frequencies were calculated for categorical variables, while the associations of coping strategies with psychological distress were handled using chi-square and Pearson correlation tests. Results: Of the 130 couples studied, 61.5% reported clinically significant anxiety and 49.2% reported depressive symptoms. Female partners consistently had higher mean scores for anxiety and depression than their male counterparts. Problem-focused coping (planning, active coping, and positive reframing) was related to lower levels of distress, while avoidant and emotion-focused coping were associated with higher anxiety and depression. Conclusions: Infertility carries a significant emotional burden, especially for women, and emotional coping strategies have a strong bearing on the psychological impact. It is critical that couple-focused psychosocial support and stress-management counseling be integrated into the psychosocial aspects of infertility care.

References

Tang N, Pei M, Liu H, Chen J, Wang Y, Xie L et al. Infertility-Related Stress, and Dyadic Coping as Predictors of Quality of Life: Gender Differences Among Couples with Infertility Issues. International journal of women's health. 2024 Dec: 1265-1276. doi: DOI: https://doi.org/10.2147/IJWH.S469513

Zhang L, Gu W, Jing X, Zhi S, Zhou N, Zhang L et al. Predicting the Dyadic Coping Through Self-Esteem Among Infertile Couples Undergoing In Vitro Fertilization and Embryo Transfer: An Actor-Partner Interdependence Model. Frontiers in Psychology. 2023 Aug; 14: 1-10. doi: DOI: https://doi.org/10.3389/fpsyg.2023.1127464

Cattaneo Della Volta MF, Vallone F, Dolce P, Zurlo MC. Psychological Health Conditions of ART-Treated Infertile Couples: A 4-Year Prospective Study. Frontiers in Psychology. 2025 Aug; 16: 1-18. doi: DOI: https://doi.org/10.3389/fpsyg.2025.1616754

Wise LA, Hoffman MN, Lovett SM, Geller RJ, Schrager NL, Ukah UV et al. Racial and Ethnic Disparities in Fecundability: A North American Preconception Cohort Study. Human Reproduction. 2025 Jun; 40(6): 1183-1194. doi: DOI: https://doi.org/10.1093/humrep/deaf067

Xu Q, Wan Z, Xiong Z, Zhu X, Han Q, Wang Y, Zhao J, Yu F. The effects of nursing interventions on anxiety and depression in infertile females undergoing assisted reproduction: a systematic review and meta-analysis. BioMed Central Women's Health. 2025 Dec; 25(1): 607. doi: DOI: https://doi.org/10.1186/s12905-025-04146-8

Jackson PL, Saunders P, Mizzi S, Hallam KT. The Efficacy of Psychological Interventions for Infertile Women: A Systematic Review and Meta-Analysis. BioMed Central Women's Health. 2025 Oct; 25(1): 506. doi: DOI: https://doi.org/10.1186/s12905-025-04054-x

Jiang L, Yang L, Yao J, Yang J, Wu M, Yuan M et al. Evaluating a new scale for infertility psychological distress: psychometric evidence from China. BioMed Central Psychology. 2025 Jul; 13(1): 667. doi: DOI: https://doi.org/10.1186/s40359-025-02991-8

Park JC. Assessment of Anxiety, Depression, And Sexual Dysfunction in Women Undergoing Fertility Treatment. Clinical and Experimental Reproductive Medicine. 2025 Feb; 52(1): 38. doi: DOI: https://doi.org/10.5653/cerm.2024.07465

Chaurasiya S, Singh R, Bahadur B, Singh S, Maurya V, Rai S. Psychological Distress in Women with Primary and Secondary Infertility: A Comparative Analysis of Depression, Anxiety, and Stress. Frontiers in Public Health. 2025 Dec; 13: 1-11. doi: DOI: https://doi.org/10.3389/fpubh.2025.1703256

El Kissi Y, Romdhane AB, Hidar S, Bannour S, Idrissi KA, Khairi H et al. General psychopathology, anxiety, depression and self-esteem in couples undergoing infertility treatment: a comparative study between men and women. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2013 Apr; 167(2): 185-189. doi: DOI: https://doi.org/10.1016/j.ejogrb.2012.12.014

Johns G, Samuel V, Freemantle L, Lewis J, Waddington L. The Global Prevalence of Depression and Anxiety Among Doctors During the COVID-19 Pandemic: Systematic Review and Meta-Analysis. Journal of Affective Disorders. 2022 Feb; 298: 431-441. doi: DOI: https://doi.org/10.1016/j.jad.2021.11.026

Jamal Y, Yaseen F, Khalid M. A Preliminary Validation of the Brief COPE Inventory for Assessing Coping Strategies among Pakistani House Job Doctors. Journal of Professional and Applied Psychology. 2022 Jun; 3(2): 267-275. doi: DOI: https://doi.org/10.52053/jpap.v3i2.108

Simionescu G, Doroftei B, Maftei R, Obreja BE, Anton E, Grab D et al. The Complex Relationship Between Infertility and Psychological Distress. Experimental and Therapeutic Medicine. 2021 Apr; 21(4): 306. doi: DOI: https://doi.org/10.3892/etm.2021.9737

Cousineau TM and Domar AD. Psychological Impact of Infertility. Best Practice and Research Clinical Obstetrics and Gynaecology. 2007 Apr; 21(2): 293-308. doi: DOI: https://doi.org/10.1016/j.bpobgyn.2006.12.003

Peterson BD, Pirritano M, Block JM, Schmidt L. Marital Benefit and Coping Strategies in Men and Women Undergoing Unsuccessful Fertility Treatments Over 5 Years. Fertility And Sterility. 2011 Apr; 95(5): 1759-1763. doi: DOI: https://doi.org/10.1016/j.fertnstert.2011.01.125

Hasanpoor-Azghdy SB, Simbar M, Vedadhir A. The Emotional-Psychological Consequences of Infertility Among Infertile Women Seeking Treatment: Results of A Qualitative Study. Iranian Journal of Reproductive Medicine. 2014 Feb; 12(2): 131. doi:

Mohammadi M, Samani RO, Navid B, Maroufizadeh S, Sabeti S. Coping Strategy in Infertile Couples Undergoing Assisted Reproduction Treatment. Middle East Fertility Society Journal. 2018 Dec; 23(4): 482-485. doi: DOI: https://doi.org/10.1016/j.mefs.2018.07.004

Gourounti K, Anagnostopoulos F, Potamianos G, Lykeridou K, Schmidt L, Vaslamatzis G. Perception of Control, Coping and Psychological Stress of Infertile Women Undergoing In Vitro Fertilization. Reproductive Biomedicine Online. 2012 Jun; 24(6): 670-679. doi: DOI: https://doi.org/10.1016/j.rbmo.2012.03.002

Reisi M, Kazemi A, Abedi MR, Nazarian N. Spouse’s Coping Strategies Mediate the Relationship Between Women’s Coping Strategies and Their Psychological Health Among Infertile Couples. Scientific Reports. 2023 Jul; 13(1): 1-10. doi: DOI: https://doi.org/10.1038/s41598-023-37380-x

Falconier MK and Kuhn R. Dyadic Coping in Couples: A Conceptual Integration and a Review of the Empirical Literature. Frontiers In Psychology. 2019 Mar; 10: 571. doi: DOI: https://doi.org/10.3389/fpsyg.2019.00571

Hwang YJ, Lee J, Hwang J, Sim H, Kim N, Kim TS. Psychiatric Considerations of Infertility. Psychiatry Investigation. 2024 Nov; 21(11): 1175. doi: DOI: https://doi.org/10.30773/pi.2024.0239

Braverman AM, Davoudian T, Levin IK, Bocage A, Wodoslawsky S. Depression, anxiety, quality of life, and infertility: a global lens on the last decade of research. Fertility and sterility. 2024 Mar; 121(3): 379-383. doi: DOI: https://doi.org/10.1016/j.fertnstert.2024.01.013

Downloads

Published

2026-03-31
CITATION
DOI: 10.54393/pjhs.v7i3.3730
Published: 2026-03-31

How to Cite

Yousaf, M., Umer, U., Raziq, N., & Shinwari, L. (2026). Psychological Impact of Infertility on Couples: A Cross-Sectional Study of Coping Strategies: Psychological Impact of Infertility on Couples. Pakistan Journal of Health Sciences, 7(3), 57–62. https://doi.org/10.54393/pjhs.v7i3.3730

Issue

Section

Original Article

Plaudit