Prevalence and risk factors of negative emotions in infertile women: A systematic review and meta-analysis

Liuxin Hu¹Youchang Yuan²Yanjing Li²Mian Cai²Jie Yin²Lijuan Zhu^1*

• ¹Jiangxi Hospital of Integrated Traditional Chinese and Western Medicine, Nanchang, China
• ²Jiangxi University of Traditional Chinese Medicine, Nanchang, China

Objective: The purpose of this study was to investigate the prevalence of anxiety and depression in female infertility patients, as well as the risk factors that are linked to these conditions, through a systematic review and meta-analysis. Methods: Eight databases—PubMed, Web of Science, Embase, Cochrane Library, Sinomed, CNKI, VIP, and WanFang—were thoroughly searched, with the search period lasting until February 28, 2025. Research on anxiety or depression and the risk factors linked to it that involved female infertility patients was included. Information was taken from each study, including study region, patient age, prevalence rates, and risk factors for anxiety or depression in female infertility patients. Results: It was discovered that 41% [95% CI ( 0.35, 0.47)] of female infertility patients had anxiety, and 42% [95% CI (0.36, 0.48)] had depression. Age [OR = 1.38, 95% CI (1.10, 1.73)], duration of infertility [OR = 1.68, 95% CI (1.30, 2.17) ], treatment expenses [OR = 2.04, 95% CI(1.78, 2.34)], and lack of knowledge about ART-related Information [OR = 1.70, 95% CI (1.26, 2.29)] were significantly associated with anxiety. Age [OR = 1.16, 95% CI (1.00, 1.33)], duration of infertility [OR = 1.83, 95% CI (1.56, 2.16)], treatment expenses [OR = 1.47, 95% CI (1.25, 1.74)], history of miscarriage [OR = 2.17, 95% CI (1.43, 3.31)], and primary infertility [OR = 2.15, 95% CI (1.55, 3.00)] were risk factors for depression. Other factors analyzed, such as place of residence, no reproductive history and family income, were not found to be statistically significant. Conclusion: Women with infertility face a high incidence of anxiety and depression, which is related to factors such as treatment costs, age, and duration of infertility. A history of miscarriage or primary infertility further increases the risk of depression, while a lack of knowledge of assisted reproductive technologies increases the risk of anxiety.