Psychological consequences of assisted reproductive technologies in women: A systematic review beyond depression and anxiety

Introduction: Assisted reproductive technologies (ART), including in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI), have transformed fertility treatment and enabled many women to achieve pregnancy. However, ART procedures are physically demanding, emotionally taxing, and often associated with high levels of stress. While depression and anxiety are commonly reported psychological outcomes, emerging evidence indicates that ART may also impact other aspects of mental health, including self-esteem, coping strategies, social relationships, sexual satisfaction, and overall quality of life. Understanding these broader psychological consequences is crucial for developing comprehensive care strategies that address the full spectrum of women’s mental health needs during fertility treatment. Despite the increasing use of ART worldwide, systematic synthesis of these wider psychological effects remains limited. Methods: A systematic literature search was conducted in PubMed, Scopus, Web of Science, and PsycINFO for studies published between ۲۰۱۰ and ۲۰۲۵. Eligible studies included quantitative, qualitative, and mixed-method designs examining psychological outcomes in women undergoing ART, excluding studies focused solely on depression or anxiety. Screening, data extraction, and quality assessment were performed independently by two reviewers according to PRISMA ۲۰۲۰ guidelines, with disagreements resolved through discussion or consultation with a third reviewer. Results: From an initial ۱,۰۴۲ records, ۲۷ studies met the inclusion criteria. Findings indicate that ART may affect women’s psychological well-being in multiple domains beyond depression and anxiety. Commonly reported consequences include emotional exhaustion, decreased self-esteem, altered body image, sexual dysfunction, and strained interpersonal relationships. Positive outcomes, such as enhanced coping skills, resilience, and strengthened partner relationships, were also observed in certain populations. Factors influencing psychological outcomes included treatment duration, prior infertility history, social support, cultural context, and individual personality traits. Heterogeneity in study designs, outcome measures, and ART protocols limited meta-analysis; however, narrative synthesis revealed consistent patterns linking ART stressors to broader psychosocial effects. Conclusion: ART represents a complex intervention with multifaceted psychological implications for women. Beyond the well-documented depression and anxiety, ART can influence self-concept, relationships, sexual health, and overall quality of life. Clinicians should incorporate comprehensive psychosocial assessment and tailored support strategies to address these diverse consequences. Future longitudinal research is warranted to clarify causal pathways and identify protective factors that enhance psychological resilience among women undergoing ART.

کلیدواژه ها:

Assisted reproductive technologies ، in vitro fertilization ، mental health ، self-esteem ، quality of life ، psychosocial impact