Gender differences in psychological status of infertile couples: a systematic review and meta-analysis

Abstract Background and aim Infertility affects approximately millions of individuals of reproductive age worldwide and can lead to significant psychological consequences, dramatically impacting the lives of those involved. This systematic review aimed to measure the gender differences in psychologi...

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Main Authors: Fahimeh Khorasani, Elnaz Iranifard, Robab Latifnejad Roudsari
Format: Article
Language:English
Published: BMC 2025-06-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-025-23314-x
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author Fahimeh Khorasani
Elnaz Iranifard
Robab Latifnejad Roudsari
author_facet Fahimeh Khorasani
Elnaz Iranifard
Robab Latifnejad Roudsari
author_sort Fahimeh Khorasani
collection DOAJ
description Abstract Background and aim Infertility affects approximately millions of individuals of reproductive age worldwide and can lead to significant psychological consequences, dramatically impacting the lives of those involved. This systematic review aimed to measure the gender differences in psychological status experienced by infertile couples. Methods A comprehensive search of observational studies in English was conducted across several databases, including PubMed, Web of Science, Cochrane Library, and Scopus, with no time restrictions applied until September 2024. The review adheres to the MOOSE Guidelines and is registered with PROSPERO (CRD42024541801). Comprehensive Meta-Analysis Version 2 was used to estimate mean difference and 95% CI and prediction interval by the random-effects model. A subgroup analysis was conducted based on the study region, stage of treatment, and measurement tools. Also, sensitivity analysis was performed using the one-study removed method. To assess publication bias, the Funnel plot and Egger’s test were used. Results Out of 748 documents from the initial search, 27 studies, involving 10,083 infertile men and women, were included in this systematic review, of which 21 studies were included in the meta-analysis. There was a significant difference between the mean scores of infertile women and men in all aspects of psychological status (Std diff in Mean: 0.31, CI 95% [0.23–0.39]; p-value ≤ 0.001). Also, there were significant differences in mean levels of anxiety (0.42, CI 95% [0.34–0.50], p-value ≤ 0.001), depression (0.39, CI 95% [0.29–0.49], p-value ≤ 0.001), stress (0.34, CI 95% [0.23–0.45], p-value ≤ 0.001), and self-efficacy (-0.54, CI 95% [-0.69–0.39], p-value ≤ 0.001) between infertile women and men. The difference in mean levels of self-esteem and sexual satisfaction did not differ significantly between infertile women and men. Conclusion Considering the differences in psychological status between infertile women and men, paying attention to gender differences is crucial when formulating policies and planning strategies for implementing solutions. It is important to consider how men and women may be affected differently when designing programs to address their infertility issues.
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spelling doaj-art-3a79cf3cf24d43a09b0f1ca822f76d5e2025-08-20T03:10:39ZengBMCBMC Public Health1471-24582025-06-0125111910.1186/s12889-025-23314-xGender differences in psychological status of infertile couples: a systematic review and meta-analysisFahimeh Khorasani0Elnaz Iranifard1Robab Latifnejad Roudsari2Reproductive Health, Student Research Committee, Mashhad University of Medical SciencesReproductive Health, Student Research Committee, Mashhad University of Medical SciencesNursing and Midwifery Care Research Center, Mashhad University of Medical SciencesAbstract Background and aim Infertility affects approximately millions of individuals of reproductive age worldwide and can lead to significant psychological consequences, dramatically impacting the lives of those involved. This systematic review aimed to measure the gender differences in psychological status experienced by infertile couples. Methods A comprehensive search of observational studies in English was conducted across several databases, including PubMed, Web of Science, Cochrane Library, and Scopus, with no time restrictions applied until September 2024. The review adheres to the MOOSE Guidelines and is registered with PROSPERO (CRD42024541801). Comprehensive Meta-Analysis Version 2 was used to estimate mean difference and 95% CI and prediction interval by the random-effects model. A subgroup analysis was conducted based on the study region, stage of treatment, and measurement tools. Also, sensitivity analysis was performed using the one-study removed method. To assess publication bias, the Funnel plot and Egger’s test were used. Results Out of 748 documents from the initial search, 27 studies, involving 10,083 infertile men and women, were included in this systematic review, of which 21 studies were included in the meta-analysis. There was a significant difference between the mean scores of infertile women and men in all aspects of psychological status (Std diff in Mean: 0.31, CI 95% [0.23–0.39]; p-value ≤ 0.001). Also, there were significant differences in mean levels of anxiety (0.42, CI 95% [0.34–0.50], p-value ≤ 0.001), depression (0.39, CI 95% [0.29–0.49], p-value ≤ 0.001), stress (0.34, CI 95% [0.23–0.45], p-value ≤ 0.001), and self-efficacy (-0.54, CI 95% [-0.69–0.39], p-value ≤ 0.001) between infertile women and men. The difference in mean levels of self-esteem and sexual satisfaction did not differ significantly between infertile women and men. Conclusion Considering the differences in psychological status between infertile women and men, paying attention to gender differences is crucial when formulating policies and planning strategies for implementing solutions. It is important to consider how men and women may be affected differently when designing programs to address their infertility issues.https://doi.org/10.1186/s12889-025-23314-xInfertilityGenderDistressStressDepressionAnxiety
spellingShingle Fahimeh Khorasani
Elnaz Iranifard
Robab Latifnejad Roudsari
Gender differences in psychological status of infertile couples: a systematic review and meta-analysis
BMC Public Health
Infertility
Gender
Distress
Stress
Depression
Anxiety
title Gender differences in psychological status of infertile couples: a systematic review and meta-analysis
title_full Gender differences in psychological status of infertile couples: a systematic review and meta-analysis
title_fullStr Gender differences in psychological status of infertile couples: a systematic review and meta-analysis
title_full_unstemmed Gender differences in psychological status of infertile couples: a systematic review and meta-analysis
title_short Gender differences in psychological status of infertile couples: a systematic review and meta-analysis
title_sort gender differences in psychological status of infertile couples a systematic review and meta analysis
topic Infertility
Gender
Distress
Stress
Depression
Anxiety
url https://doi.org/10.1186/s12889-025-23314-x
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