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

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.

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.

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.

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.