Analysis of changes in women's psychological status and nursing responses after fertility treatment failure: A retrospective cohort study

The failure of assisted reproductive technology (ART) often leads to anxiety, depression, and reduced treatment adherence, yet domestic research on psychological trajectories and nursing interventions remains limited. This single-center retrospective cohort study examined psychological changes in women after ART failure, identified influencing factors, and evaluated structured psychological care. Ninety-eight patients with ART failure (Jan 2023-Jan 2025) were assigned to supportive care (n = 48) or routine care (n = 50). Psychological status and quality of life were assessed using the self-rating anxiety scale (SAS), self-rating depression scale (SDS), and SF-36 at the day of failure, one week, and one month later. Nursing satisfaction and treatment adherence were also recorded. No significant differences in anxiety and depression scores were observed between the 2 groups on the day of ART treatment failure and at 1 week post-failure (both P > .05). However, at one month, the psychological supportive care group showed greater reductions in SAS scores (from 61.4 ± 6.3 to 49.2 ± 5.8) compared with the routine care group (from 60.9 ± 6.1 to 55.8 ± 6.0; χ2 = 8.229, P = .042), and greater reductions in SDS scores (from 63.2 ± 6.0 to 50.3 ± 5.6 vs 62.8 ± 5.9 to 56.7 ± 5.7; χ2 = 12.038, P = .007). Nursing satisfaction at one month was higher in the supportive care group (93.8% vs 72.0%; χ2 = 13.593, P = .004), as was treatment adherence (95.8% vs 74.0%; χ2 = 13.746, P = .001). In addition, all 8 SF-36 dimension scores improved more in the supportive care group than in controls, with mean increases ranging from 8.2 to 15.6 points (all P < .05). Women's psychological distress following ART failure tends to be persistent and delayed. Structured and systematic psychological care may alleviate anxiety and depression, enhance satisfaction and compliance, and improve overall quality of life. Continuous, individualized psychological support and the development of standardized reproductive psychological care systems are warranted in clinical practice.