Emotional, psychological, social and treatment-related effects of recurrent implantation failure in men and woman: A systematic review and Meta-analysis.

INTRODUCTION

Up to 10-20% of couples undergoing ICSI/IVF face recurrent implantation failure (RIF). This effects psychological well-being, may compromise treatment pursuit and is insufficiently addressed in current medical care. Therefore, we aimed to identify key aspects and give a comprehensive overview of potential psycho-social reactions to RIF as well as of strategies used, to overcome burden related to RIF.

METHODS

We conducted a systematic literature review considering manuscripts published in Pubmed, EMBASE and PsychInfo from 1995 to 2025, following PRISMA guidelines. Data from studies addressing patients undergoing IVF/ICSI-ET and consecutive RIF in a strict and broader manner are presented. Where possible, meta-analysis were conducted using standardized mean difference (MD) with corresponding 95% confidence intervals.

RESULTS

28 Studies were included. Seven main aspects regarding well-being of patients with RIF emerged: quality of life, depression, anxiety, emotional/psychological well-being, partnership/social consequences, resilience and coping/support strategies. Patients with RIF, especially women had worse quality of life, were more depressed (MD 0.69, 95% CI 0.45, 0.93) and anxious (MD 0.16, 95% CI 0.00, 0.31), and negative emotions predominated. Diverging results were found for social interactions, including partnership. Gender differences were significant for depression (MD 0.56, 95% CI 0.26, 0.87) and anxiety (MD 0.54, 95% CI 0.37, 0.71); differences in coping strategies emerged.

DISCUSSION: RIF increases psychosocial burden and distress due to infertility. Patients at potentially higher risk for psychosocial distress could be identified. In future, specialized and patient oriented psychological support should be developed and integrated into routine patient care during infertility treatment.