Brain activation, sleep disturbances, and psychological distress in women undergoing assisted reproductive treatment: a functional near-infrared spectroscopy study.

BACKGROUND: Patients undergoing assisted reproductive technology (ART) frequently manifest sleep disturbances and psychological morbidity. This study examined associations between cerebral activation patterns, sleep quality, and psychological parameters in infertility patients using Functional near-infrared spectroscopy (fNIRS). METHODS: This cross-sectional study analyzed 80 participants (38 infertility patients, 42 healthy controls). Patients were assessed on trigger day using Athens Insomnia Scale-8 (AIS-8), Generalized Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9). Cortical hemodynamic responses were measured during a Chinese verbal fluency task (VFT) using functional near-infrared spectroscopy. Independent-sample t-tests were used to assess group differences, and Pearson correlation analyses were performed to examine the relationships between brain activation patterns and psychological scale scores. RESULTS: Compared with controls, infertility patients showed significantly higher insomnia (AIS-8: 6.11 ± 3.38 vs. 1.43 ± 1.53, P < 0.001) and anxiety levels (GAD-7: 3.68 ± 3.52 vs. 1.26 ± 1.36, P < 0.001). fNIRS revealed significantly reduced activation in Broca’s area, frontal pole, and left dorsolateral prefrontal cortex (DLPFC) (P < 0.05). Higher GAD-7 scores were associated with slower response time (P < 0.05) and lower task accuracy. Increased AIS-8 scores correlated with delayed hemodynamic responses. Longer infertility duration was linked to reduced cortical activation and posterior shifts in centroid location. Primary infertility patients reported significantly worse anxiety and sleep quality than those with secondary infertility (P < 0.05). CONCLUSIONS: Infertility patients undergoing ART exhibit impaired prefrontal cortical activation during cognitive tasks, particularly in regions critical for language and executive function. These neural changes are closely associated with increased anxiety, poor sleep, and infertility duration, highlighting the need for psychological support and potential neurocognitive interventions during critical treatment phases such as the trigger day.