Khorasani Fahimeh, Iranifard Elnaz, Roudsari Robab Latifnejad
Reproductive Health, Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Midwifery, May.C., Islamic Azad University, Islamic Republic of, Maybod, Iran.
BMC Public Health. 2025 Jun 7;25(1):2131. doi: 10.1186/s12889-025-23314-x.
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.
不孕症影响着全球约数百万育龄人口，并可能导致严重的心理后果，极大地影响相关人群的生活。本系统评价旨在衡量不孕夫妇心理状态的性别差异。
对包括PubMed、科学网、考克兰图书馆和Scopus在内的多个数据库进行全面检索，查找英文观察性研究，检索时间截至2024年9月，无时间限制。本评价遵循MOOSE指南，并在PROSPERO（CRD42024541801）注册。使用综合Meta分析版本2，通过随机效应模型估计平均差、95%置信区间和预测区间。根据研究地区、治疗阶段和测量工具进行亚组分析。此外，采用逐一剔除研究法进行敏感性分析。为评估发表偏倚，使用漏斗图和Egger检验。
在初步检索得到的748篇文献中，本系统评价纳入了27项研究，涉及10,083名不孕男性和女性，其中21项研究纳入了Meta分析。不孕女性和男性在心理状态各方面的平均得分存在显著差异（平均标准差：0.31，95%置信区间[0.23 - 0.39]；p值≤0.001）。此外，不孕女性和男性在焦虑平均水平（0.42，95%置信区间[0.34 - 0.50]，p值≤0.001）抑郁（0.39，95%置信区间[0.29 - 0.49]，p值≤0.001）、压力（0.34，95%置信区间[0.23 - 0.45]，p值≤0.001）和自我效能感（-0.54，95%置信区间[-0.69 - 0.39]，p值≤0.001）方面也存在显著差异。不孕女性和男性在自尊和性满意度平均水平上的差异不显著。
考虑到不孕女性和男性在心理状态上的差异，在制定政策和规划实施解决方案的策略时，关注性别差异至关重要。在设计解决不孕症问题的项目时，考虑男性和女性可能受到的不同影响很重要。
