{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T06:22:04Z","timestamp":1788157324790,"version":"build-2803163510"},"reference-count":29,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2021,3,1]],"date-time":"2021-03-01T00:00:00Z","timestamp":1614556800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012632","name":"Nazarbayev University","doi-asserted-by":"publisher","award":["Social Policy Grant"],"award-info":[{"award-number":["Social Policy Grant"]}],"id":[{"id":"10.13039\/501100012632","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Although it is clear that infertility leads to heightened stress for patients, the impact of depressed mood and anxiety on treatment outcome is inconsistently reported. The aim of this study was to evaluate the effect of stress, depression and anxiety on in vitro fertilization (IVF) outcomes in Kazakhstani public assisted reproductive technology (ART) clinics. The prospective cohort study was performed between June 2019 and September 2020 using questionnaires to assess psychological stress, depressed mood and anxiety in women referred to IVF clinics in two public clinical centers in Kazakhstan, Nur-Sultan and Aktobe. Our study sample comprised 142 women with the average age of 33.9 \u00b1 4.9 years, and infertility duration 6.0 \u00b1 3.5 years. More than half of respondents had Center for Epidemiological Studies Depression Scale (CES-D) scores higher than 16, indicating their risk of developing clinical depression. Ninety-one percent of women from Aktobe city were at risk for clinical depression (p &lt; 0.001). Aktobe city respondents had higher stress subscale scores and anxiety scale scores (p &lt; 0.001) than Nur-Sultan respondents. Statistical analysis showed that IVF outcome was not significantly associated with depression and stress, while the higher anxiety scale scores were negatively associated with clinical pregnancy after IVF.<\/jats:p>","DOI":"10.3390\/jcm10050937","type":"journal-article","created":{"date-parts":[[2021,3,1]],"date-time":"2021-03-01T01:26:33Z","timestamp":1614561993000},"page":"937","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["The Effect of Stress, Anxiety and Depression on In Vitro Fertilization Outcome in Kazakhstani Public Clinical Setting: A Cross-Sectional Study"],"prefix":"10.3390","volume":"10","author":[{"given":"Gauri","family":"Bapayeva","sequence":"first","affiliation":[{"name":"Clinical Academic Department of Women\u2019s Health, National Research Center of Mother and Child Health, University Medical Center, Nur-Sultan 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2868-4497","authenticated-orcid":false,"given":"Gulzhanat","family":"Aimagambetova","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Nazarbayev University School of Medicine, Nur-Sultan 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alpamys","family":"Issanov","sequence":"additional","affiliation":[{"name":"Department of Medicine, Nazarbayev University School of Medicine, Nur-Sultan 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanja","family":"Terzic","sequence":"additional","affiliation":[{"name":"Department of Medicine, Nazarbayev University School of Medicine, Nur-Sultan 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Talshyn","family":"Ukybassova","sequence":"additional","affiliation":[{"name":"Clinical Academic Department of Women\u2019s Health, National Research Center of Mother and Child Health, University Medical Center, Nur-Sultan 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aidana","family":"Aldiyarova","sequence":"additional","affiliation":[{"name":"Clinical Academic Department of Women\u2019s Health, National Research Center of Mother and Child Health, University Medical Center, Nur-Sultan 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gulnara","family":"Utepova","sequence":"additional","affiliation":[{"name":"Clinical Academic Department of Women\u2019s Health, National Research Center of Mother and Child Health, University Medical Center, Nur-Sultan 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhanibek","family":"Daribay","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology #2, Marat Ospanov West Kazakhstan State Medical University, Aktobe 030000, Kazakhstan"},{"name":"Regional Perinatal Center, Aktobe 030000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gulnara","family":"Bekbossinova","sequence":"additional","affiliation":[{"name":"Regional Perinatal Center, Aktobe 030000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Askhat","family":"Balykov","sequence":"additional","affiliation":[{"name":"Regional Perinatal Center, Aktobe 030000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1543-2802","authenticated-orcid":false,"given":"Antonio Simone","family":"Lagan\u00e0","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, \u201cFilippo Del Ponte\u201d Hospital, University of Insubria, 21100 Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3914-5154","authenticated-orcid":false,"given":"Milan","family":"Terzic","sequence":"additional","affiliation":[{"name":"Clinical Academic Department of Women\u2019s Health, National Research Center of Mother and Child Health, University Medical Center, Nur-Sultan 010000, Kazakhstan"},{"name":"Department of Medicine, Nazarbayev University School of Medicine, Nur-Sultan 010000, Kazakhstan"},{"name":"Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,3,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"ACOG Committee Opinion (2019). 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