{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T16:35:50Z","timestamp":1792427750335,"version":"4.5.0"},"reference-count":80,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Assisted reproductive technologies (ART), particularly in vitro fertilization (IVF), are characterized by substantial emotional burden, uncertainty, and repeated decision-making under probabilistic conditions. Although psychological distress is common among individuals and couples undergoing ART, psychosocial care remains inconsistently integrated into fertility pathways and is rarely tailored to individual needs. This narrative review synthesizes evidence concerning infertility-related distress, anxiety and depressive symptoms, couple functioning, treatment discontinuation, psychosocial screening, and psychological interventions across the IVF trajectory. Key phases of treatment, including pretreatment assessment, ovarian stimulation, embryo transfer, the waiting period, cycle outcome, and decisions regarding repetition or discontinuation, are described, and phase-specific psychological vulnerabilities are identified. On the basis of the available literature, we propose a conceptual stepped-care framework ranging from universal psychoeducation and routine monitoring to structured psychological interventions, couple-based care, and specialist psychiatric management. Practical screening thresholds, referral criteria, reassessment intervals, and a safety pathway for suicidal ideation are outlined. Particular attention is given to male-factor infertility, strategies for engaging male partners, and the ethical and data-governance requirements of digital mental health tools. Current evidence supports psychosocial interventions for improving emotional well-being and quality of life and suggests a potential role in treatment continuation, but their effects on pregnancy and live-birth outcomes remain uncertain. The proposed framework should therefore be regarded as a clinically informed conceptual model rather than a validated prediction algorithm. Prospective studies are required to assess its feasibility, predictive performance, cost-effectiveness, and impact on patient-centered outcomes.<\/jats:p>","DOI":"10.3390\/jcm15135117","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T10:41:01Z","timestamp":1782902461000},"page":"5117","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Stratified Psychosocial Care in Assisted Reproductive Technologies: A Narrative Review and Conceptual Framework Across the IVF Pathway"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7058-4927","authenticated-orcid":false,"given":"Giuseppe","family":"Marano","sequence":"first","affiliation":[{"name":"Department of Neuroscience, Head-Neck and Chest, Section of Psychiatry, Fondazione Policlinico, Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy"},{"name":"Department of Neuroscience, Section of Psychiatry, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulio","family":"Carriero","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Head-Neck and Chest, Section of Psychiatry, Fondazione Policlinico, Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy"},{"name":"Department of Neuroscience, Section of Psychiatry, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6520-0686","authenticated-orcid":false,"given":"Elena Lucia","family":"Valle","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Head-Neck and Chest, Section of Psychiatry, Fondazione Policlinico, Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy"},{"name":"Department of Neuroscience, Section of Psychiatry, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caterina","family":"Brisi","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Head-Neck and Chest, Section of Psychiatry, Fondazione Policlinico, Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy"},{"name":"Department of Neuroscience, Section of Psychiatry, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6558-2932","authenticated-orcid":false,"given":"Gianandrea","family":"Traversi","sequence":"additional","affiliation":[{"name":"Unit of Medical Genetics, Department of Laboratory Medicine, Ospedale Isola Tiberina-Gemelli Isola, 00186 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osvaldo","family":"Mazza","sequence":"additional","affiliation":[{"name":"Spine Surgery Department, Bambino Ges\u00f9 Children\u2019s Hospital IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4688-9228","authenticated-orcid":false,"given":"Claudia","family":"d\u2019Abate","sequence":"additional","affiliation":[{"name":"Department of Gynecology, San Carlo Nancy Hospital, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosanna","family":"Esposito","sequence":"additional","affiliation":[{"name":"Unit of Gynecology and Obstetrics, A.O.R.N. Antonio Cardarelli Hospital, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9767-8752","authenticated-orcid":false,"given":"Gabriele","family":"Sani","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Head-Neck and Chest, Section of Psychiatry, Fondazione Policlinico, Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy"},{"name":"Department of Neuroscience, Section of Psychiatry, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3007-8162","authenticated-orcid":false,"given":"Marianna","family":"Mazza","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Head-Neck and Chest, Section of Psychiatry, Fondazione Policlinico, Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy"},{"name":"Department of Neuroscience, Section of Psychiatry, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/j.clinbiochem.2018.03.012","article-title":"Fertility and infertility: Definition and epidemiology","volume":"62","author":"Wyns","year":"2018","journal-title":"Clin. Biochem."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1016\/j.fertnstert.2017.06.005","article-title":"The International Glossary on Infertility and Fertility Care, 2017","volume":"108","author":"Adamson","year":"2017","journal-title":"Fertil. Steril."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"hoac051","DOI":"10.1093\/hropen\/hoac051","article-title":"Infertility prevalence and the methods of estimation from 1990 to 2021: A systematic review and meta-analysis","volume":"2022","author":"Cox","year":"2022","journal-title":"Hum. Reprod. Open"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2805","DOI":"10.1007\/s10815-025-03526-1","article-title":"Prevalence of psychological problems among individuals and couples during assisted reproductive technology(ART) treatment: A systematic review and meta-analysis","volume":"42","author":"Gu","year":"2025","journal-title":"J. Assist. Reprod. Genet."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2763","DOI":"10.1093\/humrep\/der246","article-title":"Stress, distress and outcome of assisted reproductive technology (ART): A meta-analysis","volume":"26","author":"Matthiesen","year":"2011","journal-title":"Hum. Reprod."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.1007\/s10815-025-03388-7","article-title":"Effects of emotions on IVF\/ICSI outcomes in infertile women: A systematic review and meta-analysis","volume":"42","author":"Lu","year":"2025","journal-title":"J. Assist. Reprod. Genet."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"d223","DOI":"10.1136\/bmj.d223","article-title":"Emotional distress in infertile women and failure of assisted reproductive technologies: Meta-analysis of prospective psychosocial studies","volume":"342","author":"Boivin","year":"2011","journal-title":"BMJ"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1016\/j.fertnstert.2003.08.013","article-title":"Impact of psychological factors on dropout rates in insured infertility patients","volume":"81","author":"Domar","year":"2004","journal-title":"Fertil. Steril."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1016\/j.fertnstert.2016.03.006","article-title":"Addressing the needs of fertility treatment patients and their partners: Are they informed of and do they receive mental health services?","volume":"106","author":"Pasch","year":"2016","journal-title":"Fertil. Steril."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1093\/humupd\/dmac034","article-title":"Efficacy of psychological interventions for mental health and pregnancy rates among individuals with infertility: A systematic review and meta-analysis","volume":"29","author":"Dube","year":"2023","journal-title":"Hum. Reprod. Update"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2560828","DOI":"10.1080\/0167482X.2025.2560828","article-title":"The effects of cognitive interventions on quality of life in infertile women: A meta-analysis of randomized controlled trials","volume":"46","author":"Karaahmet","year":"2025","journal-title":"J. Psychosom. Obstet. Gynecol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2285","DOI":"10.1007\/s10815-025-03543-0","article-title":"Mental health screening and psychological support should be the standard of care in fertility clinics","volume":"42","author":"Meyers","year":"2025","journal-title":"J. Assist. Reprod. Genet."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Cohen, S., Kessler, R.C., and Gordon, L.U. (1995). Conceptualizing stress and its relation to disease. Measuring Stress\u2014A Guide for Health and Social Scientists, Oxford University Press.","DOI":"10.1093\/oso\/9780195086416.001.0001"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"320","DOI":"10.4103\/jhrs.JHRS_42_18","article-title":"\u201cIn Cycles of Dreams, Despair, and Desperation:\u201d Research Perspectives on Infertility Specific Distress in Patients Undergoing Fertility Treatments","volume":"11","author":"Patel","year":"2018","journal-title":"J. Hum. Reprod. Sci."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Zurlo, M.C., Vallone, F., and Cattaneo Della Volta, M.F. (2025). Psychological predictors, moderators, and mediators of treatment outcome among ART-treated women: A prospective study. Front. Reprod. Health, 7.","DOI":"10.3389\/frph.2025.1665920"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"20916","DOI":"10.1038\/s41598-025-06397-9","article-title":"A mixed-methods study on negative psychological states of infertile women undergoing assisted reproductive treatment","volume":"15","author":"Hu","year":"2025","journal-title":"Sci. Rep."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1007\/s10880-019-09653-z","article-title":"Infertility-Related Stress and Psychological Health Outcomes in Infertile Couples Undergoing Medical Treatments: Testing a Multi-dimensional Model","volume":"27","author":"Zurlo","year":"2020","journal-title":"J. Clin. Psychol. Med. Settings"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1016\/S0015-0282(16)55633-7","article-title":"Infertility: A non-event transition","volume":"59","author":"Koropatnick","year":"1993","journal-title":"Fertil. Steril."},{"key":"ref_19","first-page":"59","article-title":"Medical waiting periods: Imminence, emotions and coping","volume":"6","author":"Boivin","year":"2010","journal-title":"Womens Health"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1093\/humrep\/der388","article-title":"Assessing infertility stress: Re-examining the factor structure of the Fertility Problem Inventory","volume":"27","author":"Gameiro","year":"2012","journal-title":"Hum. Reprod."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1111\/j.1545-5300.2003.00059.x","article-title":"Examining congruence between partners\u2019 perceived infertility-related stress and its relationship to marital adjustment and depression in infertile couples","volume":"42","author":"Peterson","year":"2003","journal-title":"Fam. Process"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1097\/JCMA.0000000000001380","article-title":"Male- and female-factor infertility and partners\u2019 quality of life during assisted reproductive technology: A dyadic actor-partner analysis","volume":"89","author":"Pan","year":"2026","journal-title":"J. Chin. Med. Assoc."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1093\/humupd\/dms031","article-title":"Why do patients discontinue fertility treatment? A systematic review of reasons and predictors of discontinuation in fertility treatment","volume":"18","author":"Gameiro","year":"2012","journal-title":"Hum. Reprod. Update"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"3127","DOI":"10.1093\/humrep\/dep340","article-title":"When and why do subfertile couples discontinue their fertility care? A longitudinal cohort study in a secondary care subfertility population","volume":"24","author":"Brandes","year":"2009","journal-title":"Hum. Reprod."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1093\/humrep\/dei355","article-title":"Reasons for discontinuation of IVF treatment: A questionnaire study","volume":"21","author":"Rajkhowa","year":"2006","journal-title":"Hum. Reprod."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1457","DOI":"10.1016\/j.fertnstert.2009.06.020","article-title":"A prospective investigation into the reasons why insured United States patients drop out of in vitro fertilization treatment","volume":"94","author":"Domar","year":"2010","journal-title":"Fertil. Steril."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1093\/humupd\/dml040","article-title":"Women\u2019s emotional adjustment to IVF: A systematic review of 25 years of research","volume":"13","author":"Verhaak","year":"2007","journal-title":"Hum. Reprod. Update"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1016\/j.fertnstert.2008.12.054","article-title":"Changes in affect and state anxiety across an in vitro fertilization\/intracytoplasmic sperm injection cycle","volume":"93","author":"Mahajan","year":"2010","journal-title":"Fertil. Steril."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"3642","DOI":"10.1111\/jocn.17195","article-title":"Infertility psychological distress in women undergoing assisted reproductive treatment: A grounded theory study","volume":"33","author":"Jiang","year":"2024","journal-title":"J. Clin. Nurs."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1111\/j.1467-9566.2009.01213.x","article-title":"The experience of infertility: A review of recent literature","volume":"32","author":"Greil","year":"2010","journal-title":"Sociol. Health Illn."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2500929","DOI":"10.1080\/0167482X.2025.2500929","article-title":"Analysis of emotional fluctuations in infertile women during ART treatment: The impact of ovarian hyperstimulation","volume":"46","author":"Zhou","year":"2025","journal-title":"J. Psychosom. Obstet. Gynecol."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Turner, K., Reynolds-May, M.F., Zitek, E.M., Tisdale, R.L., Carlisle, A.B., and Westphal, L.M. (2013). Stress and anxiety scores in first and repeat IVF cycles: A pilot study. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0063743"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Gonz\u00e1lez-Rodr\u00edguez, A., Cobo, J., Soria, V., Usall, J., Garcia-Rizo, C., Bioque, M., Monreal, J.A., and Labad, J. (2020). Women Undergoing Hormonal Treatments for Infertility: A Systematic Review on Psychopathology and Newly Diagnosed Mood and Psychotic Disorders. Front. Psychiatry, 11.","DOI":"10.3389\/fpsyt.2020.00479"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1016\/j.psyneuen.2010.10.018","article-title":"Gonadal steroids and affective symptoms during in vitro fertilization: Implication for reproductive mood disorders","volume":"36","author":"Bloch","year":"2011","journal-title":"Psychoneuroendocrinology"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2299","DOI":"10.1093\/humrep\/den257","article-title":"A feasibility study of a brief coping intervention (PRCI) for the waiting period before a pregnancy test during fertility treatment","volume":"23","author":"Lancastle","year":"2008","journal-title":"Hum. Reprod."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1459","DOI":"10.1093\/humrep\/deu093","article-title":"The impact of a self-administered coping intervention on emotional well-being in women awaiting the outcome of IVF treatment: A randomized controlled trial","volume":"29","author":"Ockhuijsen","year":"2014","journal-title":"Hum. Reprod."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Xu, L., Ma, Y., and Yan, Y. (2025). Relationship between alexithymia and post-traumatic stress disorder (PTSD) in patients with a history of early pregnancy loss (EPL) after frozen-thawed embryo transfer (FET): Mediating effects of intolerance of uncertainty (IU). BMC Psychiatry, 25.","DOI":"10.1186\/s12888-025-07595-5"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Milazzo, A., Mnatzaganian, G., Elshaug, A.G., Hemphill, S.A., and Hiller, J.E. (2016). Astute Health Study Group. Depression and Anxiety Outcomes Associated with Failed Assisted Reproductive Technologies: A Systematic Review and Meta-Analysis. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0165805"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"de Castro, M.H.M., Mendon\u00e7a, C.R., Noll, M., de Abreu Tacon, F.S., and do Amaral, W.N. (2021). Psychosocial Aspects of Gestational Grief in Women Undergoing Infertility Treatment: A Systematic Review of Qualitative and Quantitative Evidence. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph182413143"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"e45302","DOI":"10.1097\/MD.0000000000045302","article-title":"Analysis of changes in women\u2019s psychological status and nursing responses after fertility treatment failure: A retrospective cohort study","volume":"104","author":"Ding","year":"2025","journal-title":"Medicine"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"306","DOI":"10.3892\/etm.2021.9737","article-title":"The complex relationship between infertility and psychological distress (Review)","volume":"21","author":"Simionescu","year":"2021","journal-title":"Exp. Ther. Med."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Pr\u00e9musz, V., \u00c1cs, P., B\u00f3dis, J., V\u00e1rnagy, \u00c1., L\u00e1szik, \u00c1., and Makai, A. (2022). Introducing the Hungarian Version of the SCREENIVF Tool into the Clinical Routine Screening of Emotional Maladjustment. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph191610147"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"2084","DOI":"10.1093\/humrep\/der171","article-title":"The fertility quality of life (FertiQoL) tool: Development and general psychometric properties","volume":"26","author":"Boivin","year":"2011","journal-title":"Hum. Reprod."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1186\/s12955-023-02125-x","article-title":"A review of the psychometric properties and implications for the use of the fertility quality of life tool","volume":"21","author":"Woods","year":"2023","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1186\/s12955-017-0666-0","article-title":"A review of patient-reported outcome measures to assess female infertility-related quality of life","volume":"15","author":"Kitchen","year":"2017","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"2061","DOI":"10.1093\/humrep\/dew168","article-title":"The Fertility Quality of Life Questionnaire (FertiQoL) Relational subscale: Psychometric properties and discriminant validity across gender","volume":"31","author":"Donarelli","year":"2016","journal-title":"Hum. Reprod."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1234","DOI":"10.1093\/humrep\/deq054","article-title":"Who is at risk of emotional problems and how do you know? Screening of women going for IVF treatment","volume":"25","author":"Verhaak","year":"2010","journal-title":"Hum. Reprod."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"3493","DOI":"10.1093\/humrep\/des324","article-title":"Feasibility of screening patients for emotional risk factors before in vitro fertilization in daily clinical practice: A process evaluation","volume":"27","author":"Kremer","year":"2012","journal-title":"Hum. Reprod."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1016\/j.ejogrb.2012.12.011","article-title":"Quality of life and predictive factors in patients undergoing assisted reproduction techniques","volume":"167","author":"Heredia","year":"2013","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1186\/s12955-018-1058-9","article-title":"Psychometric characteristics of the FertiQoL questionnaire in a German sample of infertile individuals and couples","volume":"16","author":"Sexty","year":"2018","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"26519","DOI":"10.1038\/s41598-025-00874-x","article-title":"Investigation of depression frequency and quality of life in couples with infertility complaints in Turkey","volume":"15","author":"Turgay","year":"2025","journal-title":"Sci. Rep."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Zhou, R., Cao, Y.M., Liu, D., and Xiao, J.S. (2021). Pregnancy or Psychological Outcomes of Psychotherapy Interventions for Infertility: A Meta-Analysis. Front. Psychol., 12.","DOI":"10.3389\/fpsyg.2021.643395"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1002\/cpp.2792","article-title":"Cognitive behavioural therapy for women with infertility: A systematic review and meta-analysis","volume":"30","author":"Wang","year":"2023","journal-title":"Clin. Psychol. Psychother."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1080\/17437199.2022.2058582","article-title":"Evaluating group psychological interventions for mental health in women with infertility undertaking fertility treatment: A systematic review and meta-Analysis","volume":"17","author":"Warne","year":"2023","journal-title":"Health Psychol. Rev."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"2325","DOI":"10.1016\/S0277-9536(03)00138-2","article-title":"A review of psychosocial interventions in infertility","volume":"57","author":"Boivin","year":"2003","journal-title":"Soc. Sci. Med."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1093\/humupd\/dmaa048","article-title":"Neurophysiology of cognitive behavioural therapy, deep breathing and progressive muscle relaxation used in conjunction with ART treatments: A narrative review","volume":"27","author":"Raad","year":"2021","journal-title":"Hum. Reprod. Update"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"97","DOI":"10.4103\/apjr.apjr_43_24","article-title":"Psychosocial interventions for infertile couples: A scoping review","volume":"13","author":"Sunil","year":"2024","journal-title":"Asian Pac. J. Reprod."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1007\/s10815-023-02771-6","article-title":"The effect of self-compassion-based programs for infertility (SCPI) on anxiety and depression among women pursuing fertility treatment: A three-armed, randomised controlled trial","volume":"40","author":"Njogu","year":"2023","journal-title":"J. Assist. Reprod. Genet."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1177\/27683605261427699","article-title":"Mindful Self-Compassion for Infertility-Related Distress: A Single-Group Intervention Study","volume":"32","author":"Halleran","year":"2026","journal-title":"J. Integr. Complement. Med."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"e3483","DOI":"10.1002\/smi.3483","article-title":"The actor-partner interdependence model of fertility stress and marital quality among couples undergoing in vitro fertilization and embryo transfer: The mediating role of dyadic coping","volume":"40","author":"Song","year":"2024","journal-title":"Stress Health"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"844","DOI":"10.1186\/s13063-022-06795-8","article-title":"Development and evaluation of couple-based coping strategies with infertility: A protocol for a mixed-methods study","volume":"23","author":"Reisi","year":"2022","journal-title":"Trials"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1002\/anzf.1446","article-title":"The Effectiveness of Couple Therapy on Psychological and Relational Variables and Pregnancy Rates in Couples with Infertility: A Systematic Review","volume":"42","author":"Thompson","year":"2021","journal-title":"Aust. N. Z. J. Fam. Ther."},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Molgora, S., Fenaroli, V., Acquati, C., De Donno, A., Baldini, M.P., and Saita, E. (2019). Examining the Role of Dyadic Coping on the Marital Adjustment of Couples Undergoing Assisted Reproductive Technology (ART). Front. Psychol., 10.","DOI":"10.3389\/fpsyg.2019.00415"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1111\/jan.13844","article-title":"Marital functioning and treatment outcome in couples undergoing assisted reproduction","volume":"75","author":"Cormenzana","year":"2019","journal-title":"J. Adv. Nurs."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1046","DOI":"10.1093\/humrep\/dew040","article-title":"e-Therapy to reduce emotional distress in women undergoing assisted reproductive technology (ART): A feasibility randomized controlled trial","volume":"31","author":"Nelen","year":"2016","journal-title":"Hum. Reprod."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1016\/j.ejogrb.2024.12.053","article-title":"The effects of e-health care on health outcomes and psychological distress in patients undergoing assisted reproductive technology: A systematic review and meta-analysis of randomized controlled trials","volume":"305","author":"Wang","year":"2025","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1089\/tmj.2024.0446","article-title":"A Systematic Review of Telemedicine Solutions to Provide Psychological Interventions for Women Receiving Fertility Treatments","volume":"31","author":"Osma","year":"2025","journal-title":"Telemed. e-Health"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1017\/S1352465822000534","article-title":"Evaluating the efficacy of an internet-based cognitive behavioural therapy intervention for fertility stress in women: A feasibility study","volume":"51","author":"Bjornsdottir","year":"2023","journal-title":"Behav. Cogn. Psychother."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1093\/humrep\/deaf237","article-title":"Testing the efficacy of a self-guided psychotherapy intervention for infertility-related distress: A randomized controlled trial","volume":"41","author":"Poulter","year":"2026","journal-title":"Hum. Reprod."},{"key":"ref_70","doi-asserted-by":"crossref","unstructured":"Kremer, F., Schick, M., Roesner, S., Germeyer, A., Moessner, M., Bauer, S., Ditzen, B., and Wischmann, T. (2025). Smartphone-supported Positive Adjustment Coping Intervention (PACI) for couples undergoing fertility treatment: A randomised controlled trial. PLoS ONE, 20.","DOI":"10.1371\/journal.pone.0335776"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1356","DOI":"10.1002\/ijgo.70533","article-title":"Experiences of psychological interventions for women and men undergoing assisted reproductive technologies: A qualitative systematic review","volume":"172","author":"Chua","year":"2026","journal-title":"Int. J. Gynaecol. Obstet."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1177\/10664807241231256","article-title":"Fertility by Design: Integrating IVF, Biopsychosocial Tenets, and Counseling","volume":"32","author":"Schneider","year":"2024","journal-title":"Fam. J."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"2476","DOI":"10.1093\/humrep\/dev177","article-title":"ESHRE guideline: Routine psychosocial care in infertility and medically assisted reproduction-a guide for fertility staff","volume":"30","author":"Gameiro","year":"2015","journal-title":"Hum. Reprod."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"68","DOI":"10.3390\/women2010008","article-title":"Emotional Support for Infertility Patients: Integrating Mental Health Professionals in the Fertility Care Team","volume":"2","author":"Sax","year":"2022","journal-title":"Women"},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Tavousi, S.A., Behjati, M., Milajerdi, A., and Mohammadi, A.H. (2022). Psychological assessment in infertility: A systematic review and meta-analysis. Front. Psychol., 13.","DOI":"10.3389\/fpsyg.2022.961722"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1093\/humrep\/dez258","article-title":"A systematic review of the quality of clinical prediction models in in vitro fertilisation","volume":"35","author":"Ratna","year":"2020","journal-title":"Hum. Reprod."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1016\/j.fertnstert.2024.01.013","article-title":"Depression, anxiety, quality of life, and infertility: A global lens on the last decade of research","volume":"121","author":"Braverman","year":"2024","journal-title":"Fertil. Steril."},{"key":"ref_78","doi-asserted-by":"crossref","unstructured":"Marano, G., and Mazza, M. (2026). Peripartum Depression as a Heart Brain Endocrine Immune Syndrome: Neuroendocrine, Cardiovascular, and Inflammatory Pathways Underlying Maternal Vulnerability. Life, 16.","DOI":"10.3390\/life16020236"},{"key":"ref_79","doi-asserted-by":"crossref","unstructured":"Marano, G., d\u2019Abate, C., Traversi, G., Mazza, O., Gaetani, E., Esposito, R., Pavese, F., Paris, I., and Mazza, M. (2026). Neuroinflammation and the Female Brain: Sex Specific Mechanisms Underlying Mood Disorders and Stress Vulnerability. Life, 16.","DOI":"10.3390\/life16010139"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"107132","DOI":"10.5498\/wjp.v15.i8.107132","article-title":"Unmasking the cycle: Premenstrual and menstrual exacerbation of psychiatric disorders and impact on female mental health","volume":"15","author":"Mazza","year":"2025","journal-title":"World J. Psychiatry"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/13\/5117\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T12:04:37Z","timestamp":1782907477000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/13\/5117"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,1]]},"references-count":80,"journal-issue":{"issue":"13","published-online":{"date-parts":[[2026,7]]}},"alternative-id":["jcm15135117"],"URL":"https:\/\/doi.org\/10.3390\/jcm15135117","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,1]]}}}