Women’s Experiences and Coping Strategies for Dealing with Recurrent Implantation Failure in IVF/ICSI – An Interview Study

Objectives: Despite significant advances in reproductive medicine, embryo transfer (ET) does often not result in the desired pregnancy, which induces a significant psychological burden, results in a reduction in quality of life and the decision to prematurely stop fertility treatment.This qualitative study explores the emotional, psychological, and social impact of recurrent implantation failure (RIF) to provide a basis for better patient support and future research.Methods: The semistructured interview guide included 35 key questions developed on the basis of the available literature and clinical experience of specialists in fertility medicine.A convenience sample of women with at least three consecutive unsuccessful ETs was interviewed.Sample size was determined by achieving satiety, i.e. when no more new aspects were reported.This resulted in a total of 13 interviews, which were analyzed by qualitative content analysis.Results: RIF is associated with a broad variety of emotional reactions, of which disappointment, grief, feelings of guilt, struggling with fate, and feelings of helplessness are reported most frequently.The two-week waiting period following ET and the communication of pregnancy results are perceived as particularly stressful.The duration of fertility treatment is associated with increasing strain, especially in the case of augmenting time pressure related to age.Social support and quality of the relationship play a significant role in coping with reactions to a negative pregnancy test after ET.Conclusions: To improve patients' emotional well-being and reproductive decisions individualized psychological support using partner relationships and social networks as resources should address the unique emotional trajectory of each woman.