The impact of emotional inhibition trajectories on clinical pregnancy in infertile women undergoing assisted reproduction

Background Emotional inhibition can contribute to the development of anxiety and depression, which may adversely affect clinical pregnancy rate in infertile women. However, the impact of emotional inhibition trajectories on clinical pregnancy rates in this population remains unclear. Objective This study aimed to investigate the impact of emotional inhibition trajectories on clinical pregnancy rate in infertile women undergoing assisted reproduction. Methods This study was conducted at the Reproductive Center of a tertiary hospital in Lanzhou, Northwest China, from March 2024 to March 2025. A total of 655 participants were enrolled. Emotional inhibition was assessed at two critical time points to delineate its change trajectories (categorized as worsening, stable, or improvement). Clinical and laboratory data were collected, and participants’ clinical pregnancy rate were followed up. Binary logistic regression was used to analyze the association between emotional inhibition trajectories and clinical pregnancy. Results Three distinct emotional inhibition trajectories were identified: the worsening group, the stable group, and the improvement group. Endometrial thickness on the day of embryo transfer, emotional inhibition trajectory, and the ovarian stimulation protocol were identified as significant factors associated with clinical pregnancy. Notably, compared with the improvement group, the worsening group was associated with significantly lower odds of achieving clinical pregnancy (OR = 0.144, 95% CI [0.087–0.239]). Conclusions Infertile women with a worsening emotional inhibition trajectory had significantly poorer clinical pregnancy rate compared to those with an improvement trajectory. This suggests that progressive emotional inhibition may be a critical psychological risk factor for adverse pregnancy outcomes. These findings underscore the clinical importance of monitoring both the levels and dynamic changes of emotional inhibition, and they support implementing timely psychological interventions to potentially optimize clinical pregnancy rate.