Quality of life and psychological health among women undergoing medically assisted reproductive treatments

Background: Infertility affects an estimated 15-20% of married couples in India, and women undergoing medically assisted reproduction (MAR) are exposed to considerable psychological strain. This study assessed depression, anxiety, stress and fertility-related quality of life (QoL) among women undergoing MAR and compared women with primary and secondary infertility. Methods: A cross-sectional study was conducted among 150 women undergoing in vitro fertilisation (IVF)-based MAR treatment (75 with primary and 75 with secondary infertility) at two fertility hospitals in Chennai, India, from June to September 2025. Participants were selected by purposive sampling. Psychological health was assessed using the depression anxiety stress scales-21 (DASS-21) and QoL using the fertility quality of life (FertiQoL) tool. Data were analysed using the chi-square test, independent samples t-test and one-way ANOVA. Results: Depressive, anxiety and stress symptoms of at least mild severity were present in 76.0%, 85.3% and 86.0% of the women, respectively. Stress severity was significantly associated with type of infertility (χ2=13.38, p=0.01); moderate to extremely severe stress was seen in 58.7% of women with primary infertility and 37.3% of women with secondary infertility. Women with secondary infertility had higher total FertiQoL scores (64.06±9.38 versus 55.82±10.15; p<0.001). Infertility duration of more than 7 years was associated with depression, anxiety and stress, and with the lowest total FertiQoL score (52.5±12.3). Conclusions: Psychological distress was common among women undergoing MAR. Women with primary infertility and those with a longer duration of infertility were most affected. Routine psychological screening and psychosocial support should be included in fertility care.