Examining the Impact of Psychosocial Stress on Fertility Outcomes in Women Undergoing Intrauterine Insemination Before and During the COVID-19 Pandemic

Purpose: This study aims to identify the determinants of stress associated with infertility among women and assess their impact on the success rates of intrauterine insemination (IUI). Materials and Methods: 260 infertile women undergoing IUI treatment at the reproductive center of the Second Affiliated Hospital of Soochow University from January 2019 to July 2021 were included in this study. Participants completed the General Information Questionnaire, the Fertility Problem Inventory (FPI), the Stress Response Questionnaire (SRQ), and the Coping Style Questionnaire (CSQ). Follow-up sessions were conducted to record pregnancy outcomes, including clinical pregnancy and live birth rates. General linear regression was used to evaluate the association between FPI scores and key participant characteristics. Pearson correlation coefficients were calculated to determine the correlations between SRQ, CSQ, and FPI scores. Logistic regression analyzed the relationship between coping styles, perceived stress, various FPI domains, and pregnancy outcomes. Results: The average global stress score related to infertility was 135.1 (SD=18.2). Factors such as the outbreak of COVID-19, educational level, and monthly household income significantly influenced infertility-related stress (P<0.05). Stress reactions and negative coping styles were positively correlated with higher levels of infertility-related stress (P<0.001). However, no statistically significant relationship was found between positive coping styles and infertility-related stress (P>0.05). The scores were not consistently associated with pregnancy outcomes. Conclusion: Women undergoing IUI exhibit significant levels of stress related to infertility, which is influenced by factors such as the COVID-19 outbreak, educational level, and family income. Perceived stress and negative coping styles also contribute to this stress. These findings underscore the need for targeted psychological interventions to reduce infertility-related stress among these patients, providing a theoretical basis for such measures.