Study of Stress and Anxiety Levels Before Embryo Transfer in Women Candidates for Intracytoplasmic Sperm Injection



Barjini SB ; Masoudi M ; Pirdadeh Beiranvand S ; Moieni A ; Zare S
Source: Tehran University Medical Journal Published:2025

Abstract

Background: Intracytoplasmic sperm injection (ICSI) is one of the infertility treatments that may lead to various levels of stress and anxiety in women at different stages. Multiple factors may contribute to these psychological disorders. This study aimed to assess the levels of stress, anxiety, and depression before embryo transfer in women undergoing ICSI. Methods: This cross-sectional analytical study was conducted from July to October 2024 on 70 women candidates for ICSI at Arash Women’s Hospital in Tehran, prior to embryo transfer. Participants were selected through convenience sampling. Inclusion criteria included at least three years of infertility, no background in psychology or attendance in counseling sessions, no major physical or mental illnesses, and no severe stressful events in the past six months (such as the death of first-degree relatives or major accidents). Participants could withdraw from the study at any time. The DASS-21 (Depression, Anxiety, Stress Scale) was used to assess stress and anxiety levels. Based on the DASS-21, stress scores of 0-14 were considered normal or mild, 15-18 mild, 19-25 moderate, 26-32 severe, and ≥33 very severe. For anxiety, scores of 0-7 were considered normal or mild, 8-9 mild, 10-14 moderate, 15-19 severe, and ≥20 very severe. The validity of the tool was confirmed by Antony and validated in Iran by Sahebi. Results: Among the 70 participants, 92.8% experienced stress and anxiety. The mean stress score was 20.77±4.87, and the mean anxiety score was 11.70±4.23, indicating moderate levels. Women over 42 years old had significantly lower stress scores compared to others (P<0.001). Conversely, women under 30 showed significantly higher anxiety scores (P<0.01). No significant associations were found between stress/anxiety and other demographic or infertility-related factors (P>0.05). Conclusion: The findings indicate that women undergoing embryo transfer in ICSI procedures commonly experience stress and anxiety. Therefore, appropriate psychological interventions are recommended to support this group during treatment. Copyright © 2025 Yousefi et al. Published by Tehran University of Medical Sciences. Thiswork is licensed under a Creative © 2025 Baghaei Barjini et al. Published by Tehran University of Medical Sciences. This work is licensed under a Creative Commons Attribution-Non-Commercial 4.0 International license (https://creativecommons.org/licenses/by-nc/4.0/). Non-commercial uses of the work are permitted, provided the original work is properly cited.