Quality of life and risk for mood disorders in infertile patients across sexes and stages of assisted reproductive technology.

In vitro fertilization (IVF) can affect quality of life and psychological well-being in both female and male patients, but stage-specific patterns across different stages of IVF cycle remain incompletely characterized. We examined sex differences and stage-specific variation in fertility-related quality of life (FertiQoL) and psychological distress measured with the Patient Health Questionnaire-4 (PHQ-4). We analyzed 444 paired FertiQoL and PHQ-4 responses from 320 patients (202 females and 118 males) undergoing IVF at 11 centers in Taiwan. Assessments were available before IVF initiation, ovum pick-up (OPU), embryo transfer (ET), and the pregnancy test. Sex differences were evaluated, and stage-specific associations were estimated with linear mixed-effects models. Males had higher total FertiQoL scores than females (mean 72.78 vs. 69.14, p = 0.008), particularly in the emotional (71.39 vs. 64.08, p < 0.001) and mind/body (mean 77.91 vs. 69.36, p < 0.001) domains. Females had higher anxiety scores (Generalized Anxiety Disorder-2, GAD-2: mean 1.71 vs. 1.32, p < 0.001) and total PHQ-4 scores (mean 2.66 vs. 2.23, p = 0.006) compared to males. Nominal increases in PHQ-2 and PHQ-4 scores before embryo transfer (ET) and a nominal decrease in Tolerability scores before the pregnancy test were observed; however, these differences did not remain statistically significant after correction. Sex-related differences in selected quality-of-life domains and anxiety were observed during IVF, while stage-specific trends were also suggested. These findings highlight the importance of monitoring mental health and providing targeted psychological support and underscore the need for prospective, stage-standardized studies with linked couple data and more comprehensive clinical characterization.