Association of emotional distress and quality of sleep among women receiving in-vitro fertilization treatment

Taiwan J Obstet Gynecol. 2019 Jan;58(1):168-172. doi: 10.1016/j.tjog.2018.11.031.


Objective: Sleep disturbance is a common issue that can arise from emotional distress. Women who received the complicated invasive in-vitro fertilization (IVF) procedures can be stressful. The purpose of this study is to understanding the association between emotional distress (measured as anxiety and depression) and sleep quality for women undergoing IVF treatment.

Materials and methods: This research was of a cross-sectional questionnaire design. Questionnaires were completed during the controlled ovarian hyperstimulation of IVF treatment. A total of 97 participants complete the survey. The questionnaires included basic personal information, The Chinese Traditional Childbearing Attitude Questionnaire, Pittsburgh Sleep Quality Index (PSQI), and the Beck depression and anxiety scales.

Results: A total of 42.9% and 30% of the participants were determined to be anxious and depressed, respectively. Some participants (18.8%) required more than 30 min to fall asleep, and 56.2% of the participants had less than 7 h of sleep, 43.6% of the participants had less than 85% of sleep efficiency, and 43.3% of the participants were determined with poor sleep quality (PSQI>5). The linear regression analysis indicated that the score of the Beck anxiety index was significantly associated with sleep quality (F = 44.85, p = .000, adjust R2 = 49.4%).

Conclusion: This study revealed that some women when receiving early stage IVF treatments were anxious, depressed, and have sleep disturbance. Anxiety was significantly associated with sleep quality. It is suggested that medical care professional should understand these common issues when assisting women undergoing these complicated reproductive treatments.

Keywords: Anxiety; Depression; Infertile women; In vitro fertilization; Sleep quality.

MeSH terms

  • Adult
  • Anxiety / complications*
  • Anxiety / epidemiology
  • Anxiety / psychology
  • Cross-Sectional Studies
  • Depression / complications*
  • Depression / epidemiology
  • Depression / psychology
  • Female
  • Fertilization in Vitro / adverse effects
  • Fertilization in Vitro / psychology*
  • Humans
  • Sleep Initiation and Maintenance Disorders / epidemiology
  • Sleep Initiation and Maintenance Disorders / etiology*
  • Sleep Initiation and Maintenance Disorders / psychology*
  • Stress, Psychological / complications*
  • Stress, Psychological / epidemiology
  • Surveys and Questionnaires