Listening to the Voices of Women Undergoing Infertility Treatment: Beyond the Waiting

Listening to the Voices of Women Undergoing Infertility Treatment: Beyond the Waiting | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Listening to the Voices of Women Undergoing Infertility Treatment: Beyond the Waiting Seyma Kilci Erciyas, Ebru Cirban Ekrem, Ruken Yagiz Altintas, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7124207/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract This qualitative study sought to explore in depth the physical, emotional, psychological, and social experiences of women who have undergone infertility treatment. Semi-structured in-depth interviews were conducted via online platforms with 21 women who had received infertility treatment in the past year. Data were evaluated using inductive content analysis. As a result of the analysis, six main themes were identified: healthcare professionals’ approach, treatment environment, challenges related to treatment, effects of medications, treatment outcomes, and overall experiences. The participants reported encountering many challenges, such as lack of information, loss of motivation, financial burdens, physical and psychological side effects of medications, health concerns, and disappointments following treatment failure. On the other hand, positive treatment experiences and hopeful outcomes increased women’s commitment to the process and psychological resilience. Additionally, social and spousal support was of critical importance to the women. The findings demonstrate that infertility treatment is not only a medical procedure but also a multidimensional life experience, emphasising the necessity for healthcare professionals to adopt a more sensitive and holistic approach in providing care. Qualitative research In Vitro Fertilization Women’s health Experience Expectations Treatment process Infertility Figures Figure 1 Introduction Infertility treatment is a journey filled with hope but also accompanied by significant psychological and social burdens for couples wishing to have children. Medical procedures, such as ovulation induction, oocyte retrieval, embryo transfer, and progesterone support substantially affect couples’ daily lives [ 1 , 2 ]. Treatment failure increases depression and anxiety levels among couples, leading to decreased self-esteem and deterioration in marital relationships [ 3 ]. How women experience infertility treatment can vary depending on several factors, including the number of treatment cycles, the duration of treatment, and the outcome. The treatment process is often reported to include challenges such as physical and emotional pain, disruption of daily routines, and the pressure of wanting to have a child [ 4 ]. Particularly in Asian countries, women tend to experience more stress during the infertility process due to the widespread societal prejudice that infertility is primarily a woman’s issue [ 5 ]. Studies conducted in Türkiye have similarly demonstrated that the emotions and thoughts of infertile women influence both the treatment process and its outcomes [ 6 , 7 ]. Ensuring women’s physical, psychological, and social well-being throughout infertility treatment is crucial, not only for the success of the treatment but also for their overall health and quality of life. In this context, healthcare professionals must adopt a sensitive and holistic approach to the experiences of women facing infertility. Research emphasises that couples manage the process more effectively when supported by positive relationships; however, individuals often hesitate to seek social support and report insufficient psychological support from healthcare professionals [ 4 ]. For most couples, infertility treatment is not merely a medical intervention but rather a complex process accompanied by intense emotions, stress, and psychological uncertainty [ 6 ], [ 8 ]. In cases of treatment failure, some women retrospectively recall the process with regret, expressing feelings of having missed career or life opportunities [ 3 ]. Although the literature is rich in studies focusing on the negative outcomes of infertility treatment, there is a limited number of studies that explore the experiences of those who have undergone successful treatment. Therefore, this study aims to examine in depth the experiences of women who have undergone infertility treatment. Method Type of Research This research was designed using a phenomenological approach to identify women’s experiences regarding infertility treatment. The study employed qualitative descriptive techniques, and the data were analysed using a content analysis approach. Content analysis enables a systematic coding and classification of a large volume of textual data by examining the trends, frequencies, and relationships among words in the texts [ 9 ]. Through this approach, the emotional, psychological, and physical experiences of women undergoing infertility treatment were revealed in detail. Study Population and Sample The study population was defined based on the concept of “individual reality,” a key element in phenomenological research. Individual reality reflects the unique, personal experiences each person has accumulated throughout their life. The population consisted of women who had undergone infertility treatment within the past year. Using criterion sampling, one of the purposive sampling techniques, interviews were conducted with women who had received infertility treatment. Qualitative research relies on a sampling strategy that continues data collection until conceptual and thematic saturation is reached, meaning that no new information or themes are emerging [ 10 ]. This study’s sample size was finalised once data saturation had been achieved. Data Collection Tools The data were collected through a “Semi-Structured Interview Form” developed for this study. Women’s demographic data were collected using a “Personal Information Form,” while their experiences and opinions regarding infertility treatment were gathered using the “Interview Form on Experiences and Views Related to the Infertility Treatment Process.” Personal Information Form Prepared by the researchers, this form includes demographic and treatment-related information. The 15 items in the form aim to gather essential data such as age, education level, economic status, family type, previous pregnancies, number of live births, and number of IVF attempts. These data were used to support more in-depth analysis and to understand participants’ experiences better. Interview Form on Experiences and Views Related to the Infertility Treatment Process This form comprises five open-ended questions designed to explore participants’ experiences with the treatment process. Expert opinions were obtained from five faculty members who were experienced in qualitative research to validate the semi-structured interview form. The interview questions were as follows: What do you think about the information provided by your doctor and the clinic during the treatment process? How did the entire process affect you? How did the treatment affect your relationship with your spouse and other aspects of your life? What changes occurred in your daily life during the treatment process? Did it alter your future plans? What do you think about the potential health risks of infertility treatment? Can you describe your concerns regarding the treatment process? How did the outcome of your infertility treatment change your life? What were your experiences and expectations during this process? Data Collection The data were collected through in-depth interviews with women via the ZOOM online platform in Türkiye between 12 September 2023 and 20 January 2025. A snowball sampling method was employed. Starting with participants’ networks, women who met the inclusion criteria were recruited through social media platforms and interviewed using semi-structured online interviews. Each interview lasted between 30 and 60 minutes. With participants’ consent, all interviews were audio-recorded and transcribed verbatim. This method ensured that participants’ experiences were captured accurately and comprehensively. Data Analysis The data were analysed using a six-stage approach. First, the researcher transcribed the audio recordings and observation notes. This initial phase involved thoroughly familiarising oneself with the data by repeatedly reading the transcripts and making notes. Two researchers independently reviewed these notes, validated the audio transcripts, and agreed upon the preliminary coding. In the second stage, codes were systematically derived from the interview data [ 11 ]. In the third stage, the codes were organised into broader categories. In the fourth stage, the researchers reviewed the developing themes and the corresponding codes to ensure they addressed the research questions comprehensively. The fifth stage involved examining each theme’s naming, scope, and definitions and conducting a detailed analysis. The researchers compiled and reported the findings in the sixth and final stage. The study concluded, and the sample was finalised upon reaching the saturation point. The phenomenological approach, a pattern within qualitative research, aims to define the shared meaning of individuals’ or groups’ experiences related to a particular phenomenon or concept [ 12 ]. As this was a qualitative study, the sample size was determined based on the saturation criterion. The study adhered to the COREQ (Consolidated Criteria for Reporting Qualitative Research) checklist for qualitative research reporting [ 13 ]. Results The socio-demographic characteristics of the participants are presented in Table 1 (Socio-demographical characteristics of women). Themes and subthemes derived from participants' views on the treatment process are presented in Table 2 (Themes and subthemes related to the treatment process according to participants' views ). The analysis revealed two main themes and several related subthemes that reflect the participants’ experiences, perceptions, and emotional responses during the treatment process. Theme 1: Healthcare Professional Approach This theme includes two sub-themes: “Information Provision” and “Behaviour.” Sub-Theme 1.1: Information Provision Within this sub-theme, three categories emerged: “Adequate Information,” “Inadequate Information,” and “Conflicting Information.” Adequate Information “The information was very clear and comprehensive. Especially the explanations from the nurses were very detailed... umm… and the doctor was the same.” (P2) “So yes, the explanations from the nurses, doctors, and other healthcare staff were quite sufficient. They didn’t leave any questions in my mind.” (P8) Inadequate Information “My previous doctor was not very good at providing information; he rarely explained anything, so I changed doctors. Overall, I don’t think I was given much information.” (spoken in a sad tone) (P15) “I was not at all satisfied with the information provided during the transfer step. Before the transfer, we were not told how many embryos we had left. During the procedure, the embryologist came and said we only had two embryos remaining. That completely shattered my morale.” (P20) Conflicting Information “On the day of the insemination, they told me to lie down with my legs stretched out. But then, when we tried insemination again, they said, ‘Who told you that? If you do that, the semen won’t move toward the uterus; you need to bend your legs.’ So, two different nurses gave me two contradictory instructions.” (P9) “During the insemination, they told us to abstain from sexual intercourse. But later, the doctor who followed my pregnancy said intercourse should have been encouraged after insemination to increase the chance of conception.” (P9) “The contradictory information I received during treatment really wore me out.” (P9) Sub-Theme 1.2: Behaviour This sub-theme includes four categories: “Motivation (positive, negative),” “Attentiveness,” “Neglect,” and “Mistreatment.” Motivation “They tried to keep me motivated during the treatment process. They would say things like, ‘Just think about holding your baby in your arms’—motivating words like that.” (P11) “Our first transfer failed. The doctor there was always negative. It really brought us down.” (P19) Attentiveness “My doctor and nurse were incredibly attentive. They asked me every single day about what I ate, what I drank, and my medications. Honestly, they played the biggest role in the positive outcome.” (P3) “It was so comforting to know there were people around me who really cared. If the doctor didn’t care, the process would have been even more emotionally draining.” (P5) “The nurse gave me her phone number. Whenever I had the tiniest concern, I would call her, and she would explain things for hours.” (P20) Neglect “I had some bleeding, but it wasn’t like a miscarriage. I think if I had received a cerclage at that point, I probably wouldn’t have miscarried.” (P7) “I took hormones three times. I went through insemination twice. Even though I told them the second round would coincide with the holiday, they still gave me the injections. Later, they said, ‘Your insemination time falls during the holiday, so we’re not going to proceed.’” (P9) Mistreatment “I was hospitalised for two weeks due to bleeding and two more weeks due to OHSS. The healthcare staff seemed emotionally numb. I did not sense the compassion one would expect from a clinic that should have been more sensitive.” (P8) “The hospital really frightened me. They said they would cancel the insemination even for something as minor as a cold. One time, they cancelled because of a holiday. That made me incredibly anxious.” (P9) Theme 2: Treatment Environment This theme includes two sub-themes: “Safe Treatment Environment” and “Unsafe Treatment Environment.” Sub-Theme 2.1: Safe Treatment Environment “I did not experience any major issues during my treatment process because a sense of trust had been established. Our doctor created a secure atmosphere, and we faced no problems.” (P4) “There was so much misinformation online and in my surroundings. It was really demoralising. I chose to focus solely on what my doctor told me. That made everything much easier.” (P6) Sub-Theme 2.2: Unsafe Treatment Environment “A day-three transfer was performed, and I got my period right after—clearly, the embryo did not implant. When we spoke to the doctor, do you know what he said? ‘The sperm wasn’t high quality anyway—we expected this.’ But before, they had told us the sperm was perfectly fine and everything was going smoothly.” (P1) “I had no choice but to start IVF with a doctor I didn’t want. He provided no information and reacted harshly when I asked questions. He controlled the entire process. I felt like a test subject.” (P11) Theme 3: Difficulties Related to Treatment This theme includes two sub-themes: “Financial Difficulties” and “Access-Related Difficulties.” Sub-Theme 3.1: Financial Difficulties This sub-theme consists of five categories: “High Costs,” “Financial Loss,” “Loss of Work Time,” “Being Seen as a Financial Asset,” and “Financial Exhaustion.” “After the failed transfer, the doctor called and said to come back in a few months. Then they called again and said if we did a second cycle there, we’d get a 20% discount. We were just a commodity to them, a source of money. Maybe they even failed the first transfer intentionally just to get us to pay again.” (P1) “I was invited as a speaker at a conference abroad. But because I didn’t know whether the insemination would succeed, I missed my chance to buy a reasonably priced plane ticket. It turned into a serious financial burden.” (P9) “I went to an IVF clinic based on a friend’s recommendation, but it had turned into a commercial business. I had my examination in one room and picked up the medications from another—all within the same clinic.” (P16) Sub-Theme 3.2: Access-Related Difficulties This sub-theme includes two categories: “Difficulty Accessing Medication” and “Difficulty Accessing Services.” Difficulty Accessing Medication “There were so many different medications that were not readily available. We had to reach out to various cities just to find them.” (P3) “There was a period when Gonapeptyl was unavailable. It was a huge issue trying to find that injection. I even had to postpone the start of treatment because of it. I was supposed to begin that evening, but we just couldn’t get the injection.” (P14) Difficulty Accessing Services “I couldn’t get proper care in my city, so I had to travel elsewhere. The trip alone was exhausting. Since I had nowhere to stay, I had to live at someone else’s house.” (P11) “Even though the distance wasn’t too long, having to travel regularly physically drained me.” (P12) “My husband works shifts. Because the treatment process was lengthy, I had to stay with my family in Ankara without him at times.” (P20) Theme 4: Issues Related to Medication This theme includes three sub-themes: “Difficulty Using Medications,” “Side Effects of Medications,” and “Health Concerns.” Sub-Theme 4.1: Difficulty Using Medications “During the treatment, I had to store certain medications in a cold chain and administer the injections at specific times. If I needed to go somewhere, I had to plan everything around those hours.” (P13) “At that time, we were constantly setting alarms at home for the injection schedule. It became all about timing—‘Okay, it’s time for the injection, now this, now that.’ My entire life was built around that schedule.” (P14) Sub-Theme 4.2: Side Effects of Medications This sub-theme includes two categories: “Physical” and “Psychological.” Physical Side Effects Weight Gain “I had such a hard time losing weight. I used to be slim, but I gained nearly 7–8 kilograms. When I later tried to lose it, it was incredibly difficult. I feel like my body changed completely.” (P1) “I took a lot of hormones, and because of my autoimmune disease, I also had to undergo steroid treatment. All of that caused weight gain—due to increased appetite and fluid retention.” (P2) “The hormone treatment made me constantly hungry. I was eating all the time, day and night, and I gained weight. Healthy eating has become a real struggle for me.” (P20) Pain “Then there was the egg retrieval. That part was painful.” (P2) “The egg retrieval stage was the hardest. I mean, they put you under anaesthesia and collect the eggs. The abdominal pain is intense, it’s agonising.” (P5) “I had to get my injection in the hip. The medication didn’t dissolve and formed lumps. It was so painful—I couldn’t walk, sit, or lie down. It felt like paralysis. Whichever side the injection was given, I’d drag that leg the whole day.” (P11) OHSS (Ovarian Hyperstimulation Syndrome) “I developed OHSS during my first IVF cycle. It caused so much bloating and pain.” (P2) “I experienced OHSS. Apparently, it’s a common complication. I couldn’t get out of bed or walk for nearly three months. It was a really tough time for me.” (P8) Psychological Side Effects Tension, sadness, negative body image, anxiety “The hormone meds made me tense, irritable, aggressive... I mean, all that hormone overload. The second round made things even worse.” (P1) “The hormone injections make you feel like you’re constantly on your period—tension, bloating, irritability, everything.” (P5) “The effects of the medications made me really tense. And of course, it’s not psychologically easy—it’s a draining process.” (P6) Sub-Theme 4.3: Health Concerns This sub-theme consists of four categories: “Cancer Risk,” “Early Onset Menopause,” “Future Health Risks,” and “No Risk or Did Not Consider Risk.” Cancer Risk “I didn’t have any health concerns. All I wanted was to feel the emotion of becoming a mother. That feeling outweighed everything else.” (P1) “I did worry about the treatment because I was taking a lot of hormones. I thought, could this increase the risk of cancer in the future? But since I was focused on getting pregnant, I pushed those thoughts aside.” (P2) “Of course, I asked the doctor and nurse about my concerns. I didn’t hesitate to ask—‘Is there a risk? What level of risk?’ I accepted the explanation they gave me.” (P8) Early Onset Menopause “They told me during the first unsuccessful treatment that menopause would come earlier. Later on, they said it again, after the second cycle. That my eggs had been collected, and my menopause had been brought forward in age.” (P16) Future Health Risks “You end up using so many supplementary medications. You start to wonder—will there be side effects later? That thought was emotionally exhausting.” (P4) “Since it’s hormonal support and involves constant external intervention, of course, it made me worry. What if it causes something? What if it has long-term consequences?” (P17) No Risk / Did Not Consider Risk “I honestly don’t think IVF treatment poses any health risk.” (P3) “I don’t believe there are health risks associated with IVF. I didn’t experience any side effects from the hormones.” (P13) “All I heard from others or was told by the doctor was that the hormones might cause hair growth or weight gain. Nothing else was mentioned. I didn’t really pay attention to that aspect.” (P14) Theme 5: Treatment Outcome This theme includes two sub-themes: “Negative Outcome” and “Positive Outcome.” Sub-Theme 5.1: Negative Pregnancy Test Result This sub-theme includes five categories: “Disappointment,” “Psychological Devastation,” “Sadness,” “Exhaustion,” and “Discontinuing Treatment.” Disappointment, Devastation, Sadness, Exhaustion, Discontinuing Treatment “We received very negative results back then. Of course, we were devastated. And it’s not just the couple—our families, our relatives, everyone was upset.” (P3) “So anyway (sighs), everything looked good—embryo quality, the transfer was done. Then the day came, and the result was negative again. Another kind of collapse... When the pregnancy test is negative, it really breaks you down.” (P5) Sub-Theme 5.2: Positive Pregnancy Test Result This sub-theme includes categories such as “Ambivalent Emotions,” “Happiness,” and “Dreaming about the Future.” Ambivalence, Happiness, Future-Oriented Hope “Oh, it felt like a miracle. I’m walking on air. I wake up so often during sleep, and every time I turn over, I feel anxious, wondering if something might have happened. My anxiety increased this time. But I’m so happy.” (laughs) (P1) “When I received that news, I felt like the sun rose again in my life.” (laughs) (P7) Theme 6: Overall Experiences This theme includes three sub-themes: “Treatment Process,” “Expectations,” and “Advice to Others.” Sub-Theme 6.1: Treatment Process This sub-theme includes two categories: “Positive” and “Negative.” Negative Experiences “The losses I experienced and the treatments I underwent were all negative experiences for me. The back pain, the hormone treatments, the weight gain—these were all unpleasant.” (P2) “There was this one doctor, we’ll never forget what he said to my husband. He looked him in the eye and said, ‘No matter how hard you try, you will never have a child in your lifetime.’ That was such a huge blow for us. Our emotions were completely crushed. All our hopes were shattered.” (P3) Positive Experiences “Even if it was only for eight weeks, experiencing pregnancy was a positive thing. Another positive was the PGT—preimplantation genetic testing. Knowing that if the pregnancy had continued, I would’ve had a healthy baby with good genes gave me comfort.” (P2) “The treatment process didn’t bring major changes to my life apart from using medications and attending check-ups. But I’m more careful with my diet now. I try to exercise regularly. I’m making an effort to live a healthier lifestyle.” (P13) Sub-Theme 6.2: Expectations This sub-theme includes four categories: “Attention and Information,” “Healthy Communication,” “Receiving Quality Service,” and “Expectation of a Positive Outcome.” Attention and Information “Because we weren’t given personalised attention, and at that moment, you really want to feel special. You want to feel that their attention is focused on you. But your questions are brushed off, and you’re examined quickly. Since different departments were involved—my husband saw a urologist and I saw a gynaecologist from the infertility unit—I felt the communication between them was weak.” (P3) “My expectation from the institution and the team was to receive psychological support, answers to every question, a compassionate look, a kind gesture—that would’ve been enough for me.” (P8) Expectation of a Positive Outcome “My only expectation (cheerfully) was to have a healthy baby with fully formed arms and legs.” (P3) “Our only wish was for me to get pregnant so we could finally enter that phase of parenthood. To be able to say, ‘I’m pregnant, we’re having a child.’ We deeply longed to be able to have those conversations.” (P5) “Of course, I was hoping for a positive result. Every little sign makes you hopeful—like, is my stomach upset, am I going to the bathroom a lot at night, could I be pregnant? These things make you start expecting something.” (P10) Sub-Theme 6.3: Advice to Others This sub-theme includes eight categories: “Not Postponing Treatment,” “Not Losing Hope,” “Persevering,” “Receiving Spousal Support,” “Receiving Social Support,” “Being Mentally Prepared for Negative Outcomes,” “Taking Treatment Seriously,” and “Improving Psychological Well-being.” Not Postponing Treatment “I always tell my friends who are getting married—talk to a gynaecologist and a urologist first. If you’re going to delay having kids, do it with that knowledge.” (laughs) (P1) “I’d recommend trying to conceive naturally, calmly, and without overthinking it, especially at younger ages. I believe problems increase as we age.” (laughs) (P2) “My advice is not to postpone the idea of having children. Do your research, start treatment at a centre you trust, engage in activities that make you happy, take care of your mental health, stay connected with your partner, and maintain your social ties with friends and family.” (P20) Not Losing Hope/Persevering “Even after starting IVF, they shouldn’t lose hope. I had three losses, but I approached each round with hope. I lost the third one too, but then I had a spontaneous pregnancy on the fourth try. So I suggest continuing treatment without losing hope.” (P2) “I spoke with a few people at the hospital—I always tell them not to give up. Tune out the noise and stay focused on your goal.” (P6) “Never give up hope. I only had one egg, and they said, ‘Let’s transfer it anyway, maybe it’ll work.’ And it did. I became a mother. So yes, never give up hope.” (P11) Spousal and Social Support “The whole process is on the woman—she’ll go under anaesthesia, wake up, undergo the transfer, and feel all the pain. That’s why the spouse is crucial—he should offer full support.” (laughs) (P5) “IVF is a process that both the woman and the man need to be mentally prepared for. Serious psychological support is necessary. My family supported me, and so did my husband’s family, neighbours, and friends. That’s why I believe psychological support is vital throughout the process.” (P8) Taking Treatment and Doctors Seriously “As I said, take the treatment very seriously. Pay close attention to the timing and dosage of medications—even a 0.1 cc difference matters. So administer medications very carefully, listen closely to your nurses and doctors, and pay attention to your nutrition, exercise, and mental state. Everything matters.” (P3) “I think it’s important that patients believe they are seeing a good doctor. If you’re with a good doctor, I believe you need to trust them.” (P4) Being Mentally Prepared for Negative Outcomes “Psychologically, it’s important not to assign too much meaning to it.” (laughs) “You have to consider the possibility of failure. I was extremely positive—so positive that when it didn’t happen, it really crushed me.” (P5) “On the other hand, knowing that treatment might fail just as easily as it might succeed helps you stay prepared for anything.” (P13) Improving Psychological Well-being “Of course, becoming a mother is precious. But first, women should love themselves and get to know themselves. That helps them move through this process in a healthier state of mind.” (P13) “My advice to others going through treatment is not to listen to what others say. It’s a stressful process. Talk only to those who lift you up.” (P18) “I would suggest doing whatever activities make you feel good, maintaining your emotional health, and staying connected with your partner, friends, and family.” (P20) Discussion This study examined the experiences of women undergoing infertility treatment. Some participants stated that the information they received during the treatment process was clear and satisfactory, which helped them trust the process and understand it more thoroughly. This finding aligns with previous research suggesting that effective communication and information-sharing by healthcare professionals enhance patient compliance and offer psychological support [ 14 , 15 ]. However, other participants reported receiving insufficient or conflicting information. Inadequate or contradictory guidance may negatively affect patients’ adherence to treatment and its outcomes. Contradictory information, especially at critical stages of the process, leaves patients uncertain about what actions to take. This uncertainty adds to the physical, psychological, and financial stress of treatment and exacerbates the emotional burden already experienced by women [ 16 ]. Participants expressed that motivational messages from healthcare staff helped ease the psychological weight of treatment. These findings support existing literature that underscores the importance of psychological support in infertility care [ 5 , 17 , 19 ]. Maintaining morale among women during treatment contributes positively to their faith in the process and to the overall success of the treatment. Conversely, some participants noted that the use of negative language by healthcare staff caused discouragement. These findings are in line with prior studies that highlight the impact of emotional support and motivation on treatment success [ 20 ], [ 21 ]. Instances of neglect during the process also had a detrimental emotional impact. A systematic review has indicated that clinic-related and organisational issues are among the primary reasons patients abandon treatment [ 22 ]. Given the emotionally intense nature of infertility treatment, these findings reiterate the necessity for healthcare professionals to act with empathy and sensitivity. Positive experiences during the treatment process may enhance individuals’ motivation and help foster a more optimistic attitude. For instance, P2’s experience with genetic screening represented a hopeful memory in her journey. Since genetic testing increases the likelihood of having a healthy baby, such experiences can strengthen patients’ optimism toward treatment. The sub-theme “Expectation of a Positive Outcome” illustrates that most participants were motivated by the hope of achieving a successful result. Accordingly, hope-centred group counselling is recommended for stress management, particularly for women who have experienced unsuccessful IVF cycles [20 23]. Women also experienced physical challenges during the infertility treatment process. These included weight gain, pain from egg retrieval, OHSS, and bruising or pain at injection sites. These complaints are consistent with existing literature, which reports that procedures such as ovulation induction, egg retrieval, and embryo transfer are often accompanied by pain, ascites, and nausea [ 24 ]. Additionally, previous studies have shown that some patients discontinue treatment due to the severe pain of oocyte retrieval or because of the side effects of medications or procedures [ 22 ]. In recent years, the increased use of ART and related infertility medications has raised concerns about cancer risks. Participants in this study expressed varied thoughts about the possibility of cancer. Such concerns are often alleviated or eliminated through information provided by healthcare professionals. However, research notes that multiple factors play a role in cancer development, making it difficult to definitively establish a causal link between infertility medications and cancer [ 25 ]. Evidence from nine cohort studies also shows that infertile women are at greater risk for premature and early menopause [ 26 ]. Loss of hope and giving up are frequent psychological obstacles in infertility treatment. Although couples usually begin treatment with optimism, their stress levels tend to increase as the process continues [ 27 ]. Therefore, keeping hope alive from the beginning may help individuals better cope with the emotional demands of the process. Spousal support is one of the most critical psychological factors in infertility treatment. Emotional and practical support between partners can positively affect the treatment experience. Previous research confirms that spousal support contributes significantly to treatment adherence [ 5 , 28 ]. Likewise, support from family and friends can help make the process more manageable. Limitations To the best of our knowledge, this study is among the first to explore the multifaceted experiences of women undergoing infertility treatment in such depth. This is considered a strength of the research. However, the use of the snowball sampling method can be considered a limitation. Additionally, the study data rely solely on self-reports provided by the participants. Conclusion and Recommendations The findings indicate that infertility treatment is not solely a physical experience; it is a complex process with emotional, psychological, and social dimensions. Participants expressed a desire for personalised attention, empathy, and clear communication during treatment. The nature of the relationship established with healthcare professionals directly influences trust in the treatment and commitment to the process. To address these needs, it is recommended that healthcare workers receive training in empathy-based communication, support individuals’ active involvement in the information-sharing process, expand access to psychoeducational services such as group counselling, and restructure the treatment process in ways that minimise its impact on women’s quality of life. Abbreviations ART: Assisted Reproductive Technology COREQ: Consolidated Criteria for Reporting Qualitative Research IVF: In Vitro Fertilization OHSS: Ovarian Hyperstimulation Syndrome PGT: Preimplantation Genetic Testing ZOOM: Zoom Video Communications Platform Declarations Ethics approval and consent to participate This study was conducted in accordance with the principles of the Declaration of Helsinki. Ethical approval was obtained from the Bartin University Social and Human Sciences Ethics Committee with approval number [2023-SBB-0485/12.09.2023]. Informed consent was obtained from all participants prior to data collection. Participation was voluntary, and participants were assured of anonymity and confidentiality throughout the study. Consent for publication Not applicable. No identifying personal data are included in this manuscript. Availability of data and materials No/Not applicable (this manuscript does not report data generation or analysis). Competing Interests The authors declare that they have no competing interests. Funding None to declare. Author contributions ŞKE, ECE, OK designed the study, guided the writing of the manuscript, and reviewed the manuscript, ŞKE, ECE, OK, RYA designed the study, guided the writing of the manuscript, and reviewed the manuscript, reviewed and approved the final manuscript. ŞKE, ECE, RYA Collected the data, revised the manuscript. OK, ŞKE processed the data, performed the statistical and drafted the manuscript, revised the manuscript. Acknowledgements We sincerely thank all the women who participated in this study and shared their emotions and experiences with us so openly and wholeheartedly. Their voices made this research possible and meaningful. References Beckmann C. Infertility. Obstetrics and Gynecology. Eıght ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2014. Pasch LA, Holley SR, Bleil ME, Shehab D, Katz PP, Adler NE. Addressing the needs of fertility treatment patients and their partners: are they informed of and do they receive mental health services? Fertil Steril. 2016;106(1):209-215.e2. doi:10.1016/j.fertnstert.2016.03.006 Hammarberg K, Astbury J, Baker HWG. Women’s experience of IVF: A follow-up study. Hum Reprod. 2001;16(2):374-383. doi:10.1093/humrep/16.2.374 Ying L-Y, Wu LH, Loke AY. The experience of Chinese couples undergoing ın vitro fertilization treatment: Perception of the treatment process and partner support. PLoS One. 2015;10(10):e0139691. https://doi.org/10.1371/journal.pone.0139691. Truong LQ, Luong TB, Tran TH, et al. Infertility-related stress, social support, and coping of women experiencing infertility in Vietnam. Heal Psychol Rep. 2022;10(2):129-138. doi:10.5114/hpr.2022.113437 Turan A, Beydağ KD. The relationship of intolerance to uncertainty and psychological wellBeing in women treated with infertility. J Curr Nurs Res. 2023;3(2):44-51. Yılmaz T, Yeşiltepe Oskay Ü. Methods to cope with infertility stress and nursing attitudes. HSP. 2015;2(1):100-112. doi:10.17681/hsp.20993 Redshaw M, Hockley C, Davidson LL. A qualitative study of the experience of treatment for infertility among women who successfully became pregnant. Hum Reprod. 2007;22(1):295-304. doi:10.1093/humrep/del344 Baltacı A. The qualitative research process: How to conduct a qualitative research? AEÜSBED. 2019;5(2):368-388. doi:10.31592/aeusbed.598299 Patton M. Qualitative Research and Evaluation Methods. 4th ed. Sage publications; 2015. Creswell JW, Poth CN. Qualitative Inquiry and Research Design Choosing Among Five Approaches. Fourth Ed. SAGE Publications, Inc; 2017. Creswell JW. Nitel Araştırma Yöntemleri: Beş Yaklaşıma Göre Nitel Araştırma ve Araştırma Deseni. (Budak, A. & Budak İ, ed.). Ankara: Siyasal Kitabevi; 2018. Tong A, Sainsbury P, Craig J. Consolidated Criteria for Reporting Qualitative Research (COREQ): a 32-item Checklist for Interviews and Focus Groups. Int J Qual Heal Care. 2007;19(6):349-357. doi:10.1093/intqhc/mzm042 Mehra P, Mishra A. Role of Communication, Influence, and Satisfaction in Patient Recommendations of a Physician. Vikalpa J Decis Makers. 2021;46:025609092110270. doi:10.1177/02560909211027090 Sharkiya SH. Quality communication can improve patient-centred health outcomes among older patients: a rapid review. BMC Health Serv Res. 2023;23(1):886. doi:10.1186/s12913-023-09869-8 Rothwell E, Lamb B, Johnson E, et al. Patient perspectives and experiences with in vitro fertilization and genetic testing options. Ther Adv Reprod Heal. 2020;14:2633494119899942. doi:10.1177/2633494119899942 Dembińska AA. Psychological determinants of life satisfaction in women undergoing infertility treatment. Heal Psychol Rep. 2016;4(2):146-158. doi:10.5114/hpr.2016.56617 Elyasi F, Parkoohi PI, Naseri M, et al. Relationship between coping/attachment styles and infertility-specific distress in Iranian infertile individuals: A cross-sectional study. Int J Reprod Biomed. 2021;19(4):347-360. doi:10.18502/ijrm.v19i4.9061 Shafaghi M, Ahmadinezhad GS, Karimi FZ, Mazloum SR, Golbar Yazdi HZ, Afiat M. The effect of supportive counseling on self-esteem of infertile women after in vitro fertilization (IVF) failure: a randomized controlled trial study. BMC Psychol. 2024;12(1):408. doi:10.1186/s40359-024-01914-3 Masoumi SZ, Abdoli S, Kazemi F, et al. Stress management through cognitive reconstruction and positive thinking in women with recurrent failed In Vitro Fertilization: a randomized controlled trial. BMC Psychiatry. 2025;25(1):119. doi:10.1186/s12888-025-06533-9 Jiang L, Zeng T, Wu M, et al. Infertility psychological distress in women undergoing assisted reproductive treatment: A grounded theory study. J Clin Nurs. 2024;33(9):3642-3658. doi:10.1111/jocn.17195 Gameiro S, Boivin J, Peronace L, Verhaak CM. Why do patients discontinue fertility treatment? A systematic review of reasons and predictors of discontinuation in fertility treatment. Hum Reprod Update. 2012;18(6):652-669. doi:10.1093/humupd/dms031 Rahimi R, Hasanpour S, Mirghafourvand M, Esmaeilpour K. Effect of Hope-oriented group counseling on mental health of infertile women with failed IVF cycles: a randomized controlled trial. BMC Psychiatry. 2021;21(1):286. doi:10.1186/s12888-021-03280-5 Lin J-L, Lin Y-H, Chueh K-H. Somatic symptoms, psychological distress and sleep disturbance among infertile women with intrauterine insemination treatment. J Clin Nurs. 2014;23(11-12):1677-1684. doi:10.1111/jocn.12306 Momenimovahed Z, Taheri S, Tiznobaik A, Salehiniya H. Do the fertility drugs increase the risk of cancer? A review study. Front Endocrinol (Lausanne). 2019;10:313. doi:10.3389/fendo.2019.00313 Liang C, Chung HF, Dobson AJ, et al. Is there a link between infertility, miscarriage, stillbirth, and premature or early menopause? Results from pooled analyses of 9 cohort studies. Am J Obstet Gynecol. 2023;229(1):47.e1-47.e9. doi:10.1016/j.ajog.2023.04.009 Sharma A, Shrivastava D. Psychological problems related to infertility. Cureus. 2022;14(10):e30320. doi:10.7759/cureus.30320 Cousineau TM, Domar AD. Psychological impact of infertility. Best Pract Res Clin Obstet Gynaecol. 2007;21(2):293-308. doi:10.1016/j.bpobgyn.2006.12.003 Tables Table 1 Socio-demographical characteristics of women No Age Education status Family structure Number of treatments Status/number of previous pregnancies Number of live births P1 32 Bachelor's degree Nuclear 2 No 0 P2 37 Postgraduate Nuclear 3 Yes/4 1 P3 29 Bachelor's degree Nuclear 2 No 0 P4 37 Bachelor's degree Nuclear 1 Yes/4 0 P5 34 Bachelor's degree Nuclear 4 No 0 P6 38 Postgraduate Nuclear 2 No 0 P7 36 High school Nuclear 6 Yes/1 0 P8 34 Postgraduate Nuclear 1 No 0 P9 32 Postgraduate Nuclear 2 No 0 P10 33 Bachelor's degree Nuclear 2 Yes/1 0 P11 34 Bachelor's degree Nuclear 3 No 0 P12 33 Bachelor's degree Nuclear 2 Yes/1 1 P13 42 Postgraduate Nuclear 3 Yes/1 1 P14 33 Bachelor's degree Nuclear 2 No 0 P15 32 Associate degree Nuclear 1 No 0 P16 32 Associate degree Nuclear 2 Yes/1 1 P17 38 Postgraduate Nuclear 7 No 0 P18 34 Bachelor's degree Nuclear 5 Yes/1 1 P19 45 Postgraduate Nuclear 1 No 0 P20 28 Bachelor's degree Nuclear 1 No 0 P21 30 High school Nuclear 2 No 0 Table 2 is available in the Supplementary Files section. Additional Declarations No competing interests reported. Supplementary Files Table2.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7124207","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":501884346,"identity":"f8cf668e-975f-4c3a-ac1a-a48e7a2e3c21","order_by":0,"name":"Seyma Kilci Erciyas","email":"","orcid":"","institution":"Amasya University","correspondingAuthor":false,"prefix":"","firstName":"Seyma","middleName":"Kilci","lastName":"Erciyas","suffix":""},{"id":501884347,"identity":"bf1a31af-38d6-4ca0-b9e3-aa8efb7a466e","order_by":1,"name":"Ebru Cirban Ekrem","email":"","orcid":"","institution":"Bartin University","correspondingAuthor":false,"prefix":"","firstName":"Ebru","middleName":"Cirban","lastName":"Ekrem","suffix":""},{"id":501884348,"identity":"5ae20e18-e076-4228-b6b1-d5b8ba825cbe","order_by":2,"name":"Ruken Yagiz Altintas","email":"","orcid":"","institution":"Ege University","correspondingAuthor":false,"prefix":"","firstName":"Ruken","middleName":"Yagiz","lastName":"Altintas","suffix":""},{"id":501884349,"identity":"cfedba06-d6ac-4578-b99f-f020c3e6b2e5","order_by":3,"name":"Oya Kavlak","email":"","orcid":"","institution":"Ege University","correspondingAuthor":false,"prefix":"","firstName":"Oya","middleName":"","lastName":"Kavlak","suffix":""},{"id":501884350,"identity":"918543dd-9515-4909-b56f-a2cda33bff5e","order_by":4,"name":"Şeyma Kilci Erciyas","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA9klEQVRIiWNgGAWjYNCCAxIyDMxA+AHIZmMnUgsPSAvjDJAWZuK0MPAASWZmEMlASIt8e4/phh9nLHj429kfG9v82ibPx8zA+OFjDm4tBmfOmN3suSHBI3GYxzg5t++2YRvQhZIzt+HRIpFjdoPngwSPATMP8+HcntuMQC1szLx4tMjPf2N28w9YC/vjw5Y9t+0JamG4wWN2m+cGSAuDcTLDj9uJBLUYnEkruy1zBuIXw96G28ltzIzNeP0i33542803x+rk+PuPP5b48ee27fz25oMfPuJzGAOHAYLN2AYmG/CpBwL2B0icPwQUj4JRMApGwYgEABLtTVXBaW0bAAAAAElFTkSuQmCC","orcid":"","institution":"Amasya University","correspondingAuthor":true,"prefix":"","firstName":"Şeyma","middleName":"Kilci","lastName":"Erciyas","suffix":""}],"badges":[],"createdAt":"2025-07-14 20:08:14","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7124207/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7124207/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":89396589,"identity":"67453347-ae68-4ee7-877d-9ae5d5419a81","added_by":"auto","created_at":"2025-08-19 13:41:22","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":1034337,"visible":true,"origin":"","legend":"\u003cp\u003eThematic map of patient experiences during treatment: main themes and subthemes\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-7124207/v1/548f1223b9ed9f1ab61c3cb8.png"},{"id":91403691,"identity":"2379dc41-55dd-40e2-8450-962fd2635cb4","added_by":"auto","created_at":"2025-09-16 07:29:28","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2425833,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7124207/v1/256abfab-167a-4102-accb-6df959b6ca07.pdf"},{"id":89396586,"identity":"0efcc9e2-9bdb-4a4e-80d9-cb0958e3f430","added_by":"auto","created_at":"2025-08-19 13:41:22","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":18009,"visible":true,"origin":"","legend":"","description":"","filename":"Table2.docx","url":"https://assets-eu.researchsquare.com/files/rs-7124207/v1/be762a1793e1888d37526b0d.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Listening to the Voices of Women Undergoing Infertility Treatment: Beyond the Waiting","fulltext":[{"header":"Introduction","content":"\u003cp\u003eInfertility treatment is a journey filled with hope but also accompanied by significant psychological and social burdens for couples wishing to have children. Medical procedures, such as ovulation induction, oocyte retrieval, embryo transfer, and progesterone support substantially affect couples’ daily lives [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Treatment failure increases depression and anxiety levels among couples, leading to decreased self-esteem and deterioration in marital relationships [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. How women experience infertility treatment can vary depending on several factors, including the number of treatment cycles, the duration of treatment, and the outcome. The treatment process is often reported to include challenges such as physical and emotional pain, disruption of daily routines, and the pressure of wanting to have a child [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Particularly in Asian countries, women tend to experience more stress during the infertility process due to the widespread societal prejudice that infertility is primarily a woman’s issue [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eStudies conducted in Türkiye have similarly demonstrated that the emotions and thoughts of infertile women influence both the treatment process and its outcomes [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Ensuring women’s physical, psychological, and social well-being throughout infertility treatment is crucial, not only for the success of the treatment but also for their overall health and quality of life. In this context, healthcare professionals must adopt a sensitive and holistic approach to the experiences of women facing infertility. Research emphasises that couples manage the process more effectively when supported by positive relationships; however, individuals often hesitate to seek social support and report insufficient psychological support from healthcare professionals [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eFor most couples, infertility treatment is not merely a medical intervention but rather a complex process accompanied by intense emotions, stress, and psychological uncertainty [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e], [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. In cases of treatment failure, some women retrospectively recall the process with regret, expressing feelings of having missed career or life opportunities [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Although the literature is rich in studies focusing on the negative outcomes of infertility treatment, there is a limited number of studies that explore the experiences of those who have undergone successful treatment. Therefore, this study aims to examine in depth the experiences of women who have undergone infertility treatment.\u003c/p\u003e"},{"header":"Method","content":"\u003cp\u003e\u003cb\u003eType of Research\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThis research was designed using a phenomenological approach to identify women’s experiences regarding infertility treatment. The study employed qualitative descriptive techniques, and the data were analysed using a content analysis approach. Content analysis enables a systematic coding and classification of a large volume of textual data by examining the trends, frequencies, and relationships among words in the texts [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Through this approach, the emotional, psychological, and physical experiences of women undergoing infertility treatment were revealed in detail.\u003c/p\u003e\u003cp\u003e\u003cb\u003eStudy Population and Sample\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe study population was defined based on the concept of “individual reality,” a key element in phenomenological research. Individual reality reflects the unique, personal experiences each person has accumulated throughout their life. The population consisted of women who had undergone infertility treatment within the past year. Using criterion sampling, one of the purposive sampling techniques, interviews were conducted with women who had received infertility treatment. Qualitative research relies on a sampling strategy that continues data collection until conceptual and thematic saturation is reached, meaning that no new information or themes are emerging [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. This study’s sample size was finalised once data saturation had been achieved.\u003c/p\u003e\u003cp\u003e\u003cb\u003eData Collection Tools\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe data were collected through a “Semi-Structured Interview Form” developed for this study. Women’s demographic data were collected using a “Personal Information Form,” while their experiences and opinions regarding infertility treatment were gathered using the “Interview Form on Experiences and Views Related to the Infertility Treatment Process.”\u003c/p\u003e\u003cp\u003e\u003cb\u003ePersonal Information Form\u003c/b\u003e\u003c/p\u003e\u003cp\u003ePrepared by the researchers, this form includes demographic and treatment-related information. The 15 items in the form aim to gather essential data such as age, education level, economic status, family type, previous pregnancies, number of live births, and number of IVF attempts. These data were used to support more in-depth analysis and to understand participants’ experiences better.\u003c/p\u003e\u003cp\u003e\u003cb\u003eInterview Form on Experiences and Views Related to the Infertility Treatment Process\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThis form comprises five open-ended questions designed to explore participants’ experiences with the treatment process. Expert opinions were obtained from five faculty members who were experienced in qualitative research to validate the semi-structured interview form. The interview questions were as follows:\u003c/p\u003e\u003cul\u003e\u003cli\u003e\u003cp\u003eWhat do you think about the information provided by your doctor and the clinic during the treatment process? How did the entire process affect you?\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eHow did the treatment affect your relationship with your spouse and other aspects of your life?\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eWhat changes occurred in your daily life during the treatment process? Did it alter your future plans?\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eWhat do you think about the potential health risks of infertility treatment? Can you describe your concerns regarding the treatment process?\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eHow did the outcome of your infertility treatment change your life? What were your experiences and expectations during this process?\u003c/p\u003e\u003c/li\u003e\u003c/ul\u003e\u003cp\u003e\u003cb\u003eData Collection\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe data were collected through in-depth interviews with women via the ZOOM online platform in Türkiye between 12 September 2023 and 20 January 2025. A snowball sampling method was employed. Starting with participants’ networks, women who met the inclusion criteria were recruited through social media platforms and interviewed using semi-structured online interviews. Each interview lasted between 30 and 60 minutes. With participants’ consent, all interviews were audio-recorded and transcribed verbatim. This method ensured that participants’ experiences were captured accurately and comprehensively.\u003c/p\u003e\u003ch2\u003eData Analysis\u003c/h2\u003e\u003cp\u003eThe data were analysed using a six-stage approach. First, the researcher transcribed the audio recordings and observation notes. This initial phase involved thoroughly familiarising oneself with the data by repeatedly reading the transcripts and making notes. Two researchers independently reviewed these notes, validated the audio transcripts, and agreed upon the preliminary coding. In the second stage, codes were systematically derived from the interview data [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. In the third stage, the codes were organised into broader categories. In the fourth stage, the researchers reviewed the developing themes and the corresponding codes to ensure they addressed the research questions comprehensively. The fifth stage involved examining each theme’s naming, scope, and definitions and conducting a detailed analysis. The researchers compiled and reported the findings in the sixth and final stage.\u003c/p\u003e\u003cp\u003eThe study concluded, and the sample was finalised upon reaching the saturation point. The phenomenological approach, a pattern within qualitative research, aims to define the shared meaning of individuals’ or groups’ experiences related to a particular phenomenon or concept [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. As this was a qualitative study, the sample size was determined based on the saturation criterion. The study adhered to the COREQ (Consolidated Criteria for Reporting Qualitative Research) checklist for qualitative research reporting [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e].\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThe socio-demographic characteristics of the participants are presented in Table\u0026nbsp;1 (Socio-demographical characteristics of women). Themes and subthemes derived from participants' views on the treatment process are presented in Table\u0026nbsp;2 (Themes and subthemes related to the treatment process according to participants' views ). The analysis revealed two main themes and several related subthemes that reflect the participants\u0026rsquo; experiences, perceptions, and emotional responses during the treatment process.\u003c/p\u003e\u003cp\u003e\u003cb\u003eTheme 1: Healthcare Professional Approach\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThis theme includes two sub-themes: \u0026ldquo;Information Provision\u0026rdquo; and \u0026ldquo;Behaviour.\u0026rdquo;\u003c/p\u003e\u003cp\u003e\u003cb\u003eSub-Theme 1.1: Information Provision\u003c/b\u003e\u003c/p\u003e\u003cp\u003eWithin this sub-theme, three categories emerged: \u0026ldquo;Adequate Information,\u0026rdquo; \u0026ldquo;Inadequate Information,\u0026rdquo; and \u0026ldquo;Conflicting Information.\u0026rdquo;\u003c/p\u003e\u003cp\u003e\u003cb\u003eAdequate Information\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026ldquo;The information was very clear and comprehensive. Especially the explanations from the nurses were very detailed... umm\u0026hellip; and the doctor was the same.\u0026rdquo; (P2)\u003c/p\u003e\u003cp\u003e\u0026ldquo;So yes, the explanations from the nurses, doctors, and other healthcare staff were quite sufficient. They didn\u0026rsquo;t leave any questions in my mind.\u0026rdquo; (P8)\u003c/p\u003e\u003cp\u003e\u003cb\u003eInadequate Information\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026ldquo;My previous doctor was not very good at providing information; he rarely explained anything, so I changed doctors. Overall, I don\u0026rsquo;t think I was given much information.\u0026rdquo; (spoken in a sad tone) (P15)\u003c/p\u003e\u003cp\u003e\u0026ldquo;I was not at all satisfied with the information provided during the transfer step. Before the transfer, we were not told how many embryos we had left. During the procedure, the embryologist came and said we only had two embryos remaining. That completely shattered my morale.\u0026rdquo; (P20)\u003c/p\u003e\u003cp\u003eConflicting Information\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u0026ldquo;On the day of the insemination, they told me to lie down with my legs stretched out. But then, when we tried insemination again, they said, \u0026lsquo;Who told you that? If you do that, the semen won\u0026rsquo;t move toward the uterus; you need to bend your legs.\u0026rsquo; So, two different nurses gave me two contradictory instructions.\u0026rdquo; (P9)\u003c/p\u003e\u003cp\u003e\u0026ldquo;During the insemination, they told us to abstain from sexual intercourse. But later, the doctor who followed my pregnancy said intercourse should have been encouraged after insemination to increase the chance of conception.\u0026rdquo; (P9)\u003c/p\u003e\u003cp\u003e\u0026ldquo;The contradictory information I received during treatment really wore me out.\u0026rdquo; (P9)\u003c/p\u003e\u003cp\u003e\u003cb\u003eSub-Theme 1.2: Behaviour\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThis sub-theme includes four categories: \u0026ldquo;Motivation (positive, negative),\u0026rdquo; \u0026ldquo;Attentiveness,\u0026rdquo; \u0026ldquo;Neglect,\u0026rdquo; and \u0026ldquo;Mistreatment.\u0026rdquo;\u003c/p\u003e\u003cp\u003e\u003cb\u003eMotivation\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026ldquo;They tried to keep me motivated during the treatment process. They would say things like, \u0026lsquo;Just think about holding your baby in your arms\u0026rsquo;\u0026mdash;motivating words like that.\u0026rdquo; (P11)\u003c/p\u003e\u003cp\u003e\u0026ldquo;Our first transfer failed. The doctor there was always negative. It really brought us down.\u0026rdquo; (P19)\u003c/p\u003e\u003cp\u003e\u003cb\u003eAttentiveness\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026ldquo;My doctor and nurse were incredibly attentive. They asked me every single day about what I ate, what I drank, and my medications. Honestly, they played the biggest role in the positive outcome.\u0026rdquo; (P3)\u003c/p\u003e\u003cp\u003e\u0026ldquo;It was so comforting to know there were people around me who really cared. If the doctor didn\u0026rsquo;t care, the process would have been even more emotionally draining.\u0026rdquo; (P5)\u003c/p\u003e\u003cp\u003e\u0026ldquo;The nurse gave me her phone number. Whenever I had the tiniest concern, I would call her, and she would explain things for hours.\u0026rdquo; (P20)\u003c/p\u003e\u003cp\u003e\u003cb\u003eNeglect\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026ldquo;I had some bleeding, but it wasn\u0026rsquo;t like a miscarriage. I think if I had received a cerclage at that point, I probably wouldn\u0026rsquo;t have miscarried.\u0026rdquo; (P7)\u003c/p\u003e\u003cp\u003e\u0026ldquo;I took hormones three times. I went through insemination twice. Even though I told them the second round would coincide with the holiday, they still gave me the injections. Later, they said, \u0026lsquo;Your insemination time falls during the holiday, so we\u0026rsquo;re not going to proceed.\u0026rsquo;\u0026rdquo; (P9)\u003c/p\u003e\u003cp\u003e\u003cb\u003eMistreatment\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026ldquo;I was hospitalised for two weeks due to bleeding and two more weeks due to OHSS. The healthcare staff seemed emotionally numb. I did not sense the compassion one would expect from a clinic that should have been more sensitive.\u0026rdquo; (P8)\u003c/p\u003e\u003cp\u003e\u0026ldquo;The hospital really frightened me. They said they would cancel the insemination even for something as minor as a cold. One time, they cancelled because of a holiday. That made me incredibly anxious.\u0026rdquo; (P9)\u003c/p\u003e\u003cp\u003e\u003cb\u003eTheme 2: Treatment Environment\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThis theme includes two sub-themes: \u0026ldquo;Safe Treatment Environment\u0026rdquo; and \u0026ldquo;Unsafe Treatment Environment.\u0026rdquo;\u003c/p\u003e\u003cp\u003e\u003cb\u003eSub-Theme 2.1: Safe Treatment Environment\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026ldquo;I did not experience any major issues during my treatment process because a sense of trust had been established. Our doctor created a secure atmosphere, and we faced no problems.\u0026rdquo; (P4)\u003c/p\u003e\u003cp\u003e\u0026ldquo;There was so much misinformation online and in my surroundings. It was really demoralising. I chose to focus solely on what my doctor told me. That made everything much easier.\u0026rdquo; (P6)\u003c/p\u003e\u003cp\u003e\u003cb\u003eSub-Theme 2.2: Unsafe Treatment Environment\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026ldquo;A day-three transfer was performed, and I got my period right after\u0026mdash;clearly, the embryo did not implant. When we spoke to the doctor, do you know what he said? \u0026lsquo;The sperm wasn\u0026rsquo;t high quality anyway\u0026mdash;we expected this.\u0026rsquo; But before, they had told us the sperm was perfectly fine and everything was going smoothly.\u0026rdquo; (P1)\u003c/p\u003e\u003cp\u003e\u0026ldquo;I had no choice but to start IVF with a doctor I didn\u0026rsquo;t want. He provided no information and reacted harshly when I asked questions. He controlled the entire process. I felt like a test subject.\u0026rdquo; (P11)\u003c/p\u003e\u003cp\u003e\u003cb\u003eTheme 3: Difficulties Related to Treatment\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThis theme includes two sub-themes: \u0026ldquo;Financial Difficulties\u0026rdquo; and \u0026ldquo;Access-Related Difficulties.\u0026rdquo;\u003c/p\u003e\u003cp\u003e\u003cb\u003eSub-Theme 3.1: Financial Difficulties\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThis sub-theme consists of five categories: \u0026ldquo;High Costs,\u0026rdquo; \u0026ldquo;Financial Loss,\u0026rdquo; \u0026ldquo;Loss of Work Time,\u0026rdquo; \u0026ldquo;Being Seen as a Financial Asset,\u0026rdquo; and \u0026ldquo;Financial Exhaustion.\u0026rdquo;\u003c/p\u003e\u003cp\u003e\u0026ldquo;After the failed transfer, the doctor called and said to come back in a few months. Then they called again and said if we did a second cycle there, we\u0026rsquo;d get a 20% discount. We were just a commodity to them, a source of money. Maybe they even failed the first transfer intentionally just to get us to pay again.\u0026rdquo; (P1)\u003c/p\u003e\u003cp\u003e\u0026ldquo;I was invited as a speaker at a conference abroad. But because I didn\u0026rsquo;t know whether the insemination would succeed, I missed my chance to buy a reasonably priced plane ticket. It turned into a serious financial burden.\u0026rdquo; (P9)\u003c/p\u003e\u003cp\u003e\u0026ldquo;I went to an IVF clinic based on a friend\u0026rsquo;s recommendation, but it had turned into a commercial business. I had my examination in one room and picked up the medications from another\u0026mdash;all within the same clinic.\u0026rdquo; (P16)\u003c/p\u003e\u003cp\u003e\u003cb\u003eSub-Theme 3.2: Access-Related Difficulties\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThis sub-theme includes two categories: \u0026ldquo;Difficulty Accessing Medication\u0026rdquo; and \u0026ldquo;Difficulty Accessing Services.\u0026rdquo;\u003c/p\u003e\u003cp\u003e\u003cb\u003eDifficulty Accessing Medication\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026ldquo;There were so many different medications that were not readily available. We had to reach out to various cities just to find them.\u0026rdquo; (P3)\u003c/p\u003e\u003cp\u003e\u0026ldquo;There was a period when Gonapeptyl was unavailable. It was a huge issue trying to find that injection. I even had to postpone the start of treatment because of it. I was supposed to begin that evening, but we just couldn\u0026rsquo;t get the injection.\u0026rdquo; (P14)\u003c/p\u003e\u003cp\u003e\u003cb\u003eDifficulty Accessing Services\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026ldquo;I couldn\u0026rsquo;t get proper care in my city, so I had to travel elsewhere. The trip alone was exhausting. Since I had nowhere to stay, I had to live at someone else\u0026rsquo;s house.\u0026rdquo; (P11)\u003c/p\u003e\u003cp\u003e\u0026ldquo;Even though the distance wasn\u0026rsquo;t too long, having to travel regularly physically drained me.\u0026rdquo; (P12)\u003c/p\u003e\u003cp\u003e\u0026ldquo;My husband works shifts. Because the treatment process was lengthy, I had to stay with my family in Ankara without him at times.\u0026rdquo; (P20)\u003c/p\u003e\u003cp\u003e\u003cb\u003eTheme 4: Issues Related to Medication\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThis theme includes three sub-themes: \u0026ldquo;Difficulty Using Medications,\u0026rdquo; \u0026ldquo;Side Effects of Medications,\u0026rdquo; and \u0026ldquo;Health Concerns.\u0026rdquo;\u003c/p\u003e\u003cp\u003e\u003cb\u003eSub-Theme 4.1: Difficulty Using Medications\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026ldquo;During the treatment, I had to store certain medications in a cold chain and administer the injections at specific times. If I needed to go somewhere, I had to plan everything around those hours.\u0026rdquo; (P13)\u003c/p\u003e\u003cp\u003e\u0026ldquo;At that time, we were constantly setting alarms at home for the injection schedule. It became all about timing\u0026mdash;\u0026lsquo;Okay, it\u0026rsquo;s time for the injection, now this, now that.\u0026rsquo; My entire life was built around that schedule.\u0026rdquo; (P14)\u003c/p\u003e\u003cp\u003e\u003cb\u003eSub-Theme 4.2: Side Effects of Medications\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThis sub-theme includes two categories: \u0026ldquo;Physical\u0026rdquo; and \u0026ldquo;Psychological.\u0026rdquo;\u003c/p\u003e\u003cp\u003e\u003cb\u003ePhysical Side Effects\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eWeight Gain\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026ldquo;I had such a hard time losing weight. I used to be slim, but I gained nearly 7\u0026ndash;8 kilograms. When I later tried to lose it, it was incredibly difficult. I feel like my body changed completely.\u0026rdquo; (P1)\u003c/p\u003e\u003cp\u003e\u0026ldquo;I took a lot of hormones, and because of my autoimmune disease, I also had to undergo steroid treatment. All of that caused weight gain\u0026mdash;due to increased appetite and fluid retention.\u0026rdquo; (P2)\u003c/p\u003e\u003cp\u003e\u0026ldquo;The hormone treatment made me constantly hungry. I was eating all the time, day and night, and I gained weight. Healthy eating has become a real struggle for me.\u0026rdquo; (P20)\u003c/p\u003e\u003cp\u003e\u003cb\u003ePain\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026ldquo;Then there was the egg retrieval. That part was painful.\u0026rdquo; (P2)\u003c/p\u003e\u003cp\u003e\u0026ldquo;The egg retrieval stage was the hardest. I mean, they put you under anaesthesia and collect the eggs. The abdominal pain is intense, it\u0026rsquo;s agonising.\u0026rdquo; (P5)\u003c/p\u003e\u003cp\u003e\u0026ldquo;I had to get my injection in the hip. The medication didn\u0026rsquo;t dissolve and formed lumps. It was so painful\u0026mdash;I couldn\u0026rsquo;t walk, sit, or lie down. It felt like paralysis. Whichever side the injection was given, I\u0026rsquo;d drag that leg the whole day.\u0026rdquo; (P11)\u003c/p\u003e\u003cp\u003e\u003cb\u003eOHSS (Ovarian Hyperstimulation Syndrome)\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026ldquo;I developed OHSS during my first IVF cycle. It caused so much bloating and pain.\u0026rdquo; (P2)\u003c/p\u003e\u003cp\u003e\u0026ldquo;I experienced OHSS. Apparently, it\u0026rsquo;s a common complication. I couldn\u0026rsquo;t get out of bed or walk for nearly three months. It was a really tough time for me.\u0026rdquo; (P8)\u003c/p\u003e\u003cp\u003e\u003cb\u003ePsychological Side Effects\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eTension, sadness, negative body image, anxiety\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026ldquo;The hormone meds made me tense, irritable, aggressive... I mean, all that hormone overload. The second round made things even worse.\u0026rdquo; (P1)\u003c/p\u003e\u003cp\u003e\u0026ldquo;The hormone injections make you feel like you\u0026rsquo;re constantly on your period\u0026mdash;tension, bloating, irritability, everything.\u0026rdquo; (P5)\u003c/p\u003e\u003cp\u003e\u0026ldquo;The effects of the medications made me really tense. And of course, it\u0026rsquo;s not psychologically easy\u0026mdash;it\u0026rsquo;s a draining process.\u0026rdquo; (P6)\u003c/p\u003e\u003cp\u003e\u003cb\u003eSub-Theme 4.3: Health Concerns\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThis sub-theme consists of four categories: \u0026ldquo;Cancer Risk,\u0026rdquo; \u0026ldquo;Early Onset Menopause,\u0026rdquo; \u0026ldquo;Future Health Risks,\u0026rdquo; and \u0026ldquo;No Risk or Did Not Consider Risk.\u0026rdquo;\u003c/p\u003e\u003cp\u003e\u003cb\u003eCancer Risk\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026ldquo;I didn\u0026rsquo;t have any health concerns. All I wanted was to feel the emotion of becoming a mother. That feeling outweighed everything else.\u0026rdquo; (P1)\u003c/p\u003e\u003cp\u003e\u0026ldquo;I did worry about the treatment because I was taking a lot of hormones. I thought, could this increase the risk of cancer in the future? But since I was focused on getting pregnant, I pushed those thoughts aside.\u0026rdquo; (P2)\u003c/p\u003e\u003cp\u003e\u0026ldquo;Of course, I asked the doctor and nurse about my concerns. I didn\u0026rsquo;t hesitate to ask\u0026mdash;\u0026lsquo;Is there a risk? What level of risk?\u0026rsquo; I accepted the explanation they gave me.\u0026rdquo; (P8)\u003c/p\u003e\u003cp\u003e\u003cb\u003eEarly Onset Menopause\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026ldquo;They told me during the first unsuccessful treatment that menopause would come earlier. Later on, they said it again, after the second cycle. That my eggs had been collected, and my menopause had been brought forward in age.\u0026rdquo; (P16)\u003c/p\u003e\u003cp\u003e\u003cb\u003eFuture Health Risks\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026ldquo;You end up using so many supplementary medications. You start to wonder\u0026mdash;will there be side effects later? That thought was emotionally exhausting.\u0026rdquo; (P4)\u003c/p\u003e\u003cp\u003e\u0026ldquo;Since it\u0026rsquo;s hormonal support and involves constant external intervention, of course, it made me worry. What if it causes something? What if it has long-term consequences?\u0026rdquo; (P17)\u003c/p\u003e\u003cp\u003e\u003cb\u003eNo Risk / Did Not Consider Risk\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026ldquo;I honestly don\u0026rsquo;t think IVF treatment poses any health risk.\u0026rdquo; (P3)\u003c/p\u003e\u003cp\u003e\u0026ldquo;I don\u0026rsquo;t believe there are health risks associated with IVF. I didn\u0026rsquo;t experience any side effects from the hormones.\u0026rdquo; (P13)\u003c/p\u003e\u003cp\u003e\u0026ldquo;All I heard from others or was told by the doctor was that the hormones might cause hair growth or weight gain. Nothing else was mentioned. I didn\u0026rsquo;t really pay attention to that aspect.\u0026rdquo; (P14)\u003c/p\u003e\u003cp\u003e\u003cb\u003eTheme 5: Treatment Outcome\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThis theme includes two sub-themes: \u0026ldquo;Negative Outcome\u0026rdquo; and \u0026ldquo;Positive Outcome.\u0026rdquo;\u003c/p\u003e\u003cp\u003e\u003cb\u003eSub-Theme 5.1: Negative Pregnancy Test Result\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThis sub-theme includes five categories: \u0026ldquo;Disappointment,\u0026rdquo; \u0026ldquo;Psychological Devastation,\u0026rdquo; \u0026ldquo;Sadness,\u0026rdquo; \u0026ldquo;Exhaustion,\u0026rdquo; and \u0026ldquo;Discontinuing Treatment.\u0026rdquo;\u003c/p\u003e\u003cp\u003e\u003cb\u003eDisappointment, Devastation, Sadness, Exhaustion, Discontinuing Treatment\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026ldquo;We received very negative results back then. Of course, we were devastated. And it\u0026rsquo;s not just the couple\u0026mdash;our families, our relatives, everyone was upset.\u0026rdquo; (P3)\u003c/p\u003e\u003cp\u003e\u0026ldquo;So anyway (sighs), everything looked good\u0026mdash;embryo quality, the transfer was done. Then the day came, and the result was negative again. Another kind of collapse... When the pregnancy test is negative, it really breaks you down.\u0026rdquo; (P5)\u003c/p\u003e\u003cp\u003e\u003cb\u003eSub-Theme 5.2: Positive Pregnancy Test Result\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThis sub-theme includes categories such as \u0026ldquo;Ambivalent Emotions,\u0026rdquo; \u0026ldquo;Happiness,\u0026rdquo; and \u0026ldquo;Dreaming about the Future.\u0026rdquo;\u003c/p\u003e\u003cp\u003e\u003cb\u003eAmbivalence, Happiness, Future-Oriented Hope\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026ldquo;Oh, it felt like a miracle. I\u0026rsquo;m walking on air. I wake up so often during sleep, and every time I turn over, I feel anxious, wondering if something might have happened. My anxiety increased this time. But I\u0026rsquo;m so happy.\u0026rdquo; (laughs) (P1)\u003c/p\u003e\u003cp\u003e\u0026ldquo;When I received that news, I felt like the sun rose again in my life.\u0026rdquo; (laughs) (P7)\u003c/p\u003e\u003cp\u003e\u003cb\u003eTheme 6: Overall Experiences\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThis theme includes three sub-themes: \u0026ldquo;Treatment Process,\u0026rdquo; \u0026ldquo;Expectations,\u0026rdquo; and \u0026ldquo;Advice to Others.\u0026rdquo;\u003c/p\u003e\u003cp\u003e\u003cb\u003eSub-Theme 6.1: Treatment Process\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThis sub-theme includes two categories: \u0026ldquo;Positive\u0026rdquo; and \u0026ldquo;Negative.\u0026rdquo;\u003c/p\u003e\u003cp\u003e\u003cb\u003eNegative Experiences\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026ldquo;The losses I experienced and the treatments I underwent were all negative experiences for me. The back pain, the hormone treatments, the weight gain\u0026mdash;these were all unpleasant.\u0026rdquo; (P2)\u003c/p\u003e\u003cp\u003e\u0026ldquo;There was this one doctor, we\u0026rsquo;ll never forget what he said to my husband. He looked him in the eye and said, \u0026lsquo;No matter how hard you try, you will never have a child in your lifetime.\u0026rsquo; That was such a huge blow for us. Our emotions were completely crushed. All our hopes were shattered.\u0026rdquo; (P3)\u003c/p\u003e\u003cp\u003e\u003cb\u003ePositive Experiences\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026ldquo;Even if it was only for eight weeks, experiencing pregnancy was a positive thing. Another positive was the PGT\u0026mdash;preimplantation genetic testing. Knowing that if the pregnancy had continued, I would\u0026rsquo;ve had a healthy baby with good genes gave me comfort.\u0026rdquo; (P2)\u003c/p\u003e\u003cp\u003e\u0026ldquo;The treatment process didn\u0026rsquo;t bring major changes to my life apart from using medications and attending check-ups. But I\u0026rsquo;m more careful with my diet now. I try to exercise regularly. I\u0026rsquo;m making an effort to live a healthier lifestyle.\u0026rdquo; (P13)\u003c/p\u003e\u003cp\u003e\u003cb\u003eSub-Theme 6.2: Expectations\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThis sub-theme includes four categories: \u0026ldquo;Attention and Information,\u0026rdquo; \u0026ldquo;Healthy Communication,\u0026rdquo; \u0026ldquo;Receiving Quality Service,\u0026rdquo; and \u0026ldquo;Expectation of a Positive Outcome.\u0026rdquo;\u003c/p\u003e\u003cp\u003e\u003cb\u003eAttention and Information\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026ldquo;Because we weren\u0026rsquo;t given personalised attention, and at that moment, you really want to feel special. You want to feel that their attention is focused on you. But your questions are brushed off, and you\u0026rsquo;re examined quickly. Since different departments were involved\u0026mdash;my husband saw a urologist and I saw a gynaecologist from the infertility unit\u0026mdash;I felt the communication between them was weak.\u0026rdquo; (P3)\u003c/p\u003e\u003cp\u003e\u0026ldquo;My expectation from the institution and the team was to receive psychological support, answers to every question, a compassionate look, a kind gesture\u0026mdash;that would\u0026rsquo;ve been enough for me.\u0026rdquo; (P8)\u003c/p\u003e\u003cp\u003e\u003cb\u003eExpectation of a Positive Outcome\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026ldquo;My only expectation (cheerfully) was to have a healthy baby with fully formed arms and legs.\u0026rdquo; (P3)\u003c/p\u003e\u003cp\u003e\u0026ldquo;Our only wish was for me to get pregnant so we could finally enter that phase of parenthood. To be able to say, \u0026lsquo;I\u0026rsquo;m pregnant, we\u0026rsquo;re having a child.\u0026rsquo; We deeply longed to be able to have those conversations.\u0026rdquo; (P5)\u003c/p\u003e\u003cp\u003e\u0026ldquo;Of course, I was hoping for a positive result. Every little sign makes you hopeful\u0026mdash;like, is my stomach upset, am I going to the bathroom a lot at night, could I be pregnant? These things make you start expecting something.\u0026rdquo; (P10)\u003c/p\u003e\u003cp\u003e\u003cb\u003eSub-Theme 6.3: Advice to Others\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThis sub-theme includes eight categories: \u0026ldquo;Not Postponing Treatment,\u0026rdquo; \u0026ldquo;Not Losing Hope,\u0026rdquo; \u0026ldquo;Persevering,\u0026rdquo; \u0026ldquo;Receiving Spousal Support,\u0026rdquo; \u0026ldquo;Receiving Social Support,\u0026rdquo; \u0026ldquo;Being Mentally Prepared for Negative Outcomes,\u0026rdquo; \u0026ldquo;Taking Treatment Seriously,\u0026rdquo; and \u0026ldquo;Improving Psychological Well-being.\u0026rdquo;\u003c/p\u003e\u003cp\u003e\u003cb\u003eNot Postponing Treatment\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026ldquo;I always tell my friends who are getting married\u0026mdash;talk to a gynaecologist and a urologist first. If you\u0026rsquo;re going to delay having kids, do it with that knowledge.\u0026rdquo; (laughs) (P1)\u003c/p\u003e\u003cp\u003e\u0026ldquo;I\u0026rsquo;d recommend trying to conceive naturally, calmly, and without overthinking it, especially at younger ages. I believe problems increase as we age.\u0026rdquo; (laughs) (P2)\u003c/p\u003e\u003cp\u003e\u0026ldquo;My advice is not to postpone the idea of having children. Do your research, start treatment at a centre you trust, engage in activities that make you happy, take care of your mental health, stay connected with your partner, and maintain your social ties with friends and family.\u0026rdquo; (P20)\u003c/p\u003e\u003cp\u003e\u003cb\u003eNot Losing Hope/Persevering\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026ldquo;Even after starting IVF, they shouldn\u0026rsquo;t lose hope. I had three losses, but I approached each round with hope. I lost the third one too, but then I had a spontaneous pregnancy on the fourth try. So I suggest continuing treatment without losing hope.\u0026rdquo; (P2)\u003c/p\u003e\u003cp\u003e\u0026ldquo;I spoke with a few people at the hospital\u0026mdash;I always tell them not to give up. Tune out the noise and stay focused on your goal.\u0026rdquo; (P6)\u003c/p\u003e\u003cp\u003e\u0026ldquo;Never give up hope. I only had one egg, and they said, \u0026lsquo;Let\u0026rsquo;s transfer it anyway, maybe it\u0026rsquo;ll work.\u0026rsquo; And it did. I became a mother. So yes, never give up hope.\u0026rdquo; (P11)\u003c/p\u003e\u003cp\u003e\u003cb\u003eSpousal and Social Support\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026ldquo;The whole process is on the woman\u0026mdash;she\u0026rsquo;ll go under anaesthesia, wake up, undergo the transfer, and feel all the pain. That\u0026rsquo;s why the spouse is crucial\u0026mdash;he should offer full support.\u0026rdquo; (laughs) (P5)\u003c/p\u003e\u003cp\u003e\u0026ldquo;IVF is a process that both the woman and the man need to be mentally prepared for. Serious psychological support is necessary. My family supported me, and so did my husband\u0026rsquo;s family, neighbours, and friends. That\u0026rsquo;s why I believe psychological support is vital throughout the process.\u0026rdquo; (P8)\u003c/p\u003e\u003cp\u003e\u003cb\u003eTaking Treatment and Doctors Seriously\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026ldquo;As I said, take the treatment very seriously. Pay close attention to the timing and dosage of medications\u0026mdash;even a 0.1 cc difference matters. So administer medications very carefully, listen closely to your nurses and doctors, and pay attention to your nutrition, exercise, and mental state. Everything matters.\u0026rdquo; (P3)\u003c/p\u003e\u003cp\u003e\u0026ldquo;I think it\u0026rsquo;s important that patients believe they are seeing a good doctor. If you\u0026rsquo;re with a good doctor, I believe you need to trust them.\u0026rdquo; (P4)\u003c/p\u003e\u003cp\u003e\u003cb\u003eBeing Mentally Prepared for Negative Outcomes\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026ldquo;Psychologically, it\u0026rsquo;s important not to assign too much meaning to it.\u0026rdquo; (laughs) \u0026ldquo;You have to consider the possibility of failure. I was extremely positive\u0026mdash;so positive that when it didn\u0026rsquo;t happen, it really crushed me.\u0026rdquo; (P5)\u003c/p\u003e\u003cp\u003e\u0026ldquo;On the other hand, knowing that treatment might fail just as easily as it might succeed helps you stay prepared for anything.\u0026rdquo; (P13)\u003c/p\u003e\u003cp\u003e\u003cb\u003eImproving Psychological Well-being\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026ldquo;Of course, becoming a mother is precious. But first, women should love themselves and get to know themselves. That helps them move through this process in a healthier state of mind.\u0026rdquo; (P13)\u003c/p\u003e\u003cp\u003e\u0026ldquo;My advice to others going through treatment is not to listen to what others say. It\u0026rsquo;s a stressful process. Talk only to those who lift you up.\u0026rdquo; (P18)\u003c/p\u003e\u003cp\u003e\u0026ldquo;I would suggest doing whatever activities make you feel good, maintaining your emotional health, and staying connected with your partner, friends, and family.\u0026rdquo; (P20)\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study examined the experiences of women undergoing infertility treatment. Some participants stated that the information they received during the treatment process was clear and satisfactory, which helped them trust the process and understand it more thoroughly. This finding aligns with previous research suggesting that effective communication and information-sharing by healthcare professionals enhance patient compliance and offer psychological support [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. However, other participants reported receiving insufficient or conflicting information. Inadequate or contradictory guidance may negatively affect patients’ adherence to treatment and its outcomes. Contradictory information, especially at critical stages of the process, leaves patients uncertain about what actions to take. This uncertainty adds to the physical, psychological, and financial stress of treatment and exacerbates the emotional burden already experienced by women [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eParticipants expressed that motivational messages from healthcare staff helped ease the psychological weight of treatment. These findings support existing literature that underscores the importance of psychological support in infertility care [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Maintaining morale among women during treatment contributes positively to their faith in the process and to the overall success of the treatment. Conversely, some participants noted that the use of negative language by healthcare staff caused discouragement. These findings are in line with prior studies that highlight the impact of emotional support and motivation on treatment success [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e], [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. Instances of neglect during the process also had a detrimental emotional impact. A systematic review has indicated that clinic-related and organisational issues are among the primary reasons patients abandon treatment [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. Given the emotionally intense nature of infertility treatment, these findings reiterate the necessity for healthcare professionals to act with empathy and sensitivity.\u003c/p\u003e\u003cp\u003ePositive experiences during the treatment process may enhance individuals’ motivation and help foster a more optimistic attitude. For instance, P2’s experience with genetic screening represented a hopeful memory in her journey. Since genetic testing increases the likelihood of having a healthy baby, such experiences can strengthen patients’ optimism toward treatment. The sub-theme “Expectation of a Positive Outcome” illustrates that most participants were motivated by the hope of achieving a successful result. Accordingly, hope-centred group counselling is recommended for stress management, particularly for women who have experienced unsuccessful IVF cycles [20 23].\u003c/p\u003e\u003cp\u003eWomen also experienced physical challenges during the infertility treatment process. These included weight gain, pain from egg retrieval, OHSS, and bruising or pain at injection sites. These complaints are consistent with existing literature, which reports that procedures such as ovulation induction, egg retrieval, and embryo transfer are often accompanied by pain, ascites, and nausea [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Additionally, previous studies have shown that some patients discontinue treatment due to the severe pain of oocyte retrieval or because of the side effects of medications or procedures [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eIn recent years, the increased use of ART and related infertility medications has raised concerns about cancer risks. Participants in this study expressed varied thoughts about the possibility of cancer. Such concerns are often alleviated or eliminated through information provided by healthcare professionals. However, research notes that multiple factors play a role in cancer development, making it difficult to definitively establish a causal link between infertility medications and cancer [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. Evidence from nine cohort studies also shows that infertile women are at greater risk for premature and early menopause [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eLoss of hope and giving up are frequent psychological obstacles in infertility treatment. Although couples usually begin treatment with optimism, their stress levels tend to increase as the process continues [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. Therefore, keeping hope alive from the beginning may help individuals better cope with the emotional demands of the process. Spousal support is one of the most critical psychological factors in infertility treatment. Emotional and practical support between partners can positively affect the treatment experience. Previous research confirms that spousal support contributes significantly to treatment adherence [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. Likewise, support from family and friends can help make the process more manageable.\u003c/p\u003e\u003cp\u003e\u003cb\u003eLimitations\u003c/b\u003e\u003c/p\u003e\u003cp\u003eTo the best of our knowledge, this study is among the first to explore the multifaceted experiences of women undergoing infertility treatment in such depth. This is considered a strength of the research. However, the use of the snowball sampling method can be considered a limitation. Additionally, the study data rely solely on self-reports provided by the participants.\u003c/p\u003e"},{"header":"Conclusion and Recommendations","content":"\u003cp\u003eThe findings indicate that infertility treatment is not solely a physical experience; it is a complex process with emotional, psychological, and social dimensions. Participants expressed a desire for personalised attention, empathy, and clear communication during treatment. The nature of the relationship established with healthcare professionals directly influences trust in the treatment and commitment to the process.\u003c/p\u003e\u003cp\u003eTo address these needs, it is recommended that healthcare workers receive training in empathy-based communication, support individuals’ active involvement in the information-sharing process, expand access to psychoeducational services such as group counselling, and restructure the treatment process in ways that minimise its impact on women’s quality of life.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eART: Assisted Reproductive Technology\u003c/p\u003e\n\u003cp\u003eCOREQ: Consolidated Criteria for Reporting Qualitative Research\u003c/p\u003e\n\u003cp\u003eIVF: In Vitro Fertilization\u003c/p\u003e\n\u003cp\u003eOHSS: Ovarian Hyperstimulation Syndrome\u003c/p\u003e\n\u003cp\u003ePGT: Preimplantation Genetic Testing\u003c/p\u003e\n\u003cp\u003eZOOM: Zoom Video Communications Platform\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was conducted in accordance with the principles of the Declaration of Helsinki. Ethical approval was obtained from the Bartin University Social and Human Sciences Ethics Committee with approval number [2023-SBB-0485/12.09.2023]. Informed consent was obtained from all participants prior to data collection. Participation was voluntary, and participants were assured of anonymity and confidentiality throughout the study.\u003cbr\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable. No identifying personal data are included in this manuscript.\u003cbr\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo/Not applicable (this manuscript does not report data generation or analysis).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests. \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003cbr\u003e\u003cstrong\u003eFunding\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNone to declare.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eŞKE, ECE, OK designed the study, guided the writing of the manuscript, and reviewed the manuscript, ŞKE, ECE, OK, RYA designed the study, guided the writing of the manuscript, and reviewed the manuscript, reviewed and approved the final manuscript. ŞKE, ECE, RYA Collected the data, revised the manuscript. OK, ŞKE processed the data, performed the statistical and drafted the manuscript, revised the manuscript.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe sincerely thank all the women who participated in this study and shared their emotions and experiences with us so openly and wholeheartedly. Their voices made this research possible and meaningful.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eBeckmann C. Infertility. Obstetrics and Gynecology. Eıght ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams \u0026amp; Wilkins; 2014.\u003c/li\u003e\n\u003cli\u003ePasch LA, Holley SR, Bleil ME, Shehab D, Katz PP, Adler NE. Addressing the needs of fertility treatment patients and their partners: are they informed of and do they receive mental health services? Fertil Steril. 2016;106(1):209-215.e2. doi:10.1016/j.fertnstert.2016.03.006\u003c/li\u003e\n\u003cli\u003eHammarberg K, Astbury J, Baker HWG. Women\u0026rsquo;s experience of IVF: A follow-up study. Hum Reprod. 2001;16(2):374-383. doi:10.1093/humrep/16.2.374\u003c/li\u003e\n\u003cli\u003eYing L-Y, Wu LH, Loke AY. The experience of Chinese couples undergoing ın vitro fertilization treatment: Perception of the treatment process and partner support. PLoS One. 2015;10(10):e0139691. https://doi.org/10.1371/journal.pone.0139691.\u003c/li\u003e\n\u003cli\u003eTruong LQ, Luong TB, Tran TH, et al. Infertility-related stress, social support, and coping of women experiencing infertility in Vietnam. Heal Psychol Rep. 2022;10(2):129-138. doi:10.5114/hpr.2022.113437\u003c/li\u003e\n\u003cli\u003eTuran A, Beydağ KD. The relationship of intolerance to uncertainty and psychological wellBeing in women treated with infertility. J Curr Nurs Res. 2023;3(2):44-51.\u003c/li\u003e\n\u003cli\u003eYılmaz T, Yeşiltepe Oskay \u0026Uuml;. Methods to cope with infertility stress and nursing attitudes. HSP. 2015;2(1):100-112. doi:10.17681/hsp.20993\u003c/li\u003e\n\u003cli\u003eRedshaw M, Hockley C, Davidson LL. A qualitative study of the experience of treatment for infertility among women who successfully became pregnant. Hum Reprod. 2007;22(1):295-304. doi:10.1093/humrep/del344\u003c/li\u003e\n\u003cli\u003eBaltacı A. The qualitative research process: How to conduct a qualitative research? AE\u0026Uuml;SBED. 2019;5(2):368-388. doi:10.31592/aeusbed.598299\u003c/li\u003e\n\u003cli\u003ePatton M. Qualitative Research and Evaluation Methods. 4th ed. Sage publications; 2015.\u003c/li\u003e\n\u003cli\u003eCreswell JW, Poth CN. Qualitative Inquiry and Research Design Choosing Among Five Approaches. Fourth Ed. SAGE Publications, Inc; 2017.\u003c/li\u003e\n\u003cli\u003eCreswell JW. Nitel Araştırma Y\u0026ouml;ntemleri: Beş Yaklaşıma G\u0026ouml;re Nitel Araştırma ve Araştırma Deseni. (Budak, A. \u0026amp; Budak İ, ed.). Ankara: Siyasal Kitabevi; 2018.\u003c/li\u003e\n\u003cli\u003eTong A, Sainsbury P, Craig J. Consolidated Criteria for Reporting Qualitative Research (COREQ): a 32-item Checklist for Interviews and Focus Groups. Int J Qual Heal Care. 2007;19(6):349-357. doi:10.1093/intqhc/mzm042\u003c/li\u003e\n\u003cli\u003eMehra P, Mishra A. Role of Communication, Influence, and Satisfaction in Patient Recommendations of a Physician. Vikalpa J Decis Makers. 2021;46:025609092110270. doi:10.1177/02560909211027090\u003c/li\u003e\n\u003cli\u003eSharkiya SH. Quality communication can improve patient-centred health outcomes among older patients: a rapid review. BMC Health Serv Res. 2023;23(1):886. doi:10.1186/s12913-023-09869-8\u003c/li\u003e\n\u003cli\u003eRothwell E, Lamb B, Johnson E, et al. Patient perspectives and experiences with in vitro fertilization and genetic testing options. Ther Adv Reprod Heal. 2020;14:2633494119899942. doi:10.1177/2633494119899942\u003c/li\u003e\n\u003cli\u003eDembińska AA. Psychological determinants of life satisfaction in women undergoing infertility treatment. Heal Psychol Rep. 2016;4(2):146-158. doi:10.5114/hpr.2016.56617\u003c/li\u003e\n\u003cli\u003eElyasi F, Parkoohi PI, Naseri M, et al. Relationship between coping/attachment styles and infertility-specific distress in Iranian infertile individuals: A cross-sectional study. Int J Reprod Biomed. 2021;19(4):347-360. doi:10.18502/ijrm.v19i4.9061\u003c/li\u003e\n\u003cli\u003eShafaghi M, Ahmadinezhad GS, Karimi FZ, Mazloum SR, Golbar Yazdi HZ, Afiat M. The effect of supportive counseling on self-esteem of infertile women after in vitro fertilization (IVF) failure: a randomized controlled trial study. BMC Psychol. 2024;12(1):408. doi:10.1186/s40359-024-01914-3\u003c/li\u003e\n\u003cli\u003eMasoumi SZ, Abdoli S, Kazemi F, et al. Stress management through cognitive reconstruction and positive thinking in women with recurrent failed In Vitro Fertilization: a randomized controlled trial. BMC Psychiatry. 2025;25(1):119. doi:10.1186/s12888-025-06533-9\u003c/li\u003e\n\u003cli\u003eJiang L, Zeng T, Wu M, et al. Infertility psychological distress in women undergoing assisted reproductive treatment: A grounded theory study. J Clin Nurs. 2024;33(9):3642-3658. doi:10.1111/jocn.17195\u003c/li\u003e\n\u003cli\u003eGameiro S, Boivin J, Peronace L, Verhaak CM. Why do patients discontinue fertility treatment? A systematic review of reasons and predictors of discontinuation in fertility treatment. Hum Reprod Update. 2012;18(6):652-669. doi:10.1093/humupd/dms031\u003c/li\u003e\n\u003cli\u003eRahimi R, Hasanpour S, Mirghafourvand M, Esmaeilpour K. Effect of Hope-oriented group counseling on mental health of infertile women with failed IVF cycles: a randomized controlled trial. BMC Psychiatry. 2021;21(1):286. doi:10.1186/s12888-021-03280-5\u003c/li\u003e\n\u003cli\u003eLin J-L, Lin Y-H, Chueh K-H. Somatic symptoms, psychological distress and sleep disturbance among infertile women with intrauterine insemination treatment. J Clin Nurs. 2014;23(11-12):1677-1684. doi:10.1111/jocn.12306\u003c/li\u003e\n\u003cli\u003eMomenimovahed Z, Taheri S, Tiznobaik A, Salehiniya H. Do the fertility drugs increase the risk of cancer? A review study. Front Endocrinol (Lausanne). 2019;10:313. doi:10.3389/fendo.2019.00313\u003c/li\u003e\n\u003cli\u003eLiang C, Chung HF, Dobson AJ, et al. Is there a link between infertility, miscarriage, stillbirth, and premature or early menopause? Results from pooled analyses of 9 cohort studies. Am J Obstet Gynecol. 2023;229(1):47.e1-47.e9. doi:10.1016/j.ajog.2023.04.009\u003c/li\u003e\n\u003cli\u003eSharma A, Shrivastava D. Psychological problems related to infertility. Cureus. 2022;14(10):e30320. doi:10.7759/cureus.30320\u003c/li\u003e\n\u003cli\u003eCousineau TM, Domar AD. Psychological impact of infertility. Best Pract Res Clin Obstet Gynaecol. 2007;21(2):293-308. doi:10.1016/j.bpobgyn.2006.12.003\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTable 1\u0026nbsp;\u003c/strong\u003eSocio-demographical characteristics of women\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"605\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 40px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducation status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFamily structure\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber of treatments\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStatus/number of previous pregnancies\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber of live births\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 40px;\"\u003e\n \u003cp\u003eP1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003eBachelor\u0026apos;s degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003eNuclear\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 151px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 40px;\"\u003e\n \u003cp\u003eP2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003ePostgraduate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003eNuclear\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 151px;\"\u003e\n \u003cp\u003eYes/4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 40px;\"\u003e\n \u003cp\u003eP3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003eBachelor\u0026apos;s degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003eNuclear\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 151px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 40px;\"\u003e\n \u003cp\u003eP4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003eBachelor\u0026apos;s degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003eNuclear\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 151px;\"\u003e\n \u003cp\u003eYes/4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 40px;\"\u003e\n \u003cp\u003eP5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003eBachelor\u0026apos;s degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003eNuclear\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 151px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 40px;\"\u003e\n \u003cp\u003eP6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003ePostgraduate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003eNuclear\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 151px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 40px;\"\u003e\n \u003cp\u003eP7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003eHigh school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003eNuclear\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 151px;\"\u003e\n \u003cp\u003eYes/1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 40px;\"\u003e\n \u003cp\u003eP8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003ePostgraduate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003eNuclear\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 151px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 40px;\"\u003e\n \u003cp\u003eP9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003ePostgraduate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003eNuclear\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 151px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 40px;\"\u003e\n \u003cp\u003eP10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003eBachelor\u0026apos;s degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003eNuclear\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 151px;\"\u003e\n \u003cp\u003eYes/1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 40px;\"\u003e\n \u003cp\u003eP11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003eBachelor\u0026apos;s degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003eNuclear\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 151px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 40px;\"\u003e\n \u003cp\u003eP12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003eBachelor\u0026apos;s degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003eNuclear\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 151px;\"\u003e\n \u003cp\u003eYes/1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 40px;\"\u003e\n \u003cp\u003eP13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003ePostgraduate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003eNuclear\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 151px;\"\u003e\n \u003cp\u003eYes/1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 40px;\"\u003e\n \u003cp\u003eP14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003eBachelor\u0026apos;s degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003eNuclear\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 151px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 40px;\"\u003e\n \u003cp\u003eP15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003eAssociate degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003eNuclear\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 151px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 40px;\"\u003e\n \u003cp\u003eP16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003eAssociate degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003eNuclear\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 151px;\"\u003e\n \u003cp\u003eYes/1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 40px;\"\u003e\n \u003cp\u003eP17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003ePostgraduate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003eNuclear\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 151px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 40px;\"\u003e\n \u003cp\u003eP18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003eBachelor\u0026apos;s degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003eNuclear\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 151px;\"\u003e\n \u003cp\u003eYes/1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 40px;\"\u003e\n \u003cp\u003eP19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003ePostgraduate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003eNuclear\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 151px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 40px;\"\u003e\n \u003cp\u003eP20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003eBachelor\u0026apos;s degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003eNuclear\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 151px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 40px;\"\u003e\n \u003cp\u003eP21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003eHigh school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003eNuclear\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 151px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eTable 2 is available in the Supplementary Files section.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Qualitative research, In Vitro Fertilization, Women’s health, Experience, Expectations, Treatment process, Infertility","lastPublishedDoi":"10.21203/rs.3.rs-7124207/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7124207/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThis qualitative study sought to explore in depth the physical, emotional, psychological, and social experiences of women who have undergone infertility treatment. Semi-structured in-depth interviews were conducted via online platforms with 21 women who had received infertility treatment in the past year. Data were evaluated using inductive content analysis. As a result of the analysis, six main themes were identified: healthcare professionals\u0026rsquo; approach, treatment environment, challenges related to treatment, effects of medications, treatment outcomes, and overall experiences. The participants reported encountering many challenges, such as lack of information, loss of motivation, financial burdens, physical and psychological side effects of medications, health concerns, and disappointments following treatment failure. On the other hand, positive treatment experiences and hopeful outcomes increased women\u0026rsquo;s commitment to the process and psychological resilience. Additionally, social and spousal support was of critical importance to the women. The findings demonstrate that infertility treatment is not only a medical procedure but also a multidimensional life experience, emphasising the necessity for healthcare professionals to adopt a more sensitive and holistic approach in providing care.\u003c/p\u003e","manuscriptTitle":"Listening to the Voices of Women Undergoing Infertility Treatment: Beyond the Waiting","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-08-19 13:41:17","doi":"10.21203/rs.3.rs-7124207/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"6d503664-dc47-4a69-89db-cd1b659419c7","owner":[],"postedDate":"August 19th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-09-16T05:24:38+00:00","versionOfRecord":[],"versionCreatedAt":"2025-08-19 13:41:17","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7124207","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7124207","identity":"rs-7124207","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}