Experiences of Decision-Making and Identity Work Among Women Following Unsuccessful Assisted Reproductive Treatment: A Phenomenological Study.

PurposeThis study investigates the life adjustments, psychological experiences, and future decision-making processes of patients more than a year after assisted reproductive technology (ART) treatment failure, detailing their life trajectories.MethodsA descriptive phenomenological study was conducted at a tertiary reproductive medical center in Hangzhou, China. Women who had undergone unsuccessful ART treatment and discontinued it between October 2022 and October 2024 were purposively sampled; all had not received further ART treatment for at least 12 months at the time of the interview. Semi-structured in-depth interviews were conducted face-to-face or via video call between January and April 2026 until informational saturation was reached. Topics covered in the interviews included post-failure life changes, emotional experiences and subsequent decision-making. The data were analyzed using Colaizzi's seven-step phenomenological method. Trustworthiness was established through strategies that ensured credibility, transferability, dependability and confirmability.ResultsFour interrelated themes emerged: (1) navigating the decision to discontinue treatment, (2) evaluating and selecting post-treatment pathways, (3) implementing and adjusting to the chosen pathway, and (4) reconstructing identity and life beyond the patient role. Six distinct post-treatment trajectories were identified: relinquishing parenthood; alternative routes to parenthood; social parenting; natural conception; marital dissolution; and a suspended state. These trajectories revealed significant individual variations and dynamic psychosocial adaptations over time.ConclusionsIt is evident that women have demonstrated significant agency in rebuilding their lives through decision-making and identity adjustment more than one year after the failure of ART. It is imperative to transcend the conventional binary success or failure narratives when striving to develop comprehensive continuity-of-care services within the domain of reproductive nursing practice. The findings emphasize the necessity for reproductive nurses to establish long-term, trajectory-stratified follow-up mechanisms that identify specific psychological needs and provide layered psychosocial support.