Anxiety, Stress, Hope, and Depression among Women with Infertility: A Systematic Review
Keywords:
Infertility, Anxiety, Stress, Hope, DepressionAbstract
This study aimed to systematically review and synthesize empirical evidence on
anxiety, stress, and hope in relation to depression among women with infertility. The review was conducted following the systematic review methodology of the Joanna Briggs Institute (JBI) and reported in accordance with the PRISMA 2020 guidelines. Primary quantitative and qualitative studies published in Thai and English between 2015 and 2025 were included. Literature searches were conducted using electronic databases, including CINAHL, Scopus, Thai Journals Online (Thai JO), and Google Scholar, supplemented by manual searches of relevant journals and theses. The research questions were formulated using the Population–Exposure–Outcome (PEO) framework. Study selection, quality appraisal, and data extraction were independently performed using JBI appraisal tools. A total of 338 records were identified. After removing duplicates and screening according to the eligibility criteria, 13 studies of moderate to high methodological quality were included in the final synthesis. Narrative synthesis was used to describe anxiety, stress, and hope in relation to depression among women with infertility.
The findings revealed that: (1) women with infertility consistently experienced moderate to high levels of anxiety and stress, particularly during assisted reproductive technology (ART) treatment; (2) anxiety and stress were significantly and positively associated with depression; and (3) hope was negatively associated with depression and functioned as a protective factor, as well as a mediating variable that reduced the effects of anxiety and stress on depression.
This systematic review highlights the critical role of psychosocial factors—anxiety, stress, and hope in depression among women with infertility. The findings provide essential evidence to inform the development of mental health care, counseling services, and structured hope-enhancement programs aimed at reducing the level and severity of depression in this population.
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