title: Gender differences in emotional reactions to in vitro fertilization treatment: a systematic review.
abstract: OBJECTIVE
  The purposes of this paper are to provide a comprehensive picture of men and women's emotional reactions to infertility treatment, specifically In Vitro Fertilization (IVF) pursued by heterosexual couples, and to identify any differences between the genders.
  
  
  METHODS
  Nonexperimental studies exploring the psychological effects of IVF treatment on infertile couples were included. Six electronic databases were used to conduct a systematic search from the years 2000 to 2014. The references of the articles selected for review and other related systematic reviews were also screened to retrieve additional relevant articles. The quality of the included studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist. Descriptive analysis was adopted to synthesize the results.
  
  
  RESULTS
  A total of 22 quantitative and 4 qualitative studies were identified and included in this review. Although both men and women experienced psychological distress during the treatment, gender differences existed. Women had elevated anxiety and depression levels prior to the treatment, which became even higher on the day of the oocyte retrieval, pre- and post embryo transfer, and during the waiting period before the pregnancy test. Men of the infertile couples reported elevated depression scores before treatment, which usually increased during the time spent waiting for the outcome of the IVF treatment. Both men and women had lower scores on positive affect before the pregnancy test. A failed IVF cycle had long-term negative psychological consequences for both spouses.
  
  
  CONCLUSIONS
  The results of this review pointed to the need for a couple-based support program, aimed at improving the psychological well-being of couples.
authors.affiliation: School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China. liying.ying@connect.polyu.hk.|School of Nursing, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China. liying.ying@connect.polyu.hk.
authors.forename: Liying
authors.initials: L
authors.lastname: Ying
authors.affiliation: School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China. candy.wu@polyu.edu.hk.
authors.forename: Lai Har
authors.initials: LH
authors.lastname: Wu
authors.affiliation: School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China. hsaloke@polyu.edu.hk.
authors.forename: Alice Yuen
authors.initials: AY
authors.lastname: Loke
mesh_terms: D000328:Adult; D001007:Anxiety / Q000453:epidemiology / Q000523:psychology; D003863:Depression / Q000453:epidemiology / Q000523:psychology; D019260:Expressed Emotion; D005260:Female; D005307:Fertilization in Vitro / Q000523:psychology*; D006801:Humans; D007246:Infertility / Q000453:epidemiology / Q000523:psychology; D008297:Male; D011247:Pregnancy; D027724:Reproductive Techniques, Assisted / Q000523:psychology*; D012727:Sex Characteristics
keywords: Anxiety; Depression; Gender difference; In vitro fertilization; Infertility; Systematic review