Initial Psychological Evaluation in Couples with Unexplained Infertility: Focusing on Gender Differences

This study explored psychological distress and gender differences among couples diagnosed with unexplained infertility (UI) and undergoing evaluation for assisted reproductive treatment at the AOUP Santa Chiara Hospital in Pisa, Italy. A total of 21 heterosexual couples (N = 42) completed the Perceived Stress Scale (PSS), Depression Anxiety Stress Scale (DASS-21), Defeat Scale (DS), and Core-Fertility Quality of Life questionnaire (Core-FertiQol). Women reported significantly higher levels of anxiety and stress compared to men, as confirmed both by DASS-21 and PSS scores. No significant gender differences emerged either in depressive symptoms or defeat. In the Core-FertiQol, women scored higher in the Mind–Body component. Within-couple comparisons mirrored between-gender findings, with women showing higher distress. Despite elevated distress levels, women also demonstrated relatively preserved quality of life, possibly reflecting more adaptive coping strategies. The study provides preliminary support for the development of mindfulness-based interventions tailored to couples coping with UI. Further research with larger samples is needed to clarify gender-specific mechanisms and inform integrated psychological care in fertility settings.