- Women with PCOS-related infertility had substantially higher screening-based depressive (60% vs 14%) and anxiety (63% vs 21%) symptom burden than unexplained infertility.
- Quality of life was significantly lower in the PCOS group (66.8% vs 85.1%), notably in psychological and social domains.
- Hyperandrogenic PCOS phenotypes showed greater psychological burden and lower QoL; study supports routine psychological screening and multidisciplinary support in infertility care.
J Ovarian Res. 2026 Jul 11. doi: 10.1186/s13048-026-02186-8. Online ahead of print.
ABSTRACT
BACKGROUND: Infertility is associated with significant psychological distress and impaired quality of life (QoL) in women. Polycystic Ovarian Syndrome (PCOS), a common cause of infertility, is frequently associated with metabolic and psychological symptoms. However, limited evidence directly compares psychological symptom burden and QoL between women with PCOS-related infertility and unexplained infertility, including across PCOS phenotypes.
METHODS: This cross-sectional observational study included 240 women aged 18-40 years with infertility due to PCOS or unexplained causes, conducted at a tertiary care center between October 2019 and March 2021. PCOS was diagnosed using revised Rotterdam criteria, and unexplained infertility was defined after exclusion of known causes. Psychological outcomes were assessed using validated screening instruments (PHQ-9, BDI, BAI, and GAD-7), representing symptom severity rather than clinical psychiatric diagnoses. QoL was assessed using WHOQOL-BREF. Statistical analysis included group comparisons using appropriate parametric and non-parametric tests, with p < 0.05 considered statistically significant.
RESULTS: Women with PCOS demonstrated significantly higher screening-based depressive symptom burden (60% vs. 14%, p < 0.001) and anxiety symptom burden (63% vs. 21%, p < 0.001) compared to women with unexplained infertility. QoL scores were significantly lower in the PCOS group (66.8% vs. 85.1%, p < 0.001), particularly in psychological and social domains. Among PCOS phenotypes, hyperandrogenic phenotypes (B and C) showed relatively higher psychological symptom burden and lower QoL scores compared to other phenotypes. The PCOS group also demonstrated higher BMI and androgen levels.
CONCLUSION: Infertility associated with PCOS is linked to higher screening-based psychological symptom burden and reduced quality of life compared to unexplained infertility. Hyperandrogenic PCOS phenotypes appear to be more affected. These findings support the integration of routine psychological screening and multidisciplinary support into infertility care for women with PCOS.
PMID:42436557 | DOI:10.1186/s13048-026-02186-8
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