Table 1_Gender differences in dealing with recurrent implantation failure after fertility treatments: a foundation for adequate support models.docx

BackgroundUnderstanding patients’ needs is mandatory to optimize medical support. Previous research has identified differences in male and female coping strategies. As embryo implantation failure poses a burden for both partners and as an intact partnership is beneficial to overcome infertility, support models should adjust to the needs of both partners. Psychosocial reactions to recurrent failure of fertility treatments were identified as one of the important but under-researched topics in reproductive medicine, and especially knowledge on gender-specific reactions to recurrent implantation failure (RIF) is sparse. We therefore explored male and female emotional/ psychosocial reactions and coping strategies in RIF.
MethodsWomen and men from heterosexual couples, where embryo transfers failed to result in pregnancy at least three consecutive times, participated in qualitative semi-structured interviews. Qualitative content analysis was conducted according to the content structuring model of Kuckartz and Rädiker.
ResultsDyadic influence in conversation was apparent, with women being more verbally inclined with a vivid narrative style. Men showed a lower intensity and variety of emotional and psychosocial reactions with disappointment being dominant. Greater optimism, little negative impact on quality of life, and sexuality were key male findings. Feelings of guilt were significantly more common among women. Unexpectedly, gender differences in coping strategies were less pronounced, and shared strategies emerged.
Discussion/conclusionsExperiences with RIF of affected women cannot be directly applied to male partners as men's emotional and psychosocial consequences differ in extent and quality. This gender gap should be considered to improve clinical practice.

背景：充分理解患者需求是优化医疗支持的必要前提。既往研究已证实男性与女性的应对策略存在差异。鉴于胚胎着床失败会对伴侣双方造成沉重负担，且稳定的伴侣关系有助于克服不孕难题，因此临床支持模式应兼顾双方的个性化需求。针对辅助生殖治疗反复失败的社会心理反应，是生殖医学领域重要但研究尚不充分的议题之一，而关于反复着床失败（recurrent implantation failure, RIF）的性别特异性反应的相关知识尤为匮乏。为此，本研究针对反复着床失败患者，探究了男性与女性的情绪及社会心理反应与应对策略。
方法：本研究纳入至少连续3次胚胎移植未获临床妊娠的异性伴侣双方，采用半结构化定性访谈法开展调研，并依据Kuckartz与Rädiker提出的内容结构化模型进行定性内容分析。
结果：访谈过程中可见显著的双向互动影响特征：女性更倾向于言语表达，叙事风格生动详实；男性的情绪与社会心理反应强度更低、类型更为单一，且以失望情绪为主导。男性群体的核心表现包括更乐观的心态、对生活质量的负面影响较小、重视性生活质量；而女性群体的内疚感则显著更为普遍。出乎意料的是，双方在应对策略上的性别差异并不显著，反而呈现出共通的应对模式。
讨论/结论：反复着床失败女性患者的相关临床体验无法直接类推至男性伴侣，因男性所经历的情绪与社会心理后果在程度与性质上均存在明显差异。临床实践中应重视这一性别差异，以此优化生殖医学的诊疗服务与支持方案。