Treatment experience of patients with failed in vitro fertilization-embryo transfer: a qualitative study from the perspective of the social ecosystem theory

BackgroundA growing number of couples worldwide are seeking in vitro fertilization-embryo transfer (IVF-ET) to achieve pregnancy. However, failed IVF-ET treatment inflicts multidimensional stress on patients, involving individual, familial, and social levels, yet existing research has largely focused on single-dimensional analyses. Therefore, this study aims to systematically explore the treatment experiences of patients with failed IVF-ET using the Social-Ecological Systems Theory (SEST) as a guiding framework, in order to comprehensively understand the interplay of factors across individual, familial, and social levels.MethodsBased on the social-ecological systems theory, this study adopted a phenomenological qualitative research approach. From November 2024 to January 2025, patients who experienced failed in vitro fertilization-embryo transfer (IVF-ET) were recruited using purposive sampling for face-to-face, semi-structured interviews at a tertiary hospital in Kunming, Yunnan Province. Colaizzi's seven-step analysis method was applied to analyze the interview data.ResultsA total of 15 patients with failed IVF-ET participated in this study, and three themes and eight sub-themes were derived from the interview data: (1) Microsystem: Experiencing physical and psychological distress (dynamic changes in complex emotional experiences; experiences of somatic discomfort); (2) Mesosystem: Confronting challenges of imbalance in economic status, family relationships and life patterns (excessive economic burden; barriers to maintaining family relationships; imbalance in life and work patterns); (3) Macrosystem: Weakness of the diversified external support system (insufficient informational support; need for improvement in medical service experience; inadequate policy support).ConclusionPatients who experience failed IVF-ET-assisted pregnancy exhibit compromised social-ecological system status, accompanied by severe psychological distress and substantial economic burden, along with multiple adaptive challenges. These findings highlight the urgent clinical need to implement targeted psychological interventions, optimize medical support strategies, and mobilize multidisciplinary resources including medical staff, family, and social institutions, thereby improving the coping ability and long-term mental health outcomes of this population.