Journal of Shandong University (Health Sciences) ›› 2025, Vol. 63 ›› Issue (10): 89-97.doi: 10.6040/j.issn.1671-7554.0.2024.1436

• Clinical Medicine • Previous Articles    

Emotion regulation strategies and psychological distress in recurrent implantation failure patients: a correlational study

SUN Lijing1, MENG Yueru1, ZHANG Zhaoyi1, LIU Lei1, MA Lijin1, FANG Mei1,2   

  1. 1. The Institute of Women, Children and Reproductive Health / Reproductive Hospital Affiliated to Shandong University, Jinan 250012, Shandong, China;
    2. Center for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong, China
  • Published:2025-10-17

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Abstract: Objective To investigate the prevalence of anxiety and depression in patients with recurrent implantation failure(RIF)and analyze their associations with emotion regulation strategies(cognitive reappraisal, expressive suppression, rumination). Methods This prospective study enrolled 300 consecutive RIF patients from a tertiary reproductive medicine center(form May 5, 2023 to November 2, 2024). Demographic and baseline clinical characteristics were collected through a structured survey. The Generalized Anxiety Disorder scale(GAD-7)and the Patient Health Questionnaire(PHQ-9)were utilised to evaluate patients anxiety and depression symptoms, respectively. The Emotion Regulation Questionnaire(ERQ)and the Ruminative Response Scale(RRS)were utilised to evaluate three emotion regulation strategies: cognitive reappraisal, expressive suppression, and rumination. Dominance analysis was employed to quantify the relative contributions of emotion regulation strategies to depressive symptoms. Results Patients with recurrent implantation failure had depression scores ranging from 2.00 to 9.00 and anxiety scores from 1.00 to 7.00. The prevalence of depression symptoms was 52.33% and the prevalence of anxiety symptoms was 51.00%. A statistically significant difference was observed in the PHQ-9 scores in relation to work and marital status(P<0.05), and a statistically significant difference was identified in the GAD-7 scores in relation to parity(P<0.05). The findings of the linear regression analysis demonstrated that rumination and expression inhibition exhibited a positive correlation with the PHQ-9 scores(β=0.298,P<0.001; β=0.091,P=0.045), while cognitive reappraisal demonstrated a negative correlation with the PHQ-9 scores(β=-0.123,P=0.001). Additionally, rumination exhibited a positive correlation with the GAD-7 scores(β=0.284,P<0.001). Dominance analysis identified rumination(93.30%), cognitive reappraisal(5.03%), and expressive suppression(1.84%)as key predictors of depressive symptoms. Conclusion RIF patients demonstrate clinically significant anxiety and depression burden. Rumination is the predominant risk factor for both conditions, while cognitive reappraisal serves as a protective mechanism against depression.

Key words: Recurrent implantation failure, Depression, Anxiety, Emotional regulation strategies, Dominance analysis

CLC Number: 

  • R471
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