When Everything Looks “Normal”—But IVF Still Fails
When you’ve done everything right—your labs look good, your weight is healthy, you're not “too old”—and IVF still doesn’t work, the emotional fallout can be immense. For those living with unexplained infertility, this emotional distress isn’t just understandable—it may also be relevant to treatment outcomes.
A new 2025 study published in the Archives of Women’s Mental Health explored this very issue: how anxiety and depression symptoms affect IVF success in women with unexplained infertility. The results are eye-opening—and deeply validating for anyone who’s ever felt lost in the gap between “normal” test results and ongoing failure to conceive.
Key Findings
Emotional distress matters: Women with higher anxiety or depression scores were significantly more likely to experience failed IVF, even after adjusting for medical factors.
Not all women were equally affected:
The negative impact of anxiety was strongest in women with a BMI between ~23–31 (a range considered normal to overweight).
The impact of depression was clearest in women aged 28–39.
In women with much higher or lower BMI, or outside this age range, emotional distress didn’t show the same strong effect.
Desiring a “healthier baby” was linked to worse outcomes: Interestingly, women who strongly endorsed this goal were more likely to experience IVF failure—suggesting that internalized pressure or perfectionism may influence both stress levels and outcomes.
Why This Matters
In my work with clients navigating unexplained infertility, one of the most common and heartbreaking themes is this: “There’s no reason it’s not working. That makes it even worse.”
When we’re in pain, our brains search for answers. If we can find a reason, we feel like we might be able to fix it. Answers give us a sense of control—something to fight, to research, to prepare for. But when there’s no answer—when everything looks “normal” and IVF still fails—it can leave people in a quiet kind of chaos. You’re left blaming yourself, cycling through “what ifs,” and feeling like your body is broken in some invisible way.
This study helps us understand that emotional distress isn’t a character flaw—and it’s not about “just relaxing.” But for women who fall within certain BMI and age ranges, it might be part of the bigger picture influencing IVF outcomes.
Here’s why that might be:
If you’re not underweight or overweight, and not “too old,” you’re told you’re a “good candidate.” So when treatment fails, the emotional confusion and grief can be more acute—and distress can quietly build.
In contrast, women with high BMI or advanced age often have a clear narrative to explain setbacks (even if unfairly oversimplified). But when everything appears “normal,” the lack of answers can feel intolerable, and distress may grow unchecked.
The authors suggest that in women with no obvious physiological barriers, stress-related hormones and nervous system disruptions may have more space to influence outcomes—whether through subtle effects on the uterus, egg quality, or embryo implantation.
That doesn’t mean stress or sadness cause infertility—and it doesn’t mean you’re doing anything wrong. But if you recognize yourself in this group, it may be one more reason to find yourself support—not to control the outcome, but to care for yourself inside it. Because as many clients already sense deep down, your emotional health is deeply entwined with your reproductive journey.
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