A scoping review of the psychosocial aspects of infertility in the Middle East

Abstract

Infertility has a major psychological and social impact, particularly in the Middle East, where cultural expectations surrounding reproduction are deeply rooted. In many communities, the inability to conceive can challenge individuals’ sense of social identity and lead to pressure, stigma, and strained family relationships. Despite the high prevalence of infertility in this region, much of the available research continues to focus on Western contexts, leaving gaps in understanding experiences in non-Western settings. This scoping review aimed to address this gap by systematically mapping research on the psychosocial aspects of infertility in the Middle East. A systematic search identified 4065 studies, and following screening and charting procedures, 167 quantitative, 28 qualitative and two mixed methods studies were included, with most conducted in Iran, reflecting a geographic concentration of research. Data were analyzed to identify recurring psychological and social themes. Infertility was consistently associated with distress, shame, diminished self-esteem, and struggles with personal and social identity. Women reported higher levels of distress compared to men, highlighting gendered expectations and the disproportionate stigma directed at women. Stigma was encountered not only within families and communities but also in healthcare interactions, compounding the emotional burden. Religion emerged as the most frequently reported coping strategy, offering meaning and resilience in the face of infertility. While some studies indicated benefits of interventions such as psychological counselling, mindfulness, and therapy, few rigorously evaluated formal psychological interventions, indicating a significant gap. Social support was consistently identified as a protective factor; however, access to appropriate, culturally sensitive psychological care remained limited.