Psychological stress in infertile individuals undergoing artificial insemination with their husband’s sperm (AIH) remains understudied, despite its potential impact on reproductive outcomes. The current study aimed to evaluate the prevalence, influencing factors, and effects of psychological stress on conception success in a population undergoing AIH.

This retrospective cohort study analyzed data from 976 patients treated between June 2020 and January 2024. Standardized psychological assessments were used to evaluate anxiety, depression, somatic symptoms, and sleep quality. These included generalized anxiety disorder 7-item (GAD-7), patient health questionnaire 9-item (PHQ-9), patient health questionnaire 15-item (PHQ-15), and the Pittsburgh Sleep Quality Index. Logistic regression analysis was performed to identify predictors of stress and their association with clinical pregnancy rates.

Younger age (<30 years) was significantly correlated with higher anxiety (odds ratio (OR) = 1.801, p = 0.012). Whilst, unemployment (OR _adjusted = 2.183, p = 0.002) and prolonged duration (3–5 years) of infertility (OR _adjusted = 1.445, p = 0.014) were significantly correlated with somatic symptoms. Moreover, unemployment (OR _adjusted = 2.020, p = 0.008) and prolonged duration (≥5 years) of infertility (OR _adjusted = 1.780, p = 0.008) were also significantly correlated with sleep disorders. However, no direct links were found between anxiety, depression, somatic symptoms or sleep quality and conception outcomes.

Our findings highlight the need to target psychological interventions for specific populations, including younger individuals, unemployed persons, and patients experiencing prolonged infertility.