The Iranian Journal of Obstetrics, Gynecology and Infertility

The Iranian Journal of Obstetrics, Gynecology and Infertility

Analysis of factors affecting the tendency of infertile women to use in vitro fertilization based on the health belief model

Document Type : Original Article

Authors
Zahra Golzary 1
Mansoureh Zarean 2
Zeinab Zaremohzzabieh 3
1 PhD Student in Women's Rights, School of Social Sciences, University of Religions and Denominations, Qom, Iran.
2 Associate Professor, Department of Social Sciences and Population, Women's Research Institute, Alzahra University, Tehran, Iran.
3 Assistant Professor, Department of Social Sciences and Gender, Women and Family Studies Research Institute, University of Religions and Denominations, Qom, Iran.
10.22038/ijogi.2026.27614
Abstract
Introduction: Infertility is one of the major global health challenges with extensive physical, psychological, and social dimensions. In Iran, cultural and social pressures on infertile women further increase the complexity of this issue. In vitro fertilization (IVF) is one of the most successful methods for infertility treatment; however, its acceptance is influenced by various factors. The present study was conducted with aim to examine the factors affecting infertile women’s willingness to undergo IVF using the Health Belief Model.
Methods: This descriptive–analytical survey study was conducted in 2024–2025 among 206 infertile women attending infertility treatment centers in Qom. Data on infertile women’s inclination to use IVF were collected using a researcher‑made questionnaire based on the Health Belief Model. Data were analyzed using multiple linear regressions.
Results: The results showed that self‑efficacy and perceived benefits had a positive and significant effect on the willingness to undergo IVF, while perceived barriers had a negative and significant effect. Perceived susceptibility and perceived severity showed no significant effect. Strengthening self‑efficacy, increasing awareness of the benefits of IVF, and reducing economic and social barriers through educational and supportive interventions may improve acceptance of this treatment method.
Conclusion: The findings indicated that strengthening self‑efficacy, increasing awareness of treatment benefits, and reducing perceived barriers can be the most effective strategies for improving acceptance of IVF.
Keywords
Infertility
IVF
Health Belief Model
Women
Subjects
  1. Nsabimana A, Ninihazwe A, Irambona H, Niyonkuru E. The impact of infertility: a holistic examination of physical, emotional, and social effects on couples. IJMR 2024; 10(6):308-16.
  2. Balen A. Infertility in practice. 5nd London: CRC Press; 2022.
  3. World Health Organization. Guideline for the prevention, diagnosis and treatment of infertility. World Health Organization; 2025.
  4. Bagi M. Prevalence, reasons and consequences of childlessness in the world and iran: A systematic review. Journal of Population Association of Iran 2023; 18(35):97-148.
  5. Alinejad-Naeini M, Peyrovi H, Shoghi M. Childbearing culture: a prominent context in the process of maternal role attainment in Iranian mothers with preterm neonates. Journal of Biosocial Science 2022; 54(6):1035-46.
  6. Carson A, Webster F, Polzer J, Bamford S. The power of potential: Assisted reproduction and the counterstories of women who discontinue fertility treatment. Social Science & Medicine 2021; 282:114153.
  7. Wessel JA, Hunt S, van Wely M, Mol F, Wang R. Alternatives to in vitro fertilization. Fertility and sterility 2023; 120(3):483-93.
  8. Bakare B, Gbala MO, Oke OF, Adeniyi AA, Olanrewaju BO, Akinsipe CI, et al. In Vitro fertilization in Nigeria: A critical review of challenges, successes, and future directions. International Journal of Gynaecology Sciences 2024; 6(2):56-60.
  9. Alliu SI, Orji LC, Fagbenro DA, Olaseni AO. Factors Affecting Decisions for Surrogacy Among Nigerian Women After Failed IVF Cycles Using the Health Belief Model. Journal of Client-Centered Nursing Care 2025; 11(4):331-48.
  10. Vincenzo JL, Patton SK, Lefler LL, McElfish PA, Wei J, Curran GM. A qualitative study of older adults' facilitators, barriers, and cues to action to engage in falls prevention using health belief model constructs. Archives of gerontology and geriatrics 2022; 99:104610.
  11. Ghorbani-Dehbalaei M, Loripoor M, Nasirzadeh M. The role of health beliefs and health literacy in women's health promoting behaviours based on the health belief model: a descriptive study. BMC women's health 2021; 21(1):421.
  12. Smith J, Christofield M, Ijeoma A. Narratives and behavioral perspectives: the overlooked role of infertility in reproductive health. Reproductive Health 2025; 22(1):247.
  13. Sharifikia I, Rohani C, Estebsari F, Matbouei M, Salmani F, Hossein-Nejad A. Health belief model-based intervention on women's knowledge and perceived beliefs about warning signs of cancer. Asia-Pacific journal of oncology nursing 2019; 6(4):431-9.
  14. Cox CM, Thoma ME, Tchangalova N, Mburu G, Bornstein MJ, Johnson CL, et al. Infertility prevalence and the methods of estimation from 1990 to 2021: a systematic review and meta-analysis. Human Reproduction Open 2022; 2022(4):hoac051.
  15. Han J, Son YJ, Jang M, Cho E, Ahn J. Barriers to and Facilitators of Shared Decision‐Making Implementation in Fertility Preservation for Patients With Cancer: A Qualitative Study. Journal of Nursing Scholarship 2025; 57(6):891-905.
  16. Dhandapani K, Kodavanji B, Nithyananda Madom Anantharaya V, Arun Kumar N. Prevalence and distribution of causes of infertility according to women’s age–a cross-sectional study in a tertiary healthcare hospital setup. Journal of Basic and Clinical Physiology and Pharmacology 2023; 34(1):27-32.
  17. Dashti S, Heidari AS, Keshmiri F. Effect of interprofessional education on interprofessional professionalism behavior and Self-efficacy in communication among the infertility and reproductive medicine team. BMC Medical Education 2025; 25(1):1121.
  18. Bandura A. Cultivate self‐efficacy for personal and organizational effectiveness. Principles of Organizational Behavior: The Handbook of Evidence‐Based Management. 3nd 2023: 113-35.
  19. Zhang Z, Liu M, Zhao F, Chen H, Chen X. Fertility stress, psychological resilience, and depressive symptoms in women with polycystic ovary syndrome. Cureus 2024; 16(9).
  20. Mansouri A, Shahramian I, Salehi H, Kord N, Khosravi F, Heidari MA. Effect of sexual health education based on health belief and pender health promotion models on the sexual function of females with type II diabetes. Journal of Diabetes Nursing 2020; 8(1):992-1001.
  21. Jo M, Shin H, Kabbe A, Kim SJ. Depressive symptoms and quality of life among women experiencing infertility: The moderating effect of perceived social support. Heliyon 2025; 11(1).
  22. Cochran WG. Sampling techniques. New York, NY: Wiley; 1977.
  23. Sousa-Leite M, Costa R, Figueiredo B, Gameiro S. Discussing the possibility of fertility treatment being unsuccessful as part of routine care offered at clinics: patients’ experiences, willingness, and preferences. Human Reproduction 2023; 38(7):1332-44.
  24. Pedro J, Brandão T, Fernandes J, Barros A, Xavier P, Schmidt L, et al. Perceived threat of infertility and women’s intention to anticipate childbearing: The mediating role of personally perceived barriers and facilitators. Journal of Clinical Psychology in Medical Settings 2021; 28(3):457-67.
  25. Alhazmi RA, Bukhari M. Perception of poor prognosis and psychological impact on the infertile couples who stop IVF therapy: Cross sectional scientific perspective. Med Sci 2023; 27:134.
  26. Peterson SK, Jennings Mayo-Wilson L, Spigel L, Morgan I, Parker A. Health care experiences of individuals accessing or undergoing in vitro fertilization (IVF) in the US: a narrative review of qualitative studies. Frontiers in Reproductive Health 2025; 7:1490917.
  27. Mirzaasgari H, Momeni F, Pourshahbaz A, Keshavarzi F, Hatami M. The relationship between coping strategies and infertility self-efficacy with pregnancy outcomes of women undergoing in vitro fertilization: A prospective cohort study. International Journal of Reproductive BioMedicine 2022; 20(7):539.
  28. Tabachnick BG, Fidell LS, Ullman JB. Using multivariate statistics. 7nd ed. Boston, MA: pearson; 2019.
  29. Modarres M, Abunasri M, Alhani F, Ebrahimi E. The effectiveness of implementing family-centered empowerment model on irrational thoughts of Iranian infertile women: a randomized clinical trial. Journal of Caring Sciences 2022; 11(4):224.
  30. Rahimi R, Hasanpour S, Mirghafourvand M, Esmaeilpour K. Effect of Hope-oriented group counseling on mental health of infertile women with failed IVF cycles: a randomized controlled trial. BMC psychiatry 2021; 21(1):286.
  31. Andrei F, Salvatori P, Cipriani L, Damiano G, Dirodi M, Trombini E, et al. Self-efficacy, coping strategies and quality of life in women and men requiring assisted reproductive technology treatments for anatomical or non-anatomical infertility. European Journal of Obstetrics & Gynecology and Reproductive Biology 2021; 264:241-6.
  32. Taher TM, Saadi RB, Sarray FT. Health belief model attitudes of Iraqi women towards breast cancer and its early detection methods. Ethiopian Journal of Reproductive Health 2023; 15(1):17-25.
  33. Rashidi Fakari F, Simbar M, Saei Ghare Naz M, Rashidi Fakari F. Factors related to empowering iranian women’s fertility behaviors: a systematic review. Journal of Obstetrics, Gynecology and Cancer Research 2022; 3(3):115-22.
  34. Dabbaghi H, Rafieepour Z. Infertility and Women's Suffer (A Review of the Psychological, Social & Economic Problems of Infertility). Social Sciences 2022; 29(98):81-119.
  35. Keykhosravi Bigzadeh Z, Sodagar Sh, Jomhari F, Bahrami Hidaji M. the impact of perceived social support on Adjustment to Illness with the mediating role of resiliency and marital satisfaction in infertile woman. Journal of Analytical - Cognitive Psychology 2023; 13(51):50-66.
  36. Ghorbani M, Mohammadi E, Aghabozorgi R, Ramezani M. The effect of applying Spiritual Care Model on well-being and quality of care in cancer patients. Supportive Care in Cancer 2021; 29(5):2749-60.
The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 28, Issue 12
February 2026
Pages 27-39