Repro-REBOUND Protocol v2.0 Integrated Multimodal Protocol for Diagnosis, Prevention, and Treatment of Emotional Burnout in Couples (Women and Men) After a Failed In Vitro Fertilization Attempt
Year: 2026
Type: report
Abstract: Relevance and Pathophysiological Rationale 2.1. Scope of the Problem Women: After failed IVF, 44% of women demonstrate depression symptoms in the clinical range, and 60% — anxiety disorders; the depression level is comparable to that of oncology patients and parents who have lost a child. Meanwhile, 10–25% of patients remain in the zone of clinically significant distress for 6 months after failure. Men: Research indicates that 30–50% of male partners after failed IVF demonstrate clinically significant distress. However, men seek psychological help much less frequently due to the stigmatization of "weakness," cultural expectations regarding the role of "head of the family," and the tendency toward somatization of stress (hypertension, dyspepsia, erectile dysfunction). Male distress often has a "hidden" (latent) character — expressed through increased work activity, social isolation, aggressiveness, or emotional detachment. 2.2. Pathophysiological Model: "Failed IVF → RPS/Andrological Distress → Emotional Burnout" Women: A failed IVF cycle functions as an acute psychoemotional stressor that activates the hypothalamic-pituitary-adrenal (HPA) axis. Chronic HPA hyperactivation leads to cortisol suppression of Kiss1/GPR54 kisspeptin neurons, redistribution of energy resources from reproductive function to survival mechanisms, and transient suppression of the hypothalamic-pituitary-ovarian (HPO) axis — the development of Reproductive Pause Syndrome (RPS). Men: In men, chronic stress activates the HPA axis with suppression of the hypothalamic-pituitary-gonadal (HPG) axis at the hypothalamic and pituitary levels. Elevated cortisol reduces GnRH secretion, leading to decreased testosterone, impaired spermatogenesis, and erectile dysfunction. This condition is conditionally designated as the "Andrological Distress Continuum" (ADC) — a transient neuroendocrine adaptation analogous to RPS in women, but with dominance of androgen deficiency and behavioral markers (emotional detachment, hypercompensatory activity). Couple Aspect: Emotional burnout in a couple after failed IVF often has an asymmetric character: the woman experiences intense affective distress (crying, anxiety, guilt), while the man demonstrates emotional "freezing" — a defense mechanism that the partner perceives as indifference. This asymmetry creates "grief dissociation" in the couple and intensifies burnout in both partners. 2.3. Theoretical Integration The protocol is based on a tripartite model: Maslach's Three-Dimensional Model (emotional exhaustion, depersonalization, reduced personal accomplishment) — for clinical verification of burnout; Conservation of Resources (COR) Theory by Hobfoll — for planning recovery of lost resources (energy, time, social support, hope); RPS Concept (Women) + ADC (Men) — for neuroendocrine stratification and differential diagnosis.
Author: Hudziak, Viktoriya
Language: English
Subfield: Reproductive Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7203568346