Background Women undergoing embryo transfer have experienced both physical and psychological challenges, and their quality of life in the first trimester of pregnancy, especially their sleep quality, has been greatly affected.

Objective To analyze the sleep quality and related factors of embryo transfer (ET) female in early pregnancy.

Methods Patients with successful IVF-ET assisted pregnancy in the Reproductive Medicine Department of the Second Hospital of Hebei Medical University from June to December in 2022 were selected, and a questionnaire survey was conducted when they returned to the hospital 45 days after transplantation for re-examination B-ultrasound. The investigation included Pittsburgh Sleep Quality Index (PSQI), Self Rating Anxiety Scale (SAS), Self Rating Depression Scale (SDS), Simplified Chinese version of the Psychological Resilience Scale (CD-RISC), and Social Support Rating Scale were applied. PSQI ＞ 7 was used as the criterion to diagnose sleep disorders. The relationship between sleep quality and various influencing factors was analyzed by multivariate Logistic regression model, and the influence degree of major factors affecting sleep quality was evaluated by using information gain algorithm.

Results Totally 336 questionnaires were sent out and 325 were collected, with a recovery rate of 96.7%. The age of 325 IVF-ET pregnant women was (32.46 ± 4.52) years. The participants achieved a score of (43.75 ± 8.86) on the SAS, (50.89 ± 10.54) on the SDS. The total score of mental resilience scale on the psychological resilience scale was (64.18 ± 11.34), with subscore of (32.66 ± 10.28) for tenacity, (21.75 ± 6.37) for strength, and (9.74 ± 3.26) for optimism. The total score on the social support rating scale was (42.27 ± 4.93), which included an objective support subscore of (9.15 ± 2.13), a subjective support subscore of (25.30 ± 4.26), and a subscore for utilization of support of (7.82 ± 1.91). Logistic regression results suggested that older age and higher levels of anxiety were associated with a greater likelihood of experiencing sleep disorders. Compared to individuals with a junior high school education or below, those with a senior high school or vocational high school education were less likely to experience sleep disorders; higher levels of psychological resilience were associated with fewer occurrence of sleep disorders (P＜0.05). The results of information gain analysis showed that the factors affecting sleep quality were as follows: toughness in the mental resilience scale (1.186), subjective support score in the social support scale (0.807), strength in the mental resilience scale (0.806), optimism in the mental resilience scale (0.510), utilization of support in the social support scale (0.422), literacy level (0.419), objective support score (0.391), occupation (0.216), relationship between mother-in-law and daughter-in-law (0.213), SAS (0.192), SDS (0.162), number of transplants (0.146), age (0.117), number of egg retrieval (0.108), total social support (0.107), number of existing children (0.088), monthly income (0.082), marital relationship (0.051), residence (0.035).

Conclusion The sleep quality of embryo transfer women is poor in early pregnancy. Patients' bad mental state has a negative impact on sleep, while mental resilience and social support have positive impact on sleep quality. Clinical studies can start with improving patients' mental resilience and increasing their social support, so as to find means to improve patients' sleep quality and thus improving their quality of life.