OBJECTIVES: The aim of this study was to provide insights into the experiences, behavior and attitudes of patients towards controlled ovarian stimulation (COS). METHODS: A cross-sectional explorative study involving semi-structured in-depth interviews, including a laddering technique (means–end relation theory) to link treatment characteristics to emotional drivers. A total of 190 women (age 25-40) in France, Germany, Italy, Japan, Spain, Turkey, UK and USA who completed an IVF cycle in the last 6 months were randomly allocated via general population databases. RESULTS: When asked about their experiences during the COS phase 31% of patients mentioned that COS limited their daily activities because they wanted to be home at specific times for the injections and 19% described the schedule as stressful or emotionally demanding. Most mentioned inconveniences regarding injections were timing of injections, injection site pain and the hassle with syringes and vials. In spite of education and training on injections, 59% of women were concerned about incorrect injections. In total 45% of women experienced difficulties, like injecting at the wrong time, incorrect dosing, hitting a vessel or fear of self-injection. Having realized they had made a mistake, 68% felt worried or stressed about it and 13% were anxious that it would have a negative impact on treatment outcome. When asked women said that daily injection regimens could be improved by pen or oral administration, by pre-mixed ready-for-use methods and by reducing the number of injections. This would reduce the worries and stress associated with COS and 40% of subjects stated to believe that this would improve their emotional well-being and increase their chance of a baby. CONCLUSION: COS has serious emotional and psychological impact on patients undergoing IVF. According to women simple and short treatment regimen with less concern about correct administration will improve their emotional well-being during COS.