Data from: Efficacy of psychosocial interventions for psychological and pregnancy outcomes in infertile women and men: a systematic review and meta-analysis

Objective: To evaluate the evidence on the efficacy of psychosocial
interventions for improving pregnancy rates and reducing distress for
couples in treatment with assisted reproductive technology (ART). Design:
Systematic review and meta-analysis. Data sources PsycINFO, PubMed,
Embase, CINAHL, Web of Science and The Cochrane Library between 1978 and
April 2014. Study selection Studies were considered eligible if they
evaluated the effect of any psychosocial intervention on clinical
pregnancy and/or distress in infertile participants, used a quantitative
approach, and were published in English. Data extraction Study
characteristics and results were extracted and the methodological quality
assessed. Effect sizes (Hedges g) were pooled using a random effect model.
Heterogeneity was assessed using the Q statistic and I2, and publication
bias evaluated using Eggers’ method. Possible moderators and mediators
were explored with meta-ANOVAs and meta-regression. Results We identified
39 eligible studies (total N = 2746 men and women) assessing the effects
of psychological treatment on pregnancy rates and/or adverse psychological
outcomes, including depressive symptoms, anxiety, infertility stress, and
marital function. Statistically significant and robust overall effects of
psychosocial intervention were found for both clinical pregnancy (RR =
2.01; CI: 1.48-2.73; p<0.001) and combined psychological outcomes
(Hedges g=0.59; CI: 0.38-0.80; p=0.001,). The pooled effect sizes (ES) for
psychological outcomes were generally larger for women (g: 0.51-0.73) than
men (0.13-0.34), but the difference only reached statistical significance
for depressive symptoms (p=0.004). Meta-regression indicated that larger
reductions in anxiety were associated with greater improvement in
pregnancy rates (Slope: 0.19; p=0.004). No clear-cut differences were
found between effects of cognitive behavioral therapy (CBT) (g=0.84),
mind-body interventions (0.61), and other intervention types (0.50).
Conclusion The present meta-analysis suggests that psychosocial
interventions for couples in treatment for infertility, in particular CBT,
could be efficacious, both in reducing psychological distress and in
improving clinical pregnancy rates.