The efficacy of psychological interventions for infertile patients: a meta-analysis examining mental health and pregnancy rate
Open accessAbstract
BACKGROUND: Psychological interventions for infertile patients seek to improve mental health and increase pregnancy rates. The aim of the present meta-analysis was to examine if psychological interventions improve mental health and pregnancy rate among infertile patients. Thus, controlled studies were pooled investigating psychological interventions following the introduction of assisted reproductive treatments (ART). METHODS: The databases of Medline, PsycINFO, PSYNDEX, Web of Science and the Cochrane Library were searched to identify relevant articles published between 1978 and 2007 (384 articles). Included were prospective intervention studies on infertile patients (women and men) receiving psychological interventions independent of actual medical treatment. The outcome measures were mental health and pregnancy rate. A total of 21 controlled studies were ultimately included in a meta-analysis comparing the efficacy of psychological interventions. Effect sizes (ES) were calculated for psychological measures and risk ratios (RR) for pregnancy rate. RESULTS: The findings from controlled studies indicated no significant effect for psychological interventions regarding mental health (depression: ES 0.02, 99% CI: -0.19, 0.24; anxiety: ES 0.16, 99% CI: -0.10, 0.42; mental distress: ES 0.08, 99% CI: -0.10, 0.51). Nevertheless, there was evidence for the positive impact of psychological interventions on pregnancy rates (RR 1.42, 99% CI: 1.02, 1.96). Concerning pregnancy rates, significant effects for psychological interventions were only found for couples not receiving ART. CONCLUSIONS: Despite the absence of clinical effects on mental health measures, psychological interventions were found to improve some patients' chances of becoming pregnant. Psychological interventions represent an attractive treatment option, in particular, for infertile patients who are not receiving medical treatment.
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Analysis of 21 controlled studies on the effectiveness of psychological interventions targeting infertile patients shows that only seven of these studies were conducted on samples of greater size than ours.
“However, analysis of 21 controlled studies on the effectiveness of psychological interventions targeting infertile patients (15) shows that only seven of these studies were conducted on samples of greater size than ours.”
From Mindfulness-Based Program for Infertility: Efficacy study (2013) · cites this paper as [15]
The Description of studies reports 21 controlled studies of psychological interventions for infertile patients, and Table I lists their sample sizes (page numbers unavailable). The source does not identify the citing study’s sample size or state that exactly seven studies were larger, so that comparison is not established by our copy. (LLM, conf=0.83)
Experimental — accuracy not yet measuredStandardized psychological measures were used as dependent variables.
“By examining this efficacy study on the basis of quality indicators proposed by Hammerli and colleagues (15), we can see that standardized psychological measures were used as dependent variables, the study included an experimental and a control group, and inclusion criteria were established.”
From Mindfulness-Based Program for Infertility: Efficacy study (2013) · cites this paper as [15]
Inclusion criteria were established.
“By examining this efficacy study on the basis of quality indicators proposed by Hammerli and colleagues (15), we can see that standardized psychological measures were used as dependent variables, the study included an experimental and a control group, and inclusion criteria were established.”
From Mindfulness-Based Program for Infertility: Efficacy study (2013) · cites this paper as [15]
The study included an experimental and a control group.
“By examining this efficacy study on the basis of quality indicators proposed by Hammerli and colleagues (15), we can see that standardized psychological measures were used as dependent variables, the study included an experimental and a control group, and inclusion criteria were established.”
From Mindfulness-Based Program for Infertility: Efficacy study (2013) · cites this paper as [15]
Hämmerli showed no significant effect of psychological interventions on mental health (depression, anxiety, psychological distress).
“Hämmerli [18] showed no significant effect of psychological interventions on mental health (depression, anxiety, psychological distress).”
Longer duration interventions improved anxiety and depression scores (in Hämmerli).
“Longer duration interventions improved anxiety and depression scores.”
Hämmerli found evidence for positive effects of psychological interventions on pregnancy rates when duration was used as a moderator.
“Nevertheless, there was evidence for positive effects of psychological interventions on pregnancy rates when the duration of the psychological intervention was used as a moderator.”
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- Authors
- Hämmerli, K., Znoj, H., & Barth, J.
- Affiliations
- University of Bern (CH)
- Venue
- Human Reproduction Update
- Publisher
- Oxford University Press (OUP)
- Published
- 2009
- Volume
- 15
- Issue
- 3
- Pages
- 279-295
- ISSN
- 1355-4786 (ISSN-L)
- 1460-2369
- OpenAlex
- W2152781775
- Semantic Scholar
- d71d3ea161b6b820d176d6941912412f3147666f
- Cited by
- 218
- References
- 99
- Citations by year
- 2026: 7 · 2025: 9 · 2024: 11 · 2023: 14 · 2022: 15 · 2021: 12 · 2020: 13 · 2019: 12 · 2018: 9 · 2017: 16 · 2016: 13 · 2015: 11 · 2014: 17 · 2013: 17 · 2012: 18
- FWCI
- 1.97
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Human Reproduction Update (publishedVersion)
- PubMed (publishedVersion)
- reroDoc Digital Library (submittedVersion)
- Bern Open Repository and Information System (University of Bern) (submittedVersion, other-oa)
- Funders
- National Science Foundation
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Assisted Reproductive Technology and Twin Pregnancy
- Keywords
- psychological intervention, infertility, mental health, pregnancy rate, assisted reproduction, depression, anxiety, psychological distress, couples
- MeSH terms
- Adult, Female, Humans, Infertility, Male, Mental Health, Pregnancy, Treatment Outcome, Controlled Clinical Trials as Topic, Pregnancy Rate, Reproductive Techniques, Assisted
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