Effectiveness of infertility counseling on pregnancy rate in infertile patients undergoing assisted reproductive technologies: A systematic review and meta-analysis

Abstract

Background:Psychological interventions such as counseling for infertile patients seem to increase pregnancy rate. Objective:The aim of this systematic review and meta-analysis was to examine if counseling improves pregnancy rate among infertile patients. Thus, randomized controlled trials investigating the effect of counseling on pregnancy rate in infertile patients undergoing ART were pooled in a meta-analysis.Materials and Methods:The databases of PubMed, Scopus, Cochrane, Google Scholar, and Persian databases including SID, Iran Medex, and Magiran were searched from 1997 to July 2016 to identify relevant articles. Included studies were trials on infertile patients (women or couples) receiving counseling independent of actual medical treatment. The outcome measure was pregnancy rate. Out of 620 relevant published trials, a total of nine RCTs were ultimately reviewed systematically and included in a meta-analysis to measure the efficacy of counseling on pregnancy rate. Odds ratio and Risk difference were calculated for pregnancy rate. All statistical analyses were done by Comprehensive Meta-analysis Version 2.Results:Nine RCTs involving 1079 infertile women/couples were included in the study. The findings from RCTs indicated significant effect of counseling on pregnancy rate so that there was a positive impact of counseling on pregnancy rate (OR= 3.852; 95% CI: 2.492-5.956; p=0.00) and (RD= 0.282; 95%; CI: 0.208-0.355; p=0.00).Conclusion:Counseling was found to improve patients’ chances of becoming pregnant. So counseling represents an attractive treatment option, in particular, for infertile patients who are not receiving medical treatments.

The complex relationship between infertility and psychological distress (Review)

“…In addition, studies have indicated that interpersonal treatment, which focuses on enhancing relationships or resolving disputes with others, and cognitive behavioural therapy, can help patients with infertility with depression and anxiety (45,46). Studies have revealed that psychotherapy can be separately provided with great results to couples or in a community (47,48).…”

The association between psychosocial interventions and fertility treatment outcome: A systematic review and meta-analysis

“…a possible alteration of the regulation of sex hormone signaling, leading to reduction of the reproductive potential (8), thus it has been suggested that increased psychological distress might be linked to reduced pregnancy rates (9,10). Therefore, several studies have examined possible associations between psychosocial interventions focusing on psychological distress and ART treatment outcomes (10)(11)(12)(13)(14)(15)(16)(17), however, the results are equivocal. This systematic review and meta-analysis aim to investigate the effect of psychosocial interventions on pregnancy rates in women or couples undergoing ART treatment compared to pregnancy rates in women or couples undergoing ART treatment and not receiving psychosocial interventions.…”

Prospective study of pregnancy outcome between perceived stress and stress‐related hormones

“…Medical staff could identify patients with higher depression scores in advance, provide psychological counseling for each specific case and improve patient moods to create better outcomes. Despite the role of psychological interventions in improving the clinical pregnancy rates of IVF-ET is unclear, [25][26][27] our experience suggested that psychological intervention is necessary and should be implemented dissimilarly due to various situations.…”