Psychological and educational interventions for subfertile men and women

Abstract

The effects of psychological and educational interventions on mental health including distress, and live birth or ongoing pregnancy rates is uncertain due to the very low quality of the evidence. Existing trials of psychological and educational interventions for subfertility were generally poorly designed and executed, resulting in very serious risk of bias and serious inconsistency in study findings. There is a need for studies employing appropriate methodological techniques to investigate the benefits of these treatments for this population. In particular, attentional control groups should be employed, that is groups receiving a treatment that mimics the amount of time and attention received by the treatment group but is not thought to have a specific effect upon the participants, in order to distinguish between therapeutic and non-specific effects of interventions. Where attrition cannot be minimised, appropriate statistical techniques for handling drop-out must be applied. Failure to address these issues in study design has resulted in studies that do not provide a valid basis for answering questions about the effectiveness of these interventions.

Mindfulness‐based program for stress reduction in infertile women: Randomized controlled trial

“…A recent Cochrane review concluded that the effects of psychological and educational interventions on mental health of infertile women are uncertain due to the low quality of the existing evidence (Verkuijlen et al, ). In fact, only observational studies, non‐randomized trials, or small RCTs with high risk of bias have evaluated such interventions in the specific group of subfertile people (Feili et al, ; Galhardo et al, ; Li et al, ; Pascoe et al, ; Shahrestani et al, ).…”

“…Behavioral and cognitive therapies have been used to reduce stress and mitigate its consequences in different populations, including infertile women (Verkuijlen, Verhaak, Nelen, Wilkinson, & Farquhar, ). Some of these therapies are based on the principle of mindfulness, defined as a meditation practice that cultivates present moment awareness (Crane et al, ; Ludwig & Kabat‐Zinn, ).…”

Quality‐of‐life predictors for men undergoing infertility treatment in Japan

“…In a systematic review of 20 randomized controlled trials that examined the effects of psychosocial interventions on the pregnancy rates, mental health, and marital function of infertile couples, it was found that depression and stress were not relieved (Ying, Wu, & Loke, ). A Cochrane review of 39 studies revealed that psychological and educational interventions had effects on mental health, including distress, but live births or current pregnancy rates were uncertain because of the very low quality of evidence of the studies (Verkuijlen, Verhaak, Nelen, Wilkinson, & Farquhar, ).…”

Mental Disorders and Female Infertility

“…In the intervention group, there was a trend toward a higher rate of ongoing pregnancies (13/69 vs. 13/115) compared to the women in the standard treatment group (Chan et al, 2006). With only three studies reporting birth or pregnancy rates, a current Cochrane review concludes that the effects of psychological interventions for subfertile men and women are uncertain (Verkuijlen et al, 2016).…”