A systematic review and meta-analysis of nonpharmacological adjuvant interventions for patients undergoing assisted reproductive technology treatment

Background Assisted reproductive technology (ART) is not always successful, yet places a high psychological burden on individuals. Objectives To assess whether nonpharmacological adjuvant interventions could improve outcomes among patients receiving ART. Search strategy Electronic databases were searched from inception to March 2017, using keywords such as “fertility treatment,” “emotional distress,” and “clinical pregnancy.” Selection criteria Reports of randomized controlled trials investigating the impact of nonpharmacological interventions on emotional disorders and the pregnancy rate in patients receiving ART published in any language were included. Data collection and analysis Data were extracted into a predesigned form. Psychological ratings were pooled using standardized mean differences (SMDs). Heterogeneity was assessed. The primary outcome measures were psychological ratings at baseline and after intervention. Main results: Overall, 34 randomized controlled trials, with a total of 7213 patients, met the inclusion criteria. Nonpharmacological interventions reduced anxiety when compared with control interventions (SMD 0.25, 95% confidence interval 0.08–0.42; I2=85%), but they had no significant effects on depression and infertility distress. Conclusions Nonpharmacological interventions could improve the psychological outcomes of patients undergoing ART treatment. This article is protected by copyright. All rights reserved.