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The efficacy of psychological intervention for infertile patients.

Started by mensfe_admin, 2009-03-17 09:58

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Human reproduction update advance update, doi:10-1093/humupd/dmp002.   5th February 2009.

The efficacy of psychological intervention for the infile patients: a meta-analysis examinig mental health and pregnancy rates.

BACKROUND: Psychological interventions for infitile patients seek to improve mental health and increase pregnancy rates. The aim of the present meta-analasis 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).

METHOD: The data base of Medline, PsycINFO, PSYNDEX, web of Science and Cochrane Library were searched to identify 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 ultimatley included in a meta-analysis comparing the efficacy of psychological intervention. 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 intervention 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 positive impact of psychological intervention 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.

CONCLUTION: Despite the absence of clinical effects on mental health measures, psychological interventios were found to improve some patients' chances of becoming pregnant. Psychological interventions represented an attractive treatment option, in particular, for infertile patients who are not receiving medical treatment.