Abstract
This review aimed to examine the effects of mindfulness-based interventions on physical and psychological outcomes in women with infertility. Studies were included if participants were women diagnosed with infertility, were over the age of 18, and the design was a randomized controlled trial of a mindfulness-based intervention program. Two independent reviewers undertook eligibility screening, data extraction, and methodological quality assessment. We used RevMan software version 5.4 (The Cochrane Collaboration) to conduct the meta-analyses. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) was followed. Ten articles were finally included in the current meta-analysis. The results of the meta-analysis revealed large, significant effects of mindfulness-based interventions that can effectively reduce depression[SMD = −1.28, 95% CI (−1.95, −0.60), P < 0.0001], anxiety [SMD = −0.89, 95% CI (−1.26, −0.51), P < 0.00001] symptoms, and improve five domains of health-related quality of life (physical function [MD = 9.47, 95% CI (4.33, 14.61), P = 0.0003], general health [MD = 15.77, 95% CI (7.62, 23.92), P = 0.0002], vitality [MD = 14.85, 95% CI (4.95, 24.74), P = 0.003], role-physical [MD = 22.44, 95% CI (14.97, 29.91), P < 0.00001] and social function [MD = 8.27, 95% CI (3.56, 12.97), P = 0.0006)] in women with infertility. The current meta-analysis results revealed that mindfulness-based interventions could effectively reduce depression and anxiety symptoms and improve health-related quality of life in women with infertility. Future rigorously designed, high-quality research is required to demonstrate whether mindfulness-based intervention programs can effectively reduce perceived stress and BMI.
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12 August 2023
A Correction to this paper has been published: https://doi.org/10.1007/s00737-023-01363-8
References
Amarasekera AT, Chang D (2019) Buddhist meditation for vascular function: a narrative review. Integr med res 8(4):252–256. https://doi.org/10.1016/j.imr.2019.11.002
Asemota OA, Klatsky P (2015) Access to infertility care in the developing world: the family promotion gap. Semin Reprod Med 33(1):17–22. https://doi.org/10.1055/s-0034-1395274
Ashraf DM, Ali D, Azadeh DM (2014) Effect of infertility on the quality of life, a cross- sectional study. J Clin Diagn Res 8(10):Oc13–Oc15. https://doi.org/10.7860/jcdr/2014/8481.5063
Bai CF, Cui NX, Xu X, Mi GL, Sun JW, Shao D et al (2019) Effectiveness of two guided self-administered interventions for psychological distress among women with infertility: a three-armed, randomized controlled trial. Hum Reprod 34(7):1235–1248. https://doi.org/10.1093/humrep/dez066
Chachamovich JR, Chachamovich E, Ezer H, Fleck MP, Knauth D, Passos EP (2010) Investigating quality of life and health-related quality of life in infertility: a systematic review. J Psychosom Obstet Gynaecol 31(2):101–110. https://doi.org/10.3109/0167482x.2010.481337
Chamorro PP, Herruzo J, Pino MJ (2021) Study on the interdependent relationship between the marital satisfaction variable and the psychosocial impact of infertility and anxiety disposition, according to gender. J Sex Marital Ther 1–14. https://doi.org/10.1080/0092623x.2021.2008074
Chan CH, Chan CL, Ng EH, Ho PC, Chan TH, Lee GL, Hui WH (2012) Incorporating spirituality in psychosocial group intervention for women undergoing in vitro fertilization: a prospective randomized controlled study. Psychol Psychother 85(4):356–373. https://doi.org/10.1111/j.2044-8341.2011.02040.x
Chan CHY, Ng EHY, Chan CLW, Ho PC, Chan THY (2006) Effectiveness of psychosocial group intervention for reducing anxiety in women undergoing in vitro fertilization: a randomized controlled study. Fertil Steril 85(2):339–346. https://doi.org/10.1016/j.fertnstert.2005.07.1310
Chen Y, Yang H, Liu L, Fang R (2017) Effects of mindfulness-based stress reduction on the anxiety, depression and quality of life of patients with intrauterine adhesion: a randomized controlled trial. Inter J Clin Exp Med 10(2):2296–2305. Retrieved from <Go to ISI>://WOS:000396518500055
Cohen J (1988) Statistical power analysis for the behavioral sciences, 2nd edn. Routledge. https://doi.org/10.4324/9780203771587
Copel J (2014) Re: economic analysis of use of pessary to prevent preterm birth in women with multiple pregnancy (ProTWIN trial). S. M. S. Liem, G. J. van Baaren, F. M. C. Delemarre, I. M. Evers, G. Kleiverda, A. J. van Loon, J. Langenveld, N. Schuitemaker, J. M. Sikkema, B. C. Opmeer, M. G. van Pampus, B. W. J. Mol and D. J. Bekedam. Ultrasound Obstet Gynecol 2014; 44: 338–345. Ultrasound Obstet Gynecol 44(3):252. https://doi.org/10.1002/uog.13459
Crawford NM, Hoff HS, Mersereau JE (2017) Infertile women who screen positive for depression are less likely to initiate fertility treatments. Hum Reprod 32(3):582–587. https://doi.org/10.1093/humrep/dew351
Cserepes RE, Kőrösi T, Bugán A (2014) Characteristics of infertility-specific quality of life in Hungarian couples. Orv Hetil 155(20):783–788. https://doi.org/10.1556/oh.2014.29867
Dadhwal V, Choudhary V, Perumal V, Bhattacharya D (2021) Depression, anxiety, quality of life and coping in women with infertility: a cross-sectional study from India. Int J Gynaecol Obstet. https://doi.org/10.1002/ijgo.14084
de Mouzon J, Goossens V, Bhattacharya S, Castilla JA, Ferraretti AP, Korsak V, Nyboe Andersen A (2010) Assisted reproductive technology in Europe, 2006: results generated from European registers by ESHRE. Hum Reprod 25(8):1851–1862. https://doi.org/10.1093/humrep/deq124
Faramarzi M, Pasha H, Esmailzadeh S, Kheirkhah F, Heidary S, Afshar Z (2013) The effect of the cognitive behavioral therapy and pharmacotherapy on infertility stress: a randomized controlled trial. Inter J Fertil Steril 7(3):199–206
Galhardo A, Cunha M, Pinto-Gouveia J (2013) Mindfulness-based program for infertility: efficacy study. Fertil Steril 100(4):1059–1067. https://doi.org/10.1016/j.fertnstert.2013.05.036
Gdańska P, Drozdowicz-Jastrzębska E, Grzechocińska B, Radziwon-Zaleska M, Węgrzyn P, Wielgoś M (2017) Anxiety and depression in women undergoing infertility treatment. Ginekol Pol 88(2):109–112. https://doi.org/10.5603/GP.a2017.0019
Gungor ES, Seval O, Ilhan G, Verit FF (2018) Effect of intrauterine insemination treatment on sexual function and quality of life for infertile women. Pak J Med Sci 34(4):891–896. https://doi.org/10.12669/pjms.344.14789
Higgins JP, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, Sterne JA (2011) The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. BMJ 343:d5928. https://doi.org/10.1136/bmj.d5928
Hofmann SG, Gómez AF (2017) Mindfulness-based interventions for anxiety and depression. Psychiatr Clin North Am 40(4):739–749. https://doi.org/10.1016/j.psc.2017.08.008
Hosaka T, Matsubayashi H, Sugiyama Y, Izumi S, Makino T (2002) Effect of psychiatric group intervention on natural-killer cell activity and pregnancy rate. Gen Hosp Psychiatry 24(5):353–356. https://doi.org/10.1016/s0163-8343(02)00194-9
Hosseini MS, Mousavi P, Hekmat K, Haghighyzadeh MH, Fard RJ, Jafari RM (2020) Effects of a short-term mindfulness-based stress reduction program on the quality of life of women with infertility: a randomized controlled clinical trial. Complement Ther Med 50. https://doi.org/10.1016/j.ctim.2020.102403
Howard S (2018) The hidden costs of infertility treatment. BMJ 361:k2204. https://doi.org/10.1136/bmj.k2204
Ingebretsen M (2009) Wherever you go, there you are. IEEE Intell Syst 24(6):92
Kalhori F, Masoumi SZ, Shamsaei F, Mohammadi Y, Yavangi M (2020a) Effect of mindfulness-based group counseling on depression in infertile women: randomized clinical trial study. Inter JFertil Steril 14(1):10–16. https://doi.org/10.22074/ijfs.2020.5785
Kalhori F, Seyedeh Zahra M, Shamsaei F, Mohammadi Y, Yavangi M (2020b) Effect of mindfulness-based group counseling on depression in infertile women: clinical trial study. Inter J Fertil Steril 14(1):10–16. https://doi.org/10.22074/ijfs.2020.5785
Keng SL, Smoski MJ, Robins CJ (2011) Effects of mindfulness on psychological health: a review of empirical studies. Clin Psychol Rev 31(6):1041–1056. https://doi.org/10.1016/j.cpr.2011.04.006
Kiani Z, Simbar M, Hajian S, Zayeri F (2021) The prevalence of depression symptoms among infertile women: a systematic review and meta-analysis. Fertil Res Pract 7(1):6. https://doi.org/10.1186/s40738-021-00098-3
Kiani Z, Simbar M, Hajian S, Zayeri F, Shahidi M, Naz SG, M, Ghasemi V (2020) The prevalence of anxiety symptoms in infertile women: a systematic review and meta-analysis. Fertil Res Pract 6:7. https://doi.org/10.1186/s40738-020-00076-1
Lakatos E, Szigeti JF, Ujma PP, Sexty R, Balog P (2017) Anxiety and depression among infertile women: a cross-sectional survey from Hungary. BMC Womens Health 17(1):48. https://doi.org/10.1186/s12905-017-0410-2
Majeed MH, Ali AA, Sudak DM (2018) Mindfulness-based interventions for chronic pain: evidence and applications. Asian J Psychiatr 32:79–83. https://doi.org/10.1016/j.ajp.2017.11.025
Martinez G, Daniels K, Chandra A (2012) Fertility of men and women aged 15-44 years in the United States: National Survey of Family Growth, 2006-2010. Natl Health Stat Report (51):1–28
Mascarenhas MN, Flaxman SR, Boerma T, Vanderpoel S, Stevens GA (2012) National, regional, and global trends in infertility prevalence since 1990: a systematic analysis of 277 health surveys. PLoS Med 9(12):e1001356. https://doi.org/10.1371/journal.pmed.1001356
Massarotti C, Gentile G, Ferreccio C, Scaruffi P, Remorgida V, Anserini P (2019) Impact of infertility and infertility treatments on quality of life and levels of anxiety and depression in women undergoing in vitro fertilization. Gynecol Endocrinol 35(6):485–489. https://doi.org/10.1080/09513590.2018.1540575
Mousavi E, Hosseini S, Bakhtiyari M, Abasi I, Mohammadi A, Masjedi Arani A (2020) The effects of mindfulness-based stress reduction group therapy on anxiety, depression, stress, and the intolerance of uncertainty in infertile women. Iran J Rehab Res 18(2):137–144. Retrieved from https://ovidsp.ovid.com/athens?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=psyc18&AN=2021-40398-004
Mousavi E, Hosseini S, Bakhtiyari M, Mohammadi A, Isfeedvajani MS, Arani AM, Sadaat SH (2019) Comparing the effectiveness of the unified protocol transdiagnostic and mindfulness-based stress reduction program on anxiety and depression in infertile women receiving in vitro fertilisation. JResMed Dent Sci 7(2):44–51. Retrieved from <Go to ISI>://WOS:000469250600008
Namavar Jahromi B, Mansouri M, Forouhari S, Poordast T, Salehi A (2018) Quality of life and its influencing factors of couples referred to an infertility center in Shiraz. Iran Int J Fertil Steril 11(4):293–297. https://doi.org/10.22074/ijfs.2018.5123
Polis CB, Cox CM, Tunçalp Ö, McLain AC, Thoma ME (2017) Estimating infertility prevalence in low-to-middle-income countries: an application of a current duration approach to Demographic and Health Survey data. Hum Reprod 32(5):1064–1074. https://doi.org/10.1093/humrep/dex025
Rahiminejad ME, Moaddab A, Ebrahimi M, Rabiee S, Zamani A, Ezzati M, Abdollah Shamshirsaz A (2015) The relationship between some endometrial secretion cytokines and in vitro fertilization. Iran J Reprod Med 13(9):557–562
Rich CW, Domar AD (2016) Addressing the emotional barriers to access to reproductive care. Fertil Steril 105(5):1124–1127. https://doi.org/10.1016/j.fertnstert.2016.02.017
Royani Z, Heidari M, Vatanparast M, Yaghmaei F, Sarcheshme AK, Majomerd JK (2019) Predictors of quality of life in infertile couples. J Menopausal Med 25(1):35–40. https://doi.org/10.6118/jmm.2019.25.1.35
Safarinejad MR (2008) Infertility among couples in a population-based study in Iran: prevalence and associated risk factors. Int J Androl 31(3):303–314. https://doi.org/10.1111/j.1365-2605.2007.00764.x
Sant'Anna EM, Paiva SPC, Santos RP, Rodrigues AMS, Davis NA, Nery SF, Maia FP, Ferreira AVM, Reis FM (2022) Mindfulness-based program to support lifestyle modification and weight loss in infertile women: randomized controlled trial. J Psychosom Obstet Gynaecol 43(2):136–144. https://doi.org/10.1080/0167482x.2020.1823962
Shani C, Yelena S, Reut BK, Adrian S, Sami H (2016) Suicidal risk among infertile women undergoing in-vitro fertilization: Incidence and risk factors. Psychiatry Res 240:53–59. https://doi.org/10.1016/j.psychres.2016.04.003
Starc A, Trampuš M, Pavan Jukić D, Rotim C, Jukić T, Polona Mivšek A (2019) Infertility and sexual dysfunctions: a systematic literature review. Acta Clin Croat 58(3):508–515. https://doi.org/10.20471/acc.2019.58.03.15
Stefanaki C, Bacopoulou F, Livadas S, Kandaraki A, Karachalios A, Chrousos GP, Diamanti-Kandarakis E (2015) Impact of a mindfulness stress management program on stress, anxiety, depression and quality of life in women with polycystic ovary syndrome: a randomized controlled trial. Stress: The International Journal on the Biology of Stress 18(1):57–66. Retrieved from https://ovidsp.ovid.com/athens?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=psyc12&AN=2015-09182-008
Vander Borght M, Wyns C (2018) Fertility and infertility: definition and epidemiology. Clin Biochem 62:2–10. https://doi.org/10.1016/j.clinbiochem.2018.03.012
Zegers-Hochschild F, Adamson GD, de Mouzon J, Ishihara O, Mansour R, Nygren K, Vanderpoel S (2009) International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) revised glossary of ART terminology, 2009. Fertil Steril 92(5):1520–1524. https://doi.org/10.1016/j.fertnstert.2009.09.009
Acknowledgements
Thanks to all authors who participated in the systematic review.
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This work was supported in part by funding from the Hunan Provincial Innovation Foundation for Postgraduate under Grant number: CX20220333, as well as the Fundamental Research Funds for the Central Universities of Central South University under Grant number: 2022ZZTS0251.
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Guangpeng Wang: literature search, literature quality evaluation, data analysis and interpretation of data, and writing of the report;
Xueyan Liu: literature search, literature quality evaluation, data analysis, and writing of the report;
Jun Lei: literature quality evaluation, interpretation of data, and writing of the report.
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Wang, G., Liu, X. & Lei, J. Effects of mindfulness-based intervention for women with infertility: a systematic review and meta-analysis. Arch Womens Ment Health 26, 245–258 (2023). https://doi.org/10.1007/s00737-023-01307-2
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DOI: https://doi.org/10.1007/s00737-023-01307-2