Abstract
Preliminary evidence suggests that mind-body interventions, including mindfulness-based interventions and yoga, may be effective in reducing mental health difficulties and psychological distress in infertile patients undergoing fertility treatments. We systematically reviewed and synthesized current medical literature of the effectiveness of mind-body interventions in reducing the severity of psychological distress and improving marital function and pregnancy outcomes in infertile women/couple. Databases including PsychINFO, PubMed, EMBASE, and the Cochrane Library were searched for relevant studies. Manual searches were conducted in relevant articles. We included 12 studies that met the inclusion criteria. Four studies were randomized controlled trials (RCT), 4 non-randomized controlled trial (NRCT), and 4 uncontrolled studies (UCT). Participation in a mind-body intervention was associated with reduced anxiety trait and depression scores. The reduction was of low or moderate amplitude in most studies. Our review offers evidence for the effectiveness of mind-body interventions in reducing anxiety state and depression in infertile women and a possible improvement in pregnancy rate. Further RCTs with a precise timing of intervention are needed.
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References
Abedi Shargh N, Bakhshani NM, Mohebbi MD, Mahmudian K, Ahovan M, Mokhtari M, Gangali A (2015) The effectiveness of mindfulness-based cognitive group therapy on marital satisfaction and general health in woman with infertility. Glob J Health Sci 8:230–235. https://doi.org/10.5539/gjhs.v8n3p230
Agostini F, Monti F, Andrei F, Paterlini M, Palomba S, la Sala GB (2017) Assisted reproductive technology treatments and quality of life: a longitudinal study among subfertile women and men. J Assist Reprod Genet 34:1307–1315. https://doi.org/10.1007/s10815-017-1000-9
Astin JA, Shapiro SL, Eisenberg DM, Forys KL (2003) Mind-body medicine: state of the science, implications for practice. J Am Board Fam Pract 16:131–147
Barnes S, Brown KW, Krusemark E, Campbell WK, Rogge RD (2007) The role of mindfulness in romantic relationship satisfaction and responses to relationship stress. J Marital Fam Ther 33:482–500. https://doi.org/10.1111/j.1752-0606.2007.00033.x
Beck AT, Steer RA, Carbin MG (1988) Psychometric properties of the Beck depression inventory: twenty-five years of evaluation. Clin Psychol Rev 8:77–100. https://doi.org/10.1016/0272-7358(88)90050-5
Boivin J (2003) A review of psychosocial interventions in infertility. Soc Sci Med 1982 57:2325–2341
Boivin J, Griffiths E, Venetis CA (2011a) Emotional distress in infertile women and failure of assisted reproductive technologies: meta-analysis of prospective psychosocial studies. BMJ 342:d223
Boivin J, Takefman J, Braverman A (2011b) The fertility quality of life (FertiQoL) tool: development and general psychometric properties. Hum Reprod Oxf Engl 26:2084–2091. https://doi.org/10.1093/humrep/der171
Boivin J, Takefman JE, Tulandi T, Brender W (1995) Reactions to infertility based on extent of treatment failure. Fertil Steril 63:801–807
Brandes M, van der Steen JOM, Bokdam SB et al (2009) When and why do subfertile couples discontinue their fertility care? A longitudinal cohort study in a secondary care subfertility population. Hum Reprod Oxf Engl 24:3127–3135. https://doi.org/10.1093/humrep/dep340
Chan CHY, Chan CLW, Ng EHY et al (2012) Incorporating spirituality in psychosocial group intervention for women undergoing in vitro fertilization: a prospective randomized controlled study. Psychol Psychother 85:356–373. https://doi.org/10.1111/j.2044-8341.2011.02040.x
Chan CHY, Ng EHY, Chan CLW, Ho, Chan TH (2006) Effectiveness of psychosocial group intervention for reducing anxiety in women undergoing in vitro fertilization: a randomized controlled study. Fertil Steril 85:339–346. https://doi.org/10.1016/j.fertnstert.2005.07.1310
Chiesa A, Serretti A (2009) Mindfulness-based stress reduction for stress management in healthy people: a review and meta-analysis. J Altern Complement Med N Y N 15:593–600. https://doi.org/10.1089/acm.2008.0495
Chow K-M, Cheung M-C, Cheung IK (2016) Psychosocial interventions for infertile couples: a critical review. J Clin Nurs 25:2101–2113. https://doi.org/10.1111/jocn.13361
Cohen J (1988) Statistical power analysis for the behavioral sciences, 2nd edn. L. Erlbaum Associates, Hillsdale
Cox JL, Chapman G, Murray D, Jones P (1996) Validation of the Edinburgh postnatal depression scale (EPDS) in non-postnatal women. J Affect Disord 39:185–189
de Liz TM, Strauss B (2005) Differential efficacy of group and individual/couple psychotherapy with infertile patients. Hum Reprod Oxf Engl 20:1324–1332. https://doi.org/10.1093/humrep/deh743
Demarzo MMP, Montero-Marin J, Cuijpers P et al (2015) The efficacy of mindfulness-based interventions in primary care: a meta-analytic review. Ann Fam Med 13:573–582. https://doi.org/10.1370/afm.1863
Domar AD, Rooney KL, Wiegand B et al (2011) Impact of a group mind/body intervention on pregnancy rates in IVF patients. Fertil Steril 95:2269–2273. https://doi.org/10.1016/j.fertnstert.2011.03.046
Domar AD, Seibel MM, Benson H (1990) The mind/body program for infertility: a new behavioral treatment approach for women with infertility. Fertil Steril 53:246–249
Ebbesen SMS, Zachariae R, Mehlsen MY et al (2009) Stressful life events are associated with a poor in-vitro fertilization (IVF) outcome: a prospective study. Hum Reprod Oxf Engl 24:2173–2182. https://doi.org/10.1093/humrep/dep185
Fowers BJ, Olson DH (1989) Enrich marital inventory: a discriminant validity and cross-validation assessment. J Marital Fam Ther 15:65–79. https://doi.org/10.1111/j.1752-0606.1989.tb00777.x
Frederiksen Y, Farver-Vestergaard I, Skovgård NG, Ingerslev HJ, Zachariae R (2015) Efficacy of psychosocial interventions for psychological and pregnancy outcomes in infertile women and men: a systematic review and meta-analysis. BMJ Open 5:e006592. https://doi.org/10.1136/bmjopen-2014-006592
Galhardo A, Cunha M, Pinto-Gouveia J (2013) Mindfulness-based program for infertility: efficacy study. Fertil Steril 100:1059–1067. https://doi.org/10.1016/j.fertnstert.2013.05.036
Gameiro S, Boivin J, Peronace L, Verhaak CM (2012) Why do patients discontinue fertility treatment? A systematic review of reasons and predictors of discontinuation in fertility treatment. Hum Reprod Update 18:652–669. https://doi.org/10.1093/humupd/dms031
García-Campayo J, Demarzo M, Shonin E, Van Gordon W (2017) How do cultural factors influence the teaching and practice of mindfulness and compassion in latin countries? Front Psychol 8. https://doi.org/10.3389/fpsyg.2017.01161
Gorayeb R, Borsari ACT, Rosa-e-Silva ACJS, Ferriani RA (2012) Brief cognitive behavioral intervention in groups in a Brazilian assisted reproduction program. Behav Med Wash DC 38:29–35. https://doi.org/10.1080/08964289.2012.654834
Gürhan N, Akyüz A, Atici D, Kisa S (2009) Association of depression and anxiety with oocyte and sperm numbers and pregnancy outcomes during in vitro fertilization treatment. Psychol Rep 104:796–806. https://doi.org/10.2466/PR0.104.3.796-806
Hämmerli K, Znoj H, Barth J (2009) The efficacy of psychological interventions for infertile patients: a meta-analysis examining mental health and pregnancy rate. Hum Reprod Update 15:279–295. https://doi.org/10.1093/humupd/dmp002
Hofmann SG, Sawyer AT, Witt AA, Oh D (2010) The effect of mindfulness-based therapy on anxiety and depression: a meta-analytic review. J Consult Clin Psychol 78:169–183. https://doi.org/10.1037/a0018555
Hughes EG, da Silva AM (2011) A pilot study assessing art therapy as a mental health intervention for subfertile women. Hum Reprod Oxf Engl 26:611–615. https://doi.org/10.1093/humrep/deq385
Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, McQuay H (1996) Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 17:1–12
Julian LJ (2011) Measures of anxiety. Arthritis Care Res 63. https://doi.org/10.1002/acr.20561
Kabat-Zinn J (1990) Full catastrophe living. Delta publishing, New York
Karlidere T, Bozkurt A, Ozmenler KN, Ozsahin A, Kucuk T, Yetkin S (2008) The influence of emotional distress on the outcome of in-vitro fertilization (IVF) and/or intracytoplasmic sperm injection (ICSI) treatment among infertile Turkish women. Isr J Psychiatry Relat Sci 45:55–64
Khoury B, Lecomte T, Fortin G, Masse M, Therien P, Bouchard V, Chapleau MA, Paquin K, Hofmann SG (2013) Mindfulness-based therapy: a comprehensive meta-analysis. Clin Psychol Rev 33:763–771. https://doi.org/10.1016/j.cpr.2013.05.005
Kim M, Kim S, Chang S, Yoo JS, Kim HK, Cho JH (2014) Effect of a mind-body therapeutic program for infertile women repeating in vitro fertilization treatment on uncertainty, anxiety, and implantation rate. Asian Nurs Res 8:49–56. https://doi.org/10.1016/j.anr.2014.02.002
Klonoff-Cohen H, Chu E, Natarajan L, Sieber W (2001) A prospective study of stress among women undergoing in vitro fertilization or gamete intrafallopian transfer. Fertil Steril 76:675–687
Knight RG, Waal-Manning HJ, Spears GF (1983) Some norms and reliability data for the state--trait anxiety inventory and the Zung self-rating depression scale. Br J Clin Psychol 22(Pt 4):245–249
Li J, Long L, Liu Y, He W, Li M (2016) Effects of a mindfulness-based intervention on fertility quality of life and pregnancy rates among women subjected to first in vitro fertilization treatment. Behav Res Ther 77:96–104. https://doi.org/10.1016/j.brat.2015.12.010
Matthiesen SMS, Frederiksen Y, Ingerslev HJ, Zachariae R (2011) Stress, distress and outcome of assisted reproductive technology (ART): a meta-analysis. Hum Reprod Oxf Engl 26:2763–2776. https://doi.org/10.1093/humrep/der246
Metcalf CA, Dimidjian S (2014) Extensions and mechanisms of mindfulness-based cognitive therapy: a review of the evidence: Evidence for mindfulness-based cognitive therapy. Aust Psychol 49:271–279. https://doi.org/10.1111/ap.12074
Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, Shekelle P, Stewart LA, PRISMA-P Group (2015) Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev 4:1. https://doi.org/10.1186/2046-4053-4-1
Morris SB, DeShon RP (2002) Combining effect size estimates in meta-analysis with repeated measures and independent-groups designs. Psychol Methods 7:105–125
Murphy EM, Nichols J, Somkuti SG et al (2014) Randomized trial of harp therapy during in vitro fertilization–embryo transfer. J Evid-Based Complement Altern Med 19:93–98. https://doi.org/10.1177/2156587213514054
Ockhuijsen HDL, van Smeden M, van den Hoogen A, Boivin J (2017) Validation study of the SCREENIVF: an instrument to screen women or men on risk for emotional maladjustment before the start of a fertility treatment. Fertil Steril 107:1370–1379.e5. https://doi.org/10.1016/j.fertnstert.2017.04.008
Oron G, Allnutt E, Lackman T, Sokal-Arnon T, Holzer H, Takefman J (2015) A prospective study using Hatha Yoga for stress reduction among women waiting for IVF treatment. Reprod Biomed Online 30:542–548. https://doi.org/10.1016/j.rbmo.2015.01.011
Pedro J, Sobral MP, Mesquita-Guimarães J, Leal C, Costa ME, Martins MV (2017) Couples’ discontinuation of fertility treatments: a longitudinal study on demographic, biomedical, and psychosocial risk factors. J Assist Reprod Genet 34:217–224. https://doi.org/10.1007/s10815-016-0844-8
Piet J, Hougaard E (2011) The effect of mindfulness-based cognitive therapy for prevention of relapse in recurrent major depressive disorder: a systematic review and meta-analysis. Clin Psychol Rev 31:1032–1040. https://doi.org/10.1016/j.cpr.2011.05.002
Psaros C,Kagan L, Shifren J, Willett J, Jacquart J, Alert M,Macklin E, Styer K, Denninger J, LaRoche K, Park E, (2015) Mind–body group treatment for women coping with infertility: a pilot study. Journal of Psychosomatic Obstetrics & Gynecology 36(2):75–83
Salomon JA, Vos T, Hogan DR et al (2012) Common values in assessing health outcomes from disease and injury: disability weights measurement study for the Global Burden of Disease Study 2010. Lancet Lond Engl 380:2129–2143. https://doi.org/10.1016/S0140-6736(12)61680-8
Schumm WR, Anderson SA, Benigas JE et al (1985) Criterion-related validity of the Kansas Marital Satisfaction Scale. Psychol Rep 56:718. https://doi.org/10.2466/pr0.1985.56.3.718
Sherratt KAL, Lunn S (2013) Evaluation of a group programme of mindfulness-based cognitive therapy for women with fertility problems. J Obstet Gynaecol 33:499–501. https://doi.org/10.3109/01443615.2013.786031
Smeenk JM, Verhaak CM, Eugster A et al (2001) The effect of anxiety and depression on the outcome of in-vitro fertilization. Hum Reprod Oxf Engl 16:1420–1423
Spielberger CD, Sydeman SJ (1994) State-trait anxiety inventory and state-trait anger expression inventory. 292–321
Teasdale JD, Segal ZV, Williams JM, Ridgeway VA, Soulsby JM, Lau MA (2000) Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. J Consult Clin Psychol 68:615–623
Terzioglu F (2001) Investigation into effectiveness of counseling on assisted reproductive techniques in Turkey. J Psychosom Obstet Gynaecol 22:133–141
Terzioglu F, Turk R, Yucel C, Dilbaz S, Cinar O, Karahalil B (2016) The effect of anxiety and depression scores of couples who underwent assisted reproductive techniques on the pregnancy outcomes. Afr Health Sci 16:441–450. https://doi.org/10.4314/ahs.v16i2.12
Turner K, Reynolds-May MF, Zitek EM, Tisdale RL, Carlisle AB, Westphal LM (2013) Stress and anxiety scores in first and repeat IVF cycles: a pilot study. PloS One 8:e63743. https://doi.org/10.1371/journal.pone.0063743
Uman LS, Chambers CT, McGrath PJ, Kisely S, Matthews D, Hayton K (2010) Assessing the quality of randomized controlled trials examining psychological interventions for pediatric procedural pain: recommendations for quality improvement. J Pediatr Psychol 35:693–703. https://doi.org/10.1093/jpepsy/jsp104
Valoriani V, Lotti F, Vanni C et al (2014) Hatha-yoga as a psychological adjuvant for women undergoing IVF: a pilot study. Eur J Obstet Gynecol Reprod Biol 176:158–162. https://doi.org/10.1016/j.ejogrb.2014.02.007
Verkuijlen J, Verhaak C, Nelen WLDM et al (2016) Psychological and educational interventions for subfertile men and women. Cochrane Database Syst Rev 3:CD011034. https://doi.org/10.1002/14651858.CD011034.pub2
Volgsten H, Skoog Svanberg A, Ekselius L, Lundkvist O, Sundström Poromaa I (2008) Prevalence of psychiatric disorders in infertile women and men undergoing in vitro fertilization treatment. Hum Reprod Oxf Engl 23:2056–2063. https://doi.org/10.1093/humrep/den154
Vøllestad J, Nielsen MB, Nielsen GH (2012) Mindfulness- and acceptance-based interventions for anxiety disorders: a systematic review and meta-analysis. Br J Clin Psychol 51:239–260. https://doi.org/10.1111/j.2044-8260.2011.02024.x
Wahbeh H, Elsas S-M, Oken BS (2008) Mind–body interventions. Neurology 70:2321–2328. https://doi.org/10.1212/01.wnl.0000314667.16386.5e
Ying L, Wu LH, Loke AY (2016) The effects of psychosocial interventions on the mental health, pregnancy rates, and marital function of infertile couples undergoing in vitro fertilization: a systematic review. J Assist Reprod Genet 33:689–701. https://doi.org/10.1007/s10815-016-0690-8
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Gaitzsch, H., Benard, J., Hugon-Rodin, J. et al. The effect of mind-body interventions on psychological and pregnancy outcomes in infertile women: a systematic review. Arch Womens Ment Health 23, 479–491 (2020). https://doi.org/10.1007/s00737-019-01009-8
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DOI: https://doi.org/10.1007/s00737-019-01009-8