Effects of emotions on IVF/ICSI outcomes in infertile women: a systematic review and meta-analysis

To assess whether infertile women's psychological conditions, such as depression, anxiety, and stress, are associated with in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) outcomes, we systematically searched for relevant articles from January 1, 2004, to March 29, 2024, in five databases, including PubMed, Web of Science, EMBASE, Cochrane Library, and PsycINFO. A random-effects model was used to examine pooled standardized mean differences (SMD) and 95% confidence interval (CI). A total of 29 articles fulfilled the inclusion criteria and were included in this meta-analysis. The statistical analysis revealed that infertile women with higher levels of anxiety [SMD: -0.17, 95% CI: (-0.27, -0.06), P = 0.002] and depression [SMD: -0.17, 95% CI: (-0.30, -0.04), P = 0.008] were less likely to have a successful pregnancy following IVF/ICSI treatment. Although not statistically significant, the results indicate a trend of increasing IVF/ICSI success with increasing participants' perceived stress levels [SMD: 0.09, 95% CI: (-0.01, 0.19), P = 0.07]. There was also no statistically significant correlation between infertility-related stress and IVF/ICSI outcomes [SMD: -0.26, 95% CI: (-0.79, 0.28), P = 0.35]. In general, it suggested that medical personnel should be aware of the mental health of infertile women involved in IVF/ICSI.