The efficacy of psychological interventions for infertile women: a systematic review and meta-analysis

Infertility is a globally prevalent condition often accompanied by substantial psychological distress. This systematic review and meta-analysis evaluated the effectiveness of psychological interventions in reducing infertility-related distress and improving well-being in women and examined psychological and methodological moderators of treatment outcomes.

Sixty-nine studies involving 5,935 women were included in the systematic review, with 60 contributing data to a three-level random-effects meta-analysis. Eligible studies used randomized or controlled trial designs to evaluate psychological interventions. Primary outcomes included anxiety, depression, general distress, infertility-specific distress, and well-being. Moderator analyses examined differences by intervention type, delivery mode, dosage, format, region, and Assisted Reproductive Therapy (ART) treatment stage.

The overall pooled effect across outcomes was not statistically significant. However, domain-specific analyses indicated significant effects for anxiety (g = -0.83, p < .001), depression (g = -0.88, p < .001), and well-being (g = 1.39, p = .004). Cognitive-behavioural therapy (CBT)and counselling were among the most effective approaches. In dosage x domain analyses, well-being improved with a greater number of sessions, while longer interventions and longer session duration were associated with smaller improvements. Online delivery and regional differences also moderated treatment effects.

Psychological interventions can significantly improve specific domains of mental health among women experiencing infertility. These findings support the integration of targeted psychological care into fertility treatment and highlight the importance of selecting theory-driven approaches matched to the distinct emotional and contextual challenges of infertility. Delivery format, cultural context, and long-term follow-up should also be considered to enhance intervention impact.