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The effects of nursing interventions on anxiety and depression in infertile females undergoing assisted reproduction: a systematic review and meta-analysis.

BMC women's health·December 2025·Qinyan Xu, Zhongying Wan, Zhiyuan Xiong et al.
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Key Finding

Nursing interventions including acupuncture significantly reduced depression and anxiety in infertile women undergoing ART, with greatest effectiveness when implemented before treatment begins.

What This Means For You

Researchers analyzed 44 studies involving over 5,000 women struggling with infertility to determine whether nursing interventions could help reduce anxiety and depression during assisted reproductive technology (ART) treatments like IVF. The study examined various approaches, including acupuncture, yoga, mindfulness programs, cognitive behavioral therapy, music therapy, and stress management programs. The results showed that 40 of the 44 studies found significant improvements in both depression and anxiety levels after these interventions. Acupuncture was among the effective treatments studied. The research revealed that these supportive therapies were particularly beneficial when started before beginning ART procedures, rather than during or after treatment. For women undergoing fertility treatments, the emotional toll can be substantial, with many experiencing significant stress, anxiety, and depression throughout the process. This comprehensive analysis demonstrates that incorporating supportive interventions—including acupuncture—can meaningfully reduce psychological distress during an already challenging journey. The findings suggest that women considering ART may benefit from proactively addressing their mental health through these evidence-based approaches. If you're undergoing fertility treatment and experiencing anxiety or depression, discussing these options with your healthcare team may be worthwhile. When considering acupuncture specifically, seek a licensed acupuncturist with experience in fertility support to ensure safe, effective treatment.

Clinical Notes for Practitioners

This systematic review and meta-analysis examined 44 studies (n=5,008) evaluating nursing interventions for anxiety and depression in infertile women undergoing ART. Multiple intervention types were assessed, including acupuncture, mind-body programs, CBT, yoga, and stress management. Forty studies demonstrated favorable outcomes. Pooled analysis using random-effects modeling showed significant reductions in both depression (SMD -3.16; 95% CI: -4.38, -1.94) and anxiety (SMD -1.23; 95% CI: -1.70, -0.76). Subgroup analysis revealed superior efficacy when interventions were implemented prior to ART initiation versus during or post-treatment. Quality assessment utilized JBI critical appraisal tools; publication bias was evaluated via funnel plots and Egger's/Begg's tests. Clinical implications: Evidence supports integrating psychological interventions, including acupuncture, into pre-ART care protocols to optimize mental health outcomes in infertility patients.

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