Abstract
BACKGROUND: Many studies have investigated the impact of nursing interventions on psychological factors such as anxiety and depression in infertile women undergoing assisted reproductive technology (ART). However, the results have been inconsistent, and the effectiveness of these nursing interventions on the physiological status of these patients varies. Therefore, it is of the utmost importance to summarize and compare the outcomes of these studies across different types of nursing interventions. We performed a systematic review and meta-analysis to evaluate the effectiveness of various nursing interventions on anxiety and depression in infertile women undergoing assisted reproductive technology (ART). METHODS: A systematic search was done in the six valid databases (Cochrane, Scopus, PubMed, Medline, Embase, and Web of Science) applying two sets of keywords up to June 2025, following the PRISMA approach. The database searches were performed independently by two reviewers. Mean scores for anxiety and depression, along with 95% confidence intervals (CIs), were calculated using a random-effects model in STATA. Funnel plot was generated to examine publication bias; Egger's Begg's tests were applied to evaluate any asymmetry. The quality of the selected studies was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools. RESULTS: A total of 44 studies were reviewed in the current analysis, encompassing 5,008 infertile women. Forty of these studies reported favorable outcomes regarding depression and anxiety levels in infertile females following various interventional approaches. These interventions included mind-body programs such as Eastern body-mind-spirit therapy, mindfulness-based program for infertility (MBPI), integrative body-mind-spirit therapy, and mind-body therapeutic programs; cognitive behavioral therapy (CBT); targeted nursing care programs; group psychotherapy; Hatha yoga (HY) practice; acupuncture; stress management programs; music therapy; nursing crisis intervention programs; positive psychological interventions; drug and supplementation therapies; and positive reappraisal coping intervention (PRCI) programs. The interventions specifically targeted the psychological well-being of the patients. Both depression and anxiety levels decreased after intervention, with an overall pooled standardized mean difference (SMD) of -3.16 (95% CI: -4.38, -1.94) for depression and - 1.23 (95% CI: -1.70, -0.76) for anxiety. Subgroup analysis indicated that implementing interventions before ART was more effective than during or after ART. CONCLUSION: A comprehensive, evidence-based nursing intervention targeting infertile women undergoing ART should be developed, particularly prior to the initiation of ART.