Psychosocial interventions for infertile couples: a critical review.
OBJECTIVE
This critical review aims to identify, summarize and critically appraise the current literature evaluating the effectiveness of psychosocial interventions to improve infertile couples' well-being. It also aims to identify the design implications of effective psychosocial interventions for the management of psychosocial distress in infertile couples, especially culturally specific interventions for Chinese infertile couples. Directions for future research are discussed.


BACKGROUND
Infertility is a life crisis affecting 15% of couples in most countries. The affected couples experience considerable psychological distress and impaired interpersonal relationships. Assisted reproductive technologies offer couples hope for pregnancy, but pose an unbearable psychological burden. Psychosocial interventions have been developed to offer support; however, their effectiveness has been inconsistent.


METHODS
A thorough analysis of the literatures on the topic of psychosocial interventions for infertile couples.


METHODS
A systematic search of MEDLINE, CINAHL, PsycINFO, British Nursing Index and GoogleScholar from 2003-2015 was conducted to identify English language articles with the keywords 'psychosocial intervention' and 'infertility'. Two authors assessed all of the identified articles independently for inclusion in the review.


RESULTS
Twelve studies were included in the review: seven were interventional studies and five were review studies. The findings indicated that the psychosocial interventions in general improved psychological outcomes, marital relationships and pregnancy rates among infertile couples.


CONCLUSIONS
Psychosocial interventions should be incorporated into routine practice for infertile couples to provide timely support and counselling.


CONCLUSIONS
The implications of the review findings for the effective design of psychosocial interventions, including the content, format, duration and intervener for clinical practice are discussed. In confirming the efficacy of such intervention design, randomized controlled trials are needed to compare the interventions and usual care at clinical setting. Longitudinal design is also needed to examine the long-term effects of psychosocial interventions in infertile couples' well-being.
The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong S.A.R., China.
Ka-Ming
KM
Chow
Department of Obstetrics and Gynecology, Prince of Wales Hospital, Shatin, New Territories, Hong Kong S.A.R., China.
Mei-Chun
MC
Cheung
Centre on Behavioral Health, The University of Hong Kong, Pok Fu Lam, Hong Kong S.A.R., China.
Irene Km
IK
Cheung
D037001:Directive Counseling; D005191:Family Characteristics; D005260:Female; D006801:Humans; D007246:Infertility / Q000523:psychology* / Q000628:therapy; D008297:Male; D008393:Marriage / Q000523:psychology; D027724:Reproductive Techniques, Assisted; D013315:Stress, Psychological / Q000517:prevention & control
fertility; literature review; psychosocial nursing