The prevalence of anxiety symptoms in infertile women: a systematic review and meta-analysis

Abstract

Background: Infertile women are exposed more frequently to anxiety risk than are infertile men, thereby adversely affecting the procedures with which they are treated and the quality of their lives. Yet, this problem is often disregarded. This study accordingly determined the prevalence of anxiety symptoms among infertile women. Methods: All Persian and English studies published from the early 2000s to May 2019 were searched in international (i.e., PubMed, the Cochrane Library, Web of Science, Scopus, Embase, and PsycINFO) and national (i.e., SID, Magiran) databases as well as through Google Scholar. After the titles and abstracts of the articles were reviewed, their quality was evaluated, and relevant works for examination were selected in consideration of established inclusion and exclusion criteria. The risk of biases of individual studies according to Newcastle -Ottawa Scale was assessed. The heterogeneity of the studies was assessed using the I 2 statistic, and indicators of publication bias were ascertained using Egger's test. Stata (version 14) was employed in analyzing the findings. Results: Thirteen studies having a collective sample size of 5055 infertile women were subjected to meta-analysis, with study heterogeneity incorporated into a random effects model. The findings indicated that 36% of the infertile women involved in the evaluated studies self-reported their experience with anxiety. The pooled prevalence of the condition among the subjects was 36.17% [95% confidence interval (CI): 22.47-49.87]. The pooled prevalence levels in low-and middle-income countries and high-income countries were 54.24% (95% CI: 31.86-78.62) and 25.05% (95% CI: 15.76-34.34), respectively. The results revealed no evidence of publication bias (P Egger's test = 0.406). Conclusion: Considering the prevalence of anxiety in infertile women and its effects on health processes and quality of life, this problem requires serious consideration and planning for effective intervention, especially in lowand middle-income nations.

Re-examining the Role of Coping Strategies in the Associations Between Infertility-Related Stress Dimensions and State-Anxiety: Implications for Clinical Interventions With Infertile Couples

“…From this perspective, overall, data from the present study confirmed the international research ( Anderson et al, 2003 ; Matthiesen et al, 2011 ; Kiani et al, 2020 ) that underlined significantly higher levels of clinical anxiety in infertile patients than the general population (i.e., 5.1% of the Italian general population suffering from clinical Anxiety; de Girolamo et al, 2006 ). These findings supported the interest to explore, within the present study, the dynamic relationship between perceived infertility-related stress dimensions, adopted coping strategies, and levels of anxiety in male and female partners of infertile couples.…”

“…In line with this, a large body of research demonstrated that high levels of stress and anxiety symptoms are frequently occurring psychological disorders among infertile patients ( Mori et al, 1997 ; Chen et al, 2004 ; Verhaak et al, 2005 ; Dancet et al, 2010 ; Turner et al, 2013 ; De Berardis et al, 2014 ; Pawar et al, 2019 ; Kiani et al, 2020 ; Yazdi et al, 2020 ). Although anxiety is a normal adaptive response of individuals in stressful situations ( Semple and Smyth, 2019 ), research performed in international context underlined that the prevalence of anxiety in members of infertile couples is significantly higher than in fertile controls and in the general population ( Anderson et al, 2003 ; Matthiesen et al, 2011 ; Fallahzadeh et al, 2019 ; Kiani et al, 2020 ). Therefore, because both the prevalence and incidence of stress and anxiety symptoms stemming from infertility condition are worthy of note, research efforts were made to develop studies targeting a greater understanding of infertility-related stress process.…”

The level of anxiety in infertile women whose ART cycles are postponed due to the COVID-19 outbreak

“…The power analysis was performed based on an expected prevalence of anxiety as 36.17% in infertile women [16]. The calculation showed that at least 92 participants would need to be enrolled with an alphaerror level of 0.05 and a power of 80% to detect an increase of the prevalence from 36.17% to 50% according to the literature findings of the COVID-19.…”

A comprehensive review of the impact of COVID-19 on human reproductive biology, assisted reproduction care and pregnancy: a Canadian perspective

“…More than a third (36%) of infertile women, in general, will experience anxiety symptoms, affecting their quality of life [124]. Anxiety disorders are also prevalent in pregnant women.…”