Effectiveness of non-pharmacological interventions on pregnancy rates in infertile individuals undergoing IVF/ICSI: a systematic review and network meta-analysis

Abstract Aim To assess the impact of various non-pharmacological interventions on the likelihood of achieving pregnancy in individuals undergoing IVF/ICSI. Background Despite significant advancements in assisted reproductive technology, the strategic utilization of non-pharmacological interventions...

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Main Authors: Ke-Xian Liu, Yuan-Yuan Wu, Meng Zhang, Meng Jia, Dan Wang, Cai-Xia Zhang, Yi-Chun Guan, Pei-Ling Tian
Format: Article
Language:English
Published: BMC 2025-04-01
Series:Archives of Public Health
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Online Access:https://doi.org/10.1186/s13690-025-01571-x
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author Ke-Xian Liu
Yuan-Yuan Wu
Meng Zhang
Meng Jia
Dan Wang
Cai-Xia Zhang
Yi-Chun Guan
Pei-Ling Tian
author_facet Ke-Xian Liu
Yuan-Yuan Wu
Meng Zhang
Meng Jia
Dan Wang
Cai-Xia Zhang
Yi-Chun Guan
Pei-Ling Tian
author_sort Ke-Xian Liu
collection DOAJ
description Abstract Aim To assess the impact of various non-pharmacological interventions on the likelihood of achieving pregnancy in individuals undergoing IVF/ICSI. Background Despite significant advancements in assisted reproductive technology, the strategic utilization of non-pharmacological interventions to enhance clinical outcomes continues to pose a significant challenge in the field of reproductive medicine. Methods Relevant studies published in English or Chinese were comprehensively selected from databases including CNKI, Wanfang Data, VIP Database, PubMed, Web of Science, and Embase up to December 2023. Studies that examined various non-pharmacological interventions during IVF/ICSI treatment, and reported subsequent pregnancy outcomes, were included. The control group received standard treatment. Study quality was assessed based on the methodology and criteria outlined in the Cochrane Collaboration Handbook. This review protocol was registered with PROSPERO (CRD42023414729). Results Out of the initial 28,688 studies identified, 43 trials involving 5,779 women were included. When compared to the control treatment, cognitive-behavioral therapy, acupuncture, lifestyle intervention, health education, and music therapy were associated with a significantly increased likelihood of clinical pregnancy (OR 1.44, 95% CI 1.21 to 1.72; 1.89, 1.46 to 2.43; 1.75, 1.18 to 2.57; 2.10, 1.57 to 2.80; 1.52, 1.08 to 2.13, respectively). Among the non-pharmacological treatments studied, cognitive-behavioral therapy and lifestyle intervention were associated with the highest number of oocytes retrieved (OR 0.31, 95% CI 0.11 to 0.86; 0.15, 95% CI 0.04 to 0.58, compared to controls). No significant differences were observed among non-pharmacological interventions and the control group. Cognitive-behavioral therapy and health education led to the highest rate of high-quality embryos (OR 0.41, 95% CI 0.20 to 0.84; 0.52, 95% CI 0.28 to 0.97, compared to controls). Conclusions Non-pharmacological treatments such as cognitive-behavioral therapy, health education, lifestyle intervention, acupuncture, and music therapy showed trends suggesting better clinical outcomes in terms of pregnancy achievement compared to the control group. More high-level RCT studies are clearly necessary for future meta-analyses to better guide clinical practice. Implications for Nursing and/or Health policy: Policymakers should promote non-pharmacological programs for infertile population and develop standard guidelines. This will ensure that non-pharmacological interventions are implemented responsibly, protecting patient rights and enhancing healthcare outcomes.
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spelling doaj-art-19745eec7004429ea822a52a0a4b18cf2025-08-20T03:14:02ZengBMCArchives of Public Health2049-32582025-04-0183112310.1186/s13690-025-01571-xEffectiveness of non-pharmacological interventions on pregnancy rates in infertile individuals undergoing IVF/ICSI: a systematic review and network meta-analysisKe-Xian Liu0Yuan-Yuan Wu1Meng Zhang2Meng Jia3Dan Wang4Cai-Xia Zhang5Yi-Chun Guan6Pei-Ling Tian7Center for Reproductive Medicine, the Third Affiliated Hospital of Zhengzhou UniversityCenter for Reproductive Medicine, the Third Affiliated Hospital of Zhengzhou UniversityCenter for Reproductive Medicine, the Third Affiliated Hospital of Zhengzhou UniversityNursing Department, the Third Affiliated Hospital of Zhengzhou UniversityNursing Department, Zhejiang University School of MedicineCenter for Reproductive Medicine, the Third Affiliated Hospital of Zhengzhou UniversityCenter for Reproductive Medicine, the Third Affiliated Hospital of Zhengzhou UniversityCenter for Reproductive Medicine, the Third Affiliated Hospital of Zhengzhou UniversityAbstract Aim To assess the impact of various non-pharmacological interventions on the likelihood of achieving pregnancy in individuals undergoing IVF/ICSI. Background Despite significant advancements in assisted reproductive technology, the strategic utilization of non-pharmacological interventions to enhance clinical outcomes continues to pose a significant challenge in the field of reproductive medicine. Methods Relevant studies published in English or Chinese were comprehensively selected from databases including CNKI, Wanfang Data, VIP Database, PubMed, Web of Science, and Embase up to December 2023. Studies that examined various non-pharmacological interventions during IVF/ICSI treatment, and reported subsequent pregnancy outcomes, were included. The control group received standard treatment. Study quality was assessed based on the methodology and criteria outlined in the Cochrane Collaboration Handbook. This review protocol was registered with PROSPERO (CRD42023414729). Results Out of the initial 28,688 studies identified, 43 trials involving 5,779 women were included. When compared to the control treatment, cognitive-behavioral therapy, acupuncture, lifestyle intervention, health education, and music therapy were associated with a significantly increased likelihood of clinical pregnancy (OR 1.44, 95% CI 1.21 to 1.72; 1.89, 1.46 to 2.43; 1.75, 1.18 to 2.57; 2.10, 1.57 to 2.80; 1.52, 1.08 to 2.13, respectively). Among the non-pharmacological treatments studied, cognitive-behavioral therapy and lifestyle intervention were associated with the highest number of oocytes retrieved (OR 0.31, 95% CI 0.11 to 0.86; 0.15, 95% CI 0.04 to 0.58, compared to controls). No significant differences were observed among non-pharmacological interventions and the control group. Cognitive-behavioral therapy and health education led to the highest rate of high-quality embryos (OR 0.41, 95% CI 0.20 to 0.84; 0.52, 95% CI 0.28 to 0.97, compared to controls). Conclusions Non-pharmacological treatments such as cognitive-behavioral therapy, health education, lifestyle intervention, acupuncture, and music therapy showed trends suggesting better clinical outcomes in terms of pregnancy achievement compared to the control group. More high-level RCT studies are clearly necessary for future meta-analyses to better guide clinical practice. Implications for Nursing and/or Health policy: Policymakers should promote non-pharmacological programs for infertile population and develop standard guidelines. This will ensure that non-pharmacological interventions are implemented responsibly, protecting patient rights and enhancing healthcare outcomes.https://doi.org/10.1186/s13690-025-01571-xInfertilityPregnancy rateIn vitro fertilizationIntracytoplasmic sperm injectionNon-pharmacological interventionsSystematic review
spellingShingle Ke-Xian Liu
Yuan-Yuan Wu
Meng Zhang
Meng Jia
Dan Wang
Cai-Xia Zhang
Yi-Chun Guan
Pei-Ling Tian
Effectiveness of non-pharmacological interventions on pregnancy rates in infertile individuals undergoing IVF/ICSI: a systematic review and network meta-analysis
Archives of Public Health
Infertility
Pregnancy rate
In vitro fertilization
Intracytoplasmic sperm injection
Non-pharmacological interventions
Systematic review
title Effectiveness of non-pharmacological interventions on pregnancy rates in infertile individuals undergoing IVF/ICSI: a systematic review and network meta-analysis
title_full Effectiveness of non-pharmacological interventions on pregnancy rates in infertile individuals undergoing IVF/ICSI: a systematic review and network meta-analysis
title_fullStr Effectiveness of non-pharmacological interventions on pregnancy rates in infertile individuals undergoing IVF/ICSI: a systematic review and network meta-analysis
title_full_unstemmed Effectiveness of non-pharmacological interventions on pregnancy rates in infertile individuals undergoing IVF/ICSI: a systematic review and network meta-analysis
title_short Effectiveness of non-pharmacological interventions on pregnancy rates in infertile individuals undergoing IVF/ICSI: a systematic review and network meta-analysis
title_sort effectiveness of non pharmacological interventions on pregnancy rates in infertile individuals undergoing ivf icsi a systematic review and network meta analysis
topic Infertility
Pregnancy rate
In vitro fertilization
Intracytoplasmic sperm injection
Non-pharmacological interventions
Systematic review
url https://doi.org/10.1186/s13690-025-01571-x
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