The Effect of Cognitive Behavioral Therapy on Anxiety and Depression in Iranian Infertile Women: A Systematic and Meta-Analytical Review

Context: The prevalence of infertility, as one of the most unpleasant experiences, is approximately 13.2% in Iran. It can affect the quality of life in infertile people through mental disorders, such as depression and anxiety. Objectives: This systematic review was carried out to assess the effect of cognitive-behavioral therapy (CBT) on anxiety and depression of infertile women in Iran. Data Sources: All articles published in English and Persian until 20 February 2019 in databases, including Magiran, Iranmedex, SID, Medline (via PubMed), Scopus, Google Scholar, Embase, Cochrane Library, and Web of Sciences were searched. Study Selection: All randomized controlled clinical trials conducted in Iran on the effect of CBT on anxiety and depression were studied. In the selected studies, participants were Iranian infertile women. The used intervention was the application of CBT, the control group had received only routine care, and the outcomes were anxiety and depression. Data Extraction: Two authors separately investigated the acceptability and quality of articles, and any disagreement was solved through consensus and a third opinion. Results: Six clinical trials with 321 infertile women entered the systematic review. The meta-analysis of six studies showed that the mean depression and anxiety score in the CBT group was lower than the routine care group, which was significant only for anxiety. Conclusions: The results indicated the effectiveness of CBT intervention in reducing anxiety and depression in infertile women. However, the between-group difference was not significant in terms of depression. Convenience sampling and small sample size in the selected studies reduced the generalizability of research findings. Therefore, it is recommended to conduct clinical trials with larger sample size and accurate methodology to obtain more generalizable results.