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Depression and state anxiety scores during assisted reproductive treatment are associated with outcome: a meta-analysisPurewal, Satvinder; Chapman, Sarah; van den Akker, O. B. A; University of Wolverhampton (2018-03-26)This meta-analysis investigated whether state anxiety and depression scores during assisted reproductive technology (ART) treatment and changes in state anxiety and depression scores between baseline and during ART treatment are associated with treatment outcomes. PubMed, PsycInfo, Embase, ScienceDirect, Web of Science and Scopus were searched for studies to include in the meta-analysis. Meta-analytic data were analysed using random effects models to estimate standardised mean differences. 11 studies (2202 patients) were included. Women who achieved a pregnancy had significantly lower depression scores during treatment than women who did not become pregnant -0.302 (95% CI: -0.551 - -0.054, z = -2.387, p = 0.017; I2= 77.142%, p = 0.001). State anxiety scores were also lower in women who became pregnant -0.335 (95% CI: -0.582 - -0.087: z=-2.649, p=0.008; I2 =81.339%, p = 0.001). However, changes in state anxiety (d=-0.056; 95% CI: -0.195 - 0.082, z = -0.794; I2= 0.00%) and depression scores (d=-0.106; 95% CI: -0.296 - 0.085, z = -1.088; I2= 0.00%) from baseline to treatment were not associated with ART outcomes. Clinics should aim to promote better psychosocial care for patients to help them manage the psychological and physical demands ART treatment, giving realistic expectations.