Abstract
Counselling has been strongly recommended
by numerous governmental, medical and community associations to help infertile
people. The purpose of this review was to determine whether psychosocial
interventions improved well-being and pregnancy rates, and to identify
the kinds of interventions that were most effective. A systematic search
identified all published and unpublished papers in any language and any
source that (1) described a psychosocial intervention and (2) evaluated
its effect on at least one outcome measure in an infertile population.
A total of 380 studies met the first criteria but only 6.6% (n=25)
of these were independent evaluation studies. Analysis of these studies
showed that psychosocial interventions were more effective in reducing
negative affect than in changing interpersonal functioning (e.g., marital
and social functioning). Pregnancy rates were unlikely to be affected by
psychosocial interventions. It was also found that group interventions
which had emphasised education and skills training (e.g., relaxation training)
were significantly more effective in producing positive change across a
range of outcomes than counselling interventions which emphasised emotional
expression and support and/or discussion about thoughts and feelings related
to infertility. Men and women were found to benefit equally from psychosocial
interventions. Directions for future research on the evaluation of psychosocial
interventions are discussed.
Author Keywords: Infertility;
Counselling; Stress; Support groups
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