Effectiveness of Relaxation Interventions on Anxiety, Depression, and Quality of Life in Women with Infertility Undergoing Assisted Reproductive Technology: A Meta-Analysis of Controlled Trials

This systematic review and meta-analysis aimed to evaluate the effectiveness of relaxation interventions on anxiety, depression, stress, and quality of life in women with infertility. A comprehensive search of PubMed, OVID MEDLINE, CINAHL(R), Google Scholar, and Korean databases was conducted for articles published through March 2025. Keywords included combinations of terms related to infertility, ART, and nursing or psychotherapeutic interventions. The search identified 759 records, of which 13 met the eligibility criteria. Methodological quality was assessed using the Cochrane Risk of Bias tool, and data analysis was performed using R software (version 4.3.2). The meta-analysis included 10 randomized controlled trials (RCTs) and three non-randomized controlled trials (NRCTs), comprising 1,215 women undergoing ART. Intervention groups received relaxation programs, while comparison groups received usual care or no intervention. Relaxation interventions were associated with significant reductions in anxiety (Hedges g = -0.69) and depression (Hedges g = -0.38), and significant improvements in quality of life (Hedges g = 0.25). No statistically significant effect was observed for stress (Hedges g = -0.01; 95% CI: -0.49 to 0.47). Heterogeneity and risk of publication bias were determined to be low. Overall, relaxation programs demonstrated beneficial effects on anxiety, depression, and quality of life, but not on stress levels. Relaxation interventions appear to support the psychological well-being of women undergoing ART, with particular benefit for women with a history of repeated treatment failure. Individualized, woman-centered approaches may be more responsive to the needs of this population than universal or group-based models of care.