Higher levels of stress and worse mental health have in turn been shown to be associated with lower odds of pregnancy in general and specifically within the context of assisted fertility, suggesting that this could potentially translate into a vicious cycle for infertile couples who have experienced multiple unsuccessful cycles. This can be exacerbated by disturbances to an individual’s work and routine and the financial pressure of this costly treatment, and may be worse after multiple failed cycles. The IVF process–which includes injectable medication and multiple blood tests, clinic appointments and procedures, waiting periods and anticipation of outcomes at each phase-may lead to further psychological stress. Infertility itself has been associated with a higher prevalence of depression and anxiety, lower quality of life, and lower self-esteem. Yet it is also a relatively invasive and disruptive process that can be both physically and psychologically demanding. More than a half million babies are now born each year from IVF, as a result of over two million estimated annual treatment cycles. The efficacy of IVF among the assisted fertility options has led an increasing number of individuals to seek this specific treatment. This could be further boosted by numbers in resource-limited settings of the developing world, where an estimated 180 million couples are experiencing infertility. The demand for assisted reproduction techniques such as in-vitro fertilization (IVF) has increased in developed countries over the past decades, and is predicted to increase further in those to come. Individuals experiencing infertility represent around 8–10% of couples worldwide. Infertility and its treatment represent a global health area of increasing importance. Should the number, quality and characteristics of eligible studies not allow for reliable quantitative synthesis, the authors will limit the analysis to qualitative synthesis, with a focus on implications of findings for future research and programming. Should three or more moderate or good quality studies be identified for any one outcome of interest, correlation meta-analyses, using the Hedges-Olkin method, will be conducted to pool effect sizes and heterogeneity will be assessed.
To assess methodological quality, the authors will use a modified version of the Newcastle-Ottawa Scale.
Ten health-, psychology- and sociology-related databases will be searched using composite search terms that include keywords for ‘IVF’ and ‘social support’. The protocol for this systematic review was developed according to the PRISMA-P guidelines. Social support may derive from both naturally occurring networks and more formalized sources or interventions.
Studies will be included if they work with human subjects, provide correlation coefficients between measures of social support and at least one of the outcomes of interest, and are in the English language. We present a protocol for a systematic review of peer-reviewed published studies quantitatively investigating associations between social support and i) mental health ii) the decision to (dis)continue with IVF treatment cycles and iii) IVF success (pregnancy and birth rates) among individuals who are undertaking or have undertaken IVF cycles. Social support has been found to have positive health effects among populations facing health-related stressors worldwide, and its potential protective role for IVF patients merits further attention. However, the physical and psychological burden of IVF can negatively impact psychological wellbeing, as well as treatment retention and success. Infertility and its treatment via in-vitro fertilization (IVF) represent a global health area of increasing importance.