The potential of mobile health applications to improve couples' fertility: a systematic review and meta-analysis of randomized controlled trials

The purpose of this systematic review was to examine the safety and effectiveness of mobile health applications in couples with infertility. Nineteen databases were searched from their inception to August 2022. Only randomized controlled trials (RCTs) in which mobile health was used as an intervention in infertile couples were included. A quantitative analysis of RCTs was employed using RevMan software. Study selection, data extraction and validation were performed by two independent reviewers according to the guidelines. The Cochrane criteria for risk-of-bias were used to evaluate the methodological quality of the trials. Eight RCTs met the inclusion criteria. Among the eight RCTs, two RCTs were from the Netherlands and the remaining six RCTs were from China. Meta-analysis showed that mobile health interventions in infertile couples in China were found to be superior to usual care in terms of clinical pregnancy rate (p = 0.001), psychological status (SAS (Self-Rating Anxiety Scale): p < 0.001; SDS (SelfRating Depression Scale) p < 0.001;), infertility knowledge levels (p < 0.001), quality of life (p < 0.001), and serum levels of 5-hydroxytryptamine (p < 0.001). The effects on intervention groups using mobile health interventions in the Netherlands were not superior to the control groups that used usual care in terms of improving dietary factors (p > 0.05). In general, the positive effect of mobile health on improving clinical pregnancy rate, psychological status, infertility knowledge levels, quality of life and satisfaction with information was better than that of usual care. Mobile health interventions could be a viable supplement to the usual care for infertile couples. However, more high-quality RCTs need to be included in the future to provide additional evidence of the positive effects of mobile health in infertile couples.