Relationship Between Sleep Disturbances and In Vitro Fertilization Outcomes in Infertile Women: A Systematic Review and Meta-Analysis.

BACKGROUND

In vitro fertilization (IVF) has been acknowledged as the primary assisted reproductive technique for fertilizing oocytes outside the female reproductive system. Sleep disorders are likely to affect infertility and its treatment. The present study was to investigate the relationship between sleep disturbances and IVF outcomes in infertile women.

METHODS

Databases, including PubMed, Embase, Cochrane Library, ProQuest, and Web of Science, were searched for the relevant articles published up to September 2023. The Newcastle-Ottawa Scale was used to assess the methodological quality of the included studies. Moreover, the random and fixed effects models using the STATA (v.11) software program presented the odds ratio with a 95% confidence interval (CI). Ultimately, a funnel plot was recruited to examine the sensitivity analysis.

RESULTS

During the initial search, 426 articles were retrieved, and ultimately, nine studies remained for systematic review, and among them, four studies entered into the meta-analysis (two cohort and two cross-sectional studies). According to the fixed effects model of the cross-sectional studies, the association between sleep quality and pregnancy rate was not confirmed (OR = 0.94; 95% CI = 0.81-1.07). Regarding the fixed effects model of included cohort studies, the results indicated an association between sleep quality and the pregnancy rate (OR = 1.08; 95% CI = 1.03-1.14). According to the random effects model of the cross-sectional studies, there was no significant association between sleep quality and pregnancy rate (OR = 0.82; 95% CI = 0.37-1.26). Regarding the random effect analysis of included cohort studies, the results indicated an association between sleep quality and the pregnancy rate (OR = 1.08; 95% CI = 1.03-1.14). Based on the total fixed effect analysis of the cross-sectional and cohort studies, the results also showed a significant association between sleep quality and pregnancy rate among infertile women (OR = 1.06; 95% CI = 1.01-1.11). In contrast, according to the random effect of the total studies, this association was not confirmed (OR = 1.02; 95% CI = 0.90-1.14).

CONCLUSION

Although the meta-analysis of the cohort studies showed a significant association between sleep quality and IVF outcomes, such as pregnancy rate, due to the novelty of the subject, more studies have not been published, and this study is considered a preliminary meta-analysis. Therefore, more studies with a strong methodology need to assess the relationship between sleep disorders and IVF outcomes.