Effect of reduced needle versus standard needle on pain experience during oocyte retrieval procedure: a systematic review and meta-analysis of randomized controlled trials.

OBJECTIVE: The aim of this study was to compare reduced needle versus standard needle regarding pain experience among women undergoing oocyte retrieval procedures. METHODS: A systematic search was done in Cochrane Library, PubMed, ISI web of science, and Scopus during April 2021. We selected randomized clinical trials (RCTs) compared reduced needle versus standard needle among women undergoing ultrasound-guided oocyte retrieval procedures. Revman software was utilized for performing our meta-analysis. Our primary outcomes were pain scores evaluated by the Visual Analog Scale (VAS) during the procedure, directly post-procedure, and 30 min post-procedure. Our secondary outcomes were the request for more analgesia, clinical pregnancy rate, and rate of vaginal bleeding less than expected. RESULTS: Six RCTs met our inclusion criteria with a total number of 1063 patients. We found reduced needle was linked to a significant reduction in VAS pain score during and directly after the procedure, respectively (MD= -1.54, 95% CI [-2.38, -0.70], p = .003 and MD= -1.14, 95% CI [-1.38, -0.91], p < .001). After removal of the reported heterogeneity, the reduced needle had significantly reduced the pain score 30 min post-procedure and request for more analgesia in comparison with standard needle (p < .001). No significant difference was found between both groups regarding clinical pregnancy rate (p = .17). More patients in reduced needle group were reported to vaginally bleed less than expected compared to standard needle group (RR = 1.91, 95% CI [1.35, 2.70], p = .003). CONCLUSIONS: Patient perceived pain, analgesic requirement, and vaginal bleeding are decreased with reduced needle administration versus standard needle without affecting the clinical pregnancy rate in oocyte retrieval procedure.

The impact of music therapy on anxiety and pregnancy rate among infertile women undergoing assisted reproductive technologies: a systematic review and meta-analysis.

Objective: We aimed to perform a systematic review and meta-analysis to evaluate the effect of music therapy on anxiety and pregnancy rates among infertile women undergoing to perform assisted reproductive technologies (ART).Methods: Cochrane Library, PubMed, ISI web of science, and Scopus were searched from inception to May 2021. We included randomized controlled trials (RCTs) that compared music therapy (intervention group) to no music intervention (control group). Our primary outcomes were anxiety score using the State-Trait Anxiety Inventory (STAI) tool and pain score utilizing the Visual Analog Scale (VAS). Our secondary outcomes were the overall satisfaction score and clinical pregnancy rate. We extracted the available data from included studies and pooled them in a meta-analysis model using RevMan software. The overall quality of evidence was assessed through GRADEpro GDT software.Results: Seven RCTs with a total number of 793 patients were included in our study. Music therapy significantly reduced the anxiety score compared to control group (MD= -3.09, 95% CI [-5.57, -0.61], p = 0.01). Moreover, pain score was significantly improved after music treatment (MD= -2.93, 95% CI [-3.86, -2.00], p > 0.001). A significant improvement in the overall satisfaction score was found among music therapy group (MD= 1.51, 95% CI [0.40, 2.61], p = 0.008). Although more women in music therapy group experienced an increase in the clinical pregnancy rate in comparison with control group, the result was not statistically significant (RR= 1.08, 95% CI [0.94, 1.26], p = 0.28). The GRADEpro GDT tool showed a moderate quality of evidence for the evaluated outcomes.Conclusions: There is evidence of moderate quality that music therapy improves anxiety, pain, and satisfaction scores among infertile women undergoing ART. Moreover, it increases the clinical pregnancy rate but without statistical significance. More trials with a larger sample size are needed to investigate the influence of music therapy on the clinical outcomes of ART.