Previously submitted to: Journal of Medical Internet Research (no longer under consideration since Jul 28, 2026)
Date Submitted: Feb 20, 2026
Open Peer Review Period: Feb 21, 2026 - Apr 18, 2026
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Patient-Centeredness and Effectiveness of eHealth Interventions for Infertility Patients: A Systematic Review and Meta-analysis of Randomized Controlled Trials
ABSTRACT
Background:
Individuals with infertility often experience substantial psychosocial distress. eHealth technologies have emerged as tools for delivering patient-centered care by addressing patients’ psychosocial needs. However, no systematic review has evaluated the overall impact of eHealth interventions on patient-reported outcomes and experiences among infertility patients.
Objective:
This study aimed to (1) examine the patient-centered care components incorporated in existing eHealth interventions for infertility care and (2) synthesize the most recent evidence regarding the effects of eHealth interventions on patient-reported outcomes and patient-reported experiences among infertility patients.
Methods:
A systematic review and meta-analysis were conducted by searching seven electronic databases: MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, PsycInfo, and KoreaMed. The final search was performed in August 2025. Eligible studies were randomized controlled trials that assessed the impact of eHealth interventions on infertility patients, measured patient-reported outcomes and/or patient-reported experiences, and were published in English or Korean. Patient-centered care components were identified using a conceptual framework. Risk of bias was evaluated using the Cochrane risk-of-bias tool for randomized trials (RoB 2). Using a random-effects model, meta-analyses were conducted and reported as Hedges’ g with 95% confidence intervals (CIs). Subgroup analyses were performed to explore potential sources of heterogeneity. Assessments were conducted for publication bias, sensitivity analyses, and the certainty of evidence.
Results:
Twenty-five studies published between 2001 and 2025 were included. eHealth technologies included internet-based websites, mobile applications, real-time interactive platforms, self-monitoring devices, virtual reality devices, videos, and telephones. The most common patient-centered care components were emotional support and quality improvement to enhance access to care. eHealth interventions had statistically significant effects on infertility patients’ patient-reported outcomes at post-intervention (g = 0.428, 95% confidence interval [CI]: 0.179–0.676, k = 18, n = 2,202) and at follow-up (g = 0.824, 95% CI: 0.024–1.623, k = 5, n = 448), with low certainty of evidence. However, no statistically significant effect was observed for patient-reported experiences (g = 0.094, 95% CI: −0.097 to 0.284, k = 9, n = 890). Subgroup analyses indicated that post-intervention patient-reported outcomes differed by outcome type, gender, and intervention type.
Conclusions:
eHealth interventions may support patient-centered infertility care by improving patient-reported outcomes. To date, eHealth interventions have addressed patients’ psychological needs and reduced the need for frequent clinic visits. To advance patient-centered infertility care, future studies should develop gender-specific eHealth interventions tailored to men with infertility or couples. Clinical Trial: PROSPERO (CRD42021290277)
Citation
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