Mindfulness-Based Program for Infertility: efficacy study. A prospective study of stress among women undergoing in vitro fertilization or gamete intrafallopian transfer. The impact of group psychological interventions on distress in infertile women. Experimental emotional disclosure in women undergoing infertility treatment: Are drop outs better off? Impact of hypnosis during embryo transfer on the outcome of in vitro fertilization-embryo transfer: a case-control study. Effect of cognitive behavioral therapy in mental health and hardiness of infertile women receiving assisted reproductive therapy (ART) Results from a prospective, randomized, controlled study evaluating the acceptability and effects of routine pre-IVF counselling. Interpersonal psychotherapy versus brief supportive therapy for depressed infertile women: first pilot randomized controlled trial Impact of group psychological interventions on pregnancy rates in infertile women. Is psychotherapy a reliable alternative to pharmacotherapy to promote the mental health of infertile women? A randomized clinical trial. Hypnosis versus Diazepam for Embryo Transfer: A Randomized Controlled Study Impact of a group mind/body intervention on pregnancy rates in IVF patients. Psychotherapeutic intervention for treatment of couples with secondary infertility. A feasibility study of a brief coping intervention (PRCI) for the waiting period before a pregnancy test during fertility treatment. Communication and coping as predictors of fertility problem stress: cohort study of 816 participants who did not achieve a delivery after 12 months of fertility treatment. Changes with age in the level and duration of fertility in the menstrual cycle. Looking Out for The Secret Wound: The Effect of E-Cognitive Group Therapy with Emotional Disclosure on The Status of Mental Health in Infertile Women Online psychoeducational support for infertile women: a randomized controlled trial. Effectiveness of psychosocial group intervention for reducing anxiety in women undergoing in vitro fertilization: a randomized controlled study. Psychological factors in the aetiology of infertility: a prospective cohort study. Effectiveness of a psychosocial counselling intervention for first-time IVF couples: a randomized controlled trial. The effect of an expressive writing intervention (EWI) on stress in infertile couples undergoing assisted reproductive technology (ART) treatment: a randomized controlled pilot study. Effect of psychiatric group intervention on natural-killer cell activity and pregnancy rate. Effect of counseling on quality of marital relationship of infertile couples: a randomized, controlled trial (RCT) study Stress and outcome success in IVF: the role of self-reports and endocrine variables. A Prospective Study of the Effectiveness of Brief Professionally-Led Support Groups for Infertility Patients Poor oocyte quality rather than implantation failure as a cause of age-related decline in female fertility The performance of tests of publication bias and other sample size effects in systematic reviews of diagnostic test accuracy was assessed. Web-based treatment for infertility-related psychological distress Effects of a psychological intervention on depression in infertile couples. Investigation into effectiveness of counseling on assisted reproductive techniques in Turkey Efficacy of Emotion-Focused and Problem-Focused Group Therapies for Women with Fertility Problems A pilot study assessing art therapy as a mental health intervention for subfertile women. Internet-based support for infertile patients: a randomized controlled study Empowering patients undergoing in vitro fertilization by providing Internet access to medical data. Effects of using a nursing crisis intervention program on psychosocial responses and coping strategies of infertile women during in vitro fertilization. Cognitive-Behavioral Therapy for Idiopathic Infertile Couples Supporting stress management for women undergoing the early stages of fertility treatment: a cluster-randomized controlled trial. Incorporating spirituality in psychosocial group intervention for women undergoing in vitro fertilization: a prospective randomized controlled study.
OBJECTIVE To present and determine the impact of the Mindfulness-Based Program for Infertility ( MBPI ) . DESIGN Controlled clinical trial . SETTING University research unit . PATIENT(S ) Fifty-five infertile women completed the MBPI , and 37 infertile women were assigned to a control group . INTERVENTION(S ) The MBPI includes 10 weekly sessions , in a group format , with a duration of about 2 hours each ( men attend three sessions ) . MAIN OUTCOME MEASURE(S ) St and ardized measures of depression , state anxiety , entrapment , defeat , internal and external shame , experiential avoidance , mindfulness , self-compassion , and infertility self-efficacy were endorsed pre- and post-MBPI . RESULT ( S ) The MBPI group and the control group were shown to be equivalent at baseline . By the end of the MBPI , women who attended the program revealed a significant decrease in depressive symptoms , internal and external shame , entrapment , and defeat . Inversely , they presented statistically significant improvement in mindfulness skills and self-efficacy to deal with infertility . Women in the control group did not present significant changes in any of the psychological measures , except for a decrease in self-judgment . CONCLUSION ( S ) Increasing mindfulness and acceptance skills , as well as cognitive decentering from thoughts and feelings , seem to help women to experience negative inner states in new ways , decreasing their entanglement with them and thus their psychological distress . Data suggest that the MBPI is an effective psychological intervention for women experiencing infertility OBJECTIVE To evaluate whether baseline or procedural stress during  in vitro fertilization ( IVF ) or gamete intrafallopian transfer ( GIFT )  affects pregnancy or live birth delivery rates . DESIGN Prospect i ve study . SETTING Seven clinics in Southern California between 1993 and 1998 . PATIENT(S ) One hundred and fifty-one women completed two question naires . INTERVENTION(S ) None . MAIN OUTCOME MEASURE(S ) The number of oocytes aspirated and fertilized , the number of embryos transferred , the achievement of a pregnancy , live birth delivery , and infant outcomes . RESULT ( S ) Positive-affect negative-affect score at baseline negatively influenced the number of oocytes retrieved and embryos transferred . A higher expectation of pregnancy was associated with greater numbers of oocytes fertilized and embryos transferred . At baseline , the risk of no live birth was 93 % lower for women who had the highest positive-affect score compared to those with the lowest score . Furthermore , the score on the Infertility Reaction Scale was related to negative outcomes in live birth delivery , infant birth weight , and multiple births . During the time of the procedure , the PANAS and Bipolar Profile of Moods States results were related to the number of oocytes fertilized and embryos transferred ; stress did not affect pregnancy or delivery . CONCLUSION ( S ) Baseline ( acute and chronic ) stress affected biologic end points ( i.e. , number of oocytes retrieved and fertilized ) , as well as pregnancy , live birth delivery , birth weight , and multiple gestations , whereas ( procedural ) stress only influenced biologic end points Infertile women express higher levels of distress than fertile women , with distress peaking between the 2nd and 3rd year . The purpose of this study was to determine whether group psychological interventions could prevent this surge . One hundred eighty-four women who had been trying to conceive between 1 and 2 years were r and omized into either a cognitive-behavioral group , a support group , or a control group . All experimental participants attended a 10-session group program . Participants completed psychological question naires at intake and again at 6 and 12 months . Substantial attrition occurred , particularly in the control group . The cognitive-behavioral and support participants experienced significant psychological improvement at 6 and 12 months compared with the control participants , with the cognitive-behavioral participants experiencing the greatest positive change So far , the beneficial effects of personal written emotional disclosure have been mainly examined in relation to past or current stressful/traumatic experiences . The anticipation of a medical event has rarely been studied within this paradigm . This r and omized-controlled study examined whether written emotional disclosure would reduce emotional distress and increase pregnancy rates in women undergoing in-vitro fertilization treatment . Participants recruited from women who were undergoing IVF in the north of Greece ( n=148 ) were r and omized to an emotional-writing condition , a fact-writing condition and a control condition . Outcomes included fertility-related distress , general distress and a positive indication of pregnancy . Psychological and medical information about women who refused to participate were also collected , and this represented a fourth group for analysis ( n=66 ) . Results indicated no significant difference between groups in terms of emotional distress . However , a significant difference was observed with regard to pregnancy results , with the non- participants group reporting the highest percentage of pregnancies . The present study did not support the hypotheses that emotional disclosure will reduce infertility-related or general psychological distress and improve pregnancy outcomes in women undergoing in-vitro fertilization treatment . However , women who refused to participate in the study were more likely to get pregnant . Differences in the beneficial effects of emotional disclosure are discussed OBJECTIVE To investigate whether hypnosis during ET contributes to successful IVF/ET outcome . DESIGN Case-control clinical study . SETTING Academic Fertility and IVF Unit , Soroka Medical Center , Beer-Sheva , Israel . PATIENT(S ) Infertile couples undergoing IVF . INTERVENTION(S ) Ninety-eight IVF/ET cycles with hypnosis during the ET procedure were matched with 96 regular IVF/ET cycles . MAIN OUTCOME MEASURES Comparison of clinical pregnancy and implantation rates between the two groups . RESULT ( S ) We obtained 52 clinical pregnancies out of 98 cycles ( 53.1 % ) with an implantation rate of 28 % among hypnosis IVF/ET cycles , and 29 out of 96 ( 30.2 % ) clinical pregnancies and an implantation rate of 14.4 % in the control cycles . Our overall IVF program pregnancy rate for the same period was 32.1 % . Logistic regression analysis was performed emphasizing the positive contribution of hypnosis to the IVF/ET conception rates . CONCLUSION ( S ) This study suggests that the use of hypnosis during ET may significantly improve the IVF/ET cycle outcome in terms of increased implantation and clinical pregnancy rates . Furthermore , it seems that the patients ' attitude to the treatment was more favorable Background : Infertility is a stressful event that can give rise to psychological difficulties . Now , a wide range of psychosocial interventions for infertile couples has been developed . Objective : Purpose of this study was to determine the effect of group cognitive behavioral therapy ( CBT ) to reduce stress , anxiety and depression of women undergoing assisted reproductive therapy ( ART ) . Material s and Methods : This study was an experimental study ( before and after study with control group ) on infertile women who were referring to Gynecological clinics of Jahrom University of Medical Sciences to receive ART . 31 women who had criteria to enter the study were r and omly divided into experimental group ( n=15 ) and control group ( n=16 ) . The participants in the experimental group received 1 hour and 30 minute weekly session ’s group therapy in 15 week as intervention . For gathering data , depression , anxiety and stress scale ( DASS ) normalized Persian version and Ahvaz Hardiness Test ( AHT ) were used to assess psychological distress and psychological hardiness in pre-posttest . Results : There were significant differences in mean score of infertile psychological distress , anxiety , depression , and stress in experimental group pretest with posttest . Furthermore , the results indicated that there were significant differences between hardiness in two groups . The experimental group had higher scores in hardiness than control group ( p=0.001 ) . Conclusion : It seems to be , that group therapy interventions , specially , cognitive behavioral therapy ( CBT ) can be useful and applicable to women who receiving ART BACKGROUND The aim of this study was to evaluate a model of routine pre-IVF counselling  focusing on the narrative capacities of couples . The acceptability of counselling , the effects on emotional factors and the participants ' assessment s were considered . METHODS The study included 141 consecutive childless couples preparing for their first IVF .  R and omization was carried out through sealed envelopes attributing participants to counselled and non-counselled groups and was accepted by 100 couples . Another 12 couples refused r and omization because they wanted counselling and 29 because they did not . Question naires including the State-Trait Anxiety Inventory , the Beck Depression Inventory and assessment s of help  were mailed to couples before IVF and counselling , and after the IVF outcome . RESULTS Counselling was accepted by 79 % ( 112/141 ) of couples . There was no significant effect of counselling on anxiety and depression scores which were within normal ranges at both times . Counselling provided help for 86 % ( 75/87 ) of initially non-dem and ing subjects and 96 % ( 25/26 ) of those initially requesting a session . Help was noted in areas of psychological assistance , technical explanations and discussing relationships . CONCLUSIONS This model of routine counselling centred on the narrative provides an acceptable form of psychological assistance for pre-IVF couples Infertility is strongly associated with depression , yet treatment research for depressed infertile women is sparse . This study tested for the first time the feasibility and preliminary efficacy of interpersonal psychotherapy ( IPT ) , the evidence -based antidepressant intervention with the greatest peripartum research support , as treatment for depressed women facing fertility problems . Patients who met DSM-IV criteria for major depressive disorder of at least moderate severity were r and omized to either 12 sessions of IPT  ( n = 15 ) or brief supportive psychotherapy ( BSP ; n = 16 ) , our control intervention . Eighty percent of IPT and 63 % of BSP patients completed the 12 sessions of therapy . Patients in both treatments improved .  IPT produced a greater response rate than BSP , with more than two-thirds of women achieving a > 50 % reduction in scores on the Montgomery – Åsberg Depression Rating Scale ( MADRS ) .  IPT also tended to have lower posttreatment scores on the Beck Depression Inventory , Clinical Global Impression-Severity Scale , and anxiety subscale of the Hamilton Depression Rating Scale , with between-group effect sizes ranging from 0.61 to 0.76 . Gains persisted at 6-month follow-up . This pilot trial suggests that IPT is a promising treatment for depression in the context of infertility and that it may fare better than a rigorous active control condition . Should subsequent r and omized controlled trials support these findings , this will inform clinical practice and take an important step in assuring optimal care for depressed women struggling with infertility OBJECTIVE To determine the efficacy of two different group psychological interventions on viable pregnancy rates in women experiencing infertility of less than 2 years ' duration . DESIGN Prospect i ve , controlled , single-blind , r and omized study . SETTING Large tertiary-care teaching hospital . PATIENT(S ) One hundred eighty-four women who had been trying to get pregnant for 1 to 2 years . INTERVENTION(S ) Participants were r and omized into a 10-session cognitive-behavioral group , a st and ard support group , or a routine care control group . They were followed for 1 year . MAIN OUTCOME MEASURE(S ) Viable pregnancy . RESULT ( S ) Sixty-four [ corrected ] women discontinued participation in the study within the first year . There were a total of 47 in the cognitive-behavioral group , 48 in the support group , and 25 in the control group . There were statistically significant differences between participants in the two intervention groups versus the control group . CONCLUSION ( S ) Group psychological interventions appear to lead to increased pregnancy rates in infertile women OBJECTIVE Women with fertility problems experience a higher prevalence of negative emotions than women without fertility problems . The goal of this study was to compare the effects of psychological intervention with psychotropic medication on the mental health improvement of depressed infertile women . STUDY DESIGN In a r and omized controlled clinical trial , 89 depressed infertile women that they were recruited and divided into three groups in three groups : cognitive behavior therapy ( CBT ) , antidepressant therapy , and a control group . Twenty-nine participants in the CBT method received 10 sessions on relaxation training , restructuring , and eliminating negative automatic thoughts and dysfunctional attitudes to infertility . Thirty participants in the pharmacotherapic group took 20 mg fluoxetine daily for 90 days . Thirty control subjects did not receive any intervention . All participants completed the Beck Depression Inventory ( BDI ) and the General Health Question naire ( GHQ ) at the beginning and end of the study . Paired t-test , ANOVA , chi(2 ) , and McNemar tests were used to analyze the data . RESULTS Fluoxetine significantly reduced the mean of three subscale scores of the GHQ anxiety ( 7.3+/-4.1 vs. 5.1+/-3.2 ) , social function ( 7+/-2.8 vs. 4.3+/-2 ) , and depression ( 7.8+/-5.2 vs. 4.4+/-2.2 ) but could not significantly change the mean score of psychosomatic signs . The CBT method effectively reduced the mean of all four GHQ subscales : anxiety ( 8+/-4 vs. 3.2+/-2 ) , social function ( 7.2+/-2.6 vs. 4.7+/-2.5 ) , depression ( 7.7+/-4.2 vs. 3.6+/-2.7 ) , and psychosomatic signs ( 7.5+/-3.2 vs. 5.5+/-3.2 ) . Also , both methods significantly reduced the total GHQ scores . Successful treatment of depression in three groups was fluoxetine group 50 % , CBT 79.3 % , and control 10 % . The mean Beck scores among the groups at the beginning and end of study were , respectively : fluoxetine 23.2+/-8.6 versus 14.3+/-8.5 ( p<0.001 ) , CBT 20+/-7.9 versus 7.7+/-4.8 ( p<0.001 ) , and control 19.8+/-8.5 versus 19.7+/-8.4 ( p=0.9 ) . Although both fluoxetine and CBT significantly decreased the mean BDI scores more than the control group , the decrease in the CBT group was significantly greater than the fluoxetine group . CONCLUSION Psychotherapy , such as group CBT , was superior to or at least as effective as pharmacotherapy to promote the well being of depressed infertile women Levitas et al. ( 2006 ) showed in a cohort study that hypnosis during embryo transfer ( ET ) increased pregnancy ratio by 76 % . In order to evaluate hypnosis during ET in a general population , the authors performed a r and omized prospect i ve controlled study comparing diazepam ( usual premedication ) administered before ET plus muscle relaxation versus hypnosis plus placebo in 94 patients . Additionally , the authors studied anxiety pre and post ET . Anxiety scores were not different in the two groups before and after ET . No difference in pregnancy and birth ratio was found in the two groups . Hypnosis during ET is as effective as diazepam in terms of pregnancy ratio and anxiolytic effects , but with fewer side effects and should be routinely available . Thanks to Miss C. Desmond and Dr. G. Gormezano for their valuable help OBJECTIVE To determine if women who were r and omized to a mind/body program before starting their first IVF cycle would have higher pregnancy rates than control subjects . DESIGN R and omized , controlled , prospect i ve study . SETTING Private academically affiliated infertility center . PATIENT(S ) A total of 143 women aged≤40 years who were about to begin their first IVF cycle . INTERVENTION(S ) Subjects were r and omized to a ten-session mind/body program ( MB ) or a control group  and followed for two IVF cycles . MAIN OUTCOME MEASURE(S ) Clinical pregnancy rate . RESULT ( S ) Only 9 % of the MB participants had attended at least one-half of their sessions at cycle 1 start . Pregnancy rates for cycle 1 were 43 % for all subjects ; 76 % of the MB subjects had attended at least one-half of their sessions at cycle 2 start . Pregnancy rates for cycle 2 were 52 % for MB and 20 % for control . CONCLUSION ( S ) MB participation was associated with increased pregnancy rates for cycle 2 , prior to which most subjects had attended at least half of their sessions Twenty couples with a history of secondary infertility and no detectable organic etiology were r and omly assigned to one of two groups . One group was seen by a psychotherapist for an interview , the object of which was to detect and discuss previously unrecognized psychosexual problems or psychologic conflicts . The second group was not seen by the psychotherapist . Interviews included the presence of both members of the couple and the infertility specialist . The psychiatric interview did uncover psychologic conflicts , the most prevalent of which was a problem between the woman and her mother in which psychologic boundaries between the two women were confused . Sexual problems , marital discord , and fear of pregnancy were other issues warranting clarification and attention . After 18 months of follow-up , six of the ten women in couples interviewed had become pregnant , and one woman of nine in the control group had become pregnant BACKGROUND Waiting for a pregnancy test during fertility treatment can be particularly stressful because distress and intrusive cognitions about the nature and implication s of the result can reduce quality of life . The aim of this feasibility study was to establish whether a novel brief coping intervention ( positive re appraisal coping intervention , PRCI ) card that encouraged women waiting for an IVF pregnancy test to redefine the waiting period more positively would be acceptable and practical in this context . METHODS Women ( n = 55 ) were r and omly assigned on the day of embryo transfer . Women read either 10 statements in a PRCI ( n = 28 ) or 10 statements in a positive self-affirmative ( positive mood ) intervention ( PMI ; n = 27 ) twice daily for 14 days between embryo transfer ( T1 ) and the pregnancy test ( T2 ) . At T2 , we evaluated the practicality , acceptability , perceived benefits and endorsements of these cards . RESULTS Compared with the PMI , the PRCI was rated as more helpful and suitable for the situation , helping women to feel more positive and better helping to sustain efforts to cope . There were no differences relating to the practicality of the intervention method . CONCLUSIONS PRCI was feasible in the IVF context and was perceived as an acceptable intervention to help minimize the strain of waiting for pregnancy test results during fertility treatment . Future research needs to evaluate the full benefits of PRCI against routine care during the waiting period BACKGROUND We investigated coping strategies and communication strategies as predictors of fertility problem stress  12 months after start of fertility treatment . METHODS We used a prospect i ve , longitudinal cohort design including 2250 people beginning fertility treatment with a 12-month follow-up . Data were based on self-administered question naires measuring communication with partner and with other people , coping strategies : active-avoidance coping , active-confronting coping , passive-avoidance coping , meaning-based coping , and fertility problem stress . The study population included those participants ( n = 816 , men and women ) who had not achieved pregnancy by assisted reproduction or delivery at follow-up . RESULTS Among both men and women , difficulties in partner communication predicted high fertility problem stress ( odds ratio for women , 3.47 , 95 % confidence interval 2.09 - 5.76 ; odds ratio for men , 3.69 , 95 % confidence interval 2.09 - 6.43 ) . Active-avoidance coping ( e.g. avoiding being with pregnant women or children , turning to work to take their mind off things ) was a significant predictor of high fertility problem stress . Among men , high use of active-confronting coping ( e.g. letting feelings out , asking other people for advice , seeking social support ) predicted low fertility problem stress in the marital domain ( odds ratio 0.53 , 95 % confidence interval 0.28 - 1.00 ) . Among women , medium or high use of meaning-based coping significantly predicted low fertility problem stress in the personal and marital domain . CONCLUSION The study provides information about where to intervene with fertility patients in order to reduce their stress after medically unsuccessful treatment BACKGROUND Most analyses of age-related changes in fertility can not separate effects due to reduced frequency of sexual intercourse from effects directly related to ageing . Information on intercourse collected daily through each menstrual cycle provides the data for estimating day-specific probabilities of pregnancy for specific days relative to ovulation , and these estimates allow unconfounded analysis of ageing effects . METHODS A total of 782 healthy couples using natural family planning methods contributed prospect i ve data on 5860 menstrual cycles . Day of ovulation was based on basal body temperature measurements . Estimates of day-specific probabilities of pregnancy and the length of the fertile window were compared across age groups . RESULTS Nearly all pregnancies occurred within a 6 day fertile window . There was no evidence for a shorter fertile window in older men or women . On average , the day-specific probabilities of pregnancy declined with age for women from the late 20s onward , with probabilities of pregnancy twice as high for women aged 19 - 26 years compared with women aged 35 - 39 years . Controlling for age of the woman , fertility was significantly reduced for men aged > 35 years . CONCLUSIONS Women 's  fertility begins to decline in the late 20s with substantial decreases by the late 30s . Fertility for men is less affected by age , but shows significant decline by the late 30s Background : Considering the high prevalence of psychiatric disorders among infertile women , it seems that gynecologists , psychiatrists , and psychologists should be more attentive to identify and treat these disorders . The aim of this study is to determine the effect of E-cognitive group therapy with emotional disclosure on mentwal health status of infertile women who are receiving assisted reproduction . Material s and Methods : In this r and omized clinical trial study , 80 infertile women who were receiving hormonal therapy or other assisted reproductive technologies ( ART )  were r and omly allocated to the cognitive-behavioral treatment ( CBT ) group or the control group . The CBT group had a weekly 12-hour meeting for a period of three months . They also participated in some painting sessions ( art therapy ) and written and verbal emotional disclosure ( both individually and in group presentation ) . The Depression , Anxiety , Stress Scales ( DASS ) test and Penn State Worry Question naire ( PSWQ ) were used for data gathering . Results : Results showed the level of psychological distress decreased in the control group , but not significantly . Psychological intervention in the treatment group significantly lowered the level of psychological distress ; the mean score of DASS in all aspects was significant . The difference between the mean score of the two groups after intervention was significant ( p=0.001 ) and also according to ANCOVA ( p=0.002 ) . Differences were significant between the mean scores of both groups in the PSWQ ( p=0.001 ) , Inventory Test ( p=0.001 ) , which was confirmed by ANCOVA ( p=0.009 ) . Conclusion : These finding suggest that CBT with emotional self-disclosure promotes coping strategies among infertile women . Results also show that these approaches develop mental health and decrease stress in infertile women . Using a psychiatric approach in medical setting s could help infertile women to promote their adjustment with mental health problems due to of in infertility . ( Registration Number : I RCT 201108247407N2 ) BACKGROUND The study goal was to develop and test the effectiveness of a brief online education and support program for female infertility patients . METHODS A r and omized-controlled trial was conducted . Using a Solomon-four group design , 190 female patients were recruited from three US fertility centers and were r and omized into two experimental and two no-treatment control groups . The psychological outcomes assessed included infertility distress , infertility self-efficacy , decisional conflict , marital cohesion and coping style . Program dosage and satisfaction were also assessed at four weeks follow-up . RESULTS Women exposed to the online program significantly improved in the area of social concerns ( P = 0.038 ) related to infertility distress , and felt more informed about a medical decision with which they were contending ( P = 0.037 ) . Trends were observed for decreased global stress(P = 0.10 ) , sexual concerns ( P = 0.059 ) , distress related to child-free living ( P = 0.063 ) , increased infertility self-efficacy ( P = 0.067 ) and decision making clarity ( P = 0.079 ) . A dosage response was observed in the experimental groups for women who spent > 60 min online for decreased global stress ( P = 0.028 ) and increased self efficacy ( P = 0.024 ) . CONCLUSIONS This evidence -based eHealth program for women experiencing infertility suggests that a web-based patient education intervention can have beneficial effects in several psychological domains and may be a cost effective re source for fertility practice OBJECTIVE To evaluate the effect of the Eastern Body-Mind-Spirit ( EBMS ) group intervention on anxiety-reduction of Chinese women undergoing IVF . DESIGN R and omized controlled study . SETTING Tertiary assisted reproduction unit . PARTICIPANT(S ) Two hundred twenty-seven women undergoing their first cycle of IVF treatment . INTERVENTION(S ) The intervention group ( n = 69 ) received four sessions of EBMS group counseling , while the control group ( n = 115 ) did not receive any intervention . MAIN OUTCOME MEASURE(S ) State-Trait Anxiety Inventory . RESULT ( S ) Compared with the control group , the intervention group had a significant drop in State Anxiety mean score following intervention . A comparable number of embryos were transferred for each group , but there was a nonsignificant trend of a higher pregnancy rate in the intervention group . CONCLUSION ( S ) The Eastern Body-Mind-Spirit group intervention approach effectively reduces the anxiety level of women undergoing IVF treatment The objectives were to identify and measure psychological factors characterizing the period following the cessation of contraception and to assess these psychological factors as predictors of the couples ' fertility . A cohort of 63 couples with initially undetermined fertility status was prospect ively studied , first shortly after the cessation of  contraception , then 13 months later . The Child Project Question naire was constructed to assess psychological variations following the cessation of contraception . An Interspouse Difference Score was constructed to measure the difference between the spouses ' responses . Three male and three female factors were derived from the question naire . The Interspouse Difference Score was significantly greater in infertile than in fertile couples . Two psychological factor scores were significantly higher in fertile subjects : the wives ' level of positive expectations related to motherhood , and the husb and s ' quality of integration between the wish for a child and sexual relationships . Within the group of fertile couples , time to pregnancy was predicted by the husb and s ' above-cited factor and by the wives ' frequency of thoughts and concerns related to the desired child . The results support the conclusion that in both women and men , psychological factors specifically related to the project of conceiving a child are significant predictors of the couple 's fertility status BACKGROUND The objective of this study was to evaluate a psychosocial counselling intervention for first-time IVF couples . In this article the results on women 's distress are presented . METHODS Two hundred sixty-five couples admitted to an IVF treatment programme at the Erasmus MC were asked to participate in this study . Eighty-four couples agreed and were r and omized according to a computer-generated r and om-numbers table into either a routine-care control group or an intervention group . The intervention consisted of three sessions with a social worker trained in Experiential Psychosocial Therapy : one before , one during and one after the first IVF cycle .  Distress was measured daily during treatment by the Daily Record Keeping Chart . Depression and anxiety were measured before and after treatment by the Hospital Anxiety and Depression Scale . RESULTS No significant group differences were found . CONCLUSIONS The results of this study do not support the implementation of our counselling intervention for all first-time IVF couples . The low response rate suggests that there is little perceived need for psychosocial counselling among couples during a first IVF treatment cycle OBJECTIVES Infertile couples undergoing fertility treatments may experience stress and could benefit from psychological intervention . Expressive Writing Intervention ( EWI ) has shown promising results on various psychological outcomes , yet only one study has applied the method to infertility-related stress . Our aim was to assess feasibility and effectiveness of EWI for patients in treatment with Assisted Reproductive Technology ( ART ) . DESIGN AND PARTICIPANTS Patients enrolling in their first ART treatment at the fertility clinic , Aarhus University Hospital , Denmark were offered to participate . A total of 82 participants ( 45 women , 37 men ) , mean age : 33.17 , were r and omized  to home-based EWI or neutral writing control group and completed an infertility-related stress question naire at treatment enrollment , 3 weeks later ( at the time of down regulation ) , and 6 weeks after the intervention . The intervention took place 2 weeks after treatment start . RESULTS Mixed between-within ANOVA showed a main effect of time ( Wilks Lambda = 0.68 , F(2,28 ) = 6.48 ) as well as a significant interaction effect between group ( control/ EWI ) and time ( Wilks Lambda = 0.83 , F(2,28 ) = 2.92 ) . Infertility-related stress decreases were observed after the intervention in the EWI group compared to controls . Six weeks after the intervention , stress tended to increase in both groups , with the control group , follow-up stress levels exceeding baseline stress scores , whereas the follow-up scores of EWI- participants ' did not exceed baseline levels . CONCLUSIONS Our preliminary results suggest EWI to be a feasible , cost-effective , and efficient method for alleviating infertility-related stress , although results should be considered preliminary and further testing with a larger sample is warranted We investigated the effects of psychiatric group intervention on the emotions , natural-killer ( NK ) cell activity and pregnancy rate in Japanese infertile women by a r and omized study . Thirty-seven women completed a 5-session intervention program  and were compared with 37 controls .  Psychological discomfort and NK-cell activity ( 47.7 % to 34.1 % , P<.0001 ) significantly decreased after the intervention , whereas no significant changes were observed in controls . According to a 1-year follow-up of both groups , the pregnancy rate in the intervention group was significantly higher than that of controls ( 37.8 % vs. 13.5 % , P=.03 ) . Psychological group intervention was therefore effective in Japanese infertile women Background Infertility is a major cause of marital problems and sexual dissatisfaction . This study was conducted to determine the effects of counseling on infertile couple ’s marital relationship and sexual satisfaction . Material s and methods This study was performed as a r and omized controlled trial ( RCT ) in which 100 infertile couples ( 200 participants ) who visited Reproductive Health Research Center Tehran , Iran were r and omly assigned into two groups : intervention ( n = 50 couples , 50 wives and 50 husb and s ) and control ( n = 50 couples , 50 wives and 50 husb and s ) . Intervention was defined as three counseling sessions per week , each lasting 60–90 min . Counseling in the intervention group was conducted separately for each couple . Demographic characteristics and marital and sexual satisfaction were investigated using three question naires through interviews . The outcomes , including changes in marital satisfaction and sexual satisfaction , were compared between the two groups 3 months later . Results Based on the data collected 3 months after the intervention period , the mean scores of marital and sexual satisfaction in intervention and control groups for wives were 49.62 ± 11.09 versus 54.97 ± 12.64 ( P = 0.036 ) and 36.00 ± 8.37 versus 40.04 ± 7.69 ( P = 0.019 ) , respectively . Respective scores for husb and s were 45.48 ± 9.55 versus 50.08 ± 11.43 ( P = 0.042 ) and 33.37 ± 7.09 versus 36.63 ± 6.52 ( P = 0.025 ) , respectively . It should be noted that higher scores in question naires inspecting marital and sexual satisfaction indicate lower satisfaction . Conclusions Infertility counseling improves marital and sexual satisfaction in infertile couples BACKGROUND The aim of this study was to examine the associations between urinary levels of the stress hormones adrenaline , noradrenaline and cortisol during treatment with self reported stress , in order to investigate the mechanism for the previously observed negative association of anxiety and depression with the outcome of IVF/ICSI . METHODS In a multicentre prospect i ve cohort study , women entering their first cycle of IVF/ICSI treatment were asked to participate . From each participant nocturnal urine sample s were collected ; pre-treatment , before oocyte retrieval and before embryo-transfer ( ET ) , to assess hormonal concentrations . Additionally , two question naires were administered before the start of the treatment to measure anxiety and depression . RESULTS 168 women completed the question naires and collected at least two urine specimens . A significant positive correlation between urinary adrenaline concentrations at baseline and ET and the scores on depression at baseline were found . In women with successful treatment , lower concentrations of adrenaline at oocyte retrieval and lower concentrations of adrenaline and noradrenaline at ET , compared with unsuccessful women , were found . CONCLUSIONS The significant positive association of adrenaline concentration with pregnancy and with depression suggested that this adrenal hormone could be one of the links in the complex relationship between psychosocial stress and outcome after IVF/ICSI Objective : This study prospect ively evaluates the effectiveness and patient acceptability of professionally-led support groups in alleviating psychologic distress in infertility patients . Method : Sixty-four consecutive patients in a university hospital infertility program were administered a battery of psychologic tests before and after attendance at an 8 weekly session support group . The comparison group consisted of 35 consecutive infertility referrals to the same unit who were not initially offered the support group and were similarly tested over an 8 week period . Results : Support group patients had significantly greater ( p ≤ 0.01 ) entry than exit scores on several measures of psychologic distress and depression ( the Beck Depression Inventory , the Hamilton Rating Scale for Depression , and the Global Severity Index , Anxiety , Depression , Hostility and Obsessive Compulsive Subscales of the Brief Symptom Inventory ) . The Avoidance Coping Style on the Moos Coping Responses Inventory was correlated with a higher Global Severity Index ( p ≤ 0.01 ) . Comparison group patients had similar psychometric scores to the support group patients at entry but showed no change over 8 weeks . Attenders expressed a high rate of satisfaction with the support group . Conclusions : Professionally-led support groups are a highly acceptable and effective intervention in self-referred patients in alleviating psychological distress related to infertility Female fertility declines with advancing age . To establish whether this age-related reproductive failure results from diminished oocyte quality or uterine/endometrial inadequacy we investigated ovum donation in 35 infertile women , aged 40 years or older ( mean 42.7 [ SE 0.3 ] ) who had failed at attempts at conception with their own ( self ) oocytes .  Oocytes were donated by 29 young individuals ( mean age 33.4 [ 0.7 ] ) undergoing in-vitro fertilisation ( IVF ) .  8 ( 5.3 % ) pregnancies were achieved in 150 cycles of ovulation induction with self-oocytes and 2 ( 3.3 % ) in 60 such cycles by in-vitro fertilisation ( IVF ) , but none attained viability . By contrast in 50 cycles with donated oocytes 28 ( 56 % ) pregnancies and 15 ( 30 % ) deliveries were realised ( p less than 0.005 ) . The rate of implantation per embryo transferred was higher ( 14.7 % ) with donated oocytes than that with self-oocytes ( 3.3 % ) ( p less than 0.01 ) . To further eluci date the contribution of age to reproductive outcome , pregnancy results were compared between the young donors and older recipients . Both donors and recipients shared oocytes from the same induced cohort . Rates for clinical pregnancy and delivery did not differ between donors ( 33 % and 23 % ) and recipients ( 40 % and 30 % ) . Our data suggest that the age-related decline in female fertility is attributable to oocyte quality and is correctable by ovum donation . The uterus can adequately sustain pregnancies even when reproductive potential is artificially prolonged into the late 40s BACKGROUND AND OBJECTIVE Publication bias and other sample size effects are issues for meta-analyses of test accuracy , as for r and omized trials . We investigate limitations of st and ard funnel plots and tests when applied to meta-analyses of test accuracy and look for improved methods . METHODS Type I and type II error rates for existing and alternative tests of sample size effects were estimated and compared in simulated meta-analyses of test accuracy . RESULTS Type I error rates for the Begg , Egger , and Macaskill tests are inflated for typical diagnostic odds ratios ( DOR ) , when disease prevalence differs from 50 % and when thresholds favor sensitivity over specificity or vice versa . Regression and correlation tests based on functions of effective sample size are valid , if occasionally conservative , tests for sample size effects . Empirical evidence suggests that they have adequate power to be useful tests . When DORs are heterogeneous , however , all tests of funnel plot asymmetry have low power . CONCLUSION Existing tests that use st and ard errors of odds ratios are likely to be seriously misleading if applied to meta-analyses of test accuracy . The effective sample size funnel plot and associated regression test of asymmetry should be used to detect publication bias and other sample size related effects Infertility has been associated with stigma and negative psychosocial functioning . However , only a small proportion of this population actually receives care . Fertility patients predominantly use the Internet for information gathering , social support , and assistance with decision-making ; yet , available web re sources are unreliable sources of mental health care . Web-based alternatives also have the potential to assist with intervention access difficulties and may be of significant lower cost . This study evaluated the efficacy of a web-based approach to providing a cognitive behavioral intervention with 31 infertile women seeking medical reproductive technologies . Following r and omized assignment , participants using the web-based intervention were compared with those in a wait-list control condition on general and infertility-related psychological stress measures . Results were mixed regarding intervention efficacy . Significant declines in general stress were evidence d in the experimental group compared with a wait-list control group . However , website access did not result in statistically significant improvements on a measure of infertility-specific stress . These findings add to the literature on psychological interventions for women experiencing fertility problems . Moreover , despite the widespread use of the Internet by this population , the present study is one of the first to investigate the usefulness of the Internet to attenuate stress in this population . Preliminary results suggest general stress may be significantly reduced in infertile women using an online cognitive behavioral approach OBJECTIVE To determine factors affecting depression in infertile couples and the impact of a psychological intervention before or during infertility treatment . METHODS In a cross-sectional study with 638 infertile couples assessed for depression , 140 couples with a member who had a Beck Depression Inventory ( BDI ) score of 17 or higher were r and omized to receive psychological treatment either before or during infertility treatment . Logistic regression was performed to eliminate confounding factors . RESULTS Depression was initially found in 48 % of women and 23.8 % of men . The mean+/-SD Beck scores fell from 18.7+/-9.7 to 10.7+/-5.8 ( P<0.001 ) in the group psychologically treated before they received infertility treatment . CONCLUSION The psychological intervention was found useful in alleviating depression in infertile couples before they received infertility treatment This experimental study was conducted to determine the specific problems experienced by couples participating in assisted reproductive techniques ( ART ) and to assess couples ’ counseling needs . It was also intended to determine the effects of the counseling service model , developed and implemented by the research er , on the success rate of ART , and to assess the couples ’ anxiety , depression and life satisfaction levels . Thirty couples for the experimental group and 30 couples for the control group were included in the study . The couples in the control group experienced the routine procedures that the treatment currently includes . Couples in the experimental group took part in the counseling service model , and were informed and supported throughout the steps of the ART . A guide developed for the couples and education material developed for the counseling service model were used during the study . Three  psychological tests were given to the couples before ( pretest ) and after ( post-test ) each procedure . These tests included anxiety , depression and life satisfaction inventories . The difference means test and Student 's t test were used for statistical analysis . The results of the study showed that couples in the experimental group had lower anxiety and depression scores than the couples in the control group . Life satisfaction scores and pregnancy rates were higher for couples in the experimental group than for the couples in the control group . Statistical evaluation showed that the difference between the experimental group and the control group was significant ( p < 0 . 05 ) . This study demonstrates the importance of the counseling role of the nurse , and the development and application of counseling services in ART centers , in lowering the anxiety and depression levels of couples and ensuring success of the Competing positions exist in the literature regarding whether problem-focused or emotion-focused coping is more useful when one confronts a chronic health-related problem . In this study , 29 infertile women , who on average had been attempting conception for almost 4 years , were assigned to six sessions of training in problem- or emotion-focused coping or to a no-treatment control condition . Problem-focused training produced improvements in general distress and infertility-specific well-being at treatment termination . However , emotion-focused training result ed in greater improvement at a 1-month follow-up . Emotion-focused participants reported less depression and more infertility-specific well-being at 1 month than did controls . At 18 months , problem-focused group members were more likely to have a child than were other participants . Results argue for the efficacy of both emotion-directed and problem-focused interventions in women 's adjustment to infertility BACKGROUND Subfertility is a common but hidden source of anxiety , depressive symptoms and hopelessness . Counselling reduces this emotional burden and may even enhance the likelihood of pregnancy . Art therapy may be a useful intervention , because it facilitates the expression of feelings , both visually and verbally , and may ease emotional distress . METHODS Weekly 2-h art therapy group courses were held for a total of 21 subfertile women . The impact of subfertile women 's support systems and barriers to coping were all explored . The effectiveness of art therapy was assessed using Beck Hopelessness , Depression and Anxiety Inventories , administered before and after participation , as well as a qualitative exit question naire . RESULTS The mean age of participants was 35.7 ( SD 2.1 ) years and duration of infertility was 64 ( 12.0 ) months .  Mean Beck Hopelessness Scale fell from 6.1 ( 3.8 ) to 3.5 ( 3.1 , P = 0.01 ) after therapy . Beck Depression Inventory-II Score fell from 19.8 ( 11.0 ) to 12.5 ( 10.2 , P = 0.01 ) and Beck Anxiety Inventory Score changed from 12.4 ( 8.4 ) to 8.4 ( 5.2 , P = 0.3 ) . Based on the exit question naire , women felt the course was insightful , powerful and enjoyable . CONCLUSIONS Art therapy is an inexpensive , non-pharmacological intervention , which was associated with decreased levels of hopelessness and depressed mood in subfertile women . It also provides insight into the meaning and emotional implication s of subfertility for patients and caregivers . This pilot study highlights the need for further research in this field This study aim ed to evaluate the efficacy and patient acceptance of the first German- language Internet-based treatment for infertile patients . Infertile patients ( N = 124 ) were r and omly assigned to either an 8-week Internet-based cognitive-behavioral treatment , or to a waiting-list control group . Participants were assessed at treatment start , post-treatment , and at a 5-month follow-up . Outcome measures included mental health and pregnancy rate . From pre- to posttest , treated participants in contrast to controls did not show significant improvement , although between-group effect sizes were in favor of the intervention group on all mental health measures ( Cohen ’s d ranged from 0.16 to 0.38 ) . The intervention significantly reduced the depression level of clinical ly distressed and depressed participants . No effects were found regarding pregnancy rate . The treatment was assessed as positive or very positive by 80 % of the participants ; this finding coupled with the high dem and for such support confirm that Internet-based interventions are a promising new approach for infertile patients that needs more development and testing OBJECTIVE To study the effect of an Internet-based personal health record on the empowerment of patients undergoing IVF .  DESIGN R and omized clinical trial . SETTING Patients undergoing IVF and intracytoplasmic sperm injection ( ICSI )  in an academic research environment . PATIENT(S ) We selected patients who were undergoing an IVF or ICSI treatment , have an Internet connection , and speak fluent Dutch . INTERVENTION(S ) An Internet-based personal health record that provides patients with general and personal information concerning their given treatment and that also provides facilities for communication with fellow patients and physicians . MAIN OUTCOME MEASURE(S ) Patient empowerment ( measured as a multidimensional concept consisting of self-efficacy , actual and perceived knowledge , and involvement in the decision process ) , patient satisfaction , meaning of infertility problems , social support , anxiety , and depression . RESULT ( S ) A total of 91 female and 89 male participants were suitable for analysis . No significant differences were observed in per person change in patient empowerment . We did not find any significant differences regarding per person change in patient satisfaction , the meaning of infertility problems , social support , anxiety , and depression . CONCLUSION ( S ) Usage of the personal health record did not have any effects on patient empowerment , but , at the same time , the study did not find that the personal health record had any significant adverse effects either Infertility and its treatment may cause life crises in infertile women . The purpose of this study is to evaluate the effects of a crisis intervention program on improving psychosocial responses and enhancing coping strategies for infertile women attending different stages of an In-Vitro Fertilization V Embryo Transfer ( IVF-ET ) treatment program . Using an experimental study design , infertile women attending an IVF-ET treatment program were r and omly assigned to experimental and control groups . In the experimental group , infertile women completed and answered a question naire and received nursing crisis intervention at the initial stage of treatment ( day 3 ) . This included ( 1 ) . viewing a video explaining the therapeutic process of IVF-ET , ( 2 ) . self-hypnosis and muscle relaxation training , and ( 3 ) . provision of cognitive-behavioral counseling . The same question naire was used again for subjects at the stage of embryo transfer and before taking a pregnancy test . The women in the control group were only interviewed using the same question naire and at the same times as the experimental group . Analysis by repeated measurement ANOVA demonstrated that there was a reduction in psychosocial response in terms of interpersonal relationships , and there was an interaction between intervention effects and stage of treatment . However , there was no statistically significant difference in the level of psychosocial responses between the experimental and control groups although some meaningful findings were made . However , in terms of state of anxiety , confrontational problems , and isolated mind/body relaxation , there were significant differences between the two groups of infertile women at some stages of IVF-ET treatment . The women in the experimental group perceived a positive effect of the nursing intervention in relieving their psychosocial responses . The results of this nursing crisis intervention could be helpful in nursing practice when dealing with infertile women attending IVF treatment programs Background : The purpose of this pilot study was to evaluate the impact of a 6-month cognitive-behavioral therapy for infertile couples . Methods : Seventeen idiopathic infertile couples participated in a therapy program comprised of modules to behaviorally optimize the chance of conception , improve sexual functioning and satisfaction , reduce thoughts of helplessness and , if necessary , improve marital communication skills . Pre- to posttreatment changes in the therapy group were compared to changes in two control groups . Results : The therapy group showed an improvement in sperm concentration , a reduction in thoughts of helplessness and a decrease in marital distress . By the end of therapy participants practice d timed intercourse more reliably and reported unchanged sexual pleasure and satisfaction during the nonfertile period of the menstrual cycle . At the 6-month follow-up , problem-focused thoughts had decreased . The live birth rate was higher in the therapy group than in epidemiological sample s. Conclusion : Preliminary data suggest that cognitive-behavioral treatment may be an effective approach for the treatment of infertility AIM The purpose of this study was to determine the effects of a support program for the stress management of women undergoing fertility treatment to reduce stress related to infertility and treatment . METHODS We r and omly assigned seven institutions into an experimental group ( four institutions , n = 96 ) and a control group ( three institutions , n = 44 ) using cluster r and omization . The women in the experimental group were asked to continue stress management homework for 3 months . A nurse provided feedback on the homework every month . Those in the control group were given only the booklet . The primary outcomes were the risk ratios of " depression " and " anxiety " according to the Hospital Anxiety and Depression Scale . The secondary outcomes were " health status " from the Medical Outcomes Study Short-Form 36-item Health Survey ( SF-36 ) v2 and " satisfaction " from the Visual Analogue Scale .  We excluded 15 women who became pregnant and performed an intention-to-treat analysis of 125 women . RESULTS There were no differences in the incidence of depression and anxiety between the experimental and control groups . There were significant interaction effects between the program and time in the scores of the two subscales of SF-36 and the summary . There was no difference in satisfaction . The use of ovulation-enhancing agents showed that the scores of " role functioning physical " and " physical component summary " in the non-use subgroup were higher at 2 and 3 months in the experimental group , compared to the control group . CONCLUSIONS Positive effects of the support program were observed on two subscales of the SF-36 in the subgroup that did not use ovulation-enhancing agents OBJECTIVES This study examined the efficacy of a group intervention , the Integrative Body-Mind-Spirit ( I-BMS ) intervention , which aims at improving the psychosocial and spiritual well-being of Chinese women undergoing their first IVF treatment cycle . DESIGN The I-BMS intervention facilitates the search of meaning of life in the context of family and childbearing , as well as the letting go of high IVF expectations . A r and omized controlled study of 339 women undergoing first IVF treatment cycle in a local Hong Kong hospital was conducted ( intervention : n= 172 ; no-intervention control : n= 167 ) . METHODS Assessment s of anxiety , perceived importance of childbearing , and spiritual well-being were made at r and omization ( T(0 ) ) , on the day starting ovarian stimulations ( T(1 ) ) , and on the day undertaking embryo transfer ( T(2 ) ) . RESULTS Comparing T(0 ) and T(2 ) , interaction analyses showed women who had received the intervention reported lower levels of physical distress , anxiety , and disorientation . They reported being more tranquil and satisfied with their marriage , and saw childbearing as less important compared to women in the control group . CONCLUSIONS These findings suggest that I-BMS intervention was successful at improving the psychosocial and spiritual well-being of women undergoing their first IVF treatment cycle . This study highlights the importance of providing integrative fertility treatment that incorporates psychosocial and spiritual dimensions
OBJECTIVE To evaluate the evidence on the efficacy of psychosocial interventions for improving pregnancy rates and reducing distress for couples in treatment with assisted reproductive technology ( ART ) .