Discussion
depression, IVFPsychological disorders, infertility, anxiety
TYPE 2 DIABETES, DISEASES
The aim of this study was to determine the effect of an infertility coaching program on perceived stress in infertile women undergoing ARTs. The findings of the present study showed that the presence of an infertility coach can mitigate stress in infertile women. The interventions performed in the intervention group had an effect on the stress perceived on the days of ovum retrieval, embryo transfer, and pregnancy test, such that the stress in these three stages was reduced compared to the stages before the intervention. In the control group, the amount of stress in the stages of ovum retrieval, embryo transfer, and pregnancy test day was significantly increased compared to before the outset of the study.The results of this study are in line with the study of Latifnejad et al. 2011 (participatory counseling)In the study of Latifnejad et al.A study was performed by Yazdani et al. in 2017 to determine the effect of a counseling program provided by a midwife on perceived stress in infertile women and the outcome of assisted reproductive therapy in a clinical trial study. In this study, the intervention group received six two-hour group counseling sessions each week, which were performed by a consulting midwife. The results showed that group counseling by a midwife reduced the perceived stress of infertility and improved treatment outcomes. The results of this study are consistent with the present findings such that midwifery counseling reduced perceived infertility stress and improves treatment outcomesKheirkhah et al. in a clinical trial aimed at determining the effect of group counseling on infertility adjustment in infertile women concluded that group counseling is effective in increasing the adjustment of infertile women undergoing IVF and ICS treatmentA review study by Boivin, it was aimed to determine the effect of psychological interventions on the mental health and fertility of infertile women and to determine the type of more effective interventions. It was found that psychological interventions were effective in reducing the negative effects of infertility and increasing pregnancy. It has been shown that group counseling interventions with an emphasis on educational skills have been more effective than counseling interventions and expression of feelings and support groupsChan et al. conducted psychosocial counseling with an approach to Chinese teachings called the Oriental Program to affect the body and soul of women undergoing IVF treatment and reduce their anxiety. The results showed a significant reduction in anxiety levels in the intervention groupGurhan’s study showed that counseling by a nurse did not cause a significant difference in the rate of depression between the case and control groups. The counseling sessions were short and consisted of two 20-min sessions by a nurse and one 60-min general session by a nursing faculty member. Due to the fact that IVF treatment is invasive and the grief of these people is more, effective emotional coping skills are necessary in counseling these patientsThe results of the study of Klerk et al. with the aim of counseling in the first period of IVF treatment were not effective. In this study, counseling interventions were presented to patients in three sessionsThe results of Sexton study showed that Internet-based intervention to deal with infertility stress significantly reduced the general stress symptoms of infertile women, but there was no statistically significant difference between the two groups in terms of perceived infertility stress. Given the nature of the intervention in Sexton's study, it seems that there were many intervening variables in this study that were not well controlled and were beyond the control of researchers and may have affected the reported results. Also, the research units were from the general population of infertile people and no significant results were found in terms of variables such as type of infertility, duration of infertility, current treatment method, number of cases of ARTs, etc. that affect the effectiveness of psychological counseling in women undergoing IVFPsychological disorders such as stress cause a vicious cycle that leads to aggravation of problems, and by using counseling programs, infertile people can strengthen their family foundation by taking advantage of desirable marital satisfaction and living without stress and concern. Obviously, the resources and teamwork of gynecologists, midwifery counselors, and psychologist in infertility clinics play an important role in reducing the problems of these patients. In explaining the findings, it should be mentioned that identifying negative future thoughts and replacing them with positive and real thoughts, as well as cooperation of midwives, psychologists and gynecologists in counseling infertile women, is emphasized. Due to the fact that infertile people are affected by psychological and social stress, treatment results are also reduced due to this stressStudies related to the effect of coaching programs on diseases such as type 2 diabetes showed that coaching can improve treatment outcomes and adherence to treatment while being cost-effectiveIn various studies, it has been tried to reduce stress in infertile women using various ways. It should be mentioned that to improve treatment outcomes, a combination of supportive and educational counseling with the infertility treatment team, including a trained midwife specializing in midwifery counseling due to the midwifery clinical basis and a good understanding of the field of counseling, can be powerful support during the treatment of infertile women undergoing ARTs.