Supporting stress management for women undergoing the early stages of fertility treatment: A cluster‐randomized controlled trial*

Abstract

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 randomly assigned seven institutions into an experimental group (four institutions, n = 96) and a control group (three institutions, n = 44) using cluster randomization. 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 ovulationenhancing 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.

Efficacy of psychosocial interventions for psychological and pregnancy outcomes in infertile women and men: a systematic review and meta-analysis

“…Only three studies had included an active/attention control condition, for example, non-emotional writing or receiving an information booklet. 70 71 74 One study offered gift certificates to the control group participants if they responded to the follow-up questionnaires. 89 Relatively few studies were UCTs (k=8).…”

“…Furthermore, only four studies explicitly stated that the analysis was based on an intention-to-treat (ITT) approach. 70 72 83 92 Two additional studies used methods comparable to ITT, for example, carrying last (baseline) observations forward or use of multilevel linear modelling. 69 97 Four studies stated that there were no differences between completers and dropouts without specifying this further, 41 64 81 85 and the remaining studies failed to report whether there were dropouts or how such missing data were dealt with.…”

Validity and Reliability of the Japanese Version of the Fertility Quality of Life (FertiQoL) Tool for Couples Undergoing Fertility Treatment

“…As for the current status of intervention studies, stress management has been implemented in infertile women in Japan, and this has been shown to improve their QOL [10]. In addition, intervention studies for improving the QOL of infertile couples are being conducted in other countries, and counseling and educational programs have been shown to be effective [11].…”

The effect of psychosocial interventions on anxiety and depression in infertile women and men in assisted reproductive treatment: a systematic review

“…The researcher sent the stress management questionnaire by email, then participants responded and resubmitted. 27 Preparatory psychosocial counselling was performed for medically assisted reproduction by Hakim. The broad purpose of the session was to discuss the implications of pursuing IUI treatment and specific topics addressed included the role and availability of counselling services; the psychosocial and infertility history; potential concerns about IUI treatment; the experience of infertility-related stress on both individuals and the relationship; the utilization of coping strategies; availability and use of social support and any other stressors of concern.…”