Online Program Quadruples Pregnancy Rate for Infertile Women
MARCH 18, 2020
Jessica Clifton, PhD
Lead study author Jessica Clifton, PhD, and a team of investigators sought to determine if an internet-based mind and body program would lead to patients experiencing infertility being willing to be recruited and being ready to engage in a fertility-specific intervention. The team found that women who participated in the program, the Mind/Body Program for Fertility, were more than two-times more likely to become pregnant and experienced medium to large decreases in depression and anxiety compared with a control group.
Offering the program removes barriers to counseling that may otherwise prevent women in fertility treatment from getting help, Clifton said in a statement.
“It could enable women across the country, no matter where they live or what their circumstances, to reduce their distress and increase their chances of conceiving,” she added.
The internet-based intervention mirrored the 10-week, face-to-face program, which included information and exercises structured into 10 modules designed to take <1 hour each to complete. Modules had text; audio; video; interactive elements; and electronic downloads. Therapist feedback was provided after each module and to answer questions.
The patients who were assigned to this group were asked to complete the self-guided program. Strategies and skills taught included:
- Knowledge about the relationship between stress, lifestyle, and fertility
- Relaxation techniques
- Cognitive restructuring
- Stress reduction strategies
- Listening and communication skills
- Strategies for emotional expression and coping with anger
- Assertiveness training and goal-setting skills
After each module, homework was assigned to track health-related information, time participating in relaxation exercises, and cognitive behavioral therapy tools.
Clifton, a faculty scientist from the Department of Psychological Sciences at the University of Vermont, and colleagues recruited women with infertility issues who were >18 years old and never gave birth; had access to the internet; spoke English; had no psychotropic medication changes in the last month; had not participated in a Mind/Body Program for Fertility; and had no suicidal ideation or intent, a psychotic or eating disorder, or substance abuse or dependence.
Eligible patients were randomized to the internet-based intervention or a quasi-controlled wait-list condition. Each patient was emailed a mid-assessment at five-weeks and a post-assessment at either 10-weeks (control group) or at the end of the online program (intervention group).
If a participant completed the mid-assessment, they were considered retained. Those in the intervention group who completed >5 out of 10 modules were considered to have adhered to the program.
Participants rated their ability to complete each module and the helpfulness after completion. During post-assessment, each participant was given the Client Satisfaction Inventory Short-Form, which assessed the satisfaction with the treatment’s effects.
To assess psychological distress, participants completed online self-report assessments at 3 timepoints, which included 2 primary measures: The Beck Anxiety Inventory and the Beck Depression Inventory-II.
Individuals reported pregnancy rates throughout the study period.
Overall, 71 patients were randomized. Time between pre- and post-assessment differed significantly between the intervention (233.97) and wait-list groups (90.73).
On average, participants in the intervention group completed 4 modules and waited on average 21 days to complete the first module.
Women who participated in the program had a significant reduction in distress (anxiety, P=.003; depression, P=.007; stress, P=.041; fertility-social, P=.018; fertility-sexual, P=.006) compared to the wait-list group.
What’s more, the odds of becoming pregnant was 4.47-times higher for the intervention group participants than the wait-list group (95% CI, 1.56-12.85; P=.005).
The findings suggested that the program was feasible and acceptable for women seeking infertility treatment.
The study, “An internet-based mind/body intervention to mitigate distress in women experiencing infertility: A randomized pilot trial,” was published online in the journal PLOS ONE.