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Exploratory randomized trial on the effect of a brief psychological intervention on emotions, quality of life, discontinuation, and pregnancy rates in in vitro fertilization patients.
Fertil Steril. 2015 Aug; 104(2):440-51.e7.FS

Abstract

OBJECTIVE

To determine whether a brief self-administered cognitive coping and relaxation intervention (CCRI) would lead to decreased treatment termination in in vitro fertilization (IVF) patients compared with routine care (RC).

DESIGN

Randomized, controlled, prospective study.

SETTING

Private academically affiliated infertility center.

PATIENT(S)

One hundred sixty-six women about to begin their first IVF cycle.

INTERVENTION(S)

Randomization to the self-administered CCRI or RC control group and then observation for 12 months.

MAIN OUTCOME MEASURE(S)

Treatment discontinuation within 12 months (primary outcome), clinical pregnancy rate and psychological well-being (secondary outcomes).

RESULT(S)

The 12-month pregnancy rate was similar for the RC and CCRI groups (odds ratio [OR] 1.02; 95% CI, 0.53-1.98). Of the patients who were not pregnant on the first cycle, 15 of 46 (15.2%) patients assigned to RC discontinued compared with 5 of 55 (5.5%) patients assigned to the CCRI (OR 3.11; 95% CI, 0.756-12.80). The CCRI group engaged in statistically significantly more positive reappraisal coping (OR 0.275; 95% CI, 0.16, 0.39) than the RC control group (OR 0.097; 95% CI, -0.03, .23). The CCRI group had an improved Fertility Quality of Life (FertiQoL CORE: OR 4.07; 95% CI, 2.07, 6.06; FertiQoL Emotional: OR 5.95; 95% CI, 2.89, 9.00) compared with the control group (Core OR: 0.67; 95% CI, -1.55, 2.89; Emotional: OR -0.02, 95% CI, -3.36, 3.32). The CCRI group reported less global anxiety (OR 0.275; 95% CI, 0.16, 0.39) than the control group (OR 0.471; 95% CI, -2.40, 3.34). The CCRI reported positive evaluations for the intervention (e.g., ease of use, helpfulness, perceived stress reduction).

CONCLUSION(S)

Use of the CCRI tool led to improved psychological status but not statistically significantly more treatment cycles or a higher pregnancy rate.

CLINICAL TRIAL REGISTRATION NUMBER

NCT01318291.

Authors+Show Affiliations

Domar Center for Mind/Body Health, Boston IVF, Harvard Medical School, Boston, Massachusetts. Electronic address: domar@domarcenter.com.Domar Center for Mind/Body Health, Boston IVF, Harvard Medical School, Boston, Massachusetts.Domar Center for Mind/Body Health, Boston IVF, Harvard Medical School, Boston, Massachusetts.Cardiff Fertility Studies Research Group, School of Psychology, Cardiff University, Wales, United Kingdom.

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26072382

Citation

Domar, Alice D., et al. "Exploratory Randomized Trial On the Effect of a Brief Psychological Intervention On Emotions, Quality of Life, Discontinuation, and Pregnancy Rates in in Vitro Fertilization Patients." Fertility and Sterility, vol. 104, no. 2, 2015, pp. 440-51.e7.
Domar AD, Gross J, Rooney K, et al. Exploratory randomized trial on the effect of a brief psychological intervention on emotions, quality of life, discontinuation, and pregnancy rates in in vitro fertilization patients. Fertil Steril. 2015;104(2):440-51.e7.
Domar, A. D., Gross, J., Rooney, K., & Boivin, J. (2015). Exploratory randomized trial on the effect of a brief psychological intervention on emotions, quality of life, discontinuation, and pregnancy rates in in vitro fertilization patients. Fertility and Sterility, 104(2), 440-e7. https://doi.org/10.1016/j.fertnstert.2015.05.009
Domar AD, et al. Exploratory Randomized Trial On the Effect of a Brief Psychological Intervention On Emotions, Quality of Life, Discontinuation, and Pregnancy Rates in in Vitro Fertilization Patients. Fertil Steril. 2015;104(2):440-51.e7. PubMed PMID: 26072382.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Exploratory randomized trial on the effect of a brief psychological intervention on emotions, quality of life, discontinuation, and pregnancy rates in in vitro fertilization patients. AU - Domar,Alice D, AU - Gross,Jill, AU - Rooney,Kristin, AU - Boivin,Jacky, Y1 - 2015/06/13/ PY - 2015/02/12/received PY - 2015/05/08/revised PY - 2015/05/08/accepted PY - 2015/6/15/entrez PY - 2015/6/15/pubmed PY - 2015/12/30/medline KW - Cognitive coping and relaxation intervention KW - IVF KW - Positive Reappraisal Coping Intervention KW - compliance KW - depression KW - discontinuation KW - dropout KW - stress management SP - 440 EP - 51.e7 JF - Fertility and sterility JO - Fertil Steril VL - 104 IS - 2 N2 - OBJECTIVE: To determine whether a brief self-administered cognitive coping and relaxation intervention (CCRI) would lead to decreased treatment termination in in vitro fertilization (IVF) patients compared with routine care (RC). DESIGN: Randomized, controlled, prospective study. SETTING: Private academically affiliated infertility center. PATIENT(S): One hundred sixty-six women about to begin their first IVF cycle. INTERVENTION(S): Randomization to the self-administered CCRI or RC control group and then observation for 12 months. MAIN OUTCOME MEASURE(S): Treatment discontinuation within 12 months (primary outcome), clinical pregnancy rate and psychological well-being (secondary outcomes). RESULT(S): The 12-month pregnancy rate was similar for the RC and CCRI groups (odds ratio [OR] 1.02; 95% CI, 0.53-1.98). Of the patients who were not pregnant on the first cycle, 15 of 46 (15.2%) patients assigned to RC discontinued compared with 5 of 55 (5.5%) patients assigned to the CCRI (OR 3.11; 95% CI, 0.756-12.80). The CCRI group engaged in statistically significantly more positive reappraisal coping (OR 0.275; 95% CI, 0.16, 0.39) than the RC control group (OR 0.097; 95% CI, -0.03, .23). The CCRI group had an improved Fertility Quality of Life (FertiQoL CORE: OR 4.07; 95% CI, 2.07, 6.06; FertiQoL Emotional: OR 5.95; 95% CI, 2.89, 9.00) compared with the control group (Core OR: 0.67; 95% CI, -1.55, 2.89; Emotional: OR -0.02, 95% CI, -3.36, 3.32). The CCRI group reported less global anxiety (OR 0.275; 95% CI, 0.16, 0.39) than the control group (OR 0.471; 95% CI, -2.40, 3.34). The CCRI reported positive evaluations for the intervention (e.g., ease of use, helpfulness, perceived stress reduction). CONCLUSION(S): Use of the CCRI tool led to improved psychological status but not statistically significantly more treatment cycles or a higher pregnancy rate. CLINICAL TRIAL REGISTRATION NUMBER: NCT01318291. SN - 1556-5653 UR - https://www.unboundmedicine.com/medline/citation/26072382/Exploratory_randomized_trial_on_the_effect_of_a_brief_psychological_intervention_on_emotions_quality_of_life_discontinuation_and_pregnancy_rates_in_in_vitro_fertilization_patients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0015-0282(15)00356-8 DB - PRIME DP - Unbound Medicine ER -