Psychotherapeutic counseling and pregnancy rates in in vitro fertilization.
OBJECTIVE
Since the Austrian propagation bill of July 1, 1992, was passed into law, Austrian physicians are committed to offer psychological counseling to women before performing assisted reproductive techniques, unless refused by the patient. The acceptance of psychotherapeutic counseling (PSITCO) and its influence on pregnancy rate were carefully reviewed.


METHODS
The study comprised 1156 consecutive patients (mean age, 33.3 years) and 1736 in vitro fertilization (IVF) cycles. In a consent form for follicle puncture, the patients were interviewed about PSITCO as follows. Several methods of psychological support during IVF-embryo transfer treatment were offered to patients especially psychotherapy, hypnotherapy, and relaxation and physical perception exercises.


RESULTS
Forty-two and three-tenths percent of patients rejected PSITCO, 17.8% had already received PSITCO, and 10.4% were willing to undergo PSITCO. The acceptance of PSITCO had no relevance on pregnancy rate. The cumulative calculation of pregnancy rates showed that up to 56.4% of women who had undergone PSITCO conceived. In patients who were planning to undergo PSITCO, the pregnancy rate was 41.9%. Concerning the cumulative pregnancy rate, this study showed that patients who accepted or underwent PSITCO had a higher pregnancy rate than those who did not avail themselves of this possibility.


CONCLUSIONS
These results should encourage sterility specialists to consider psychological therapy as an essential aspect of IVF. Solely a written declaration of the patient stating his/her awareness of the possibility to undergo PSITCO is, in our opinion, insufficient.
Poehl
M
M
Institute for Sterility Treatment, Vienna, Austria.
Bichler
K
K
Wicke
V
V
Dörner
V
V
Feichtinger
W
W
D000328:Adult; D001317:Austria; D003376:Counseling; D004624:Embryo Transfer / Q000523:psychology*; D005260:Female; D005307:Fertilization in Vitro / Q000331:legislation & jurisprudence / Q000523:psychology*; D006801:Humans; D006990:Hypnosis; D007258:Informed Consent; D007407:Interviews as Topic; D011247:Pregnancy / Q000523:psychology / Q000706:statistics & numerical data*; D011248:Pregnancy Complications / Q000453:epidemiology; D012064:Relaxation Therapy; D012944:Social Support