title: 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.
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).
  
  
  METHODS
  Randomized, controlled, prospective study.
  
  
  METHODS
  Private academically affiliated infertility center.
  
  
  METHODS
  One hundred sixty-six women about to begin their first IVF cycle.
  
  
  METHODS
  Randomization to the self-administered CCRI or RC control group and then observation for 12 months.
  
  
  METHODS
  Treatment discontinuation within 12 months (primary outcome), clinical pregnancy rate and psychological well-being (secondary outcomes).
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  Use of the CCRI tool led to improved psychological status but not statistically significantly more treatment cycles or a higher pregnancy rate.
  
  
  BACKGROUND
  NCT01318291.
authors.affiliation: Domar Center for Mind/Body Health, Boston IVF, Harvard Medical School, Boston, Massachusetts. Electronic address: domar@domarcenter.com.
authors.forename: Alice D
authors.initials: AD
authors.lastname: Domar
authors.affiliation: Domar Center for Mind/Body Health, Boston IVF, Harvard Medical School, Boston, Massachusetts.
authors.forename: Jill
authors.initials: J
authors.lastname: Gross
authors.affiliation: Domar Center for Mind/Body Health, Boston IVF, Harvard Medical School, Boston, Massachusetts.
authors.forename: Kristin
authors.initials: K
authors.lastname: Rooney
authors.affiliation: Cardiff Fertility Studies Research Group, School of Psychology, Cardiff University, Wales, United Kingdom.
authors.forename: Jacky
authors.initials: J
authors.lastname: Boivin
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D061345:Early Medical Intervention / Q000639:trends; D004644:Emotions; D005260:Female; D005307:Fertilization in Vitro / Q000523:psychology* / Q000639:trends*; D005500:Follow-Up Studies; D006801:Humans; D007247:Infertility, Female / Q000523:psychology* / Q000628:therapy; D011247:Pregnancy; D018873:Pregnancy Rate / Q000639:trends*; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D016896:Treatment Outcome
keywords: Cognitive coping and relaxation intervention; IVF; Positive Reappraisal Coping Intervention; compliance; depression; discontinuation; dropout; stress management