Effectiveness of double ABCX-based psychotherapy for psychological distress among women undergoing in vitro fertilization-embryo transfer: a three-arm randomized controlled trial

Abstract

Objective

This study aimed to evaluate the effectiveness of double ABCX-based psychotherapy for psychological distress during in vitro fertilization-embryo transfer (IVF-ET) among a female group (FG), couple group (CoG) and control group (CG).

Methods

A total of 201 women undergoing their first IVF-ET cycle were randomized into three groups. The 6-session intervention was delivered at each visit to the IVF clinic. The primary outcomes were depression and anxiety, and the secondary outcomes included sleep quality, serum cortisol (nmol/L) levels and the clinical pregnancy rate, which were assessed before and after the intervention.

Results

The group-by-time effects were significant for depression, anxiety, sleep quality and serum cortisol levels, with larger effect sizes in the FG than in the CoG. There was no significant difference in the pregnancy rate among the three groups.

Conclusion

Psychotherapy effectively mitigated psychological distress, suggesting greater effectiveness for couples undergoing IVF couples than for women only. It is structured and easy to use during the IVF treatment cycle.

Trial registration number

https://register.clinicaltrials.gov (NCT03931187, retrospectively registered on April 23, 2019)

IMPACT STATEMENT

• Double ABCX-based psychotherapy, which was developed in this study, effectively mitigated depression, anxiety, sleep disturbance and increased cortisol levels, suggesting greater effectiveness for couples undergoing IVF-ET than women only.

• Double ABCX-based psychotherapy is structured and easy to use during the IVF-ET treatment cycle, thereby presenting a promising and feasible approach to improve care for couples or women with assisted reproductive technique-related stress.

Keywords:

• In vitro fertilization-embryo transfer
• double ABCX-based therapy
• psychosocial intervention
• depression
• anxiety

Acknowledgments

We are very grateful to the participants who participated in the trial and all clinicians in the center who supported the study. We thank all the clinicians and experts in offering their feedback during developing the intervention.

Authors’ contributions

All authors have participated in the study and have read and approved the submitted version of the manuscript. The authors declare they have no conflicts of interest. The authors abide by the copyright terms and conditions of Elsevier and the Australian College of Midwives. D. C. And A. W. were responsible for design, implementation, and writing. W. Z., Y. G., and S.Y. participated in data collection, analysis, and reporting. J.Z. was responsible for design, supervision, writing and date interpretation.

Ethical statement

All procedures involving human subjects/patients were approved by the Ethical Institutional Review Board of the researcher’s university on May 2017 (2017055). Written informed consent was obtained from all patients.

Patient or public contribution

Patients, service users, caregivers or members of the public were not involved in the design or conduct of the study, in the analysis or interpretation of the data, or in the preparation of the manuscript.

Disclosure statement

The authors have no conflicts of interest to declare.

Data availability statement

The data that support the findings of this study are available from the corresponding author, upon reasonable request.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.