Creating affiliations, learning, and mindfulness for in vitro fertilization patients (CALM IVF): a clinical trial

Rachel M Whynott; Karen M Summers; Rachel B Mejia; Lisa S Segre; Ginny Ryan; Stacey A Pawlak

doi:10.1016/j.xfre.2023.01.002

Creating affiliations, learning, and mindfulness for in vitro fertilization patients (CALM IVF): a clinical trial

F S Rep. 2023 Jan 7;4(1):61-71. doi: 10.1016/j.xfre.2023.01.002. eCollection 2023 Mar.

Authors

Rachel M Whynott¹, Karen M Summers², Rachel B Mejia², Lisa S Segre³, Ginny Ryan¹, Stacey A Pawlak⁴

Affiliations

¹ Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Washington, Seattle, Washington.
² Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Iowa Carver College of Medicine, Iowa City, Iowa.
³ College of Nursing, University of Iowa, Iowa City, Iowa.
⁴ Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa.

Abstract

Objective: Determine if group psychoeducational support can improve in vitro fertilization (IVF) patients' quality of life (QoL).

Design: Randomized controlled trial (NCT04048772).

Setting: University-affiliated IVF clinic.

Patients: Women (n = 76) and male partners undergoing initial autologous IVF cycle from August 2019, to December 2020.

Interventions: Couples were assigned to groups based on projected oocyte retrieval date. Groups were randomly assigned to the control or intervention arm. Clinic closures because of the COVID-19 pandemic delayed treatment for a portion of participants. Groups were conducted in person before and virtually during the pandemic.

Main outcome measures: The primary outcome was a change in fertility quality of life (FertiQoL) from baseline to 3 days after retrieval. Secondary outcomes were changes in depression (Patient Health Questionnaire 9), anxiety (Generalized Anxiety Disorder 7), resilience (Connor-Davidson Resilience scale), IVF knowledge scores, and the likelihood of return to treatment.

Results: Knowledge scores among women in Creating Affiliations, Learning, and Mindfulness (CALM) for IVF groups significantly increased compared with control (mean difference 13.19 [3.53 - 22.84]) before the pandemic. During the pandemic, women in CALM IVF had significant improvement in the social FertiQoL score compared with controls (10.42 [1.79 - 19.04]). Compared with controls, male CALM IVF participants had significantly greater improvement in total FertiQoL (mean difference 6.68 [0.39 - 12.98]), treatment FertiQoL (8.26 [0.69 - 15.82]), and resilience (Connor-Davidson 1.13 [0.54 - 1.72]). Immediate return to care did not significantly differ between arms.

Conclusions: For women undergoing IVF, group psychoeducational programs can improve IVF knowledge and social QoL during a pandemic. Participation in a group psychoeducational program can improve QoL and resilience in IVF dyad male partners.

Clinical trial registration number: Trial registration NCT04048772.

Keywords: IVF; anxiety; depression; group treatment; infertility; psychoeducational support; quality of life.

Associated data

ClinicalTrials.gov/NCT04048772