Psychological Variables Effects on The Success of Fertility Treatment

Background: This study aimed to examine the effectivenessof mindfulness based stress reduction on success of ICSI/ IVFtreatment, infertility stress, psychological symptoms and qualityof life in infertile women.Materials and Methods: In this prospective study, a total of۱۳۰ infertile women (referred to Royan Institute in Tehran)were studied during their first IVF treatment. All subjects completedquestionnaires of demographic, Depression Anxiety andStress Scale (DASS-۲۱), Brief Symptom Inventory, FertilityProblem Inventory and Fertility Quality of Life. The patientswere randomly and equally divided in two groups of interventionand control. The data were analyzed using both adjustedand unadjusted approaches. In the unadjusted methods, Chisquaretest was used to investigate any association between thestudy group and categorical variables. Independent samples andpaired t-tests were utilized to assess the continuous variablesmean difference between the groups and within the time, respectively.Since the data was collected in two different timepoints over the study duration, generalized estimating equation(GEE) approach was used to assess the adjusted effect of interventionand time on the psychological factors. Two differentmodels were fitted; first the psychological responses were assessedby intervention, time and the interaction between timeand intervention while in the second model the intervention andtime variables were adjusted for education, number for abortions,type of infertility, marriage duration, infertility duration,age and cause of infertility.Results: A total of ۱۳۰ infertile patients were assessed. The resultsshowed that among all the psychometric variables measuredby the research tools, global stress which was calculatedusing the sums for all five subscales scores, subscales scores ofglobal stress, total FertiQol sore and social subscales of CoreFertiQol were significant predictors of successful IVF/ICSI.Applying a negative binomial regression, it was found that for one score increase in global stress and total FertiQol scores theincidence of successful IVF/ICSI decreases by a rate of ۳%The patients GSI score was the same before the intervention(P=۰.۵۲۱) and it decreased after the intervention both in withinand between groups comparisons (P<۰.۰۰۱). After the intervention,the PST score in the intervention group was significantlyhigher than the control group (P<۰.۰۰۱). The PSDI score reducedin both groups and it was lower among patients in the interventiongroup (P<۰.۰۰۱). The stress, anxiety and depressiondecreased significantly just in the intervention group. In contrastto social concern, other dimensions reduced significantly in theintervention group. After adjusting for demographic/infertilityvariables, the effects of intervention, time and their interactionon psychological variables were not significant. According tothe results of adjusted estimations (Model ۲), the GSI score increasedin the control group while decreased in the intervention.The PST score decreased in the control group and increased inthe intervention group. The PSDI scores decrement was higherin the intervention group than control group. The mean decreasescore of depression was ۳.۶۰۸ (P=۰.۰۰۷). Similar to unadjustedresults, the GEE showed that social (P=۰.۳۸۰) and sexual concern(P=۰.۵۰۵) was not influenced by the intervention. In contrast,the mean decrease in relationship, rejection and need forparents concern in the intervention group was ۳.۴۵۱ (P=۰.۰۴۳),۸.۸۲۴ (P<۰.۰۰۱), and ۱۶.۴۱۲ (P<۰.۰۰۱), respectively.Conclusion: The present study suggests that MBSR is efficacious,both in reducing psychological distress and improvingclinical pregnancy rates.

کلیدواژه ها:

Global Stress ، MBSR ، IVF/ICSI Success ، FertiQol