CALM IVF (Creating Affiliations, Learning, and Mindfulness for In Vitro Fertilization Patients)

Overview

The investigators have designed a psychoeducational group curriculum specifically for new in vitro fertilization (IVF) patients (both male and female) to improve their treatment knowledge, to allow them to engage more in their care, to offer a support network, to improve satisfaction, and to provide them with tools to help reduce their stress and anxiety while undergoing the IVF process. The investigators plan to have four to eight infertility patients and their partners participate in a group at a time, for which they will attend three 1-1.5 hour interactive sessions that are scheduled throughout their first IVF cycle. These sessions will provide additional time for discussion about treatment with providers, learning opportunities on topics of interest to fertility patients, and stress reduction techniques. They will do several surveys before and after the intervention for comparison, including assessment of quality of life, depression, anxiety, resilience, and a knowledge assessment. The investigators will also track the patients to see if they pursue additional treatment in the instance of a negative pregnancy test compared to patients undergoing the standard treatment. The investigators plan to recruit a control group that receives the standard of care treatment here at the University of Iowa.

Full Title of Study: “Creating Affiliations, Learning, and Mindfulness for In Vitro Fertilization Patients”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Supportive Care
    • Masking: None (Open Label)
  • Study Primary Completion Date: August 2021

Detailed Description

Patients and their partners will be randomized in a 2:1 fashion to two different treatment arms: A) standard of care in vitro fertilization (IVF) at the investigational institution as well as participating in an additional psychoeducational group or B) standard of care IVF at the investigational institution. The intervention group will consist of three additional evening visits for 1-1.5 hours per session. The sessions will include an interactive educational component addressing usual questions and concerns of IVF patients, such as reviewing common IVF myths, and also more information regarding treatment and technologies. Each session will also include teaching of coping strategies (such as awaiting the pregnancy test, how to cope with insensitive remarks from friends and family) as well as relaxation exercises, such as progressive muscle relaxation and deep breathing. The patients will be consented at their new IVF visit and will take their initial assessments (FertiQoL, GAD-7, PHQ-9, the Connor-Davidson Resilience Scale, and a knowledge assessment) within 24 hours of the new visit. The patients will be assigned into groups based on when they are going through their IVF stimulations, so they will have similar experiences at similar times. Patients will take their final assessments on the third day after egg retrieval, regardless of group assignment.

Interventions

  • Behavioral: CALM IVF
    • The intervention will be three 1-1.5 hour interactive sessions that are scheduled throughout the participant’s first in vitro fertilization cycle. These sessions will provide additional time for discussion about treatment with providers, learning opportunities on topics of interest to fertility patients, and stress reduction techniques.
  • Other: Standard of Care
    • Patients will receive the standard of care IVF treatment at the University of Iowa.

Arms, Groups and Cohorts

  • Experimental: Intervention
    • Standard of care in vitro fertilization patients randomized to the psychoeducational group intervention.
  • Other: Control
    • Standard of care in vitro fertilization patients at our institution.

Clinical Trial Outcome Measures

Primary Measures

  • Change in female fertility patient quality of life score during IVF treatment cycle
    • Time Frame: From enrollment to 2-4 days after oocyte retrieval
    • FertiQoL International (Fertility Quality of Life Questionnaire 2008), scored scale from 0-100, with higher values indicating a higher quality of life and low scores indicating a lower quality of life.

Secondary Measures

  • Change in female GAD-7 score during IVF treatment cycle
    • Time Frame: From enrollment to 2-4 days after oocyte retrieval
    • Generalized Anxiety Disorder 7-item scale, with higher scores indicating higher likelihood of an anxiety disorder and lower scores indicating less likelihood of an anxiety disorder.
  • Change in female PHQ-9 score during IVF treatment cycle
    • Time Frame: From enrollment to 2-4 days after oocyte retrieval
    • Patient Health Questionnaire, with higher score indicating increased likelihood of a depressive disorder and lower scores indicating less likelihood of a depressive disorder.
  • Change in female Connor-Davidson Resilience Scale during IVF treatment cycle
    • Time Frame: From enrollment to 2-4 days after oocyte retrieval
    • Connor-Davidson Resilience Scale, with higher scores indicating greater resilience, and lower scores indicating lower resilience
  • Change in female knowledge assessment during IVF treatment cycle
    • Time Frame: From enrollment to 2-4 days after oocyte retrieval
    • Assessment of knowledge regarding IVF treatment, with higher scores indicating a greater knowledge of IVF treatment, and lower scores indicating less knowledge regarding IVF treatment
  • Likelihood of continued IVF treatment in the instance of a negative pregnancy test
    • Time Frame: Three months after embryo transfer
    • Patients who are not pregnant after embryo transfer will be followed for three months to assess likelihood to return for additional treatment after negative embryo transfer outcome.
  • Change in male fertility patient quality of life score during IVF treatment cycle
    • Time Frame: From enrollment to 2-4 days after oocyte retrieval
    • FertiQoL International (Fertility Quality of Life Questionnaire 2008), scored scale from 0-100, with higher values indicating a higher quality of life and low scores indicating a lower quality of life.
  • Change in male GAD-7 score during IVF treatment cycle
    • Time Frame: From enrollment to 2-4 days after oocyte retrieval
    • Generalized Anxiety Disorder 7-item scale, with higher scores indicating higher likelihood of an anxiety disorder and lower scores indicating less likelihood of an anxiety disorder.
  • Change in male PHQ-9 score during IVF treatment cycle
    • Time Frame: From enrollment to 2-4 days after oocyte retrieval
    • Patient Health Questionnaire, with higher score indicating increased likelihood of a depressive disorder and lower scores indicating less likelihood of a depressive disorder.
  • Change in male Connor-Davidson Resilience Scale during IVF treatment cycle
    • Time Frame: From enrollment to 2-4 days after oocyte retrieval
    • Connor-Davidson Resilience Scale, with higher scores indicating greater resilience, and lower scores indicating lower resilience
  • Change in male knowledge assessment during IVF treatment cycle
    • Time Frame: From enrollment to 2-4 days after oocyte retrieval
    • Assessment of knowledge regarding IVF treatment, with higher scores indicating a greater knowledge of IVF treatment, and lower scores indicating less knowledge regarding IVF treatment

Participating in This Clinical Trial

Inclusion Criteria

  • All patients starting their first in vitro fertilization cycle at the University of Iowa Hospitals and Clinics Exclusion Criteria:

  • Patients who have already undergone in vitro fertilization treatment at any institution – Non-English speakers – Fertility preservation patients – Patients using donor oocytes, embryos, or sperm – Patients taking psychotropic medications for depression or anxiety that have had a dosing adjustment within 3 months of study enrollment

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: 99 Years

Are Healthy Volunteers Accepted: Accepts Healthy Volunteers

Investigator Details

  • Lead Sponsor
    • Rachel Whynott
  • Provider of Information About this Clinical Study
    • Sponsor-Investigator: Rachel Whynott, Fellow Physician – University of Iowa
  • Overall Official(s)
    • Rachel M Whynott, MD, Principal Investigator, University of Iowa

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