Descriptive statistics for depressive symptoms.

Background
Couples undergoing fertility treatment experience emotional stress. Meta-analyses show heterogeneous results regarding the effectiveness of psychosocial interventions on anxiety and depression.
Objective
The aim of this study was to reduce psychosocial stress (anxiety, depression) in infertile patients. In addition, pregnancy rates and perceived distraction as well as perceived subjective relief were determined.
Methods
In a two-arm RCT we used “Positive Adjustment Coping Intervention (PACI)”. Participants received the first of 13 daily text messages on their smartphones on the day on which the cryopreserved embryos were thawed or one day after oocyte aspiration. Patients in the PACI condition obtained daily positive adjustment statements and were asked to relate these to their personal situation at least twice a day. Patients in the comparison condition were given daily think tasks providing cognitive distraction. Anxiety and depression scores were assessed with ScreenIVF and perceived distraction as well as relief with an evaluation form.
Results
PACI did not reduce participant´s depressive scores measured with standardized questionnaire (P < .007, N = 227), did not significantly change participant´s anxiety (N = 227), nor did it increase pregnancy rates (N = 191). PACI had a significant effect on subjective perceived distraction (P = .005, N = 197) and on perceived relief (P = .026, N = 197).
Conclusion
This is the first RCT to use modern media to test a simple positive adjustment cognition intervention in women and men who underwent fertility treatment. The low-dose psychosocial intervention apparently was not sufficient to reduce emotional distress during the waiting period between embryo transfer and pregnancy test. Preferably, psychosocial support for infertile individuals could be provided face-to-face to reduce the target variables depression and anxiety. However, PACI has a positive influence on perceived distraction and perceived relief.
Trial registration
ClinicalTrials.gov: NCT03118219 (July 9, 2019)

背景
接受辅助生殖治疗的夫妇普遍存在情绪应激问题。现有荟萃分析显示，社会心理干预对焦虑、抑郁症状的改善效果存在异质性。
目的
本研究旨在减轻不孕患者的社会心理应激（焦虑、抑郁），同时探究干预对妊娠率、受试者感知的分心程度及主观缓解感受的影响。
方法
本研究采用双臂随机对照试验（RCT）设计，干预措施为「积极适应应对干预（Positive Adjustment Coping Intervention, PACI）」。受试者于冷冻胚胎解冻当日或取卵术后1日，通过智能手机接收13条每日短信中的第一条。PACI组受试者每日接收积极适应话术，并需每日至少两次将话术内容与自身处境相结合进行思考；对照组受试者则接收旨在提供认知分心的日常思考任务。采用ScreenIVF量表评估焦虑与抑郁得分，采用评估问卷测量受试者感知的分心程度及主观缓解感受。
结果
经标准化测评，PACI未能显著降低受试者的抑郁得分（P < 0.007, N = 227），对焦虑症状亦无显著改善作用（N = 227），同时未提升妊娠率（N = 191）。但PACI对受试者的主观感知分心程度（P = 0.005, N = 197）及主观缓解感受（P = 0.026, N = 197）均产生了显著影响。
结论
本研究为首个采用现代媒介，针对接受辅助生殖治疗的男女受试者开展简易积极适应认知干预的随机对照试验。低剂量社会心理干预似乎不足以缓解胚胎移植与妊娠检测等待期间的情绪应激。未来或可考虑为不孕人群提供面对面的社会心理支持，以改善抑郁、焦虑等核心靶标症状。不过，PACI对受试者的感知分心程度及主观缓解感受具有积极作用。
试验注册
ClinicalTrials.gov: NCT03118219（2019年7月9日）