Emotional freedom techniques-based counseling with breathing exercises in in vitro fertilization: effects on psychological distress and well-being.

PURPOSE: To investigate whether psychosocial care during in vitro fertilization (IVF) treatment affects the emotional capacity and well-being of women undergoing fertility treatment.

METHODS

This randomized controlled, single-blind study was conducted between February 2020 and March 2021. A total of 112 women undergoing IVF were recruited based on predefined inclusion and exclusion criteria. After a 24.1 % loss to follow-up (n = 27), data from 85 participants (42 in the experimental group, 43 in the control group) were analyzed. The control group received routine care, while the intervention group attended a structured seven-session counseling program that included coping strategies such as Emotional Freedom Technique (EFT) and breathing exercises. Psychological outcomes were measured at three time points using Screening Tool on Distress in Fertility Treatment (SCREENIVF), Fertility Quality of Life Tool (FertiQol), COMPI Fertility Problem Stress Scales (COMPI-FPSS), and Subjective Units of Distress (SUD) scale. Group comparisons were analyzed with appropriate statistical methods.

RESULTS

Baseline characteristics did not differ between groups (p > 0.05). The experimental group had a higher positive hCG rate on day + 13 of IVF (42.9 % vs. 18.6 %, p = 0.015). Post-intervention, they showed greater reductions in anxiety (Cohen's d = -0.72, 95 % CI [-1.15 to -0.28], p = 0.001) and helplessness (Cohen's d = 1.26, 95 % CI [0.79-1.72], p < 0.001), and increased acceptance (p < 0.001), while depression decreased non-significantly (p = 0.167). Personal and social stress decreased (Cohen's d = -0.99, 95 % CI [-1.43 to -0.54], p < 0.001; social domain p = 0.003), but marital stress did not (p = 0.619). FertiQOL total and Treatment Environment scores improved (Cohen's d = -1.89, 95 % CI [-2.39 to -1.39], p < 0.001; Cohen's d = -1.71, 95 % CI [-2.20 to -1.22], p < 0.001), whereas Treatment Tolerance did not differ (p = 0.001). SUD scores decreased after sessions 2, 4, and 5 (r = -0.62 to -0.63, 95 % CI [-0.77 to -0.46], p < 0.001). Effect sizes indicate medium to large clinical relevance. Participants at risk per SCREENIVF showed marked stress reduction and improved quality of life, with referrals to mental health services as needed.

CONCLUSION

Psychosocial care during IVF treatment appears to reduces psychological distress and enhances treatment-related well-being in women undergoing fertility procedures. These findings support the incorporation of psychosocial interventions into standard fertility care.