Reduce Distress and Increase Pregnancy in Women with Fertility Problems with Mind-Body Practices

Reduce Distress and Increase Pregnancy in Women with Fertility Problems with Mind-Body Practices

 

By John M. de Castro, Ph.D.

 

mindfulness becomes the perfect antidote for the paradoxical land mines infertility presents. Mindfulness starts from the perspective that you are whole and complete already, regardless of flaws or imperfections. It is based on the concept of original goodness: your essential nature is good and pure. Proceeding from this vantage point gives you freedom from the bondage of inadequacy and insecurity.” – Janetti Marrota

 

Infertility is primarily a medical condition due to physiological problems. It is quite common. It is estimated that in the U.S. 6.7 million women, about 10% of the population of women 15-44, have an impaired ability to get pregnant or carry a baby to term and about 6% are infertile. Infertility can be more than just a medical issue. It can be an emotional crisis for many couples, especially for the women. Couples attending a fertility clinic reported that infertility was the most upsetting experience of their lives.

 

Women with infertility reported feeling as anxious or depressed as those diagnosed with cancer, hypertension, or recovering from a heart attack. In addition, infertility can markedly impact the couple’s relationship, straining their emotional connection and interactions and the prescribed treatments can take the spontaneity and joy from lovemaking making it strained and mechanical. The stress of infertility and engaging in infertility treatments may exacerbate the problem. Since mindfulness training has been shown to reduce depression, anxiety, and stress it is reasonable to believe that mind-body training may be helpful in reducing the distress in women with fertility issues.

 

In today’s Research News article “An internet-based mind/body intervention to mitigate distress in women experiencing infertility: A randomized pilot trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7080396/), Clifton and colleagues recruited childless adult women who were seeking care for infertility. They were randomly assigned to either a wait-list control condition or to receive a 10-week online program of mind/body for fertility including weekly online modules and homework assignments. “The skills and strategies taught included: (a) knowledge regarding the relationship between stress, lifestyle, and fertility; (b) relaxation techniques including diaphragmatic breathing and Hatha Yoga; (c) mindfulness; (d) cognitive restructuring; (e) stress reduction strategies; (f) listening and communication skills; (g) strategies for emotional expression and effective coping with anger; and (h) assertiveness training and goal-setting skills.” They were measured before and after training for anxiety, depression, perceived stress, and fertility problems.

 

They found that in comparison to baseline and the wait-list control group, the women who received the training had significantly lower levels of anxiety, depression, perceived stress, and infertility related stress specific to sexual and social concerns. At the end of the study the women who received the training had significantly higher self-reported pregnancy rates. 53% of the trained women reported successful pregnancy while only 20% of the wait-list control women did.

 

The study was a randomized controlled trial but the control condition, wait-list, was passive. It would be important for future research to include an active control condition, such as online health education. In addition, the program included a complex set of practices and it is impossible to tease apart what components or combination of components were necessary for the effects observed. It would be interesting in future research to examine the effectiveness of the individual components.

 

Nevertheless, these are interesting and potentially important findings. The online mind/body for fertility program produced significant reductions in the distress levels of the women and increased the likelihood of becoming pregnant. By reducing the psychological distress produced by infertility the program appeared to markedly improve the likelihood of becoming pregnant. This is very helpful in reducing the suffering produced by infertility and thereby improving pregnancy success..

 

In addition, the fact that the program was implemented online makes it scalable at low cost to large groups of women over wide geographic areas and the women can engage in the program at times and places that were most comfortable and convenient for them. This greatly expands the usefulness of the program.

 

So, reduce distress and increase pregnancy in women with fertility problems with mind-body practices.

 

“Many women fear that becoming mindful and starting to meditate will make them passive in their quest for a child.  This simply isn’t so.  The wish for a child remains vibrant and active – it’s simply that happiness doesn’t depend on the fulfillment of this wish.” – Beth Heller

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Clifton, J., Parent, J., Seehuus, M., Worrall, G., Forehand, R., & Domar, A. (2020). An internet-based mind/body intervention to mitigate distress in women experiencing infertility: A randomized pilot trial. PloS one, 15(3), e0229379. https://doi.org/10.1371/journal.pone.0229379

 

Abstract

Objective

To determine if an internet-based mind/body program would lead to participants experiencing infertility (1) being willing to be recruited and randomized and (2) accepting and being ready to engage in a fertility-specific intervention. Secondary exploratory goals were to examine reduced distress over the course of the intervention and increased likelihood to conceive.

Methods

This was a pilot randomized controlled feasibility trial with a between-groups, repeated measure design. Seventy-one women self-identified as nulliparous and meeting criteria for infertility. Participants were randomized to the internet-based version of the Mind/Body Program for Fertility or wait-list control group and asked to complete pre-, mid- and post-assessments. Primary outcomes include retention rates, number of modules completed, and satisfaction with intervention. Secondary exploratory outcomes sought to provide preliminary data on the impact of the program on distress (anxiety and depression) and self-reported pregnancy rates relative to a quasi-control group.

Results

The retention, adherence, and satisfaction rates were comparable to those reported in other internet-based RCTs. Although time between pre- and post-assessment differed between groups, using intent-to-treat analyses, women in the intervention group (relative to the wait-list group) had significant reduction in distress (anxiety, p = .003; depression, p = .007; stress, p = .041 fertility-social, p = .018; fertility-sexual, p = .006), estimated as medium-to-large effect sizes (ds = 0.45 to 0.86). The odds of becoming pregnant was 4.47 times higher for the intervention group participants as compared to the wait-list group, OR 95% CI [1.56, 12.85], p = .005 and occurred earlier. The findings suggest that the research design and program specific to this population are feasible and acceptable. Replication efforts with an active control group are needed to verify distress reduction and conception promotion findings.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7080396/

 

Decrease Depression in Women with Reproductive Problems with Mindfulness

Decrease Depression in Women with Reproductive Problems with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness is a potentially feasible and efficacious intervention for reducing depressive symptoms and preventing major depression among people with subthreshold depression in primary care.” – Samuel Wong

 

Infertility is primarily a medical condition due to physiological problems. It is quite common. It is estimated that in the U.S. 6.7 million women, about 10% of the population of women are infertile. Infertility can be more than just a medical issue. It can be an emotional crisis for many couples, especially for the women. Couples attending a fertility clinic reported that infertility was the most upsetting experience of their lives. Women with infertility reported feeling as anxious or depressed as those diagnosed with cancer, hypertension, or recovering from a heart attack.

 

Mindfulness training been shown to be an effective treatment for depression and its recurrence and even in the cases where drugs fail. This is especially true for Mindfulness-Based Cognitive Therapy (MBCT) which was specifically developed to treat depression. So, it would be expected that MBCT would be effective in treating the depression that occurs in women with infertility and sexual dysfunction.

 

In today’s Research News article “Comparative Effectiveness of Antidepressant Medication versus Psychological Intervention on Depression Symptoms in Women with Infertility and Sexual Dysfunction.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5767934/ ), Pasha and colleagues recruited women with infertility who were also showing symptoms of depression. They were randomly assigned to receive either Psychosexual Therapy, Antidepressant drugs, or treatment as usual. Psychosexual Therapy consisted of MBCT, relaxation training, and behavior sex therapy. MBCT consisted of 2-hour sessions once a week for 8 weeks and included home practice. MBCT involves mindfulness training, containing sitting and walking meditation and body scan, and cognitive therapy to alter how the patient relates to the thought processes that often underlie and exacerbate psychological symptoms. Depression and sexual dysfunction levels were measured before and after training.

 

They found that both the Psychosexual Therapy and antidepressant drug groups had significant decreases in depression, but the Psychosexual Therapy group had significantly greater improvements (58% decrease) than the antidepressant drug group (28% decrease). They also found that the lower the levels of depression the higher the levels of sexual function. These results suggest that Psychosexual Therapy that includes Mindfulness-Based Cognitive Therapy (MBCT) is not only an effective treatment for depression in women with infertility but is also superior in effectiveness to antidepressant drugs. This is a remarkable result, with Psychosexual Therapy being far superior to drug treatment in treating depression in these women.

 

So, decrease depression in women with reproductive problems with mindfulness.

 

“mindfulness regimens, at least as they are often structured, may be better attuned to addressing the ways that women typically process emotions than the ways that men often do.” – David Orenstein

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Pasha, H., Basirat, Z., Faramarzi, M., & Kheirkhah, F. (2018). Comparative Effectiveness of Antidepressant Medication versus Psychological Intervention on Depression Symptoms in Women with Infertility and Sexual Dysfunction. International Journal of Fertility & Sterility, 12(1), 6–12. http://doi.org/10.22074/ijfs.2018.5229

 

Abstract

Background

Fertility loss is considered as a challenging experience. This study was conducted to compare the effectiveness of antidepressant medication and psychological intervention on depression symptoms in women with infertility and sexual dysfunctions (SD).

Materials and Methods

This randomized, controlled clinical trial study was completed from December 2014 to June 2015 in Babol, Iran. Of the 485 participants, 93 were randomly assigned in a 1:1:1 ratio to psychosexual therapy (PST), bupropion extended-release (BUP ER) at a dose of 150 mg/d, and control (no intervention) groups. The Beck Depression Inventory (BDI) was completed at the beginning and end of the study. Duration of study was eight weeks. Statistical analyses were performed by using paired-test and analysis of covariance.

Results

The mean depression score on the BDI was 22.35 ± 8.70 in all participants. Mean BDI score decreased significantly in both treatment groups (PST: P<0.0001, BUP: P<0.002) from baseline to end of the study, whereas intra-individual changes in BDI score were not significant in the control group. The decrease in mean BDI score was greater with PST compared to BUP treatment (P<0.005) and the control group (P<0.0001). The PST group showed greater improvement in depression levels (severe to moderate, moderate to mild) in comparison with the two other groups (P<0.001). Drug treatment was well tolerated by the participants in the BUP group.

Conclusion

PST can be a reliable alternative to BUP ER for relieving depression symptoms in an Iranian population of women with infertility and SD

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5767934/

 

Improve Fertility with Mindfulness

 

“Using your mind to improve your fertility? Not as strange as you might think! If you have ever blushed, you’ll understand what I mean. That embarrassment you felt, visible to the world. Research shows emotions influence all body functions, especially fertility hormones. Fertility Mindfulness tips the odds of conceiving in your favor. Re-align your mindset and prepare for conception success, no matter what you have experienced.” – Helena Tubridy

 

Infertility is primarily a medical condition due to physiological problems. It is quite common. It is estimated that in the U.S. 6.7 million women, about 10% of the population of women 15-44, have an impaired ability to get pregnant or carry a baby to term and about 6% are infertile.

 

Infertility can be more than just a medical issue. It can be an emotional crisis for many couples, especially for the women. Couples attending a fertility clinic reported that infertility was the most upsetting experience of their lives. Women with infertility reported feeling as anxious or depressed as those diagnosed with cancer, hypertension, or recovering from a heart attack. Men’s reactions are more complicated. If the reason for the infertility is due to an issue with the woman, then men aren’t as distressed as the women. But if they are the ones who are infertile, they experience the same levels of low self-esteem, stigma, and depression as infertile women do. In addition, infertility can markedly impact the couple’s relationship, straining their emotional connection and interactions and the prescribed treatments can take the spontaneity and joy from lovemaking making it strained and mechanical.

 

The stress of infertility and engaging in infertility treatments may exacerbate the problem. The anxiety and stress may actually make it more difficult to conceive. In fact, recent studies found that higher rates of infertility treatment success in people who were undergoing a mind–body interventions. So, reducing stress and anxiety may be beneficial for conception. Since mindfulness training has been shown to reduce anxiety (see http://contemplative-studies.org/wp/index.php/category/research-news/anxiety/) and stress (see http://contemplative-studies.org/wp/index.php/category/research-news/stress/) it is reasonable to believe that mindfulness training may be helpful for conception in women with fertility issues.

 

In today’s Research News article “Effects of a mindfulness-based intervention on fertility quality of life and pregnancy rates among women subjected to first in vitro fertilization treatment”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1162617577095500/?type=3&theater

Li and colleagues conducted a 6-week mindfulness training with women undergoing in-vitro fertilization treatment. In comparison to a treatment as usual control group, they found that the mindfulness training produced significant improvements in mindfulness, self-compassion, emotion regulation, improved coping responses and fertility quality of life. There was also a decrease in the influence of infertility on physical health, cognition, and behavior. Importantly, the treatment resulted in significantly higher proportion of the participants who had a viable pregnancy by virtue of in vitro fertilization.  Hence it appears that mindfulness treatment improves the women’s psychological and physical well-being and this in turn improves their ability to have a successful outcome to in vitro fertilization, becoming pregnant.

 

These are wonderful and encouraging findings that mindfulness can have such significant positive benefits for women with infertility. The fact that mindfulness is known to reduce the physical and psychological responses to stress, reduce anxiety, and improve emotion regulation is likely responsible for these benefits. This allows the women to better cope with the difficulties of infertility and its treatment.

 

Mindfulness training is a safe and effective treatment with many benefits for virtually everyone and for many psychological and medical issues. The results from this study add infertility treatment to the usefulness and positive effects of mindfulness training. This can be of great benefit to large numbers of women who struggle with infertility.

 

So, improve fertility with mindfulness.

 

“My bottom line is that if mindfulness and meditation are things that you would be interested in anyway, then using them as a strategy to help cope with fertility treatment sounds logical and beneficial.” – Erin Stronach

 

CMCS – Center for Mindfulness and Contemplative Studies