Acceptance and commitment therapy for women experiencing infertility: A randomized controlled trial

Abstract

Approximately one in six Canadian couples are infertile, defined as the inability to achieve pregnancy despite 12 or more months of active attempts to conceive. While the psychological burden is well-established in the literature, currently available and adapted psychological interventions have had minimal effects on infertility-related distress, anxiety, or depression. We examined the efficacy of Acceptance and Commitment Therapy (ACT) to reduce distress associated with infertility. In Study One, we created the ACT-based intervention in collaboration with a panel of women who had lived experience with infertility. We then conducted a pilot trial with 20 women and used their feedback to refine and update the intervention. Study Two involved a randomized controlled trial (RCT) of the updated ACT intervention, recruiting 90 women who were randomized to the intervention or waitlist control groups. This study aimed to rigorously evaluate the efficacy of the ACT program in alleviating infertility-related distress. Among the recruited sample, 71% completed the entire intervention. Among the eighty-five participants who provided at least partial outcome data, the intervention group showed statistically greater improvements in all three primary outcomes: anxious symptoms (B(SE) = -2.3 (1.3), p = .036), depressive symptoms (B(SE) = -3.8 (1.2), p <.001), and fertility quality of life (B(SE) = 13.6 (3.1), p <.001) relative to the waitlist control group when adjusting for baseline symptom severity. Psychological inflexibility also decreased (B(SE) = -0.6 (0.2), p = .004), while psychological flexibility and relationship satisfaction remained unchanged (p > .05) in the intervention condition compared to the waitlist control condition. Effects were maintained at a one-month follow-up. This intervention shows promise as a cost-effective and accessible intervention for individuals experiencing infertility.