Anxiety in couples undergoing IVF: evidence from E-Freeze randomised controlled trial

Area of Science:

• Reproductive Medicine
• Psychological Health in Fertility Treatment
• Clinical Trials in Assisted Reproduction

Background:

• In vitro fertilization (IVF) use is increasing, with patients experiencing significant anxiety.
• Participation in randomized controlled trials (RCTs) and treatment delays may exacerbate patient anxiety.

Purpose of the Study:

• To investigate risk factors and impacts of anxiety in heterosexual couples undergoing IVF within a randomized trial.
• To examine anxiety in relation to treatment arm allocation, specifically a delay in embryo transfer.

Main Methods:

• A mixed-methods study analyzed data from 604 couples in the multi-center E-Freeze RCT (UK, 2016-2019).
• State-Trait Anxiety Inventory (STAI-S) scores were measured at consent (T1) and embryo transfer (T2).
• Regression analyses explored associations between anxiety scores and demographic/clinical factors, and qualitative content analysis of questionnaires was performed.

Main Results:

• Women's anxiety at T1 was linked to infertility duration, ethnicity, and male partner's anxiety. At T2, women's anxiety correlated with ethnicity, clinic location, their own T1 score, and partner's T2 score.
• Women reported higher anxiety than men, with greater increases between T1 and T2.
• Crucially, women's anxiety scores did not correlate with non-compliance or clinical pregnancy rates.

Conclusions:

• Anxiety in IVF patients is influenced by various factors, including partner anxiety and demographic characteristics.
• Women can be reassured that their self-reported anxiety does not affect IVF success (clinical pregnancy).
• Patient-centered care, clear communication, and staff support are vital for managing psychological well-being during IVF.