Development and Preliminary Evaluation of an AI Chatbot-Based Psychosocial Self-Management Program for Women with...

Women undergoing infertility treatment experience elevated perceived stress, anxiety, and difficulty identifying and describing their emotions (alexithymia), yet access to conventional psychological care is constrained by stigma, time, and cost.

To develop an artificial intelligence (AI) chatbot-based psychosocial self-management program for women with infertility and to examine its feasibility and preliminary patterns of change in perceived stress, depressive symptoms, state anxiety, and alexithymia. Feasibility was the primary objective; the four psychological measures were secondary and are reported as exploratory.

A non-randomized, two-group pretest-posttest feasibility study was conducted with 37 women recruited sequentially from a single infertility centre in the Republic of Korea; the comparison group was recruited and assessed first (n = 19), followed by the intervention group (n = 18). The intervention group completed six chatbot sessions over two weeks. Outcomes were the Perceived Stress Scale (PSS), Patient Health Questionnaire-9 (PHQ-9), State-Trait Anxiety Inventory-State subscale (STAI-S), and the 20-item Toronto Alexithymia Scale (TAS-20).

Feasibility indicators were favourable: retention was 92.5% overall (37/40) and 90.0% in the intervention group (18/20), and all retained intervention participants completed all six sessions (108/108, 100%). The groups differed at baseline in age (33.33 ± 3.36 vs. 35.84 ± 4.00 years, p = 0.047). Group × time interactions favoured the intervention group for perceived stress (F(1, 35) = 14.37, p < 0.001, η_p² = 0.29), state anxiety (F(1, 35) = 4.40, p = 0.043, η_p² = 0.11), and alexithymia (F(1, 35) = 6.92, p = 0.013, η_p² = 0.16), but not for depressive symptoms (F(1, 35) = 3.66, p = 0.064, η_p² = 0.09).

The program was feasible in terms of retention and adherence, with all retained intervention participants completing all six sessions. Because allocation was non-random and confounded with calendar time, and because the sample was small, these findings describe preliminary patterns of change and do not establish effectiveness. An adequately powered randomized trial with concurrent recruitment, an attention-matched comparator, and follow-up assessment is required.