A recent study published in PLOS One highlights how a solution-focused approach (SFA) can significantly improve anxiety, depression, sleep quality, and reproductive health in women undergoing in vitro fertilization-embryo transfer (IVF-ET).
Infertility affects 3.5% to 16.7% of women in developed countries and 6.9% to 9.3% in developing nations, with many seeking assisted reproductive technologies (ART) to conceive. However, the success rates of ART decrease with age, particularly after 35, which can lead to heightened emotional distress and reduced overall well-being.
“The negative emotions, such as anxiety and depression, experienced by older women with infertility can worsen their quality of life, sleep, and even negatively impact pregnancy outcomes and fetal health,” the study’s authors noted.
What is the Solution-Focused Approach (SFA)?
SFA is a psychological method that aims to foster personal growth by helping individuals focus on solutions rather than problems. It involves five key steps: identifying the problem, setting goals, exploring expectations, providing feedback, and evaluating progress. Previous studies have shown that SFA is effective across various populations.
In this study, the researchers applied SFA to women aged 35 and older who were undergoing IVF-ET. They measured the impact of SFA on mental health, sleep quality, reproductive life quality, and clinical pregnancy outcomes.
Study Design and Methodology
The study involved women aged 35 and older who were undergoing IVF-ET and had high self-reported anxiety (50 or higher) and depression (53 or higher). Women with serious health conditions, male partners with severe oligozoospermia, or those receiving psychological treatments in the past two months were excluded.
Participants first completed self-reported questionnaires to assess their demographics, clinical conditions, and health-related outcomes. Following this, women in the SFA group received their first intervention session immediately after the assessment.
On the day of embryo transfer, both groups underwent further evaluations, which included measuring anxiety, depression, sleep quality, reproductive health quality, and satisfaction with the intervention. Clinical pregnancy rates were also monitored 28 to 30 days later.
Control vs. SFA Intervention Group
The control group received routine care, including guidance during the IVF-ET procedure and related stages like ovulation induction, oocyte retrieval, and embryo transfer. In addition to standard care, the SFA group received psychological support through SFA interventions.
During these sessions, patients discussed the sources of their anxiety and depression in a 30 to 60-minute session at each key stage of the IVF process. These included the start of treatment, ovulation induction, HCG trigger day, oocyte retrieval day, and embryo transfer day.
Measuring Outcomes
The effectiveness of the SFA was assessed through several measurement tools. Anxiety and depression were evaluated using the 20-item self-rating anxiety scale (SAS) and the 20-item self-rating depression scale (SDS). Both scales range from 20 to 80, with higher scores indicating more severe symptoms.
Additional measures included the Pittsburgh Sleep Quality Index (PSQI), the Fertility Quality of Life (FertiQoL) scale, and a satisfaction questionnaire developed by the study authors.
Study Results
A total of 112 women participated in the study, with 56 in the intervention group and 56 in the control group. After a few dropouts, the final analysis included 54 participants per group. The average age was 41.12 ± 4.12 years, and most participants had a healthy body mass index (BMI), with 46.6% falling within the normal range of 18.5–23.9 kg/m².
While there were no significant differences in baseline scores between the groups, the SFA group showed substantial improvements after the intervention. Anxiety and depression scores dropped significantly by 10.35 and 5.09 points, respectively, compared to the control group. In addition, the SFA group had a significantly better PSQI score, indicating improved sleep quality.
Regarding quality of life, the SFA group also reported better fertility-related life quality with a difference of 2.39 points on the FertiQoL scale. Most participants in the SFA group expressed satisfaction with the intervention, although two women were dissatisfied with the number and length of sessions.
Importantly, the clinical pregnancy rates did not differ between the two groups, suggesting that while the SFA intervention improved mental health and quality of life, it did not directly influence pregnancy outcomes.
Conclusion
This study confirms the positive impact of the solution-focused approach on reducing anxiety and depression in older women undergoing IVF-ET. Additionally, it highlights improvements in sleep quality and reproductive life quality. The findings suggest that SFA can be an effective tool in psychological care for women facing infertility challenges, supporting both emotional well-being and overall life satisfaction during IVF treatment.
