199-206
The Effect of The Cognitive Behavioral Therapy and Pharmacotherapy on Infertility Stress:A Randomized Controlled Trial
Authors: Mahbobeh Faramarzi , Hajar Pasha , Seddigheh Esmailzadeh , Farzan Kheirkhah , Shima Heidary , Zohreh Afshar
Number of views: 573
Background: Infertility has been described as creating a form of stress leading to a variety
of psychological problems. Both psychotherapy and pharmacotherapy are effective
treatments for infertility stress. The aim of this study was to evaluate the effectiveness of
cognitive behavioral therapy along with fluoxetine for improvement infertility stress in
infertile women.
Materials and Methods: In a randomized controlled clinical trial, 89 infertile women
with mild to moderate depression (Beck scores 10-47) were recruited into the following
three groups: i. cognitive behavior therapy (CBT), ii. antidepressant therapy,
and iii. control group. Twenty-nine participants in the CBT method received gradual
relaxation training, restructuring, and eliminating of negative automatic thoughts
and dysfunctional attitudes to infertility for 10 sessions. Thirty participants in the
pharmacotherapy group took 20 mg fluoxetine daily for 90 days. Thirty individuals
in control group did not receive any intervention. All participants completed fertility
problem inventory (FPI) and the Beck Depression Inventory (BDI) at the beginning
and end of the study. We applied Chi-square paired t test, ANOVA and Turkey’s test
to analyze the data.
Results: The mean of the infertility stress scores in CBT, fluoxetine, and control
groups at the beginning and end of the study were as follows, respectively: 3.5 ±
0.62 vs.2.7 ± 0.62 (p<0.05), 3.5 ± 0.53 vs.3.2 ± 4.4 (p<0.05), and 3.4 ± 0.55 vs. 3.5
± 0.48. In CBT group, the mean scores of social concern, sexual concern, marital
concern, rejection of child-free lifestyle, and need for parenthood decreased meaningfully
compared to those before starting the therapy. But in fluoxetine group,
mean score of women sexual concern out of those five main problems of infertility
reduced significantly. Also, fluoxetine and CBT reduced depression compared to the
control group.
Conclusion: CBT improved the social concerns, sexual concerns, marital concerns,
rejection of child-free lifestyle, and need for parenthood more than floxitine group.
Thus, CBT was not only a reliable alternative to pharmacotherapy, but also superior
to fluoxetine in resolving and reducing of infertility stress (Registration Number:
IRCT2012061710048N1).