1 - (SYM 48) Acceptance and Commitment Therapy for Infertility Patients

In the US, around 19% of couples suffer from infertility (ASRM). Infertility-related psychological distress is common and associated with reductions in the likelihood of pursuing and continuing infertility treatment (Domar et al., 2018). Meta-analyses support the use of psychological interventions with infertility patients. However, effects have generally been small and short-term (Dube et al., 2023), highlighting the need to investigate interventions that produce larger, longer-lasting effects. Moreover, studies have focused on symptom reduction as main outcomes. However, in the context of infertility’s frequent stressors, solely examining symptom reduction may not be sufficient for understanding an intervention’s impact. For example, what if an intervention can increase the likelihood that a patient pursues activities that are important to her even while experiencing appropriate distress?

Infertility patients commonly engage in experiential avoidance, characterized by avoidance of difficult or unwanted internal experiences, to cope with their distress (Schuette et al., 2023). Experiential avoidance is associated with the development and maintenance of psychological distress (Hayes-Skelton & Eustis, 2020). Thus, using a therapeutic approach that addresses this process might be particularly beneficial (Barbosa, Santos, & Pedro, 2023). In the current paper, we outline Acceptance and Commitment Therapy (ACT) as a potentially well-suited intervention for infertility patients due to its emphasis on acceptance, rather than avoidance, of emotional pain and commitment to values-based action. We present a case series (PRO00115010) in which women undergoing fertility treatment at a major medical center receive 12 sessions of ACT (target N=10). Patients receive therapy at the fertility clinic, as part of a comprehensive, integrated healthcare model designed to increase access to care and meet complex patient needs. We examine change in psychological processes (i.e., psychological flexibility, values clarity, tolerance of uncertainty) that are hypothesized mechanisms of change, mood (i.e., distress, depression, anxiety), and behavior (i.e., engagement with values-based activities). To our knowledge, there are no RCTs examining the use of ACT with infertility patients in the US. Investigating relationships between change in mood, distress, and psychological processes can inform future clinical trials by illuminating potential mechanisms through which psychological interventions benefit infertility patients.