JBRA Assisted Reproduction 2025;29(Suppl.2 SBRA 2025):85
Poster Presentation
29th Annual Congress of the SBRA. São Paulo/SP - Brazil, 2025
doi: 10.5935/1518-0557.20263665
P-73. Effects of a Group-Based Cognitive Behavioral Therapy Program on Anxiety and Stress in Women Undergoing Infertility Treatment: Preliminary Findings from a Randomized Study
Paula Barros Terraciano1, Thalyta Freitas dos Santos Laguna2, Isabel Oliveira Durli1, Maria Eduarda Leite Simões1, Amanda Wink-Santos1, Manuela Cardoso Marques1, Stephanie Lins-Silveira1, Ivan Sereno Montenegro1, Eduardo Pandolfi Passos3, Markus Berger1
1 Hospital de Clínicas de Porto Alegre - Porto Alegre - Rio Grande do Sul – Brasil
2 Universidade Federal do Rio Grande do Sul - Porto Alegre - Rio Grande do Sul – Brasil
3 Hospital Moinhos de Vento - Porto Alegre - Rio Grande do Sul – Brasil
Objective: To assess anxiety and stress levels in women undergoing infertility treatment, before and after participation in a group-based Cognitive Behavioral Therapy (CBT) program, exploring clinical response trends and possible associations with quality of life.
Methods: This is an experimental study with pre- and post-intervention assessment, conducted at a public hospital in southern Brazil. Forty-two women aged between 20 and 40 years, all with a diagnosis of infertility, participated. Participants were randomly allocated into two groups: Intervention Group (IG, 22) and Control Group (CG, 20). The IG attended eight weekly sessions involving cognitive-behavioral techniques, while the CG received no intervention during the study period. Anxiety was assessed using the Beck Anxiety Inventory (BAI), and stress was assessed using the Lipp Stress Symptoms Inventory for Adults (ISSL-R), both administered before and after the intervention. Sociodemographic data were collected through a specific questionnaire, and quality of life was assessed using the Fertility Quality of Life Tool (FertiQol), both used for exploratory analysis. The data presented refer to a partial analysis of an ongoing master's research project, still in the statistical analysis phase. All the prodecedures were approved by the Institutional Ethics Committee (number 2023-0475).
Results: Regarding anxiety (BAI), in the total sample (N=42), 42.9% of participants showed a reduction in anxiety levels, 16.7% an increase, and 40.5% remained stable. Improvement was observed in the scores, with an increase in the percentage of participants classified with minimal anxiety — considered within normal and desirable parameters (from 38.1% to 52.4%) and a reduction in moderate (from 21.4% to 14.3%) and severe levels (from 7.1% to 4.8%). In the IG, 59.1% showed improvement, with a marked shift toward minimal anxiety (from 31.8% to 59.1%) and a sharp decrease in the moderate level (from 27.3% to 4.5%). The CG remained relatively stable, with 25% showing improvement, 25% worsening, and 50% unchanged, along with an increase in moderate anxiety (from 15% to 25%). As for stress (ISSL-R), the initial assessment showed that 59.5% of participants were at severe levels, 31% at moderate levels, and 9.5% at mild levels. After the intervention, the IG showed a significant reduction in stress levels: 59.1% transitioned to less severe phases, 31.8% remained stable, and 9.1% worsened. In contrast, in the CG, only 15% improved, 55% remained in the same phase, and 30% worsened, progressing to more severe levels of stress.
Conclusion: The preliminary data indicate that, at the pre-intervention stage, the prevalence of moderate and severe stress (90.5%) was considerably higher than that of anxiety at the same levels (28.5%), suggesting that, in the context of infertility, stress may represent a more chronic and pervasive response to the prolonged demands of the reproductive process, whereas anxiety tends to manifest in a milder and more episodic form. The evidence gathered so far suggests that group-based psychological interventions grounded in CBT have an effective potential to promote emotional reorganization, symptom reduction, and improved regulation of the psychophysiological states activated by the reproductive experience. Chronic stress related to infertility may trigger dysfunctions in the hypothalamic-pituitary-adrenal (HPA) axis, directly affecting neuroendocrine balance, immune system functioning, cognitive performance, emotional well-being, and, consequently, quality of life. Therefore, regardless of the final statistical significance of the data, the effects observed thus far present clinically relevant implications for the participants' overall health and quality of life, reinforcing the importance of incorporating structured psychological interventions into assisted reproduction contexts. The ongoing statistical analysis will be essential to confirm the robustness of these effects and support their applicability on a broader clinical scale.