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Impact of empathic physician contact on patient anxiety and distress during the waiting period after embryo transfer: a randomized controlled trial

  • Jaimin S. Shah
    Correspondence
    Corresponding author.
    Affiliations
    Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston MA, USA

    Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston MA, USA

    Boston IVF/Eugin Group, Waltham MA, USA
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  • Laura E. Dodge
    Affiliations
    Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston MA, USA

    Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston MA, USA

    Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston MA, USA
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  • Denis A. Vaughan
    Affiliations
    Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston MA, USA

    Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston MA, USA

    Boston IVF/Eugin Group, Waltham MA, USA
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  • Kristin L. Rooney
    Affiliations
    Boston IVF/Eugin Group, Waltham MA, USA
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  • Alan S. Penzias
    Affiliations
    Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston MA, USA

    Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston MA, USA

    Boston IVF/Eugin Group, Waltham MA, USA
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  • Alice D. Domar
    Affiliations
    Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston MA, USA

    Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston MA, USA

    Boston IVF/Eugin Group, Waltham MA, USA

    Domar Center for Mind/Body Health, Boston IVF, Waltham MA, USA
    Search for articles by this author

      Highlights

      • A physician phone call during the waiting period mitigates patient anxiety/distress
      • Most participants who received the physician call reported it to be helpful
      • Most participants who received the physician call reported a decrease in anxiety/distress

      Abstract

      Research question

      Can an empathic physician phone call in the interval between embryo transfer and first serum human chorionic gonadotrophin measurement decrease anxiety and distress amongst patients undergoing IVF?

      Design

      This was a randomized controlled trial at a single academically-affiliated fertility centre including patients aged 18–43 undergoing their first embryo transfer with autologous fresh or euploid cryopreserved embryos following preimplantation genetic testing for aneuploidies (frozen embryo transfer, FET/PGT-A). After embryo transfer, participants were randomized to a 5-minute scripted phone call (intervention) from a single physician 3–4 days after embryo transfer or to routine care. The primary and secondary outcomes included were change in State-Trait Anxiety Inventory (STAI) and Hospital Anxiety and Depression Scale (HADS) scores from the start of IVF stimulation to 8–9 days after embryo transfer, respectively.

      Results

      A total of 231 participants (164 fresh, 67 FET/PGT-A) were randomized to intervention (n = 116) or routine care (n = 115). While mean STAI and HADS scores increased in both groups, the intervention group experienced lower mean increases than the routine care group for both the STAI (3.3 [0.97] versus 7.8 [1.10], respectively; P = 0.002) and the HADS (0.3 [0.44] versus 2.4 [0.53], respectively; P = 0.003). Most participants in the intervention group found the call helpful (91.4%) and reported that it decreased distress and anxiety (81%).

      Conclusions

      A brief empathic phone call from a physician during the waiting period resulted in significantly lower self-reported levels of patient anxiety and distress. As the intervention in this study averaged 5 min, implementing this in clinical practice would not be onerous and may ease the distress associated with the waiting period.

      Keywords

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      Biography

      Jaimin S Shah, MD, is a Clinical Fellow in Reproductive Endocrinology and Infertility at Beth Israel Deaconess Medical Center/Harvard Medical School and Boston IVF. He completed his medical school and residency at the McGovern Medical School in Houston, Texas. His research interests include mental health and perinatal outcomes.
      Key message
      A brief empathic physician phone call during the waiting period resulted in significantly lower self-reported levels of patient anxiety/distress. As the intervention used in this study averaged 5 min of physician time, implementing this in clinical practice would not be onerous and may ease the distress associated with the waiting period.