P-42: The effect of medical clowning on in vitro fertilization and embryo transfer treatment

Abstract

The aim of our study was to evaluate the impact of medical clowning following embryo transfer on pregnancy rates after IVF-ET. Medical clowning involves a new approach of using humor as an adjunctive therapy in medical situations. No reports are available concerning the impact of humor on infertility or the outcome of IVF. A prospective randomized study was performed in a university affiliated IVF unit. A medical clowning session of 10-15 minutes was especially composed, suitable for couples under fertility treatment. The medical clown team of our center invented this program. 186 patients who underwent IVF-ET at the IVF unit of Assaf-Harofeh Medical Center were included in the study. Following routine embryo-transfer procedure, every other Thursday for a period of 10 months, all patients were offered a personal encounter with a professional medical clown who performed a similar bedside routine session. Bits of this medical clown session will be shown by a short video. The outcome of the treatment cycles of patients who had an encounter with the medical clown (study group) was compared to the outcome of the patients, who had a routine embryo transfer on a successive Thursday, who did not encounter a medical clown (control group). 186 patients were included in the study and control groups. Patients mean age (34.0±5.0 vs 33.9±6.1, p=ns, study and control groups respectively), length of infertility (3.9±3.0 vs 4.1±3.1 years, p=ns, study and control groups respectively), number of previous IVF cycles (3.1±3.6 vs 3.0±3.2, p=ns, study and control groups respectively), indications for IVF between the two groups were comparable. Regarding the treatment cycle parameters, the number of oocytes retrieved were comparable (11.2±8.1 vs 11.2±7.2, for the study vs control groups, p=ns). Although the mean number of embryos transferred was less in the study group (2.3±0.8 vs 2.6±1.4, p<0.01), 33 patients out of the 93 in the study group conceived (35.5% per embryo transfer), whereas only 18 patients out of the 93 in the control group conceived (19.3% per embryo transfer). This difference was significant (p=0.002, Chi-square test), Odds ratio 2.29; 95% CI limits: 1.11-4.72. For the first time, in a prospective randomized study, medical clowning has been shown as an original, effective adjunctive intervention having a beneficial effect upon outcome of IVF-ET. The benefits of use of humor and medical clowning should be further investigated in conjunction with infertility and its treatment.