ObjectiveInfertility treatment is associated with high levels of stress and anxiety. Some countries mandate routine counseling to couples during infertility treatment. We conducted an RCT comparing the efficacy of Stress Management And Resiliency Training (SMART) to stress reduction CD.DesignRCTMaterials and MethodsHeterosexual couples undergoing a first IVF cycle were eligible. Exclusion criteria were female age >40 years, recurrent miscarriage and current or recent (6 months) psychotic episode. Couples were randomized 1:1 to the SMART arm or CD. Those in the SMART arm attended a single 90-minutes group session that taught skills in self-awareness, and ways to strengthen attention, and incorporate greater gratitude, compassion, acceptance and purpose. Breathing-based relaxation was also incorporated. CD arm received a stress reduction CD. All participants completed validated instruments: Perceived Stress Scale (PSS-10), Fertility problem inventory (FPI), General Anxiety Disorder (GAD-7), Gratitude Questionnaire (GQ-6), Satisfaction with Life Scale (SWL) and Subjective Happiness Scale (SHS) at baseline, 6- and 12-weeks after enrollment. The study had 80% power to detect a significant difference with 28 people per group. Paired t-tests were used to compare the change in scores within a group and 2-sample t-tests were used for between group comparisons.ResultsOf 40 couples (n=80) consented, 5 withdrew, 5 were lost to follow-up and 30 (n=60) had complete data. Baseline demographics were comparable between the two groups. At 12 weeks, compared to baseline, significant improvements were observed in generalized and fertility related stress, anxiety and happiness in SMART arm compared to no significant improvement in CD arm. SMART group had significant improvements in generalized and fertility related anxiety at 12 weeks compared with CD group. Both men and women responded to SMART therapy.ConclusionsTabled 1Comparison of Score Differences within and Between Groups.Comparison within groupComparison between groupsSMART ArmCD ArmScore Differencep-valueScore Differencep-valuep-valuePSS-10-6.57<0.0001-1.930.140.008FPI-Total-20.14<0.0001-7.180.060.024GAD-7-3.12<0.0001-1.430.10.12GQ-61.820.10-0.250.690.10SWL1.460.121.210.150.83SHS1.540.0070.790.130.31Score Difference= 12 week scores - baseline scores Open table in a new tab