{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T23:39:38Z","timestamp":1782949178594,"version":"3.54.5"},"reference-count":45,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T00:00:00Z","timestamp":1765152000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"\n Background<\/jats:title>\n Couples undergoing fertility treatment experience emotional stress. Meta-analyses show heterogeneous results regarding the effectiveness of psychosocial interventions on anxiety and depression.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n The aim of this study was to reduce psychosocial stress (anxiety, depression) in infertile patients. In addition, pregnancy rates and perceived distraction as well as perceived subjective relief were determined.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n In a two-arm RCT we used \u201cPositive Adjustment Coping Intervention (PACI)\u201d. Participants received the first of 13 daily text messages on their smartphones on the day on which the cryopreserved embryos were thawed or one day after oocyte aspiration. Patients in the PACI condition obtained daily positive adjustment statements and were asked to relate these to their personal situation at least twice a day. Patients in the comparison condition were given daily think tasks providing cognitive distraction. Anxiety and depression scores were assessed with ScreenIVF and perceived distraction as well as relief with an evaluation form.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n PACI did not reduce participant\u00b4s depressive scores measured with standardized questionnaire (\n \n P<\/jats:italic>\n <\/jats:italic>\n \u2009<\u2009.007, N\u2009=\u2009227), did not significantly change participant\u00b4s anxiety (N\u2009=\u2009227), nor did it increase pregnancy rates (N\u2009=\u2009191). PACI had a significant effect on subjective perceived distraction (\n \n P<\/jats:italic>\n <\/jats:italic>\n \u2009=\u2009.005, N\u2009=\u2009197) and on perceived relief (\n \n P<\/jats:italic>\n <\/jats:italic>\n \u2009=\u2009.026, N\u2009=\u2009197).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n This is the first RCT to use modern media to test a simple positive adjustment cognition intervention in women and men who underwent fertility treatment. The low-dose psychosocial intervention apparently was not sufficient to reduce emotional distress during the waiting period between embryo transfer and pregnancy test. Preferably, psychosocial support for infertile individuals could be provided face-to-face to reduce the target variables depression and anxiety. However, PACI has a positive influence on perceived distraction and perceived relief.<\/jats:p>\n <\/jats:sec>\n \n Trial registration<\/jats:title>\n \n ClinicalTrials.gov:\n NCT03118219<\/jats:ext-link>\n (July 9, 2019)\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pone.0335776","type":"journal-article","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T18:22:31Z","timestamp":1765218151000},"page":"e0335776","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Smartphone-supported Positive Adjustment Coping Intervention (PACI) for couples undergoing fertility treatment: A randomised controlled trial"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1171-9478","authenticated-orcid":true,"given":"Franziska","family":"Kremer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maren","family":"Schick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Roesner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariane","family":"Germeyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Moessner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Bauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5853-4572","authenticated-orcid":true,"given":"Beate","family":"Ditzen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7837-0138","authenticated-orcid":true,"given":"Tewes","family":"Wischmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,12,8]]},"reference":[{"issue":"9","key":"pone.0335776.ref001","first-page":"1786","article-title":"The International Glossary on Infertility and Fertility Care, 2017","volume":"32","author":"F Zegers-Hochschild","year":"2017","journal-title":"Human Reproduction"},{"issue":"4","key":"pone.0335776.ref002","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1016\/S0015-0282(01)02008-8","article-title":"A prospective study of stress among women undergoing in vitro fertilization or gamete intrafallopian transfer","volume":"76","author":"H Klonoff-Cohen","year":"2001","journal-title":"Fertil Steril"},{"issue":"4","key":"pone.0335776.ref003","doi-asserted-by":"crossref","first-page":"940","DOI":"10.1007\/s11013-024-09871-7","article-title":"Infertility as Trauma: Understanding the Lived Experience of Involuntary Childlessness","volume":"48","author":"C Archetti","year":"2024","journal-title":"Cult Med Psychiatry"},{"issue":"11","key":"pone.0335776.ref004","doi-asserted-by":"crossref","first-page":"2476","DOI":"10.1093\/humrep\/dev177","article-title":"ESHRE guideline: routine psychosocial care in infertility and medically assisted reproduction-a guide for fertility staff","volume":"30","author":"S Gameiro","year":"2015","journal-title":"Hum Reprod"},{"issue":"2","key":"pone.0335776.ref005","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1007\/s10865-005-3667-0","article-title":"Predicting emotional response to unsuccessful fertility treatment: a prospective study","volume":"28","author":"CM Verhaak","year":"2005","journal-title":"J Behav Med"},{"issue":"1","key":"pone.0335776.ref006","doi-asserted-by":"crossref","first-page":"59","DOI":"10.2217\/WHE.09.79","article-title":"Medical waiting periods: imminence, emotions and coping","volume":"6","author":"J Boivin","year":"2010","journal-title":"Womens Health (Lond)"},{"issue":"10","key":"pone.0335776.ref007","doi-asserted-by":"crossref","first-page":"2299","DOI":"10.1093\/humrep\/den257","article-title":"A feasibility study of a brief coping intervention (PRCI) for the waiting period before a pregnancy test during fertility treatment","volume":"23","author":"D Lancastle","year":"2008","journal-title":"Hum Reprod"},{"issue":"1","key":"pone.0335776.ref008","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1016\/0022-2496(85)90020-3","article-title":"The psychological cost of waiting","volume":"29","author":"EE Osuna","year":"1985","journal-title":"Journal of Mathematical Psychology"},{"issue":"1","key":"pone.0335776.ref009","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1080\/14647270802331487","article-title":"Social and psychological consequences of infertility and assisted reproduction - 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