Effects of Heart Rate Variability (HRV) Biofeedback for Women Undergoing First-time In Vitro Fertilization and Embryo Transfer.

Context
Patients receiving in vitro fertilization and embryo transfer (IVF-ET) treatments can be anxious and depressed and have other negative emotions. Psychological interventions might improve the clinical pregnancy rate of infertile patients. Heart rate variability (HRV) biofeedback can be an effective technique to treat anxiety and stress symptoms.


Objective
The study intended to investigate the effects and clinical outcomes of HRV biofeedback for women undergoing in vitro fertilization-embryo transfer (IVF-ET) for the first time.


Design
The research team performed a prospective randomized controlled study.


Setting
The study took place at the Reproduction Center of the First Affiliated Hospital of Hebei Medical University in Shijiazhuang, Hebei, China.


Participants
Participants were 60 women who received IVF-ET for the first time at the hospital between January 2015 and December 2017.


Intervention
Participants were randomly divided into the intervention group (n = 30), who received HRV biofeedback, and the control group, who received routine education (n = 30).


Outcome Measures
At baseline and postintervention, the research team analyzed outcomes using: (1) the scores from a self-rating anxiety scale (SAS) and a self-rating depression scale (SDS); (2) HRV indexes, including the standard deviation of normal to normal (SDNN), root mean square of successive differences (RMSSD), percentage of successive R-R intervals that differ by more than 50 milliseconds (PNN50), total power (TP), low frequency (LF), high frequency (HF), and rate of LF and HF (LF/HF); and (3) pregnancy rates.


Results
The control group's SAS scores were significantly higher postintervention, at 48.63 ± 4.75, than those of the intervention group, at 39.23 ± 7.60 (P = .000). The control group's SDS scores, at 53.07 ± 3.89, were also significantly higher postintervention than those of the intervention group, at 41.40 ± 9.60 (P = .000). For the intervention group, between baseline and postintervention four of the HRV indexes significantly increased: (1) SDNN-from 53.67 ± 9.03 to 79.57 ± 20.48 (p=0.000), (2) RMSSD-from 54.97 ± 13.94 to. 83.74 ± 34.40 (P = .000), (5) PNN50-15.04 ± 6.06 to 22.92 ± 9.90 (P = .001) and (4) TP-from 851.32 ± 486.47 to 1579.59 ± 746.86 (P = .000). The clinical pregnancy rate in the intervention group was higher than that in the control group but the difference wasn't statistically significant, at 60.00% and 46.67%, respectively (P = .438).


Conclusions
HRV biofeedback treatment significantly increased four HRV indexes and decreased the anxiety and depression of women undergoing IVF-ET for the first time, showing a potential clinical application.