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Many people who are having fertility treatment describe a wearing mix of hope, waiting, injections, appointments and disappointment. It is natural to wonder whether a short online psychological programme could make that load easier. A 2025 Canadian trial found that one did ease distress and improve quality of life, but it did not show any difference in pregnancy rates. Feeling better and becoming more likely to conceive are separate questions, and this study speaks to the first only.

What the researchers did

The trial was published online on 16 December 2025 in Human Reproduction by a team at the University of Regina. It was registered in advance on ClinicalTrials.gov. Recruitment took place across Canada from January to November 2024, through fertility clinics, social media and online support groups.

A total of 173 adults assigned female at birth who were experiencing infertility were randomly assigned, by a 1:1 process, to one of two groups. One group received the Coping with Infertility programme: seven weekly video modules of about ten minutes each, delivered by email or a mobile app, each with a homework task. Topics included challenging unhelpful thoughts and core beliefs, doing meaningful activities, coping with grief, relationships and living by personal values. No therapist was involved. The other group continued with usual life and care and was offered the programme after the study. The analysis included 160 people. Most participants were white, married or in a common-law relationship, highly educated, and pursuing medically assisted reproduction.

What they found

Compared with the waitlist group, people who did the programme reported better results on the main measures at the end of the programme:

• Fertility-related quality of life (the primary outcome): average score 63.2 compared with 54.5, a moderate effect size (0.53).
• Infertility-related distress: 21.6 compared with 23.9 (smaller effect, 0.35), where lower is better.
• Depressed mood: 5.3 compared with 7.7 (effect size 0.56).
• Anxiety: 5.1 compared with 7.7 (effect size 0.66).

The differences were largest for people who already had notable symptoms at the start. Among those with clearer depression or anxiety scores, effect sizes were above 0.9. A larger share of the programme group reached a level of improvement that researchers consider clinically meaningful.

Not everything changed. There was no significant effect on relationship quality. Rates of new mood or anxiety diagnoses were lower in the programme group (9.7% versus 18.6%) before adjusting for starting levels, but not after adjusting, so this should not be read as a clear difference.

Pregnancy rates were 13.0% in the programme group and 21.5% in the comparison group. That difference was not statistically significant, and the authors state that pregnancy was not measured by best-practice methods. The honest reading is that the study cannot say whether the programme affects pregnancy either way. It was not designed or powered to answer that question.

About three quarters of the programme group completed all seven modules, and 85% watched at least half.

What this does and does not show

This trial shows that, for this group of people, a short self-guided programme was linked to better emotional wellbeing in the following weeks compared with waiting. It does not show that stress causes infertility, that reducing stress leads to pregnancy, or that people who struggle emotionally have done anything wrong. Points to consider:

• The comparison group had no active alternative. People who know they are getting something may feel better partly for that reason, so the study cannot show how much was due to the specific content of the programme.
• Measures were self-reported, and follow-up lasted about four months.
• Most participants were similar in background, and there were too few LGBTQIA+ participants to compare subgroups, so the results may not fit everyone, including people in Australia.
• Taking part was voluntary, so participants may be more motivated than average.
• The programme was designed as a support tool. It is not a substitute for care from a doctor, psychologist or counsellor if distress is severe.

If your distress feels overwhelming, or you have thoughts of harming yourself, please contact your doctor, Lifeline on 13 11 14, or call 000 in an emergency.

This article is general education, not medical advice. It does not suggest starting, stopping or changing any treatment.

Questions to ask

• What emotional support does my clinic offer during treatment, and how can I tell when ordinary stress has become something I should get help with?
• Would a self-guided online programme be enough for me, or would talking with a psychologist or counsellor suit me better?
• How can my partner, if I have one, and I support each other through the waiting, and what do we want from each other during the hard days?

Source: Testing the efficacy of a self-guided psychotherapy intervention for infertility-related distress: a randomized controlled trial DOI: 10.1093/humrep/deaf237

AI-generated editorial illustration. The scene is fictional and does not depict a study participant or demonstrate treatment effectiveness. This article summarises published research in our own words and is general information, not personal health advice.