Effects of White Noise on Pain, Anxiety and Comfort During in Invitro Fertilization: a Randomized Controlled Trial

Assisted reproductive techniques are interventions that involve the in vitro processing of human oocytes, sperm or embryos for reproductive purposes (Zegers-Hochschild et al., 2017). In these interventions, various procedures such as ovarian stimulation, oocyte collection and embryo placement in the uterus are performed (Zhang et al., 2022). The most advanced and frequently used method of these procedures is in vitro fertilization. In in vitro fertilization, after the fertilization of sperm and oocyte in a tube in a laboratory environment, the resulting embryos are placed in the uterus with a catheter under ultrasound guidance (Çavuşoğlu, 2017). It has been reported that approximately 8 million children have been born since the initiation of procedures such as in vitro fertilization in the world (Fauser, 2019). Infertility is an important crisis in the lives of couples as it affects individuals physically, psychologically, emotionally, sexually and socially (Assaysh-Öberg et al, 2023; Kırca and Pasinlioğlu, 2019; Oh et al, 2024; Öztürk et al, 2020; Rooney and Domar, 2018). Because painful invasive procedures and interventions for diagnosis, uncertainty about the cause of infertility, lack of information about the treatment process, high cost of treatment, negative outcomes and social pressure lead to psychological problems in infertile individuals (Martínez-Pampliega et al, 2019; Oh et al, 2024; Öztürk et al, 2020; Rooney and Domar, 2018). The most common psychological problems are stress, anxiety and depression, and women experience stress before, during and after treatment (Kim et al, 2020; Kirca and Pasinlioglu, 2019; Rooney and Domar, 2018). The stress experienced both reduces the effectiveness of infertility treatment and causes treatment discontinuation (Kirca and Pasinlioglu, 2019; Rooney and Domar, 2018). In a study conducted on infertile women in Romania, it was reported that 63% of infertile women experienced stress during assisted reproductive treatment (Margan et al, 2022). Again, in a study examining the effect of stress on assisted reproductive treatment outcomes in infertile women in Tunisia, it was stated that women were much more stressed on the day of embryo transfer, and that primary infertile women had significantly higher stress levels than secondary infertile women (Sallem et al, 2021). There is a bidirectional and complex relationship between infertility and stress (Boivin, 2019). In addition, invasive procedures performed during the infertility diagnosis and treatment process cause pain, while the thought of whether the treatment will be successful or not causes stress (Assaysh-Öberg et al., 2023; de Boer et al., 2020). Health professionals need to support infertile women in coping with stress in order to reduce their stress levels (Rooney and Domar, 2018). When the studies in the literature are examined, different non-pharmacological methods such as acupuncture, yoga, meditation, deep breathing exercises, massage, art therapy and mind/body therapy have been used in infertile women to cope with stress (Akimbekov and Razzaque, 2021; Sis Çelik and Kırca, 2018; Gönül and Arslan, 2019; Kırca and Pasinlioğlu, 2019; Meier et al., 2021; Rooney and Domar, 2018). However, no study has been found examining the effect of white noise during in vitro fertilization. White noise is a continuous monotonous sound such as wind, waterfall, ocean waves or rain in the environment, and is a sound obtained by mixing equal amounts of different frequency sounds in a laboratory environment and preparing them in a digital environment and calibrating all of its frequencies (Cho and Hwang, 2021; Lin et al, 2018). Therefore, it was decided to conduct this study. The aim of this study is to determine the effect of white noise on pain, anxiety and comfort during in vitro fertilization.

Research Hypothesis; H01: There is no difference in pain between the white noise and control groups. H02: There is no difference in anxiety between the white noise and control groups.

H03: There is no difference in comfort between the white noise and control groups.

MATERIAL AND METHODS

Research Method