Mindfulness Based Program for Infertility

The Mindfulness Based Program for Infertility (MBPI) was developed based on the Mindfulness Based Program for Stress Reduction, the Mind/Body Program for Infertility and basic principles of Acceptance and Commitment Therapy. This program aims, fundamentally, learning and practicing emotion regulation skills, particularly mindfulness and acceptance. It addresses values (chosen life directions) clarification, interpersonal communication, healthy lifestyles, and emotional self-care. The training of these skills occurs at all sessions and is also encouraged between sessions. Support materials are provided for this, including a Participant's Manual and an audio CD with several mindfulness meditation instructions. The MBPI encloses 10 weekly sessions of 2 hours each, except for one of the sessions that lasts for one day. It is a structured psychosocial intervention program, with a group format (max. 15 women). Male partners are invited to participate in 3 sessions.

MBPI sessions were carried out by a clinical psychologist with previous training in contextual-behavioral therapies. A Therapist Manual was structured, describing the details for conducting each session.

Most of the MBPI sessions follow a similar structure. They begin with a first half-hour of sharing (optional). After the first half hour a formal mindfulness practice is held, followed by sharing how participants felt, what they have noticed, how was the experience for them. The set of formal practices selected for the MBPI is commonly used in mindfulness programs. Informal mindfulness practice is also presented as early as the second session through mindful eating. The three minutes breathing space exercise ends each session. Metaphors and experiential exercises are included in most of the sessions. These comprise an experiential exercise of listening to others, the introduction of values clarification (valued life directions) through the imagery exercise "10 years of marriage", the integration of a greater number of positive aspects in day-to-day experience, a psychoeducational component regarding healthy lifestyle (exercise, nutrition, caffeine, alcohol, nicotine, etc.). Moreover, the promotion of psychological flexibility/acceptance is intended to be achieved through mindfulness practice, but also through the use of metaphors such as "the mind as a radio always on", "the coach and passengers" and through emphasizing the importance of values clarification and committed action.

Previously to data collection, ethical approval was obtained from the Scientific Council of the Faculty of Psychology and Educational Sciences of the University of Coimbra. Participants were women aged 18 years old or older, presenting a medically established infertility diagnosis. Participants answered a recruitment announcement posted at the Portuguese Fertility Association (patients association) website after getting the approval of this association board. Participants were informed about the voluntary and confidential nature of the data. A semi-structured clinical interview was used for MBPI admission. This interview allows the gathering of demographic and clinical data and the screening for severe psychopathology. Women who answered the recruitment announcement but lived in places where the MBPI sessions were not scheduled were invited to participate in the study as members of the control group and were given the opportunity to participate in future editions.

All participants were required to sign the informed consent and a numerical unique code was assigned to each participant.