THE IMPACT OF THE FERTISTRONG APP ON ANXIETY AND DEPRESSION IN MEN.

The impact of infertility on distress levels in men is poorly explored; however initial research does indicate that men commonly report symptoms of anxiety and depression. Despite the publication of dozens of studies on psychological interventions with women, there is a paucity of such research on men. The goal of the present pilot study was to determine if a recently developed cognitive-behavioral and relaxation mobile app, targeted at men experiencing infertility, could lead to decreases in psychological distress. This pilot project utilized a randomized controlled design. Thirty nine men participated in a randomized study of the FertiStrong app May/June of 2018. There was only a brief period of time allowed for recruitment as the app was launched nationwide less than two months after it was developed. Participants completed a demographic form, the Hospital Anxiety and Depression Scale (HADS) and Fertility Problem Inventory (FPI) at baseline and follow-up. Participants randomized to the intervention group were introduced to the FertiStrong app, instructed to download it on their phone, and to use it when needed. Control participants received routine infertility care. The follow-up testing was approximately one month after recruitment. The HADS and FPI were converted to numeric values and compared baseline to follow up with a paired t test. The Shapiro Wilk test was used to test for normality of distributions. One participant was excluded, resulting in 38 participants, 19 in each group. There were no differences between the two groups on any of the demographic characteristics (P>0.31). For the HADS anxiety domain, the control group had a small increase between baseline and follow up while the intervention group had a small decrease, but no statistical significance. For the HADS depression domain, there was a slight increase in the control group and no change in the intervention group but there was no significant difference. For the FPI, the control group had a two point increase, changing from moderately stressed at baseline to extremely high while the intervention group had a five point decrease, changing from extremely high to moderately high, but not significant. Each of the FPI five domain-specific scores in the intervention group decreased at follow up and one, Rejection of Childfree lifestyle, was significant (P=0.03). Several statements increased in both groups at follow-up but the increase in stress level was significantly greater in the control group than the intervention group (P>0.02). Recruitment was challenging for this study due to the short recruitment phase and the sample size was thus smaller than planned. The small size could have contributed to the lack of significant differences in the HADS. However, despite the small sample size, there were several significant improvements noted in the intervention group and on all testing, the intervention group trended to less distress. More research is needed on convenient interventions for men experiencing infertility.