Graduation Year


Document Type




Degree Granting Department

Measurement and Evaluation

Major Professor

John Ferron, Ph.D.

Co-Major Professor

Jeff Kromrey, Ph.D.

Committee Member

Cynthia Parshall, Ph.D.

Committee Member

Karen M. Perrin, Ph.D.


infertility, depression, research synthesis, in vitro fertilization (IVF), meta-analysis


The psychological impacts of infertility have been well documented in the literature, providing evidence to support that at least some women who confront infertility are at risk for heightened distress and depressive symptoms. In response to this accumulated evidence, it has been argued that psychoeducational interventions may provide an important component to the treatment of infertility. While several theoretical models postulate the effects of stress on infertility treatment outcomes, results of these investigations have led to conflicting conclusions. However, a synthesis of the accumulated data examining the effects of stress on ART treatment outcomes was nonexistent until the conduct of this study. Therefore, the purpose of this study was to investigate the impact of stress on ART treatment outcomes and to determine whether psychoeducational interventions mitigate the impact of stress experienced by women during an ART treatment program. Two hypotheses were tested: 1. Increased levels of stress will be associated with a lower likelihood of Assisted Reproductive Technology (ART) treatment success, and 2. Psychoeducational interventions will mitigate the effects of stress experienced during Assisted Reproductive Technology (ART) treatment. A meta-analysis analyzing the results for each hypothesis was tested through a hierarchical linear regression model. A total of 13 studies, representing 43 effect sizes, were included in the analysis investigating the relationship between stress and ART treatment outcomes. Results of the HLM regression model suggest that stress has a small negative association with ART treatment outcomes (d=0.2012, p< .05). The analysis investigating the relationship between psychoeducational interventions and stress included a total of 4 studies, representing 12 effect sizes. Empirical evidence gathered through this analysis revealed that the effect of psychoeducational interventions on the stress experienced by women participating in an ART treatment program were not statistically significant (d=0.3071, p>.05). However, because this analysis was based on such a small sample of studies, generalizations regarding the efficacy of psychoeducational interventions cannot be made. Therefore, research aimed at investigating the impacts of a variety of programs should continue in an effort to provide more conclusive information.