P-580 Virtual reality as tool to reduce anxiety during embryo transfer.
Authors: Garcia Pombo S , Armijio Sánchez A , Gómez Manzorro M D , Ibañez Alonso J A , Mantrana Bermejo E , Tirado Carillo M D P 
Published: June 2023

Abstract

Study question
Is the use of virtual reality during embryo transfer effective as a measure to reduce anxiety during the procedure?

Summary answer
With the current evidence, it cannot be affirmed that virtual reality is useful as a tool to reduce anxiety during embryo transfer.

What is known already
The embryo transfer (ET), the last and crucial procedure of in vitro fertilization (IVF), generates anxiety, especially in couples with a history of reproductive failure. The latest evidence suggests that a high level of stress can influence reproductive results. Virtual reality (VR) seems to be a useful tool that helps to relieve pain, stress, anxiety and depression symptoms. VR has recently been proposed as a method to alleviate pain and emotional impact in other gynecological procedures such as hysteroscopy. It would be interesting to study the potential beneficial impact of the application of virtual reality to reduce anxiety during ET.

Study design, size, duration
This is an experimental and ramdomized study. A total of 128 infertile women undergoing ET were included, who were grouped into two groups based on whether or not they used VR glasses. In all of them, the level of anxiety was assessed according to validated questionnaires (STAI and GAD-7) along with other clinical parameters such as pain (VAS) or blood pressure. The recruitment period was from May to June 2022.

Participants/materials, setting, methods
128 women between the ages of 18 and 40 who underwent vitrified or fresh embryo transfer were included. Patients under treatment with antidepressants or anxiolytics, drug users, or neurosensory deficits were excluded. In the experimental group, the usual ET procedure was performed applying VR (virtual reality class 1 medical device developed by Deepsen and Metronic®). The study was carried out in the Assisted Human Reproduction Unit of the Virgen de Valme University Hospital (Seville).

Main results and the role of chance
The 128 participants were randomized into two groups, 64 in each study arm: experimental group (exposed to VR) and control group (normal ET procedure). The characteristics of the patients were comparable between the two groups. Systolic blood pressure (120.62 ± 15.11 vs 126.04 ± 12.26), diastolic blood pressure (75.41 ± 9.58 vs 81.28 ± 9.28) and mean blood pressure (90. 14 ± 10.97 vs 95.54 ± 9.79) after embryo transfer were significantly (p &lt; 0.05) lower in the experimental group compared to the control group. However, no differences were observed between the two groups in pain (VAS), blood pressure before the procedure, respiratory rate and oxygen saturation before and after ET. Anxiety level scores (STAI and GAD-7) were comparable between the two groups. Unlike the only comparable study in which a higher pregnancy rate was observed in the experimental group (although without statistical significance), in our study the pregnancy rate was higher in the control group (33.3% vs 43.8%). However, in our study the gestation rate that exceeded 6 weeks of pregnancy was higher in the experimental group (81% vs 71.4%), although without statistical significance.

Limitations, reasons for caution
The sample size is too small, making it difficult to find significant relationships. In addition, there are no previous studies that support the theory of the study.

Wider implications of the findings
There is only one previous comparable study evaluating the use of VR in assisted reproduction. Our findings suggest changes in blood pressure with the use of VR, although this is not the case in the rest of the parameters analyzed. A larger sample is needed to confirm these findings.

Trial registration number
Not applicable