Currently, an estimated 80 million couples globally are grappling with infertility. In China, the infertility rate has escalated from 2.5%-3% two decades ago to approximately 12.5%-15% today, affecting over 40 million individuals [1]. This statistic indicates that one in every eight couples is dealing with infertility issues. Additionally, the prevalence of infertile couples is on the rise due to factors such as environmental pollution, delayed age of childbearing, and increased life pressures, among others [2]. Infertility adversely affects both the physical and emotional well-being of couples. Studies have demonstrated a reciprocal relationship between infertility and the emotional states of partners, noting that emotions significantly influence both the occurrence and treatment outcomes of infertility. Emotional stress during pregnancy can also precipitate negative pregnancy outcomes[3].
Initially, infertility may induce heightened emotional stress in couples, leading to pervasive negative emotions including depression, anxiety, disappointment, and guilt [4]. These feelings can foster mutual sorrow and a pervasive sense of confusion and helplessness. Additionally, the infertility treatment process itself imposes significant physical and psychological burdens, manifesting as distress from medications, surgical interventions [5], and procedures like tubal flushing. These adverse emotions may further impede the couple's ability to cope with and manage infertility, intensifying both the condition and associated distress. Research indicates that emotions not only respond to but also exacerbate infertility challenges[6]. Negative emotions can diminish fertility in couples by affecting reproductive organs and altering hormonal balances. Evidence suggests that emotional disorders such as anxiety and depression can impair ovarian function and disrupt menstrual cycles in women, thus hindering ovulation and conception [7]. Similarly, emotional distress is linked to compromised male fertility, with studies correlating anxiety and depression with reduced sperm quality and sexual dysfunction [8]. The enduring nature of infertility can amplify negative emotions in couples, fostering a sense of disappointment and helplessness that evolves into a deleterious cycle of ever-increasing emotional distress[9].
Research highlights that emotional wellbeing is intricately linked to both the severity of infertility and the success of treatment efforts. Couples with pronounced emotional difficulties may find their infertility issues to be more complex and challenging to resolve [10]. Consequently, addressing emotional health is imperative in the comprehensive treatment of infertility, necessitating a holistic approach that considers both the physical and emotional dimensions of care[11]. Though it's recognized that emotions might impact the outcomes of infertility treatments adversely, the efficacy of rural tourism as a means to ameliorate emotional well-being remains ambiguous. Preliminary non-interventional research and subsequent studies aiming for moderate emotional improvements have not established a definitive link between enhanced emotional states and increased rates of pregnancy or live births in infertility patients [12]. Contrarily, a distinct study focusing on emotionally stressed women suffering from infertility for two or more years, who engaged in a lifestyle intervention program, reported promising outcomes with a 77% pregnancy rate and a 67% live birth rate [13]. These participants managed to reduce their initial emotional stress coefficients by an average of 10%. On the flip side, those without emotional interventions only saw a marginal reduction of just over 1% in their stress coefficients and did not report any follow-up pregnancies [14].
Considering the evidence at hand, the specific impact and degree of emotional amelioration necessary to positively influence fertility outcomes is still a subject of uncertainty[15]. Generally, interventions aimed at emotional relief, such as regular psychological counseling, are known to achieve a 10% reduction in stress levels, correlating with better control of blood pressure, blood sugar, and lipid profiles[16]. Additionally, other research indicates that patients who align such emotional objectives with lifestyle alterations see enhanced secretion of reproductive hormones, thereby boosting ovarian function and follicle growth [17].
The objective of this study is to assess the potential of combining rural tourism with relaxation techniques to elevate conception and live birth rates in cohorts of infertile women.