Effect of couple-based acceptance and commitment therapy on lifestyle in infertile women with polycystic ovary syndrome: a randomized controlled trial

Polycystic Ovary Syndrome (PCOS) is one of the main causes of infertility in women. Lifestyle modification has been identified as the first-line treatment. This study aimed to determine the effectiveness of Acceptance and Commitment–based Cognitive-Behavioral Therapy (ACT) with a couple-based approach in improving a health-promoting lifestyle. This randomized controlled clinical trial was conducted on 68 infertile women with PCOS and their husbands. Participants were randomly assigned to two groups of 34. The intervention group received eight weekly sessions of Couple-Based Acceptance and Commitment Therapy, while the control group received routine care. The primary outcome was the score of health-promoting lifestyle, and secondary outcomes included Body Mass Index (BMI) and menstrual regularity. Variables were measured using the HPLP-II questionnaire at three time points: before the intervention, immediately after, and four weeks after the intervention. Data were analyzed using independent t-test, chi-square test, and repeated-measures ANOVA in SPSS. Prior to the intervention, no significant statistical differences were observed between the two groups regarding the studied variables ( p > 0.05). After the intervention, the total lifestyle score and all its subscales (including nutrition, physical activity, stress management, interpersonal relations, spiritual growth, and health responsibility) showed a significant increase in the intervention group compared to the control group ( p < 0.001). A significant reduction was also observed in the mean BMI of the intervention group compared to the control group ( p = 0.002). At follow-up, the percentage of women with regular menstrual cycles was significantly higher in the intervention group than that in the control group ( p = 0.027). Couple-Based Acceptance and Commitment Therapy improved health-promoting lifestyle scores,, reduced BMI, and and a higher proportion of regular menstrual cycles at short-term follow-up in infertile women with PCOS. Therefore, this therapeutic approach may be used as an effective complementary intervention alongside standard infertility treatments for this patient group. Iranian Registry of Clinical Trials, IRCT20240922063120N1, registered on 25 October 2024.