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Music listening sessions did not improve DASS-21 scores in women undergoing artificial inseminationMusic listening before artificial insemination shows link to higher pregnancy rates

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Key Takeaway
Note that music-listening sessions did not improve DASS-21 scores in women undergoing artificial insemination.

This randomized trial evaluated the impact of music-listening sessions on the psychological state and clinical outcomes of women undergoing artificial insemination by husband (AIH). The study was conducted in a single-center setting and included a sample size of 254 women. The primary objective was to determine if brief music interventions could mitigate psychological distress during the infertility treatment process.

The intervention group received routine care plus two 30-minute music-listening sessions, administered immediately before and after the AIH procedure. The comparator group received routine care only. The primary outcome measure was the continuous 21-item Depression Anxiety Stress Scales (DASS-21) score at a follow-up point of day 35 after AIH.

Regarding the primary outcome, DASS-21 anxiety, depression, and stress scores did not differ between the intervention and control groups after adjustment for baseline scores. Specifically, the differences were 0.01 point or less for anxiety and depression, and 0.08 point for stress. The p-values for these differences were P ≥.868, indicating no statistically significant improvement in psychological distress following the music intervention.

In terms of secondary outcomes, a higher rate of clinical pregnancy was observed in the intervention group compared to the control group. The intervention group reported 34/127 (26.77%) clinical pregnancies, while the control group reported 14/127 (11.02%) clinical pregnancies. This difference reached statistical significance with a p-value of P =.001.

Safety and tolerability data were not reported for this study. No specific adverse events, serious adverse events, or discontinuations were documented. Consequently, the tolerability of the music-listening intervention cannot be quantified from the available evidence.

These results provide a nuanced view of psychological interventions in infertility. While the primary psychological outcome was not improved, the higher pregnancy rate in the intervention group is currently hypothesis-generating. This is because the study was not powered for pregnancy outcomes and the specific psychological mechanism through which music might influence these outcomes was not demonstrated. The results do not provide a definitive basis for changing clinical protocols regarding psychological support for AIH patients.

Several methodological limitations were identified. The study was not powered to detect differences in clinical pregnancy rates. Furthermore, the proposed psychological mechanism was not demonstrated, and factors such as non-specific attention or other unmeasured variables could not be excluded. These limitations suggest that the observed difference in pregnancy rates may not be directly attributable to the music intervention.

Clinicians should note that the intervention did not improve the primary psychological outcome of anxiety, depression, or stress. While the higher clinical pregnancy rate is notable, it should be interpreted with caution due to the lack of power and a demonstrated mechanism. Further research is required to determine if specific types of music or different durations could impact psychological outcomes, and to investigate why the pregnancy rates differed despite the lack of change in DASS-21 scores.

How this fits prior evidence

How this fits prior evidence This study addresses a gap in psychological interventions for infertility. While prior evidence indicates that recurrent implantation failure worsens quality of life and raises depression and anxiety in IVF patients, this study found that music-listening sessions did not significantly improve DASS-21 scores in women undergoing AIH. The finding of a higher clinical pregnancy rate in the intervention group (26.77% vs 11.02%, P =.001) is hypothesis-generating and does not confirm a psychological mechanism.

For many women and couples facing infertility, the journey toward pregnancy can be emotionally and physically taxing. When undergoing treatments like artificial insemination, the stress of the process can be significant. This research looked into whether a simple addition, such as listening to music, could provide a different experience or potentially impact the success of the procedure for women undergoing artificial insemination by their husbands.

Researchers conducted a randomized trial involving 254 women undergoing artificial insemination. The study divided these women into two groups. One group received routine care, while the other group received routine care plus two 30-minute music-listening sessions. These sessions took place immediately before and after the insemination procedure. The goal was to see if this intervention would affect the women's psychological well-being or their chances of achieving a clinical pregnancy.

The results showed a notable difference in pregnancy rates. In the group that listened to music, 26.77 percent of the women achieved a clinical pregnancy. In the group that received only routine care, the rate was 11.02 percent. However, the study also looked at the psychological impact. The researchers measured anxiety, depression, and stress levels using a standard 21-item scale. After adjusting for their starting scores, there was no significant difference in these mental health scores between the two groups. This means the music did not significantly change the reported levels of stress or anxiety during the procedure.

It is important to look at these results with a balanced perspective. While the higher pregnancy rate in the music group is interesting, the study was not specifically designed or powered to measure pregnancy outcomes. This means the sample size was not large enough to be certain that the difference was due to the music specifically. Additionally, the researchers did not find a clear psychological reason why the music might have helped, and other factors like general attention could have played a role.

For patients today, this study provides an interesting observation but does not change immediate medical protocols. Because the study was small and did not prove a direct cause, it is currently considered hypothesis-generating. It suggests that music might be a helpful, low-risk addition to the experience, but it is not a proven medical treatment for increasing pregnancy rates. Patients should continue to work closely with their doctors to determine the best path forward for their specific needs.

What this means for you:
Music listening before insemination showed a link to higher pregnancy rates, but did not improve stress levels.

Study Details

Study typeRct
Sample sizen = 127
EvidenceLevel 2
PublishedSep 2026
View Original Abstract ↓
BACKGROUND: Infertility treatment can be psychologically burdensome. Evidence on music listening during artificial insemination by husband (AIH) remains limited. We evaluated whether a standardized periprocedural music intervention reduced psychological distress and explored its association with clinical pregnancy. METHODS: In this single-center, open-label randomized trial, 254 women undergoing AIH were allocated 1:1 to routine care or routine care plus two 30-minute music-listening sessions, immediately before and after AIH. The prespecified primary outcome was the continuous 21-item Depression Anxiety Stress Scales (DASS-21) score at follow-up; clinical pregnancy was secondary. DASS-21 was completed at baseline and at day 35 after AIH. Clinical pregnancy was assessed by ultrasonography at days 30 to 35. RESULTS: Continuous DASS-21 anxiety, depression, and stress scores did not differ between groups after adjustment for baseline scores (all P ≥ .868). Absolute postintervention differences were 0.01 point or less for anxiety and depression and 0.08 point for stress, indicating neither statistical nor clinically meaningful improvement. Clinical pregnancy occurred in 34/127 participants (26.77%) in the intervention group and 14/127 (11.02%) in the control group (exploratory secondary outcome; P = .001). CONCLUSION: The intervention did not improve the primary psychological outcome. The higher clinical pregnancy rate is hypothesis-generating because the trial was not powered for pregnancy, the proposed psychological mechanism was not demonstrated, and nonspecific attention and other unmeasured factors cannot be excluded. Replication using an attention-matched control, immediate state-anxiety and physiological measures, participant-preference assessment, and live-birth follow-up is required.
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