As I perused a recent issue of the prestigious and widely-read, peer-reviewed journal of the American Society for Reproductive Medicine: Fertility and Sterility, I came across an article that caught my eye, titled “The effect of medical clowning on pregnancy rates after in vitro fertilization and embryo transfer.” (Friedler et al. Vol 95, No. 6, May 2011, pp 2127-30).
What is medical clowning? What does this have to do with IVF and infertility? The authors studied a little over 200 women undergoing IVF at a medical center in Israel. About half of the women were visited by a medical clown after embryo transfer while they were in the recovery unit at the center and about half the patients did not have a visit.
Medical clowning is usually used in the pediatric setting as a way to make children more comfortable in a medical environment. The clowns receive special training in this area. In this medical center, the clowns would visit the IVF recovery room every other week. For the study, the authors looked at pregnancy rates in the patients that had the visit and compared these pregnancy rates to the pregnancy rate in patients that did not have the visit.
Immediately after having an embryo transfer and entering the recovery area on a stretcher, the patients had a visit with the clown, dressed as a “chef de cuisine” (don’t ask me what that is – this is just what the paper says). The professional medical clown performed a 15 minute, one-on-one routine that included jokes, tricks and magic. The routine was the same for every patient and was one that the authors deemed appropriate for their IVF patients.
What happened? The patients that had the visit with the clown had a 2.67 fold higher pregnancy rate than the women that were not visited by the clown! More than double the pregnancy rate!
Coincidence? Perhaps – it was a small study. However, the authors do not think so. They site evidence from various other studies for an effect of humor and laughter upon hormonal, neurobiological and immune systems that may provide an explanation for a positive role for humor in stress management, and a possible positive impact of humor and stress management upon fertility treatment success rates.
This is not the same as saying – “just relax and you’ll get pregnant” – studies that support stress management and better IVF outcomes are similar to this study – they support the possibility that stress management may have an impact upon fertility treatment outcomes, not that you can cause your own fertility by being stressed out. This is an important difference – infertility is real – not “in your head” – but once you have infertility – we know it can have a profound negative impact upon your psychological health.
What is the bottom line? Please don’t go out and buy a clown suit and force your husband to prance around in it! Please do think about ways to bring more laughter into your life, despite the fact that if you are infertile, you may be experiencing one of the most stressful times of your life. Laughter may not be the best medicine or the only medicine, but there is evidence that it may make your treatment more effective.
Serena H. Chen, MD
Copyright Serena H. Chen, MD 2012