Rural Tourism Combined with Relaxation Guidance on Fertility Outcomes in the Infertility Population

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The primary indicators monitored in this study were the pregnancy rate, live birth rate, and emotional state of the patients.Out of the participants, 32% had recently undergone rural tourism combined with relaxation guidance. The study found that those who received this combined approach had a significantly higher conception rate (88% vs. 54%) and live birth rate (71% vs. 37%) compared to those who did not participate in the rural tourism and relaxation guidance.The findings suggest that incorporating rural tourism with relaxation guidance significantly improves the live birth rates in infertile patients. Therefore, it is recommended that healthcare providers consider this combined approach as a part of the infertility treatment and care plan for patients. Rural tourism relaxation guidance infertility conception rate live birth rate Introduction 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. Methods This research constitutes a retrospective cohort analysis of infertile couples attending the outpatient clinic of the Reproductive Centre at Anhui Provincial Maternal and Child Health Hospital. Prior to commencement, the Anhui Provincial Maternal and Child Health Hospital Review Committee (IRB-23188) approved the study. The purpose, process, risks, and benefits of the study were explained orally or in writing to all individuals involved in the study, and their informed consent was obtained. Furthermore, this study was conducted in accordance with the Declaration of Helsinki. From September 2021 to September 2023, couples consulted the same reproductive specialist at the hospital. Infertility was characterized as the inability to conceive after 12 months of regular, unprotected intercourse and included female patients with any etiology of infertility, encompassing those with regular and anovulatory cycles. Additionally, only couples who underwent a follow-up of at least 18 months post their initial reproductive clinic visit were included. Those who had previously undergone psychological treatment were excluded from the study. Participants were recommended to integrate rural tourism with relaxation activities, extending for at least one week. They were also advised to modify their lifestyle, including ceasing work-related mental activities and engaging in up to 30 minutes of physical exercise per day, five days a week. A weekly phone follow-up and a monthly office visit were conducted to ascertain adherence to the rural tourism and relaxation regimen. During this period, intake of any medication was prohibited. The emotional states of the infertile couples were assessed biannually using the Patient-Reported Outcomes Measurement Information System (PROMIS). PROMIS evaluates negative and tense emotions, self-image, social cognition, as well as symptoms indicative of a loss of positive affect and engagement. Its reliability in measuring emotions has been robustly substantiated in both the general population (r = 0.92) and clinical patients (r = 0.92%) [18], with its structural validity also affirmed across three time points (r = 0.72–0.89) [19]. Baseline screenings for infertility-related abnormalities were conducted on all female patients, including assessments of body mass index, baseline follicle-stimulating hormone, anti-Müllerian hormone, and antral follicle count among others. For statistical analysis, continuous variables across groups were compared using one-way ANOVA, while categorical variables were analyzed using either the Chi-square test or Fisher's exact test. Results During the study's timeframe, 208 patients receiving infertility treatment were counseled to participate in rural tourism complemented by relaxation techniques. Table 1 delineates the baseline characteristics of the study cohort. On average, the women were predominantly obese, with an average BMI of 33 kg/m². "Approximately one-third of the patients engaged in at least one standard session of rural tourism combined with relaxation. According to Table 2 , participants' average emotional T-scores (covering depression, tension, loss of self-cognition, and diminished positive affect) were around 50, marginally surpassing the standard American PROMIS benchmark (Table 1 ). Despite no notable disparities in age, infertility causation, or initial emotional PROMIS scores, those partaking in rural tourism with relaxation reported reduced incidences of depression, tension, and a diminished sense of self-cognition and positive affect compared to non-participants. Participants in the rural tourism and relaxation program recorded significantly elevated rates of pregnancy and live births (refer to Table 3 ). Within this cohort, a higher inclination towards natural conception was observed (35% vs. 17%; P = .15). Non-spontaneous conceptions were exclusively facilitated via intrauterine insemination (IUI) or in vitro fertilization (IVF). The rate of IVF pregnancies among patients with non-spontaneous conception did not significantly diverge from those who didn't participate in the relaxation program (71.4% vs. 44.4%; P = .35). The duration until conception was consistent across both groups. Subgroup analysis revealed a trend of higher live birth rates in non-PCOS patients who underwent the combined rural tourism and relaxation approach (76.9% vs. 45.5%; P = .11). Particularly, patients with a history of recurrent miscarriages doubled their live birth success rate through the program compared to those who didn't participate (67% vs. 33%; P = .089). Discussion This investigation highlights that the integration of rural tourism with relaxation techniques may significantly enhance pregnancy and live birth rates in individuals grappling with infertility. Notably, over one-third of participants engaging in this blended approach managed to conceive spontaneously. The observed boost in conception and live birth rates post-intervention could primarily be attributed to an increased normalization of ovulation among patients [20]. However, it's important to note that a substantial number still required assisted reproductive technologies, indicating that the benefits of the combined approach extend beyond ovulation normalization. These promising results emphasize the potential of incorporating rural tourism and relaxation into comprehensive infertility treatment plans, although further research is needed to elucidate the specific mechanisms at play [21]. Despite the availability of professional consultation and ongoing support, a significant portion of the cohort did not achieve the desired relaxation state through rural tourism, particularly those diagnosed with depression or prone to emotional instability. This observation suggests a need for more nuanced or robust interventions, especially for individuals exhibiting higher baseline PROMIS scores for depression and other emotional distress indicators. Recent smaller scale studies indicate that relaxation and focused emotional interventions can lead to improved reproductive outcomes, suggesting that such strategies might be beneficial for a select patient group [22]. Nevertheless, the effectiveness of these interventions requires further exploration to optimize emotional wellness strategies in the context of fertility treatment. The study's conclusions are tempered by its limitations, including its small sample size and retrospective design, which may introduce selection bias and limit the generalizability of findings. The influence of lifestyle compliance and the potential confounding effects of male factor infertility and partner dynamics also warrant consideration. While the lifestyle intervention aimed to alleviate stress and improve overall well-being, the variations in partner support and external stressors during the intervention period could have impacted the results [23]. Additionally, the study's cohort included a diverse range of infertility causes, with male factor infertility possibly affecting many couples' ability to conceive. More severe cases of male factor infertility might not respond to lifestyle and emotional interventions alone, highlighting the need for a multifaceted approach to infertility treatment [24]. Moreover, the broader implications of emotional well-being on reproductive health extend beyond infertility itself. Women with underlying emotional distress are more susceptible to a range of pregnancy complications, including gestational diabetes, hypertensive disorders, and adverse postpartum outcomes. The offspring of emotionally distressed mothers also face increased risks for various health issues, underscoring the importance of emotional health in the broader context of maternal and child well-being [25]. In conclusion, this study reinforces the notion that emotional well-being is a critical, yet often overlooked, factor in reproductive health. By fostering an environment that supports relaxation and emotional balance through rural tourism, patients may not only enhance their fertility outcomes but also contribute to improved overall health and well-being. As such, patients experiencing infertility are encouraged to consider rural tourism combined with relaxation as part of their ongoing treatment and self-care regimen. Further investigation is warranted to refine these approaches and understand their full impact on fertility and long-term health outcomes. Declarations Data Availability Statement The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions. Disclosure Statement No potential conflict of interest was reported by the authors. Funding This study was sponsored by a project of key common technology research and development projects (GJ2022SM09) from the Bureau of Science and Technology of Hefei (China). Author's Contribution Xc.F. and D.Z. contributed equally to this work. The experiments were conceived and designed by G.N., D.Z., Zj.D.; Carry out experiments: Xc.F., D.Z., Zj.D.; My.H.; Analysis data: G.N.; Compilation manual: D.Z.; The manual has been strictly revised, and the final version has been completed/corrected: Xc.F., G.N., My.H. Conflict Of Interest The author declares that the study was conducted without any commercial or financial relationship that may constitute a potential conflict of interest. References B. Bagchi, S. Seal, M. Raina, D.N. Basu, I. Khan, Carcass Scavenging Relaxes Chemical-Driven Female Interference Competition in Flour Beetles, The American naturalist, 199 (2022) E1-e14. M.L. Boutet, G. Casals, B. Valenzuela-Alcaraz, L. García-Otero, F. Crovetto, A. Borrás, M.S. Cívico, D. Manau, E. Gratacós, F. Crispi, Subfertility versus ART: unraveling the origins of fetal cardiac programming, Human reproduction (Oxford, England), 38 (2023) 1961-1969. S. Chen, S. Gietel-Basten, How genuine are sub-replacement ideal family sizes in urban China?, Population studies, (2023) 1-20. T. Yoldemir, M. Yassa, K. Atasayan, Comparison of anxiety scores between unexplained primary and secondary infertile couples, Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology, 37 (2021) 1008-1013. H. Wang, Single women's access to egg freezing in mainland China: an ethicolegal analysis, Journal of medical ethics, 50 (2023) 50-56. X. Dai, G. Williams, S. Lin, C. Baker, M. Wu, W. Du, J. Hua, The sibling effect on neurodevelopment of preschoolers under China's newly relaxed child policy: A national retrospective cohort study, Frontiers in psychology, 13 (2022) 988622. M. Tsiknia, V. Skiada, I. Ipsilantis, S. Vasileiadis, N. Kavroulakis, S. Genitsaris, K.K. Papadopoulou, M. Hart, J. Klironomos, D.G. Karpouzas, C. 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Tables Table 1 Baseline patient characteristics. basic feature Parameter values Number of people (n) 208 Age (y) 33.49 ± 4.37 BMI (kg/m2) 33.17 ± 6.67 Obese patients (BMI ≥ 30 kg/m2) 116 (56%) pregnant woman (n) 1.81 ± 1.51 Note: The data is expressed as mean ± SD or n (%); BMI = Body Mass Index. Table 2 Characteristics divided by relaxation situation. Rural tourism and relaxation YES NO P- value N 68 140 Age (y) 33.72 ± 4.63 33.00 ± 4.02 .584 baseline PROMIS emotion (t-score) 64.3 ± 6.67 64.7 ± 6.37 .067 PROMIS depression (t-score) 50.91 ± 8.31 64.64 ± 8.42 .006 PROMIS tension (t-score) 50.46 ± 7.62 64.74 ± 7.52 .002 PROMIS loss self-awareness (t-score) 51.53 ± 9.03 64.78 ± 8.99 .001 PROMIS loses positive emotions (t-score) 52.27 ± 8.96 65.20 ± 9.04 .007 The causes of infertility PCOS 69% 24% .003 Male factors 20% 24% .692 Decreased ovarian reserve function 14% 24% .891 Endometriosis 9% 6% .767 Unexplained infertility 7% 18% .755 comprehensive 46% 35% .829 Note: The data is expressed as mean ± SD or n (%); PCOS = Polycystic ovary syndrome. Table 3 Fertility outcomes related to relaxation in combination with rural tourism. rural tourism and relaxation YES NO P- value Fertility rate 88% 54% .049 Active yield 71% 37% .024 Spontaneous conception rate 35% 17% .145 Pregnancy time (d) 226.57 231.35 .695 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4115084","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":280619706,"identity":"fc94ce08-6958-429b-82b4-ab66772c0bb9","order_by":0,"name":"xianchun fu","email":"","orcid":"","institution":"Maternal and Child Medical Center of Anhui Medical University, Hefei Maternity and Child Health Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"xianchun","middleName":"","lastName":"fu","suffix":""},{"id":280619707,"identity":"2b35c26e-b750-4cfb-b390-d06b8c9d45b7","order_by":1,"name":"di zhong","email":"","orcid":"","institution":"Hefei BOE Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"di","middleName":"","lastName":"zhong","suffix":""},{"id":280619708,"identity":"1479afde-6348-4c5c-be19-ec54a6f5f6bd","order_by":2,"name":"Zhijun Dai","email":"","orcid":"","institution":"Maternal and Child Medical Center of Anhui Medical University, Hefei Maternity and Child Health Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Zhijun","middleName":"","lastName":"Dai","suffix":""},{"id":280619709,"identity":"39643923-c7f9-45be-b2ea-38b2064030ec","order_by":3,"name":"Gang Ni","email":"","orcid":"","institution":"Maternal and Child Medical Center of Anhui Medical University, Hefei Maternity and Child Health Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Gang","middleName":"","lastName":"Ni","suffix":""},{"id":280619710,"identity":"6a8dbe84-ff1b-423a-9a84-ecc79cf24453","order_by":4,"name":"Mingyun Hong","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA5ElEQVRIiWNgGAWjYBACfmbGxgcMBmA2I4yBH0i2Nx82gKpkNiBKi8GZY2kCUDabBHEuu5FjxnSj4I7dhhu5xyp/FNyRZ2A/fHQDPh2MM3LMHucYPEvecCMv7TaPwTPDBp60tBv4tDBL5Jgb5xgcTjYAWnebweAwY4MEjxleLWwSOWbSMC2FPwwO2xPUwsNzLA2kxQ6khYHH4HAiQS0S7M2HQQ5LkDzzxlgaqCW5jZBf7A8zNj7O+XPYnu94juHHH38O2/azHz6GVwsMJC44APMdMcrBtsk3EKt0FIyCUTAKRhwAAC2STyJzS1YJAAAAAElFTkSuQmCC","orcid":"","institution":"Maternal and Child Medical Center of Anhui Medical University, Hefei Maternity and Child Health Hospital","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Mingyun","middleName":"","lastName":"Hong","suffix":""}],"badges":[],"createdAt":"2024-03-17 01:59:21","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4115084/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4115084/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":53245622,"identity":"d92367fe-0e0e-4176-aed2-8b8e34bd6f23","added_by":"auto","created_at":"2024-03-22 11:10:46","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":198928,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4115084/v1/4a157360-bf32-4aa8-b981-138151dfa10f.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Rural Tourism Combined with Relaxation Guidance on Fertility Outcomes in the Infertility Population","fulltext":[{"header":"Introduction","content":"\u003cp\u003eCurrently, 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].\u003c/p\u003e\n\u003cp\u003eInitially, 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\u0026apos;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].\u003c/p\u003e\n\u003cp\u003eResearch 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\u0026apos;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].\u003c/p\u003e\n\u003cp\u003eConsidering 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].\u003c/p\u003e\n\u003cp\u003eThe 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.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eThis research constitutes a retrospective cohort analysis of infertile couples attending the outpatient clinic of the Reproductive Centre at Anhui Provincial Maternal and Child Health Hospital. Prior to commencement, the Anhui Provincial Maternal and Child Health Hospital Review Committee (IRB-23188) approved the study. The purpose, process, risks, and benefits of the study were explained orally or in writing to all individuals involved in the study, and their informed consent was obtained. Furthermore, this study was conducted in accordance with the Declaration of Helsinki. From September 2021 to September 2023, couples consulted the same reproductive specialist at the hospital. Infertility was characterized as the inability to conceive after 12 months of regular, unprotected intercourse and included female patients with any etiology of infertility, encompassing those with regular and anovulatory cycles. Additionally, only couples who underwent a follow-up of at least 18 months post their initial reproductive clinic visit were included. Those who had previously undergone psychological treatment were excluded from the study.\u003c/p\u003e\n\u003cp\u003eParticipants were recommended to integrate rural tourism with relaxation activities, extending for at least one week. They were also advised to modify their lifestyle, including ceasing work-related mental activities and engaging in up to 30 minutes of physical exercise per day, five days a week. A weekly phone follow-up and a monthly office visit were conducted to ascertain adherence to the rural tourism and relaxation regimen. During this period, intake of any medication was prohibited.\u003c/p\u003e\n\u003cp\u003eThe emotional states of the infertile couples were assessed biannually using the Patient-Reported Outcomes Measurement Information System (PROMIS). PROMIS evaluates negative and tense emotions, self-image, social cognition, as well as symptoms indicative of a loss of positive affect and engagement. Its reliability in measuring emotions has been robustly substantiated in both the general population (r\u0026thinsp;=\u0026thinsp;0.92) and clinical patients (r\u0026thinsp;=\u0026thinsp;0.92%) [18], with its structural validity also affirmed across three time points (r\u0026thinsp;=\u0026thinsp;0.72\u0026ndash;0.89) [19].\u003c/p\u003e\n\u003cp\u003eBaseline screenings for infertility-related abnormalities were conducted on all female patients, including assessments of body mass index, baseline follicle-stimulating hormone, anti-M\u0026uuml;llerian hormone, and antral follicle count among others.\u003c/p\u003e\n\u003cp\u003eFor statistical analysis, continuous variables across groups were compared using one-way ANOVA, while categorical variables were analyzed using either the Chi-square test or Fisher\u0026apos;s exact test.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eDuring the study\u0026apos;s timeframe, 208 patients receiving infertility treatment were counseled to participate in rural tourism complemented by relaxation techniques. Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e delineates the baseline characteristics of the study cohort. On average, the women were predominantly obese, with an average BMI of 33 kg/m\u0026sup2;.\u003c/p\u003e\n\u003cp\u003e\u0026quot;Approximately one-third of the patients engaged in at least one standard session of rural tourism combined with relaxation. According to Table \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e, participants\u0026apos; average emotional T-scores (covering depression, tension, loss of self-cognition, and diminished positive affect) were around 50, marginally surpassing the standard American PROMIS benchmark (Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e). Despite no notable disparities in age, infertility causation, or initial emotional PROMIS scores, those partaking in rural tourism with relaxation reported reduced incidences of depression, tension, and a diminished sense of self-cognition and positive affect compared to non-participants.\u003c/p\u003e\n\u003cp\u003eParticipants in the rural tourism and relaxation program recorded significantly elevated rates of pregnancy and live births (refer to Table \u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e). Within this cohort, a higher inclination towards natural conception was observed (35% vs. 17%; P\u0026thinsp;=\u0026thinsp;.15). Non-spontaneous conceptions were exclusively facilitated via intrauterine insemination (IUI) or in vitro fertilization (IVF). The rate of IVF pregnancies among patients with non-spontaneous conception did not significantly diverge from those who didn\u0026apos;t participate in the relaxation program (71.4% vs. 44.4%; P\u0026thinsp;=\u0026thinsp;.35). The duration until conception was consistent across both groups. Subgroup analysis revealed a trend of higher live birth rates in non-PCOS patients who underwent the combined rural tourism and relaxation approach (76.9% vs. 45.5%; P\u0026thinsp;=\u0026thinsp;.11). Particularly, patients with a history of recurrent miscarriages doubled their live birth success rate through the program compared to those who didn\u0026apos;t participate (67% vs. 33%; P\u0026thinsp;=\u0026thinsp;.089).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis investigation highlights that the integration of rural tourism with relaxation techniques may significantly enhance pregnancy and live birth rates in individuals grappling with infertility. Notably, over one-third of participants engaging in this blended approach managed to conceive spontaneously. The observed boost in conception and live birth rates post-intervention could primarily be attributed to an increased normalization of ovulation among patients [20]. However, it\u0026apos;s important to note that a substantial number still required assisted reproductive technologies, indicating that the benefits of the combined approach extend beyond ovulation normalization. These promising results emphasize the potential of incorporating rural tourism and relaxation into comprehensive infertility treatment plans, although further research is needed to elucidate the specific mechanisms at play [21].\u003c/p\u003e\n\u003cp\u003eDespite the availability of professional consultation and ongoing support, a significant portion of the cohort did not achieve the desired relaxation state through rural tourism, particularly those diagnosed with depression or prone to emotional instability. This observation suggests a need for more nuanced or robust interventions, especially for individuals exhibiting higher baseline PROMIS scores for depression and other emotional distress indicators. Recent smaller scale studies indicate that relaxation and focused emotional interventions can lead to improved reproductive outcomes, suggesting that such strategies might be beneficial for a select patient group [22]. Nevertheless, the effectiveness of these interventions requires further exploration to optimize emotional wellness strategies in the context of fertility treatment.\u003c/p\u003e\n\u003cp\u003eThe study\u0026apos;s conclusions are tempered by its limitations, including its small sample size and retrospective design, which may introduce selection bias and limit the generalizability of findings. The influence of lifestyle compliance and the potential confounding effects of male factor infertility and partner dynamics also warrant consideration. While the lifestyle intervention aimed to alleviate stress and improve overall well-being, the variations in partner support and external stressors during the intervention period could have impacted the results [23]. Additionally, the study\u0026apos;s cohort included a diverse range of infertility causes, with male factor infertility possibly affecting many couples\u0026apos; ability to conceive. More severe cases of male factor infertility might not respond to lifestyle and emotional interventions alone, highlighting the need for a multifaceted approach to infertility treatment [24].\u003c/p\u003e\n\u003cp\u003eMoreover, the broader implications of emotional well-being on reproductive health extend beyond infertility itself. Women with underlying emotional distress are more susceptible to a range of pregnancy complications, including gestational diabetes, hypertensive disorders, and adverse postpartum outcomes. The offspring of emotionally distressed mothers also face increased risks for various health issues, underscoring the importance of emotional health in the broader context of maternal and child well-being [25].\u003c/p\u003e\n\u003cp\u003eIn conclusion, this study reinforces the notion that emotional well-being is a critical, yet often overlooked, factor in reproductive health. By fostering an environment that supports relaxation and emotional balance through rural tourism, patients may not only enhance their fertility outcomes but also contribute to improved overall health and well-being. As such, patients experiencing infertility are encouraged to consider rural tourism combined with relaxation as part of their ongoing treatment and self-care regimen. Further investigation is warranted to refine these approaches and understand their full impact on fertility and long-term health outcomes.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eData Availability Statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDisclosure Statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo potential conflict of interest was reported by the authors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was sponsored by a project of key common technology research and development projects (GJ2022SM09) from the Bureau of Science and Technology of Hefei (China).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor\u0026apos;s Contribution\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eXc.F. and D.Z. contributed equally to this work. The experiments were conceived and designed by G.N., D.Z., Zj.D.; Carry out experiments: Xc.F., D.Z., Zj.D.; My.H.; Analysis data: G.N.; Compilation manual: D.Z.; The manual has been strictly revised, and the final version has been completed/corrected: Xc.F., G.N., My.H.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict Of Interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe author declares that the study was conducted without any commercial or financial relationship that may constitute a potential conflict of interest.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eB. Bagchi, S. Seal, M. Raina, D.N. Basu, I. Khan, Carcass Scavenging Relaxes Chemical-Driven Female Interference Competition in Flour Beetles, The American naturalist, 199 (2022) E1-e14.\u003c/li\u003e\n\u003cli\u003eM.L. Boutet, G. Casals, B. Valenzuela-Alcaraz, L. Garc\u0026iacute;a-Otero, F. Crovetto, A. Borr\u0026aacute;s, M.S. C\u0026iacute;vico, D. Manau, E. 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Aksoy Derya, The effect of hypnofertility on fertility preparedness, stress, and coping with stress in women having in vitro fertilization: A randomized controlled trial, Journal of reproductive and infant psychology, (2022) 1-12.\u003c/li\u003e\n\u003cli\u003eA. Katsouda, M. Markou, P. Zampas, A. Varela, C.H. Davos, V. Vellecco, G. Cirino, M. Bucci, A. Papapetropoulos, CTH/MPST double ablation results in enhanced vasorelaxation and reduced blood pressure via upregulation of the eNOS/sGC pathway, Frontiers in pharmacology, 14 (2023) 1090654.\u003c/li\u003e\n\u003cli\u003eA. Fang, J. Hu, W. Zhao, M. Feng, J. Fu, S. Feng, P. Lou, H. Ren, X. Chen, Extracting clinical named entity for pituitary adenomas from Chinese electronic medical records, BMC medical informatics and decision making, 22 (2022) 72.\u003c/li\u003e\n\u003cli\u003eR.J. Fensham, R. Adinehvand, S. Babidge, M. Cantonati, M. Currell, L. Daniele, A. Elci, D.M.P. Galassi, \u0026Aacute;. de la Hera Portillo, S. Hamad, D. Han, H.A. Jawadi, J. Jotheri, B. Laffineur, A.H. Mohammad, A. Naqinezhad, A. Navidtalab, K. Nicoll, T. Odeh, V. Re, B. Sanjuan, V. Souza, L.E. Stevens, M. Tekere, E. Tshibalo, J. Silcock, J. Webb, B. van Wyk, M. Zamanpoore, K.G. Villholth, Fellowship of the Spring: An initiative to document and protect the world\u0026apos;s oases, The Science of the total environment, 887 (2023) 163936.\u003c/li\u003e\n\u003cli\u003eC. Gendron, P. Bourrinet, A. Dencausse, N. Fretellier, Preclinical Safety Assessment of Gadopiclenol: A High-Relaxivity Macrocyclic Gadolinium-Based MRI Contrast Agent, Investigative radiology, (2023).\u003c/li\u003e\n\u003cli\u003eJ.F. Fonseca, G.B. Vergani, M.S.D. Lima, K.M. Silva, A.W.U. Monteiro, A.F. Ramos, B.R.C. Alves, J.M.G. Souza-Fabjan, M.E.F. Oliveira, R. Batista, Nonsurgical Embryo Recovery as a Feasible Tool for Supporting Embryo Biobanks of Locally Adapted Brazilian Sheep and Goats, Biopreservation and biobanking, 20 (2022) 493-501.\u003c/li\u003e\n\u003cli\u003eJ. Hurtado, S. Revale, L.M. Matzkin, Propagation of seminal toxins through binary expression gene drives could suppress populations, Scientific reports, 12 (2022) 6332.\u003c/li\u003e\n\u003cli\u003eM. Iglesias-Carrasco, B. Taboada, M. Lozano, P. Carazo, R. Garcia-Roa, E. Rodriguez-Exposito, F. Garcia-Gonzalez, Sexual selection buffers the negative consequences of population fragmentation on adaptive plastic responses to increasing temperatures, Evolution; international journal of organic evolution, (2023).\u003c/li\u003e\n\u003cli\u003eY. Jiang, F. Yang, Motherhood Health Penalty: Impact of Fertility on Physical and Mental Health of Chinese Women of Childbearing Age, Frontiers in public health, 10 (2022) 787844.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab1\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eBaseline patient characteristics.\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003ebasic feature\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eParameter values\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNumber of people (n)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e208\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eAge (y)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e33.49\u0026thinsp;\u0026plusmn;\u0026thinsp;4.37\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eBMI (kg/m2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e33.17\u0026thinsp;\u0026plusmn;\u0026thinsp;6.67\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eObese patients (BMI\u0026thinsp;\u0026ge;\u0026thinsp;30 kg/m2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e116 (56%)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003epregnant woman (n)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.81\u0026thinsp;\u0026plusmn;\u0026thinsp;1.51\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003ctfoot\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"2\"\u003eNote: The data is expressed as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD or n (%); BMI\u0026thinsp;=\u0026thinsp;Body Mass Index.\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tfoot\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n\u003ctable id=\"Tab2\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eCharacteristics divided by relaxation situation.\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eRural tourism and relaxation\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eYES\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eNO\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003e\u003cem\u003eP-\u003c/em\u003evalue\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eN\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e68\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e140\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eAge (y)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e33.72\u0026thinsp;\u0026plusmn;\u0026thinsp;4.63\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e33.00\u0026thinsp;\u0026plusmn;\u0026thinsp;4.02\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e.584\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ebaseline PROMIS emotion (t-score)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e64.3\u0026thinsp;\u0026plusmn;\u0026thinsp;6.67\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e64.7\u0026thinsp;\u0026plusmn;\u0026thinsp;6.37\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e.067\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePROMIS depression (t-score)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e50.91\u0026thinsp;\u0026plusmn;\u0026thinsp;8.31\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e64.64\u0026thinsp;\u0026plusmn;\u0026thinsp;8.42\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e.006\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePROMIS tension (t-score)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e50.46\u0026thinsp;\u0026plusmn;\u0026thinsp;7.62\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e64.74\u0026thinsp;\u0026plusmn;\u0026thinsp;7.52\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e.002\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePROMIS loss self-awareness (t-score)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e51.53\u0026thinsp;\u0026plusmn;\u0026thinsp;9.03\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e64.78\u0026thinsp;\u0026plusmn;\u0026thinsp;8.99\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePROMIS loses positive emotions (t-score)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e52.27\u0026thinsp;\u0026plusmn;\u0026thinsp;8.96\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e65.20\u0026thinsp;\u0026plusmn;\u0026thinsp;9.04\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e.007\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eThe causes of infertility\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"1\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePCOS\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e69%\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e24%\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e.003\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eMale factors\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e20%\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e24%\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e.692\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eDecreased ovarian reserve function\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e14%\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e24%\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e.891\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eEndometriosis\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e9%\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e6%\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e.767\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eUnexplained infertility\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e7%\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e18%\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e.755\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ecomprehensive\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e46%\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e35%\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e.829\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003ctfoot\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"4\"\u003eNote: The data is expressed as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD or n (%); PCOS\u0026thinsp;=\u0026thinsp;Polycystic ovary syndrome.\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tfoot\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n\u003ctable id=\"Tab3\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eFertility outcomes related to relaxation in combination with rural tourism.\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003erural tourism and relaxation\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eYES\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eNO\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003e\u003cem\u003eP-\u003c/em\u003evalue\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eFertility rate\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e88%\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e54%\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e.049\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eActive yield\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e71%\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e37%\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e.024\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eSpontaneous conception rate\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e35%\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e17%\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e.145\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePregnancy time (d)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e226.57\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e231.35\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e.695\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003c/div\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Rural tourism, relaxation guidance, infertility, conception rate, live birth rate","lastPublishedDoi":"10.21203/rs.3.rs-4115084/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4115084/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThis study aims to investigate the effects of rural tourism combined with relaxation guidance on the conception rates and live birth rates among patients suffering from infertility.A retrospective cohort study was conducted, involving 208 infertile couples who received treatment at a reproductive centre in Anhui province between September 2021 and September 2023. The primary indicators monitored in this study were the pregnancy rate, live birth rate, and emotional state of the patients.Out of the participants, 32% had recently undergone rural tourism combined with relaxation guidance. The study found that those who received this combined approach had a significantly higher conception rate (88% vs. 54%) and live birth rate (71% vs. 37%) compared to those who did not participate in the rural tourism and relaxation guidance.The findings suggest that incorporating rural tourism with relaxation guidance significantly improves the live birth rates in infertile patients. Therefore, it is recommended that healthcare providers consider this combined approach as a part of the infertility treatment and care plan for patients.\u003c/p\u003e","manuscriptTitle":"Rural Tourism Combined with Relaxation Guidance on Fertility Outcomes in the Infertility Population","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-03-20 19:19:24","doi":"10.21203/rs.3.rs-4115084/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"8adec2ff-01eb-4f7a-a979-714d6fe03021","owner":[],"postedDate":"March 20th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-03-22T11:02:39+00:00","versionOfRecord":[],"versionCreatedAt":"2024-03-20 19:19:24","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4115084","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4115084","identity":"rs-4115084","version":["v1"]},"buildId":"cBFmMYwuxLRRLfASyISRj","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}