Micaela Stevenson Wyszewianski, MD; Paige Johnson, RN, BS; Ryan Hanson, MS; Amy Pan, PhD; Melodee Liegl, MS; Kate Schoyer, MD; Jayme Bosler, MD; Robert Rydze, MD; Jamie Neary, APNP; Stephanie Gunderson, MD
WMJ. 2026;125(3):366-370. Published August 11, 2026.
ABSTRACT
Introduction: Patients undergoing infertility evaluation and treatment frequently experience anxiety and depressive symptoms. Easily available and highly accessible online mental health tools have not previously been evaluated using validated screening measures in this population. The objective of this study was to assess whether SilverCloud, an online, self-guided mental health program, is associated with reductions in anxiety and depressive symptom scores among patients experiencing infertility.
Methods: A retrospective cohort study was conducted among female patients undergoing an initial infertility consultation at a single academic center. Patients completed Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) questionnaires and were offered enrollment in SilverCloud at their initial infertility consultation. Baseline PHQ-9 and GAD-7 scores from initial consultations were compared between patients who enrolled in SilverCloud and those who did not. For patients who engaged in SilverCloud, Wilcoxon signed-rank tests were used to compare PHQ-9 and GAD-7 scores before and after completion of SilverCloud modules.
Results: A total of 354 patients were included in the analysis. Fifty-two patients enrolled in SilverCloud, and 32 completed at least 1 module. Baseline data demonstrated that patients who enrolled in SilverCloud had significantly higher GAD-7 scores (0.5 vs 0; P = .006). Among patients who completed at least 1 SilverCloud module, PHQ-9 and GAD-7 scores decreased significantly decreased after engagement (PHQ-9: 8.0 vs 6.5; P < .04; GAD-7: 12.5 vs 9.5; P = .02).
Conclusions: Patients experiencing infertility who utilized SilverCloud experienced significant decreases in PHQ-9 and GAD-7 scores, suggesting improvement in anxiety and depression symptoms.