Table 1.

Content of the PERMA model intervention

Sessions	Aim	Contents
1	Positive emotions	The welcome session, explanation of rules and homework. Explanation of four key elements of emotional intelligence including management, perception, understanding, and using emotions regarding infertility. Happiness and life satisfaction are important subjects. Try to increase positive emotions about the past by forgiveness, about the present by physical pleasures and mindfulness, and about the future by hopefulness. Write down three things you experienced today that were fun and made you happy. Describe how you felt.
2	Engagement	Experience of flow in various activities by more concentration in the moment and increasing self-awareness. When time stops for you and you are completely absorbed by the task. Positive mental engagement and flow suppress mental ruminations regarding infertility. Write down three things you experienced today when all your attention was on something or someone and you were not aware of your surroundings. When the clock stops for you, when you lose consciousness, you are completely absorbed in your work. Describe how you feel.
3	Positive relationship	Positive and engagement are two elements to achieve well-being and positive relationships. Relationships are essential to well-being. More support and connectivity to others can promote a good purpose in life and meaning. This process is a valuable way to feel more positive. Kindness for others improves the feeling of well-being and increases capacity for love, compassion, empathy, teamwork, and cooperation. Positive relations involve participation and cooperation and so help us to avoid comparing ourselves with others, and promote comparing our diseases like infertility with couples who have children in an empathic way. Three things you experienced today where you had a positive experience with people. Only a very small part of being positive is related to isolation and loneliness. When was the last time you laughed out loud? When was the last time you felt indescribably happy? All of these happened alongside other people. By managing relationships and choosing the right people, we can have close and intimate relationships with those around us. Write down how you feel about these experiences. You can also practice kindness.
4	Meaning	Meaning is a feeling of belonging to the bigger community than the self by more socialization that produces a sense of meaning, such as through religion, family, and the community. Couples with infertility can create a better meaning of life with the help of other couples with infertility. Write down three things you experienced today that were important, significant, and meaningful to you personally. Write down how you feel about these experiences.
5	Accomplishment	Feeling of happiness regarding achievement, competence, and success in daily life. Review of gained positive things like having more support, empathy with another couple with infertility, successes in life or infertility treatments like the maturation of the oocyte, better sperm analysis test and things like these. Write down three things you experienced today when you were successful and thought you did a very good job and describe how you felt. Assessment of positive changes in thoughts, perceptions, beliefs, and emotions regarding fertility problems.
PERMA: Positive emotions, Engagement, Relationship, Meaning, Accomplishment