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女性对体外受精/卵胞浆内单精子注射治疗的长期心理调适

Long-term psychological adjustment to IVF/ICSI treatment in women.

作者信息

Verhaak C M, Smeenk J M J, Nahuis M J, Kremer J A M, Braat D D M

机构信息

Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands.

出版信息

Hum Reprod. 2007 Jan;22(1):305-8. doi: 10.1093/humrep/del355. Epub 2006 Sep 14.

Abstract

BACKGROUND

The aim of this study was to gain more insight into long-term psychological adjustment to IVF in women.

METHODS

In a prospective cohort study, 298 women entering their first IVF treatment cycle (including ICSI) completed standardized psychological questionnaires before the start of the treatment, just after the last treatment cycle, and 6 months and 3-5 years after the last treatment cycle. The main outcome measures were state anxiety, depression and mode of adaptation to unsuccessful IVF.

RESULTS

Anxiety and depression were found at follow-up to return to baseline levels following treatment not resulting in a live birth, after an initial increase during treatment. On the contrary, treatment resulting in a live birth was found to lead to a more positive long-term emotional status. Women who focused on new life goals as a mode of adaptation 3-5 years after IVF without a live birth showed lower levels of anxiety and depression compared with those who persisted in their attempts to get pregnant.

CONCLUSIONS

Treatment that resulted in a live birth led to more positive emotional adjustment. In addition, most women who did not give birth to a child after treatment adjusted well psychologically. Positive adjustment was related to developing new life goals rather than persisting in attempts to get pregnant. Helping women to change life goals after abandoning treatment might have beneficial effects on the adaptation process.

摘要

背景

本研究旨在更深入地了解女性对体外受精(IVF)的长期心理调适情况。

方法

在一项前瞻性队列研究中,298名进入首个IVF治疗周期(包括卵胞浆内单精子注射)的女性在治疗开始前、最后一个治疗周期刚结束后、最后一个治疗周期后的6个月以及3至5年时完成了标准化心理问卷。主要结局指标为状态焦虑、抑郁以及对IVF未成功的适应方式。

结果

在治疗未导致活产的情况下,随访发现焦虑和抑郁在治疗期间最初有所增加后,又恢复到基线水平。相反,导致活产的治疗被发现会带来更积极的长期情绪状态。与那些持续尝试怀孕的女性相比,在IVF未成功后的3至5年里,将新生活目标作为适应方式的女性焦虑和抑郁水平较低。

结论

导致活产的治疗会带来更积极的情绪调适。此外,大多数治疗后未生育子女的女性心理调适良好。积极的调适与制定新的生活目标有关,而不是持续尝试怀孕。帮助女性在放弃治疗后改变生活目标可能会对适应过程产生有益影响。

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