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焦虑和抑郁对首次体外受精(IVF)或卵胞浆内单精子注射(ICSI)治疗的取消率和妊娠率没有影响。

Anxiety and depression have no influence on the cancellation and pregnancy rates of a first IVF or ICSI treatment.

作者信息

Lintsen A M E, Verhaak C M, Eijkemans M J C, Smeenk J M J, Braat D D M

机构信息

Department of Obstetrics and Gynaecology, Radboud University Nijmegen Medical Centre, 6500 HB Nijmegen, The Netherlands.

出版信息

Hum Reprod. 2009 May;24(5):1092-8. doi: 10.1093/humrep/den491. Epub 2009 Jan 28.

Abstract

BACKGROUND

After many years of research, the impact of psychological distress on the IVF treatment outcome is still unclear. This study aimed to determine the influences of anxiety and depression before and during IVF or ICSI treatment on the cancellation and pregnancy rates of inductees.

METHODS

In a multicentre prospective cohort study, we assessed anxiety and depression at baseline and the procedural anxiety level one day before oocyte retrieval, with the short versions of the State Anxiety Inventory (STAI) and the Beck Depression Inventory-Primary Care (BDI-PC). The effect of baseline anxiety and depression on the cancellation and pregnancy rates of 783 women in their first IVF or ICSI treatment was evaluated. We also determined if a change in anxiety from the start of treatment until just before oocyte retrieval affects the pregnancy rate. The predictive value of distress was assessed while controlling for several factors in subfertility treatment.

RESULTS

Neither baseline nor procedural anxiety, nor depression affected the ongoing pregnancy rates, with odds ratios (ORs) of 1.04 (95% CI 0.82-1.33), 0.96 (95% CI 0.77-1.20) and 0.85 (95% CI 0.65-1.10), respectively. Neither did the anxiety gain score affect the pregnancy rate, OR 1.08 (95% CI 0.83-1.41). A cancellation of treatment could not be predicted by either anxiety or depression, OR 1.16 (95% CI 0.83-1.63) and 0.85 (95% CI 0.59-1.22), respectively.

CONCLUSIONS

Inductees in IVF treatment can be reassured that anxiety and depression levels before and during treatment have no significant influence on the cancellation and pregnancy rates.

摘要

背景

经过多年研究,心理困扰对体外受精(IVF)治疗结局的影响仍不明确。本研究旨在确定IVF或卵胞浆内单精子注射(ICSI)治疗前及治疗期间的焦虑和抑郁对受助者取消治疗率和妊娠率的影响。

方法

在一项多中心前瞻性队列研究中,我们使用状态焦虑量表(STAI)简版和初级保健贝克抑郁量表(BDI-PC)在基线时以及取卵前一天评估焦虑和抑郁以及手术焦虑水平。评估了基线焦虑和抑郁对783名首次接受IVF或ICSI治疗的女性的取消治疗率和妊娠率的影响。我们还确定了从治疗开始到取卵前焦虑的变化是否会影响妊娠率。在控制不育治疗中的几个因素的同时评估了困扰的预测价值。

结果

基线焦虑、手术焦虑和抑郁均未影响持续妊娠率,优势比(OR)分别为1.04(95%可信区间0.82-1.33)、0.96(95%可信区间0.77-1.20)和0.85(95%可信区间0.65-1.10)。焦虑增加得分也未影响妊娠率,OR为1.08(95%可信区间0.83-1.41)。焦虑或抑郁均无法预测治疗取消,OR分别为1.16(95%可信区间0.83-1.63)和0.85(95%可信区间0.59-1.22)。

结论

可以让接受IVF治疗的受助者放心,治疗前及治疗期间的焦虑和抑郁水平对取消治疗率和妊娠率没有显著影响。

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