Ebbesen S M S, Zachariae R, Mehlsen M Y, Thomsen D, Højgaard A, Ottosen L, Petersen T, Ingerslev H J
Department of Psychology, University of Aarhus, Jens Chr. Skous vej 4, 8000 Aarhus, Denmark.
Hum Reprod. 2009 Sep;24(9):2173-82. doi: 10.1093/humrep/dep185. Epub 2009 May 22.
There is preliminary evidence to suggest an impact of stress on chances of achieving a pregnancy with in-vitro fertilization (IVF). The majority of the available research has focused on stress related to infertility and going through IVF-treatment, and it is still unclear whether non-fertility-related, naturally occurring stressors may influence IVF pregnancy chances. Our aim was to explore the association between IVF-outcome and negative, i.e. stressful, life-events during the previous 12 months.
Prior to IVF, 809 women (mean age: 31.2 years) completed the List of Recent Events (LRE) and questionnaires measuring perceived stress and depressive symptoms.
Women who became pregnant reported fewer non-fertility-related negative life-events prior to IVF (Mean: 2.5; SD: 2.5) than women who did not obtain a pregnancy (Mean: 3.0; SD: 3.0) (t(465.28) = 2.390, P = 0.017). Logistic regression analyses revealed that the number of negative life-events remained a significant predictor of pregnancy (OR: 0.889; P = 0.02), when controlling for age, total number of life-events, perceived stress within the previous month, depressive symptoms, and relevant medical factors related to the patient or treatment procedure, including duration of infertility, number of oocytes retrieved and infertility etiology. Mediation analyses indicated that the association between negative life events and IVF pregnancy was partly mediated by the number of oocytes harvested during oocyte retrieval.
A large number of life-events perceived as having a negative impact on quality of life may indicate chronic stress, and the results of our study indicate that stress may reduce the chances of a successful outcome following IVF, possibly through psychobiological mechanisms affecting medical end-points such as oocyte retrieval outcome.
有初步证据表明压力会影响体外受精（IVF）的受孕几率。现有的大多数研究都集中在与不孕不育及接受IVF治疗相关的压力上，目前尚不清楚与生育无关的自然发生的压力源是否会影响IVF的受孕几率。我们的目的是探讨IVF结果与过去12个月内负面（即有压力的）生活事件之间的关联。
在进行IVF之前，809名女性（平均年龄：31.2岁）完成了近期事件清单（LRE）以及测量感知压力和抑郁症状的问卷。
成功怀孕的女性在IVF前报告的与生育无关的负面生活事件（平均值：2.5；标准差：2.5）少于未怀孕的女性（平均值：3.0；标准差：3.0）（t(465.28)=2.390，P = 0.017）。逻辑回归分析显示，在控制年龄、生活事件总数、前一个月的感知压力、抑郁症状以及与患者或治疗程序相关的相关医学因素（包括不孕不育持续时间、获取的卵母细胞数量和不孕病因）后，负面生活事件的数量仍然是怀孕的显著预测因素（比值比：0.889；P = 0.02）。中介分析表明，负面生活事件与IVF怀孕之间的关联部分是由卵母细胞采集过程中收获的卵母细胞数量介导的。
大量被认为对生活质量有负面影响的生活事件可能表明存在慢性压力，我们的研究结果表明，压力可能会降低IVF后成功受孕的几率，可能是通过影响诸如卵母细胞采集结果等医学终点的心理生物学机制。
