Leuven University Fertility Centre (LUFC), University Hospital Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium.
Hum Reprod. 2010 Jun;25(6):1471-80. doi: 10.1093/humrep/deq030. Epub 2010 Mar 25.
The distress that couples experience in IVF treatment is well-documented though research exploring factors that might contribute to the distress is scarce and the role of infertility-specific versus more general psychological characteristics in predicting psychological distress remains unexplored. This exploratory study aimed to describe, explore and test a self-constructed conceptual framework designed to understand the relative impact of infertility-specific and general psychological characteristics, in predicting psychological distress.
Validated self-report questionnaires that measured the concepts of the encompassing framework (personality characteristics self-criticism and dependency, attachment in the partner relationship, child wish, coping, intrusiveness, infertility-related stress and general psychological distress) were completed by 106 women and 102 men before starting the first IVF/ICSI treatment at a university hospital-based fertility centre. Data were analysed by hierarchical multivariate linear regression analysis and path analysis.
The overall conceptual psychological framework explained 55% of the variance in psychological distress. The strongest predictors of psychological distress were general psychological characteristics: passive and active coping, self-criticism and dependency and intrusiveness. A path analysis confirmed the framework and highlighted the mediating role of coping and intrusiveness. In the final analysis, none of the infertility-specific variables significantly predicted psychological distress.
The current study of patients starting IVF-treatment demonstrated that general psychological characteristics, specifically active and passive coping, personality characteristics, dependency and self-criticism and intrusiveness, are more important in predicting the variability in psychological distress than infertility-specific concerns. The results raise important questions for infertility counselling. However, the cross-sectional nature of the study only allows for insight into baseline measurement (before starting the first IVF-treatment) and therefore this area of research could benefit from additional longitudinal studies.
尽管有研究探讨了可能导致不孕不育夫妇在体外受精（IVF）治疗中感到痛苦的因素，但IVF 治疗中夫妇所经历的痛苦是有据可查的。然而，此类研究很少，并且不孕不育特异性与更普遍的心理特征在预测心理痛苦方面的作用仍未得到探索。本探索性研究旨在描述、探讨和测试一个自我构建的概念框架，旨在了解不孕不育特异性和一般心理特征对预测心理痛苦的相对影响。
在一所大学医院的生育中心开始第一次 IVF/ICSI 治疗之前，106 名女性和 102 名男性完成了涵盖概念框架的经过验证的自我报告问卷（人格特征自我批评和依赖性、伴侣关系中的依恋、孩子的愿望、应对、侵扰、与不孕不育相关的压力和一般心理困扰）。使用分层多元线性回归分析和路径分析对数据进行分析。
总体概念心理框架解释了心理困扰的 55%。心理困扰的最强预测因素是一般心理特征：被动和主动应对、自我批评和依赖性以及侵扰。路径分析证实了该框架，并强调了应对和侵扰的中介作用。在最终分析中，没有一个不孕不育特异性变量能显著预测心理困扰。
本研究对开始 IVF 治疗的患者进行了研究，结果表明，一般心理特征，特别是主动和被动应对、人格特征、依赖性、自我批评和侵扰，比不孕不育特异性问题更能预测心理困扰的可变性。结果为不孕不育咨询提出了重要问题。然而，由于该研究仅为横断面研究，仅能提供关于基线测量（在开始第一次 IVF 治疗之前）的见解，因此该研究领域可能受益于额外的纵向研究。
