Department of Reproductive Medicine, The First Affiliated Hospital of Harbin Medical University, 23 Youzheng Street, Nangang District, Harbin, Heilongjiang, 150001, China.
J Assist Reprod Genet. 2013 Jan;30(1):35-41. doi: 10.1007/s10815-012-9904-x. Epub 2012 Dec 5.
To evaluate whether psychological stress, as well as changes in hypothalamus-pituitary-adrenal (HPA) axis and sympathetic nervous system (SNS) at different time points during a first in vitro fertilization (IVF) cycle, correlates with the reproductive outcome.
A prospective study was conducted in 264 women undergoing IVF or intracytoplasmic sperm injection (ICSI) treatment between January 2009 and March 2010. Standardized psychological questionnaires were used to assess anxiety and depression. Norepinephrine and cortisol in serum were measured with specific assays.
The non-pregnant women reported higher anxiety and depression scores at the pregnancy detection day compared with the pregnant group. Lower levels of norepinephrine and cortisol at the time of oocyte retrieval and lower levels of cortisol at the time of pregnancy test were found in women with successful treatment. Significant increases in serum norepinephrine and cortisol values were observed during ovarian stimulation. State Anxiety scores were negatively correlated with live birth rate, and positively associated with serum norepinephrine and cortisol values.
State anxiety is associated with both pregnancy rate and live birth rate in IVF patients, an effect that is partly mediated by activities in the HPA and SNS.
评估在体外受精（IVF）周期的不同时间点，心理压力以及下丘脑-垂体-肾上腺（HPA）轴和交感神经系统（SNS）的变化是否与生殖结局相关。
2009 年 1 月至 2010 年 3 月期间，对 264 名接受 IVF 或胞浆内单精子注射（ICSI）治疗的女性进行了前瞻性研究。使用标准化的心理问卷评估焦虑和抑郁。用特定的测定法测量血清中的去甲肾上腺素和皮质醇。
与妊娠组相比，在妊娠检测日，未怀孕的女性报告的焦虑和抑郁评分更高。在治疗成功的女性中，在取卵时去甲肾上腺素和皮质醇水平较低，在妊娠试验时皮质醇水平较低。在卵巢刺激期间，血清去甲肾上腺素和皮质醇值显著升高。状态焦虑评分与活产率呈负相关，与血清去甲肾上腺素和皮质醇值呈正相关。
在 IVF 患者中，状态焦虑与妊娠率和活产率均相关，这种作用部分是由 HPA 和 SNS 的活动介导的。
