Einstein College of Medicine/Montefiore Medical Center, Hartsdale, NY, USA.
J Assist Reprod Genet. 2013 Nov;30(11):1451-8. doi: 10.1007/s10815-013-0098-7. Epub 2013 Sep 17.
To study implications of psychological distress on in vitro fertilization (IVF) outcome of an infertile couple.
Prospective study in an academic infertility practice setting. Couples undergoing embryo transfer (ET) following IVF were offered participation. Female patient (n = 89) and partner (n = 77) completed questionnaires reflecting dysphoria (POMS) and pessimism (LOT) after undergoing ET. Relationship between dysphoria and pessimism and implications of individual and couple's psychological distress on IVF cycle parameters and outcomes were assessed using multivariable analyses.
Statistically significant correlations between dysphoria and pessimism were observed within the individual and between partners, (p < 0.01). Higher couple pessimism correlated with longer duration of controlled ovarian hyperstimulation (COH, p = 0.02); higher partner psychological distress related to lower fertilization rate (FR, p = 0.03). On adjusted analyses, partner's depression score was an independent predictor of reduced likelihood of clinical pregnancy (p = 0.03).
Our data validate the concept of a "stressed couple". Adverse implications of a couple's psychological distress for gamete biology (longer duration of COH and lower FR with increasing distress) are suggested. Partner's depressive scores negatively correlated with IVF success. These findings suggest the importance of including partner's evaluation in studies that focus on effects of psychological stress on IVF outcome; future studies should examine whether interventions aimed at reducing psychological stress for the infertile couple may improve IVF cycle success.
研究心理困扰对不孕夫妇体外受精（IVF）结局的影响。
在学术不孕不育实践环境中进行前瞻性研究。接受 IVF 胚胎移植（ET）的夫妇被邀请参与。女性患者（n=89）和伴侣（n=77）在接受 ET 后完成反映抑郁（POMS）和悲观（LOT）的问卷。使用多变量分析评估个体和夫妻心理困扰对 IVF 周期参数和结局的影响。
在个体内和夫妻之间均观察到抑郁和悲观之间存在显著的相关性（p<0.01）。夫妻双方的悲观情绪越高，控制性卵巢过度刺激（COH）的持续时间越长（p=0.02）；伴侣的心理压力越大，受精率（FR）越低（p=0.03）。在调整分析中，伴侣的抑郁评分是临床妊娠可能性降低的独立预测因素（p=0.03）。
我们的数据验证了“紧张夫妻”的概念。夫妻心理困扰对配子生物学的不良影响（随着压力的增加，COH 持续时间延长，FR 降低）表明。伴侣的抑郁评分与 IVF 成功率呈负相关。这些发现表明，在关注心理压力对 IVF 结局影响的研究中，纳入伴侣评估的重要性；未来的研究应探讨是否针对不孕夫妇的心理压力进行干预可以提高 IVF 周期的成功率。
