Clinic Institute of Gynecology, Obstetrics and Neonatology, Faculty of Medicine, Hospital Clinic-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Villarroel 170, 08036, Barcelona, Spain.
Department of Obstetrics and Gynecology, Faculty of General Medicine, Saratov State Medical University n.a. V.I. Razumovsky, Saratov, Russian Federation.
Reprod Sci. 2021 Oct;28(10):2830-2838. doi: 10.1007/s43032-021-00546-x. Epub 2021 Mar 24.
The objectives of this study are to assess the prevalence of psychological complaints and changes in sexual function in infertile PCOS women compared with patients with other infertility causes (tubal and male infertility factors) and to identify the predisposing factors. An observational study with three cohorts of infertile women was designed including 37 PCOS patients, 36 women with tubal factor, and 31 women with male factor. Clinical history and physical examination were carried out in all patients. All subjects completed the Hamilton Anxiety Rating Scale, the Beck Depression Inventory, and the Female Sexual Function Index questionnaires. Women with infertility due to PCOS showed a significantly higher prevalence of depressive (48.6 vs 19.4 and 12.9%, p < 0.01) and anxiety symptoms (21.6 vs 5.6 and 3.2%, p = 0.041) than respondents of reference groups. Sexual function in PCOS subjects was impaired in the areas orgasm and satisfaction (p < 0.01 for both) compared to patients of reference groups. Clinical, biochemical hyperandrogenism, and overweight were associated with a higher incidence of depressive and anxiety symptoms in the infertile PCOS group (p < 0.01 for all). Besides, the severity of anxiety symptoms was associated with the number of medically assisted reproduction attempts (p = 0.014). Weight gain and age (p = 0.04 and p = 0.047) were associated with impaired sexual functioning. The relation between reduced sexuality and depressive/anxiety symptoms was found (p = 0.038 and p = 0.012, respectively). Infertile PCOS patients showed the highest prevalence of psychological complaints and some impairment in their sexual functioning. Mental health and sexual functioning need to be part of the routine clinical screening of every PCOS patient. The study was registered at clinicaltrials.gov (identifier: NCT03306459) https://clinicaltrials.gov/ct2/show/NCT03306459?cond=PCOS&cntry=ES&city=Barcelona&draw=2&rank=3.
本研究的目的是评估与患有其他不孕原因（输卵管和男性因素）的患者相比，多囊卵巢综合征（PCOS）不孕女性的心理投诉和性功能变化的发生率，并确定易患因素。设计了一项观察性研究，包括三个不孕女性队列，共纳入 37 名 PCOS 患者、36 名输卵管因素患者和 31 名男性因素患者。对所有患者进行临床病史和体格检查。所有受试者均完成了汉密尔顿焦虑量表、贝克抑郁量表和女性性功能指数问卷。与对照组相比，因 PCOS 导致不孕的女性表现出明显更高的抑郁（48.6%比 19.4%和 12.9%，p<0.01）和焦虑症状（21.6%比 5.6%和 3.2%，p=0.041）。与对照组相比，PCOS 患者的性功能在性高潮和满意度方面受损（两者均 p<0.01）。临床、生化高雄激素血症和超重与不孕 PCOS 组中抑郁和焦虑症状的发生率增加相关（所有均 p<0.01）。此外，焦虑症状的严重程度与辅助生殖尝试次数相关（p=0.014）。体重增加和年龄（p=0.04 和 p=0.047）与性功能受损相关。发现性健康状况与抑郁/焦虑症状之间存在关联（p=0.038 和 p=0.012）。患有 PCOS 的不孕患者表现出最高的心理投诉发生率和一些性功能障碍。心理健康和性功能应成为每个 PCOS 患者常规临床筛查的一部分。该研究在 clinicaltrials.gov 注册（标识符：NCT03306459）https://clinicaltrials.gov/ct2/show/NCT03306459?cond=PCOS&cntry=ES&city=Barcelona&draw=2&rank=3。
