不孕夫妇的压力、焦虑和抑郁与首次 IVF 或 ICSI 治疗结果无关。
Stress, anxiety, and depression in infertile couples are not associated with a first IVF or ICSI treatment outcome.
机构信息
Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China.
State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China.
出版信息
BMC Pregnancy Childbirth. 2021 Oct 27;21(1):725. doi: 10.1186/s12884-021-04202-9.
BACKGROUND
Psychological distress may exert a negative influence on reproductive function of couples at reproductive age. Couples seeking assisted reproductive technology (ART) treatment may have a higher prevalence of psychological distress than fertile couples. However, whether psychological distress is associated with the outcome of ART treatment remains unknown. We aimed to investigate the association of pre-treatment psychological distress and clinical pregnancy rate among infertility couples undergoing in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) treatment.
METHODS
This nested case-control study was conducted based on women who underwent their first fresh IVF or ICSI cycle in the Jiangsu Birth Cohort Study (JBC) between November 2015 and January 2019. A total of 150 women who did not obtain clinical pregnancy after first IVF or ICSI fresh embryo transfer were identified as cases, and a total of 300 age matched women who obtained clinical pregnancy were identified as controls. Conditional logistic regression analyses were used to investigate the association between psychological distress and the outcome of first IVF or ICSI treatment, adjusting for multiple potential confounders.
RESULTS
No statistically significant association was observed between score of maternal symptoms of psychological distress and clinical pregnancy. Adjusted ORs of logistic regression were 1.00 (95% CI 0.97-1.03) for anxiety, 0.98 (95% CI 0.95-1.02) for depression, and 0.98 (95% CI 0.95-1.01) for perceived stress, respectively. When treat depression and anxiety as categorical variables, 62 (13.8%) were classified as clinical depression, 11 (2.4%) were classified as clinical anxiety, among 450 women in the present study. Psychological distress symptoms were also not associated with clinical pregnancy rate. Adjusted ORs of logistic regression were 0.27 (95% CI 0.03-2.33) for anxiety, 0.88 (95% CI 0.46-1.68) for depression, respectively.
CONCLUSIONS
Our findings firstly indicated that psychological distress experienced prior to IVF/ICSI treatment was not associated with clinical pregnancy.
背景
心理困扰可能对育龄夫妇的生殖功能产生负面影响。寻求辅助生殖技术（ART）治疗的夫妇可能比有生育能力的夫妇有更高的心理困扰发生率。然而，心理困扰是否与 ART 治疗的结果有关尚不清楚。我们旨在调查体外受精（IVF）或胞浆内精子注射（ICSI）治疗前心理困扰与不孕夫妇临床妊娠率的关系。
方法
本巢式病例对照研究基于 2015 年 11 月至 2019 年 1 月期间在江苏出生队列研究（JBC）中首次接受新鲜 IVF 或 ICSI 胚胎移植的女性。共 150 名首次 IVF 或 ICSI 新鲜胚胎移植后未获得临床妊娠的女性被确定为病例，共 300 名年龄匹配的获得临床妊娠的女性被确定为对照组。采用条件 logistic 回归分析调查心理困扰与首次 IVF 或 ICSI 治疗结果之间的关系，同时调整了多个潜在混杂因素。
结果
母体心理困扰症状评分与临床妊娠无统计学显著相关性。logistic 回归调整后的 OR 分别为焦虑 1.00（95%CI 0.97-1.03）、抑郁 0.98（95%CI 0.95-1.02）和感知压力 0.98（95%CI 0.95-1.01）。当将抑郁和焦虑作为分类变量时，在 450 名女性中，62 名（13.8%）被归类为临床抑郁症，11 名（2.4%）被归类为临床焦虑症。心理困扰症状也与临床妊娠率无关。logistic 回归调整后的 OR 分别为焦虑 0.27（95%CI 0.03-2.33）、抑郁 0.88（95%CI 0.46-1.68）。
结论
我们的研究结果首次表明，IVF/ICSI 治疗前的心理困扰与临床妊娠无关。
Zotero 插件