Sommerfeldt Bente, Skårderud Finn, Kvalem Ingela Lundin, Gulliksen Kjersti S, Holte Arne
Institute of Eating Disorders, Oslo, Norway.
Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway.
Front Psychol. 2023 Apr 17;14:1126941. doi: 10.3389/fpsyg.2023.1126941. eCollection 2023.
There is a higher prevalence of eating disorders among women seeking fertilization (IVF). Women with a history of eating disorders may be particularly vulnerable to eating disorder relapse during IVF, pregnancy, and early motherhood. The experience of these women during this process has hardly been studied scientifically, despite its high clinical relevance. The overall aim of this study is to describe how women with a history of eating disorders experience the process of becoming a mother through IVF, pregnancy, and the postpartum period.
We recruited women with a history of severe anorexia nervosa who had undergone IVF ( = 7) at public family health centers in Norway. Semi-openly, the participants were interviewed extensively first during pregnancy, and then 6 months after birth. The 14 narratives were analyzed using interpretative phenomenological analyses (IPA). All participants were required to complete the Eating Disorder Examination Questionnaire (EDE-Q) and were diagnosed (DSM-5) by using the Eating Disorder Examination (EDE), during both pregnancy and postpartum.
All participants experienced a relapse of an eating disorder during IVF. They perceived IVF, pregnancy, and early motherhood to be overwhelming, confusing, a source of severe loss of control, and a source of body alienation. There were four core phenomena that were reported that were strikingly similar across all participants: "anxiousness and fear," "shame and guilt," "sexual maladjustment," and "non-disclosure of eating problems." These phenomena persisted continuously throughout IVF, pregnancy, and motherhood.
Women with a history of severe eating disorders are highly susceptible to relapse when undergoing IVF, pregnancy, and early motherhood. The process of IVF is experienced as extremely demanding and provoking. There is evidence that eating problems, purging, over-exercising, anxiousness and fear, shame and guilt, sexual maladjustment, and non-disclosure of eating problems continue throughout IVF, pregnancy, and the early years of motherhood. Therefore, it is necessary for healthcare workers providing services to women undergoing IVF to be attentive and intervene when they suspect a history of eating disorders.
在寻求体外受精（IVF）的女性中，饮食失调的患病率较高。有饮食失调病史的女性在IVF、怀孕和初为人母的早期阶段可能特别容易出现饮食失调复发。尽管这一过程在临床上具有高度相关性，但这些女性在此过程中的经历几乎没有得到科学研究。本研究的总体目标是描述有饮食失调病史的女性如何经历通过IVF、怀孕和产后成为母亲的过程。
我们在挪威的公共家庭健康中心招募了有严重神经性厌食症病史且接受过IVF的女性（n = 7）。参与者在孕期首先接受了半开放式的广泛访谈，然后在产后6个月再次接受访谈。使用解释性现象学分析（IPA）对这14份叙述进行了分析。所有参与者在孕期和产后都被要求完成饮食失调检查表问卷（EDE-Q），并通过饮食失调检查（EDE）进行诊断（DSM-5）。
所有参与者在IVF期间都经历了饮食失调的复发。她们认为IVF、怀孕和初为人母的早期阶段压力巨大、令人困惑，是严重失控的根源，也是身体异化的根源。所有参与者都报告了四个核心现象，这些现象惊人地相似：“焦虑和恐惧”、“羞耻和内疚”、“性适应不良”以及“饮食问题不披露”。这些现象在整个IVF、怀孕和为人母的过程中持续存在。
有严重饮食失调病史的女性在接受IVF、怀孕和初为人母的早期阶段极易复发。IVF过程被认为极其苛刻且具有刺激性。有证据表明，饮食问题、催吐、过度运动、焦虑和恐惧、羞耻和内疚、性适应不良以及饮食问题不披露在整个IVF、怀孕和初为人母的早期阶段都会持续存在。因此，为接受IVF的女性提供服务的医护人员在怀疑其有饮食失调病史时，有必要保持警惕并进行干预。
