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卵母细胞捐赠者的身体状况和心理社会经历:一项混合方法研究。

Oocyte donors' physical outcomes and psychosocial experiences: a mixed-methods study.

作者信息

Adlam Kirby, Koenig Mary Dawn, Patil Crystal L, Steffen Alana, Salih Sana, Kramer Wendy, Hershberger Patricia E

机构信息

Department of Human Development Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, Illinois.

Department of Human Development Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, Illinois.

出版信息

Fertil Steril. 2025 Jul;124(1):95-103. doi: 10.1016/j.fertnstert.2024.12.019. Epub 2025 Jan 13.

Abstract

OBJECTIVE

To expand knowledge on physical outcomes and psychosocial experiences of oocyte donors after donation across 3 age cohorts.

DESIGN

Cross-sectional mixed-methods survey.

PATIENTS

A total of 363 participants (ages: 22-71 years, M = 38.8) recruited from Donor Sibling Registry and Facebook groups donated an average of 3.3 times, with 77.1% using nonidentified donation. Most were White (92.8%) and over half (59%) were married at the time of survey. Average length of time from initial donation to study participation was 13.75 years.

EXPOSURE

Previous oocyte donation.

MAIN OUTCOME MEASURES

Self-reported physical outcomes and psychological experiences after donation.

RESULTS

Most donors (89.5%) completing the online survey (N = 363) reported a positive overall experience. Self-reported physical outcomes, including changes to menstrual cycles, ovulation, or fertility, were reported by 21% of participants after donation. Many (41.4%) reported procedural pain, and 10.5% reported ovarian hyperstimulation syndrome. Anxiety (25.8%) and depression (23.2%) were the most common self-reported diagnoses. Validated measures (Patient Reported Outcomes Measurement Information System Bank V1.0 Depression, Patient Reported Outcomes Measurement Information System Bank V1.0 Anxiety) were used to assess mild or greater anxiety and depression (25.1% and 17.6%, respectively; t-score ≥55). Participants screened clinically significant rates of alcohol/drug misuse (11.5%; ≥2 Cut down, Annoyed, Guilty, Eye opener-Adapted to Include Drugs), with 50% of those reporting depressive symptoms. Anonymity was the most common qualitative response for reported emotional distress (17%) and regret (20%). Most participants (94.3%) reported no contact by clinics for medical updates after donation, despite 25% reporting they had changes in their health to communicate. Participants' open-ended responses detailed the 3 most important concerns: improved communication with clinics; desire for less anonymity; and more information on long-term donor health outcomes.

CONCLUSION

Most participants felt their oocyte donation experience was positive despite reported pain, menstrual cycle changes, and emotional distress. Depression and anxiety were the most common self-reported diagnoses. Depression rated higher than the national prevalence. Elevated Cut down, Annoyed, Guilty, Eye opener-Adapted to Include Drugs was associated with depression, indicating the importance of screening oocyte donors for mental health and drug/alcohol misuse. Concerns included lack of communication after procedure and lack of information provided on long-term health outcomes. Clinicians can incorporate these findings when counseling this population.

摘要

目的

拓展对3个年龄组卵母细胞捐赠者捐赠后身体状况和心理社会经历的认识。

设计

横断面混合方法调查。

患者

从捐赠者同胞登记处和脸书群组招募了363名参与者(年龄:22 - 71岁,平均年龄M = 38.8岁),平均每人捐赠3.3次,77.1%的人采用匿名捐赠。大多数为白人(92.8%),超过半数(59%)在调查时已婚。从首次捐赠到参与研究的平均时间为13.75年。

暴露因素

既往卵母细胞捐赠。

主要结局指标

捐赠后自我报告的身体状况和心理经历。

结果

完成在线调查的大多数捐赠者(89.5%,N = 363)报告总体经历为积极。21%的参与者报告了捐赠后自我感觉的身体变化,包括月经周期、排卵或生育能力的改变。许多人(41.4%)报告有手术疼痛,10.5%报告有卵巢过度刺激综合征。焦虑(25.8%)和抑郁(23.2%)是最常见的自我报告诊断。采用经过验证的测量工具(患者报告结局测量信息系统库V1.0抑郁量表、患者报告结局测量信息系统库V1.0焦虑量表)评估轻度及以上焦虑和抑郁(分别为25.1%和17.6%;t评分≥55)。参与者筛查出临床上有显著意义的酒精/药物滥用率(11.5%;≥2项减少、烦恼、内疚、警觉——改编后纳入药物相关情况),其中50%的人报告有抑郁症状。匿名是报告情绪困扰(17%)和后悔(20%)时最常见的定性回答。尽管25%的参与者报告其健康状况有变化需要沟通,但大多数参与者(94.3%)报告捐赠后诊所未就医疗情况进行随访。参与者的开放式回答详细列出了3个最重要的担忧:改善与诊所的沟通;希望减少匿名性;以及获取更多关于捐赠者长期健康结局的信息。

结论

尽管报告有疼痛、月经周期变化和情绪困扰,但大多数参与者认为他们的卵母细胞捐赠经历是积极的。抑郁和焦虑是最常见的自我报告诊断。抑郁发生率高于全国患病率。“减少、烦恼、内疚、警觉——改编后纳入药物相关情况”得分升高与抑郁相关,表明筛查卵母细胞捐赠者的心理健康和药物/酒精滥用情况很重要。担忧包括术后缺乏沟通以及未提供长期健康结局的信息。临床医生在为这一人群提供咨询时可纳入这些研究结果。

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