Facchinetti F, Matteo M L, Artini G P, Volpe A, Genazzani A R
Clinica Ostetrica e Ginecologica, Università di Modena, Italy.
Fertil Steril. 1997 Feb;67(2):309-14. doi: 10.1016/S0015-0282(97)81916-4.
To evaluate the association between the vulnerability to stress and the treatment outcome of couples undergoing IVF-ET.
Controlled, prospective clinical study.
The Assisted Reproduction Unit of the Department of Obstetrics and Gynecology, University of Modena.
PATIENT(S): Forty-nine infertile women consecutively admitted to standard superovulation treatment. Mean age was 33.9 years, duration of infertility was 6.3 years. Reasons for assisted reproduction were mechanical factor in 22 cases, sperm problem in 9 cases, and endocrine disorder in 6 cases. In 12 cases, infertility was unexplained. More than 55% already had an IVF-ET attempt.
INTERVENTION(S): The day of oocyte pick-up, subjects were submitted to Stroop Color and Word test, a task measuring the ability to cope with a cognitive stressor, involving attentional and sympathoadrenal systems. Systolic (SBP) and diastolic blood pressure, as well as heart rate (HR) were measured at baseline, during the test, and 10 minutes after the end of testing.
MAIN OUTCOME MEASURE(S): The evidence of a biochemical pregnancy (beta-hCG value 12 days after ET) define the success and failure groups.
RESULT(S): Sixteen women (33%) had a biochemical pregnancy, 12 also had ultrasound evidence. Eight gave birth to healthy infants. Age, education, causes, and duration of infertility were similar in the success and failure groups. The latter were more involved in a job outside home than the former. Moreover, they had a lower number of both fertilized oocytes and transferred embryos. In response to the Stroop test, every subject reported an increase of cardiovascular parameters. However, women becoming pregnant showed a lower response of both SBP and HR than women who failed.
CONCLUSION(S): Both a major cardiovascular vulnerability to stress and working outside home are associated to a poor outcome of IVF-ET treatment.
评估接受体外受精-胚胎移植（IVF-ET）的夫妇的应激易感性与治疗结局之间的关联。
对照性前瞻性临床研究。
摩德纳大学妇产科辅助生殖科。
49名连续接受标准超促排卵治疗的不孕女性。平均年龄33.9岁，不孕时间6.3年。辅助生殖的原因包括机械因素22例、精子问题9例、内分泌紊乱6例。12例病因不明。超过55%的患者已经尝试过IVF-ET。
取卵当天，受试者接受斯特鲁普色词测验，这是一项测量应对认知应激源能力的任务，涉及注意力和交感肾上腺系统。在基线、测试期间和测试结束后10分钟测量收缩压（SBP）、舒张压以及心率（HR）。
生化妊娠的证据（ET后12天β-hCG值）定义成功组和失败组。
16名女性（33%）发生生化妊娠，其中12名还有超声证据。8名产下健康婴儿。成功组和失败组在年龄、教育程度、病因和不孕时间方面相似。失败组比成功组更多地从事家庭以外的工作。此外，她们的受精卵子数和移植胚胎数均较少。对斯特鲁普测验的反应中，每个受试者的心血管参数均有升高。然而，成功妊娠的女性的SBP和HR反应低于未成功的女性。
对应激的主要心血管易感性和家庭以外工作均与IVF-ET治疗的不良结局相关。
