行助孕治疗的女性患者抑郁状况及应对方式的调查

Depression and its coping strategies in infertile women undergoing in vitro fertilization and embryo transfer

目的探讨行体外受精-胚胎移植（IVF-ET）或单精子胞浆内注射（ICSI）治疗女性患者的抑郁状况、影响因素以及应对方式。方法采用简版式流行病学调查中心用抑郁量表（CES-D10）及简版式应对策略问卷（brief COPE），对223例行IVF-ET或ICSI治疗的患者进行问卷调查，并监测基础性激素、人绒毛膜促性腺激素（HCG）注射13雌二醇（E2）水平及获卵数。结果抑郁症状检出率为20．6％（46／223）；婚龄〉8年、不孕时间〉6年者抑郁症状发生率较高，家庭月收入≤3000元者抑郁症状的危险性是〉3000元者的14倍，男方因素不孕者抑郁症状的危险性为非男方因素不孕者的2／5；随着基础促卵泡激素值、获卵数、否认因子分值的升高，抑郁症状的发生率增加；基础E2值高、工具支持及幽默评分高者抑郁症状发生率减低。结论部分行助孕治疗的女性患者存在抑郁症状，应针对其危险因素进行干预研究，提高心理健康水平。

Objective To know prevalence of depression, its coping strategies and risk factors among infertile women with in vitro fertilization and embryo transfer （IVF-ET） or intracytoplasmic sperm injection. Methods Infertile women with IVF-ET were interviewed with center for epidemiologic studies short depression scale （CES-D10） and an abbreviated version of the COPE inventory （brief COPE）, and their basal sex hormone values and estradiol （ E2 ） on the day of human chorionic gonadotropin （HCG） administration were monitored, as well as the number of oocytes yielded was counted. Results Prevalence of depression was 20.6% in infertile women, higher in those with more than eight years of marriage, infertility for more than six years, and receiving treatment for at least three years. Risk of depression among the women of infertility with monthly family income less than 3000 yuan was 14 times as those with more than 3000 yuan and risk of depression among them due to the factors of their husbands was 2/5 as those not due to men＇s. Depressive symptoms in the women increased with increasing of their basal follicle stimulating hormone （FSH） level, counted egg number and scores of denial items. Occurrence of their depressive symptoms decreased with higher basal E2 levels, and scores of substance use and humor. Conclusions Some infertile women with IVF-ET do have depression and preventive intervention should be aimed at related factors for depression to improve their psychological health.