生殖心理健康管理系统在试管婴儿患者中的应用

Application of reproductive mental health management system in patients receiving IVF-ET

目的探索心理健康管理系统的应用对试管婴儿患者妊娠结局的影响。方法回顾性分析2015年7月至2016年6月于邢台不孕不育专科医院行体外受精-胚胎移植(IVF-ET)助孕的患者,对所有患者使用抑郁自评量表(SDS)、焦虑自评量表(SAS)进行调查,筛选出SAS、SDS得分50分以上的220例患者,采用简单随机化法将其分为两组(每组各110例),A组为实验组,使用生殖心理健康管理系统,B组为对照组,不做处理,所有患者均采用达菲林黄体期长方案,实验自患者进入体外受精用药周期前2周开始,到移植后4周确定是否为临床妊娠时结束。对比两组干预前后SDS、SAS结果及妊娠结局。结果干预后A组患者SDS、SAS结果显著低于B组(F值分别为285.936、410.133,均P<0.05);A组干预前后SAS、SDS评分比较差异有统计学意义(t值分别为19.137、18.139,均P<0.05);两组患者年龄、不孕年限、体质指数(BMI)、基础促卵泡生成素(FSH)值、降调节天数、促性腺激素(Gn)天数、人绒毛膜促进性腺激素(hCG)日促黄体生成激素(LH)、hCG日雌二醇(E_2)、hCG日孕酮(P)、内膜厚度、获卵数、移植胚胎数等因素比较差异均不显著,经多因素方差分析排除以上因素影响,结果显示A组优质胚胎数、临床妊娠率显著高于B组(F=4.640,P<0.05;χ~2=3.189,P<0.05)。结论运用心理健康管理系统对改善IVF-ET患者负性情绪具有积极作用,对提高患者临床妊娠率可能具有促进作用。

Objective To explore the effect of mental health management system on pregnancy outcomes of patients receiving in vitro fertilization and embryo transfer（ IVF-ET）. Methods Patients treated with IVF-ET in Xingtai Infertility Specialist Hospital from July 2015 to June 2016 were retrospectively analyzed. All patients were assessed with self-rating anxiety scale（ SAS） and self-rating depression scale（ SDS）. A total of 220 patients with scores of SAS and SDS above 50 were screened out and randomly divided into two groups,with 110 cases in each group. Group A was experimental group accepting reproductive mental health management system,and group B was control group using no special treatment. All patients adopted diphereline long luteal phase scheme. Experiment began at 2 weeks before patients getting into IVF medication cycle,and ended at 4 weeks after transplantation when clinical pregnancy was determined. Results of SDS,SAS and pregnancy outcomes in two groups were compared. Results After intervention,results of SDS and SAS in group A were significantly lower than those in group B（ F value was 285. 936 and 410. 133,respectively,both P〈0. 05）. Scores of SAS and SDS in group A showed statistically significant differences before and after intervention（ t value was 19. 137 and 18. 139,respectively,both P〈0. 05）. There were no significant differences in age,duration of infertility,body mass index（ BMI）,basic follicle stimulating hormone（ FSH） value,down regulation days,gonadotropin（ Gn） days,luteinizing hormone（ LH）,estradiol（ E_2） and progesterone（ P） on HCG day,endometrial thickness,number of oocytes retrieved and number of embryos transferred between two groups. Multivariate analysis of variance was used to exclude influence of above factors,and results showed that number of high quality embryos and clinical pregnancy rate in group A were significantly higher than those in group B（ F = 4. 640,P〈0. 05; χ^2= 3. 189,P〈0. 05）. Conclusion Mental health management system plays a positive role in improving emotions of IVF-ET patients,and may boost patient＇s clinical pregnancy rate.