认知行为疗法对PCOS不孕患者辅助生殖妊娠结局的影响

Effect of cognitive behavioral therapy on pregnancy outcome in infertile women with PCOS undergoing assisted reproductive technology

目的探究认知行为疗法(CBT)对多囊卵巢综合征(PCOS)不孕患者辅助生殖技术(ART)后妊娠结局的影响.方法选取2018年1月—2019年12月期间上饶市妇幼保健院收治的80例肥胖型PCOS不孕患者作为观察对象,使用随机数字表法分为常规组(n=40,予以常规护理)与CBT组(n=40,在常规护理基础上进行CBT干预).比较2组患者在进入ART周期前与接受胚胎移植后的心理情况[汉密尔顿焦虑量表(HAMA)、抑郁量表(HAMD)评分]和辅助生殖妊娠相关结局.结果进入ART周期前,2组的HAMA、HAMD评分差异均无统计学意义(P>0.05);接受胚胎移植后,CBT组的HAMA、HAMD评分明显低于常规组(P<0.05).CBT组的种植率、临床妊娠率明显高于常规组(P<0.05);2组的流产率、异位妊娠率差异无统计学意义(P>0.05).结论多囊卵巢综合征患者行辅助生殖技术期间开展认知行为疗法,可有效减少其焦虑、抑郁情绪,提高妊娠率.

Objective To investigate the effect of cognitive behavioral therapy(CBT)on pregnancy outcome in infertile patients with ovarian syndrome(PCOS)undergoing assisted reproductive technology(ART).Methods Eighty infertile obese PCOS patients admitted to our hospital from January 2018 to December 2019 were selected as the observation subjects and divided into the conventional group(n=40,given routine care)and CBT group(n=40,CBT intervention on the basis of routine care)using the random number table.Psychological conditions[Hamilton Anxiety Rating Scale(HAMA),Depression Rating Scale(HAMD)scores]and assisted reproductive pregnancy-related outcomes were compared between the two groups before entering the ART cycle and after receiving embryo transfer.Results Before entering ART cycle,there was no significant difference in HAMA and HAMD scores between the two groups(P>0.05);after receiving embryo transfer,the HAMA and HAMD scores in the CBT group were significantly lower than those in the conventional group(P<0.05).The implantation rate and clinical pregnancy rate in the CBT group were significantly higher than those in the conventional group(P<0.05);there was no significant difference in the abortion rate and ectopic pregnancy rate between the two groups(P>0.05).Conclusion Cognitive behavioral therapy can effectively reduce anxiety and depression and improve pregnancy rate in patients with ovarian syndrome during assisted reproductive technology.