体外受精-胚胎移植不同阶段的抑郁、焦虑状态与助孕结局的关系分析

The analysis of the influence of depression and anxiety at different stages on the outcome in patients with in vitro fertilization and embryo transfer

目的 分析体外受精-胚胎移植(in vitro fertilization-embryo transfer, IVF-ET)助孕不同阶段的抑郁、焦虑状态差异与助孕结局的联系。方法 选择2016年1月至2018年12月西南医科大学附属医院211例卵巢储备功能正常并接受IVF-ET的女性,分别于进周期日(T1)、hCG日(T2)完成抑郁自评量表、焦虑自评量表,回顾性分析不同阶段抑郁、焦虑变化及与胚胎移植结局的联系。结果 T2焦虑评分(51.19±8.43)及发生率(44.55%)均显著高于T1(46.61±8.46,28.91%),差异有统计学意义(P<0.05);抑郁评分及发生率在T1、T2间差异无统计学意义(P>0.05);不同阶段抑郁组与无抑郁组比较、焦虑组与无焦虑组比较,实验室结局(获卵率、MⅡ卵率、优胚率等)、鲜胚移植及第一次冻融胚胎移植的临床妊娠率和胚胎种植率差异均无统计学意义(P>0.05)。结论 女性在IVF-ET不同阶段存在较高的抑郁或焦虑发生风险,取卵前焦虑状态较为明显;长方案IVF-ET助孕患者进周期日、hCG日抑郁、焦虑与助孕结局无显著联系。

Objective To explore the difference between depression and anxiety at different stages of in vitro fertilization-embryo transfer(IVF-ET) and its relationship with IVF-ET outcomes.Methods 211 IVF-ET women with normal ovarian reserve in the Affiliated Hospital of Southwest Medical University from January 2016 to December 2018 were included.Self-rating depression scale(SDS) and self-rating anxiety scale(SAS) were completed to determine the depression and anxiety on the day they started their treatment(T1) and on hCG day(T2),respectively, and the relationship between depression and anxiety at different stages and IVF-ET outcome were analyzed retrospectively.Results The anxiety score(51.19±8.43) and incidence(44.55%) at stage T2 were significantly higher than those at stage T1(46.61±8.46,28.91%),the differences were statistically significant(P<0.05).While depression score and incidence were not significantly different at different stages(P>0.05).The laboratory outcome(egg harvesting rate,MⅡ egg rate, excellent embryo rate, etc) and IVF-ET outcome were not significantly different between women with anxiety(depression) and cases without anxiety(depression)(P>0.05).Conclusion IVF-ET patients have a high risk of depression or anxiety at different stages of treatment, and the anxiety state before ovum pick-up is obvious.There may be no significant relationship between IVF-ET outcome and the depression and anxiety on the day they started their treatment or on hCG day in patients underwent long protocol.