体外受精-胚胎移植过程中焦虑抑郁、子宫收缩频率和妊娠结局的相关性  

Correlation between psychological factors,uterine contraction frequency and pregnancy outcome during in vitro fertilization and embryo transfer process

作　　者：何玉洁[1] 王瑛 土增荣[1] 张红梅[1] 范晶[1] 

机构地区：[1]山西医科大学第一医院生殖与遗传科,太原030001 [2]山西晋城市人民医院妇产科

出　　处：《山西医科大学学报》2016年第12期1108-1111,共4页Journal of Shanxi Medical University

基　　金：山西医科大学第一医院院基金项目(YG1304)

摘　　要：目的探讨体外受精-胚胎移植（IVF/ICSI）过程中移植日焦虑抑郁与妊娠结局的关系、子宫收缩频率与妊娠结局的关系、焦虑抑郁与子宫收缩频率的关系。方法选取2014-012014-07符合标准的86例行IVF/ISCI治疗的不孕症患者作为研究对象,于胚胎移植日,发放焦虑自评量表（SAS）及抑郁自评量表（SDS）的调查问卷,现场调查现场收回。同时阴道超声监测患者子宫收缩波,并记录。观察妊娠结局至胚胎移植后4周,按妊娠结局分为临床妊娠组和非妊娠组,分析焦虑抑郁、子宫收缩频率与妊娠结局的相关性。结果临床妊娠组39例,非妊娠组47例。移植日非妊娠组的SAS评分明显高于临床妊娠组（P〈0.05）,而两组SDS评分比较,差异无统计学意义（P〉0.05）。移植日的SAS评分与妊娠结局进行回归分析,SAS评分与妊娠结局相关（P〈0.05）,SAS评分越低,成功妊娠可能性越大;两组不同妊娠结局间的子宫收缩频率比较,临床妊娠组子宫收缩频率≤4次/min较非妊娠组多（P〈0.05）,移植日子宫收缩频率与妊娠结局相关（P〈0.05）,子宫收缩频率过强不容易妊娠;将移植日的SAS评分与子宫收缩频率进行关联性分析,移植日的子宫收缩频率与SAS评分之间有正相关性（r=0.704,P〈0.05）。结论对于接受IVF/ICSI治疗的不孕症患者,移植日子宫收缩频率过快及明显焦虑的患者,不容易妊娠,且焦虑情绪可能导致子宫收缩频率增加,不利于妊娠。Objective To investigate the relationship among anxiety / depression at the transplantation day,uterine contraction rate and pregnancy outcome during the IVF / ICSI process. Methods Eighty-six inferility patients with IVF / ISCI treatment from January 2014 to July 2014 were chosen as the subjects,and self-rating anxiety surveys（ SAS） and self-rating depression surveys（ SDS） were distributed at the embryo transplantation day and collected after completion. Simultaneously,the uterine contraction wave was monitored and recorded using transvaginal ultrasound. Then,patients were classified into clinical pregnancy group and non-pregnancy group according to the pregnancy outcome after 4 weeks＇ monitoring. The correlations among anxiety / depression,uterine contraction rate and pregnancy outcome were analyzed. Results The 86 patients were divided into clinical pregnancy group（ n = 39） and non-pregnancy group（ n = 47）. The SAS score in non-pregnancy group was significantly higher than in pregnancy group（ P 〈0. 05）,while the difference of SDS score between the two groups was not statistically significant（ P 〈0. 05）. The regression analysis showed that the lower the SAS score was at the transplantation day,the higher the pregnancy success rate was（ P 〈0. 05）. The uterine contraction rate was correlated with pregnancy success rate（ P 〈0. 05）. The uterine contraction rate and SAS score were positively correlated at the transplantation day（ r = 0. 704,P 〈0. 05）. Conclusion For non-pregnant patients with IVF/ICSI treatment,those with anxiety/depression have a higher uterine contraction rate and a lower success rate of pregnancy. Furthermore,anxiety / depression may cause a high uterine contraction rate,which further reduces the success rate of pregnancy.

关 键 词：焦虑 抑郁 子宫收缩频率 妊娠结局 体外受精-胚胎移植 

分 类 号：R713.7[医药卫生—妇产科学]