不孕症妇女经体外受精-胚胎移植治疗失败后情感体验的质性研究

目的探讨经体外受精-胚胎移植(IVF-ET)治疗失败的不孕症妇女的情感体验,以指导护理工作。方法采用质性研究的方法,选取10例经(IVF-ET)多次治疗失败的不孕症妇女。通过面谈收集资料,采用现象学描述性方法分析资料。结果本研究得出的主题包括4个:挫败感、压力沉重、放弃怀孕、重新规划未来。结论接受(IVF-ET)治疗的不孕症妇女,在失败使她们经历了挫败感、承受各方面压力之后,最终要接受现实,并重新规划未来的生活,护士在这一过程中需要给予更多的关爱与疏导。     

不孕妇女经体外授精-胚胎移植成功受孕的生活体验的质性研究

目的探讨经体外授精-胚胎移植（IVF-ET）治疗成功的不孕症妇女的生活经历,以指导护理工作。方法采用质性研究的方法,选取10例经IVF—ET治疗成功的不孕症妇女,经知情同意,通过面谈收集资料,采用现象学描述性方法分析资料。结果本研究数据提炼的主题包括7个：坚实的信念、明确的定位、积极的配合、支持的需要、绝对的隐私、工作的影响以及过山车般的情感体验。结论不孕症妇女在经IVF治疗期间经历了很多情感体验,值得护理人员注意及适时指导,帮助她们成功受孕。     

行辅助生殖不孕症病人挫败感现状及影响因素分析

目的:探讨行辅助生殖不孕症病人挫败感现状,并分析其影响因素.方法:采用便利抽样方法选取2020年1月—2021年1月于医院行辅助生殖的不孕症病人220例行调查研究,使用的调查工具为一般资料调查表、挫败感量表(The Defeat Scale,DS)、病人健康问卷抑郁量表(PHQ-9)和社会支持评定量表(SSRS).采用单因素分析、Pearson相关性分析和多因素分析研究行辅助生殖不孕症病人挫败感的影响因素.结果:220例行辅助生殖不孕症病人的挫败感得分为(27.08±6.74)分.经单因素分析、Pearson相关性分析和多因素分析显示,文化水平、生育情况、婚龄、抑郁和社会支持情况为行辅助生殖不孕症病人的影响因素(P<0.01).结论:本研究所纳入的不孕症病人的挫败感水平较高,严重影响了不孕症病人的生育问题和正常生活.依据本研究分析所得的影响因素,为其制定改善挫败感的应对策略,对于改善不孕症病人的心理状况,树立其配合治疗的信心至关重要.     

行体外受精-胚胎移植的不孕症患者挫败感现状及影响因素分析

目的:调查行体外受精-胚胎移植(IVF-ET)治疗的不孕症患者的挫败感现状,并分析其影响因素。方法 :应用便利抽样法,选择2019年7—11月在长沙市某生殖医学中心进行IVF-EF治疗的284例不孕症患者作为研究对象,采用一般资料调查表、中文版挫败感量表、患者健康问卷抑郁量表(PHQ-9)、Locke-Wollance婚姻调适问卷(MAT)进行调查。结果 :284例不孕症患者的挫败感得分为(26.10±6.31)分;多元线性逐步回归分析结果显示:不孕年限、抑郁、行IVF-ET治疗总次数和夫妻婚姻调适度是行IVF-ET治疗的不孕症患者挫败感的主要影响因素,解释了83.2%的总变异。结论 :行IVF-ET治疗的不孕症患者挫败感处于中等偏高水平,医务人员应当重视对处于治疗阶段的、心理挫败感较高的不孕症患者进行针对性的心理干预措施,提高其治疗信心与状态。     

不孕妇女经体外授精-胚胎移植成功受孕后情感体验的质性研究

目的探讨经体外授精-胚胎移植(IVF-ET)治疗成功的不孕症妇女的情感体验,以指导护理工作。方法采用现象学研究方法,对9例经体外授精-胚胎移植治疗成功的不孕症妇女,经知情同意后进行半结构式访谈,运用Colaizzi资料分析原则对资料进行整理分析,提炼主题。结果经分析提炼的主题包括7个:坚定的信念、明确的定位、积极的配合、支持的需要、绝对的隐私、工作的影响以及过山车般的情感体验。结论不孕症妇女在经IVF-ET治疗期间经历了很多情感体验,值得护理人员注意及适时指导,帮助她们成功受孕。     

不孕症妇女的情感分析与支持策略

目的探讨不孕症妇女在接受治疗与护理过程中的真实心理感受,为其提供有效的情感支持。方法采用立意取样法,对16例不孕症妇女采用半结构式深入访谈法收集资料,用Colaizzi法对收集的资料进行分析。结果不孕症妇女在治疗与护理过程中的情感痛苦主要表现在以下3个方面:1疾病本身带来的痛苦感受:各种检查与治疗带来的痛苦。2各种压力带来的痛苦感受:自身的压力、家庭的压力、周围环境的压力等带来的痛苦感受。3情感支持的需求:渴望得到家庭成员特别是配偶的支持与理解。结论重视不孕症患者的主观感受,为其提供有效的情感支持,营造宽容环境,需要多方面共同努力。     

不孕症女性生育压力、羞辱感、自尊与生育生活质量的相关性研究

目的:探讨不孕症女性病人生育压力、羞辱感、自尊与生育生活质量的相关关系。方法:采用便利抽样法选取某三级甲等医院生殖中心就诊的不孕症女性318例为研究对象进行横断面调查。通过一般资料调查表、生育生活质量量表(FeriQoL)、生育压力量表(FPI)、女性不孕症病人羞辱感量表(ISS)、自尊量表(SES)对研究对象开展问卷调查。结果:不孕症女性生育生活质量总分为(58.64±17.17)分,处于较低水平,生育压力、羞辱感、自尊与生育生活质量显著相关(P<0.01),其中生育压力、羞辱感与生育生活质量呈显著负相关(P<0.01),自尊与生育生活质量呈显著正相关(P<0.01)。不孕女性羞辱感及自尊在生育压力和生育生活质量的结构方程模型拟合度理想：χ²/df=2.356,GFI=0.876,IFI=0.946,CFI=0.945,RMSEA=0.079,且羞辱感及自尊在生育压力和生育生活质量间存在中介效应。羞辱感在生育压力与生活质量关系中中介效应值为-0.272,间接效应95%CI为[-0.405,-0.170],未包含0在内,自尊在生育压力与生活质量关...     

宫腔镜检查在IVF—ET失败患者中的应用

目的探讨宫腔镜检查在IVF—ET失败患者中应用的重要性。方法回顾分析2008年1月至2009年1月86例在IVF—ET失败后行宫腔镜检查的病例资料。结果检查结果发现86例患者中57例有镜下异常,阳性率达66．28％。原发性不孕症宫腔镜检查异常为32例（61．54％）,继发性不孕症宫腔镜检查异常为25例（73．53％）,病变发生以子宫内膜息肉、子宫内膜炎及宫腔粘连为常见。结论IVF-ET失败患者中宫腔病变发生率高,是导致IVF—ET失败的重要因素之一,在IVF—ET失败患者中有重要作用。     

焦虑对体外受精胚胎移植治疗结果的影响

[目的 ]评估在体外受精胚胎移植(IVF -ET)治疗过程中焦虑情绪对治疗结果的影响。 [方法 ]采用焦虑状态 /特性询问表对 5 2例不孕妇女在取卵前晚进行焦虑状态的调查分析 ,并在治疗后 14d按血绒毛膜促性腺激素 (HCG)值分为成功组和失败组 ,比较两组妇女焦虑状态分值的高低与IVF -ET治疗结果的相关性。结果 :在IVF治疗过程中 ,成功组和失败组的焦虑特性差异无统计学意义 (P >0 .0 5 ) ,而焦虑状态的分值比较 ,失败组明显高于成功组 (P <0 .0 1)。结论 :在辅助生育治疗过程中减少应激原 ,降低焦虑情绪 ,可提高治疗的成功率。     

IVF—ET妇女治疗过程中的心理反应和家庭社会支持的相关性研究

目的探讨不孕症采用自然周期行体外受精和胚胎移植（IVF—ET）治疗过程中妇女的心理反应及家庭、社会支持状况，分析产生心理反应的影响因素，为临床医护人员对IVF—ET妇女进行心理支持提供依据。方法使用症状自评量表（SCL-90）和社会支持量表进行取样问卷调查。结果IVF—ET治疗妇女家庭功能普遍较好，心理反应除精神病性因子外，其他各因子得分与常模比较有显著性差异，且与家庭功能显著呈负相关性，社会支持与常模比较有显著性差异（P〈0．05，P〈0．01）。结论关注IVF—ET治疗过程中妇女的心理反应，采取正确方式加强其家庭功能。同时，医务人员应在已婚妇女中及时普及生育保健知识。     

Transforming hope: the lived experience of infertile women who terminated treatment after in vitro fertilization failure

Assisted reproductive treatments provide the hope of pregnancy for infertile women, but do not always turn this hope into reality. The purpose of this study was to explore the lived experience of infertile women who terminated treatment after in vitro fertilization (IVF) failure. Using a qualitative research design, 24 subjects were recruited who had experienced IVF failure and decided to terminate their treatment. Data were collected through interviews, and analyzed using interpretive research strategies of phenomenology. This study protocol was reviewed and approved by the University Review Board for Research. Informed consent was obtained from each subject. The theme of lived experience which emerged from the data was "transforming hope". This theme included three categories: (1) accepting the reality of infertility, (2) acknowledging the limitations of treatment involving high technology, and (3) re-identifying one's future. The results illustrated that counseling for these women should involve the provision of both positive and negative information, evaluation of the response to treatment, and assistance in defining their future.     

A Narrative Analysis of the In Vitro Fertilization Experiences of Survivors of Sexual Abuse

ObjectiveTo explore the lived experience of in vitro fertilization (IVF) from the perspective of survivors of sexual abuse.DesignIn this qualitative study, narrative analysis provided the framework to understand participants’ IVF experiences.SettingParticipants were recruited through a regional support group for women with infertility.ParticipantsThree women (mean age = 33.3 years) who self-identified as a survivor of sexual abuse and had at least one IVF experience participated in this study.MeasurementsEach participant wrote a narrative text of her experience. Burke’s method was followed for analysis of the narratives.ResultsThe most frequent imbalance was between what is happening (i.e., IVF procedures) and how the health care team provided the care. The repercussion was a negative experience for survivors, stemming from an insensitive manner in which their physical and verbal care was delivered by health care teams. These women were also deeply protective of their oocytes (eggs), embryos, and children.ConclusionHealth care providers may use these findings to better meet the physical and psychological needs of survivors of sexual abuse who are coping with infertility. Providers can have a more positive effect on the IVF experience of survivors by ensuring that the procedures they perform and the information they share are explained fully and delivered in a trauma-informed manner.     

部分卵子卵胞浆内单精子注射在辅助生殖技术中的应用价值

[目的]探讨部分卵子卵胞浆内单精子注射(half-ICSI)指征的选择及其在辅助生殖技术中挽救受精失败的意义.[方法]回顾性分析2007年1月至2008年12月在本院生殖中心实施采卵周期的常规体外受精(IVF)及half-ICSI患者的临床资料,比较两种方法的临床特征、受精率及妊娠率.[结果]half-ICSI组在不孕年限、不孕年限大于10年、原发性不孕及男方轻中度少弱畸精子症所占比例显著高于IVF组(P＜0.05);half-ICSI组低受精率及完全受精失败率较IVF组明显增高(P＜0.05),但Half-ICSI组中低受精组的妊娠率与常规IVF妊娠率相比差异无统计学意义(P＞0.05);half-ICSI组内IVF、ICSI均受精组各项精液参数均高于仅ICSI受精组,但仅在处理前精子总活率、处理前A级精子、处理前B级精子、处理后B级精子百分率上差异有统计学意义(P＜0.05);half-ICSI中根据移植胚胎来源分为IVF组、IVF+ ICSI及ICSI组,以移植IVF+ICSI混合胚胎的着床率及妊娠率为最高,差异有统计学意义(P＜0.05).[结论]对于原发性不孕、不孕年限大于10年、男方轻中度少弱畸精子症的患者,无论是单项或合并多项明确不孕原因存在可疑受精障碍,可考虑行half-ICSI治疗,避免完全受精失败及妊娠率低下.     

体外受精-胚胎移植早孕保胎孕妇心理状态调查及护理对策

目的：分析体外受精-胚胎移植（IVF-ET）早孕保胎孕妇的心理状态,提出护理对策。方法采用心理状态90项症状自评量表（SCL -90）调查IVF-ET早孕保胎孕妇的心身症状水平,并对心身症状的频数进行分析。结果 IVF-ET早孕保胎孕妇的焦虑、抑郁、躯体化、敌对、强迫和人际关系敏感得分明显高于国内常模（P＜0．05）。结论 IVF-ET早孕保胎孕妇存在明显的心理问题,需要采取相应的护理措施。     

Efficacy of brief couples support groups developed to manage the stress of in vitro fertilization treatment

OBJECTIVE: To assess the efficacy of brief couples support groups offered concurrently with in vitro fertilization (IVF) treatment. PATIENTS AND METHODS: Couples in IVF treatment were given the option of participating in a biweekly support group at the IVF clinic at Wilford Hall Medical Center, San Antonio, Tex. At least 1 member of 26 couples participated in the brief couples support groups, and at least 1 member of 19 other couples completed the questionnaires but did not attend the support group sessions and so comprised the control group. Facilitators used cognitive behavioral techniques to help participants process their feelings and cognitions about their infertility. Emotional and cognitive factors were assessed both before and after group attendance by using the Beck Depression Inventory; the Beck Anxiety Inventory; the Life Orientation Test, which assesses optimism and pessimism; the Survey of Personal Views, which measures irrational beliefs; and the Social Provisions Scale, which measures social support. RESULTS: Women who attended group sessions were significantly less anxious after the IVF treatment than they were before the cycle (P < .001). Men who attended the group sessions were more optimistic than nongroup men or the women at the completion of the IVF cycle (P < .001) but endorsed greater numbers of irrational beliefs (P < .001). CONCLUSIONS: Despite the fact that the service was relatively inexpensive compared with IVF in the civilian community, the complexity of IVF treatment and the logistic and psychological stress experienced by couples made it hard to form and maintain such groups. Nevertheless, both men and women derived psychological benefit from the group: women reported less anxiety and men greater optimism on completion of the group sessions.     

Grief responses and coping strategies among infertile women after failed in vitro fertilization treatment

Scand J Caring Sci; 2010; 24; 507–513
Grief Responses and coping strategies among Infertile Women after failed in vitro fertilization Treatment Reproductive technology has increased the childbearing potential for many infertile women, but in vitro fertilization (IVF) failures are common, which often trigger grief responses and coping strategies to manage the stressful life event. The present cross‐sectional study investigated 66 women who had experienced at least one failure with IVF treatment. The data were gathered by a self‐administered structured questionnaire, and included the participant’s personal profile, grief responses and the Jalowiec’s coping scale. The most common grief response among the respondents was bargaining, followed by acceptance, depression, anger, denial, and isolation. The order of coping strategies used, from highest‐to‐lowest, were confrontative, optimistic, self‐reliant, fatalistic, supportive, evasive, palliative, and emotive. Use and self‐perceived effectiveness among all coping strategies had a high correlation, except emotion. Bargaining, the most common grief response, was associated with a variety of coping strategies. All coping strategies were correlated with grief responses. The results of identifying the grief responses and associated coping strategies of women who have undergone failed IVF treatment may assist nurses and other health care professionals in their efforts to provide appropriate information, care and psychological support.     

卵细胞与胞浆内精子注射胚胎体外发育情况分析

目的:比较传统的体外受精(IVF)与胞浆内精子注射(ICSI)胚胎体外发育情况。方法:1.将同一病人卵子随机平均分为两部分,分别实施IVF与ICSI技术,比较两组受精率与优质胚胎率。2.回顾性分析154例IVF与34例ICSI胚胎体外发育情况,比较两组受精率与优质胚胎率。结果:1.分组比较结果显示,IVF组与ICSI组受精率相比,以总卵子数计算未见显著性差异[63.0％(87/138)与65.2％(86/132);P>005];但当ICSI组以注射卵子数计算时则两者间有显著性差异[63.0％(87/138)与84.3％(86/102);P<0.05]。优质胚胎率两组间未见显著性差异[54.0％(47/87)与55.8％(48/86);P>0.05]。2.回顾性分析结果显示,IVF组未受精率7.9％(12/154),而ICSI组未见此现象发生。IVF组ICSI组受精率相比,以总卵子数计算未见显著性差异(61.5％比60.1％,P>0.05);当ICSI组以注射卵子数计算时则有显著性差异(61.5％比77.6％,P<0.05)。优质胚胎率两组间未见显著性差异(52.9％比56.1％,P>0.05)。结论:应用胞浆内精子注射有较高的受精率,且不会降低优质胚胎率。将回收卵子同时行IVF与ICSI能避免受精失败的发生。     

Influence of estrogen levels on thermal perception, pain thresholds, and pain tolerance: studies on women undergoing in vitro fertilization

We examined the relationship between estrogen and pain in women undergoing in vitro fertilization (IVF). Quantitative sensory tests (QST) were performed twice during the IVF-regimen: once during hormonal down-regulation and once during hormonal up-regulation. A group of healthy men and a group of women using monophasic contraceptives were also examined, to control for session-to-session effects. Among the women undergoing IVF, serum 17β-estradiol levels differed strongly between treatments as expected, and increased from 65.7 (SD = 26) pmol/L during the down-regulation phase, to 5,188 (SD = 2,524) pmol/L during the up-regulation phase. Significant outcomes in the QST were only seen for temperature perception thresholds (1.7 °C versus 2.2 °C; P = .003) and cold pain threshold (11.5 °C versus 14.5 °C; P = .04). A similar change in cold pain threshold was also seen in the 2 control groups, however, and statistical analysis suggested that this change was due to a session-to-session effect rather than being the result of hormonal modulation. Heat pain thresholds, heat tolerance, pressure pain thresholds, and the cold pressor test showed no significant differences between sessions. These data demonstrate that pain perception and pain thresholds in healthy women show little, if any, changes even with major variations in serum estradiol levels. PERSPECTIVE: This study shows that pain perception and tolerance in women undergoing in vitro fertilization do not vary, despite the dramatic changes in 17β-estradiol levels induced by the treatment regimen. The result thus suggests that in humans, contrary to experimental animals, changes in estrogen levels have little influence on pain sensitivity.     

未成熟卵体外成熟与体外受精妊娠胚胎移植14d血清人绒毛膜促性腺激素β亚单位水平的比较

背景:相关研究表明,体外受精与胚胎移植治疗妊娠后血清人绒毛膜促性腺激素β亚单位水平对妊娠结局有预测作用,未成熟卵体外成熟治疗妊娠后血清人绒毛膜促性腺激素β亚单位水平对妊娠结局的预测作用不详.目的:比较不孕症患者体外受精与胚胎移植和未成熟卵体外成熟治疗妊娠后血清人绒毛膜促性腺激素β亚单位水平,探讨血清人绒毛膜促性腺激素β亚单位水平对未成熟卵体外成熟治疗妊娠患者的预测价值.方法:采用回顾性分析的方法,以在本中心行未成熟卵体外成熟治疗后妊娠实验阳性的42例患者为研究组,同期行体外受精治疗后妊娠实验阳性的66例患者作为对照组,比较两组患者胚胎移植后第14天血清人绒毛膜促性腺激素β亚单位水平.结果与结论:胚胎移植后14 d,分别在研究组和对照组内,单、双胎妊娠患者血清人绒毛膜促性腺激素β亚单位水平差异均有显著性意义.血清人绒毛膜促性腺激素β亚单位水平≥ 800 U/L时,两组双胎妊娠的发生率均明显增高.提示血清人绒毛膜促性腺激素β亚单位水平对未成熟卵体外成熟治疗后妊娠患者的结局具有预测价值,未成熟卵体外成熟/体外受精妊娠胚胎移植14 d血清人绒毛膜促性腺激素β亚单位水平及其对妊娠结局的预测是相同的.