体外受精-胚胎移植妇女婚姻质量、负性情绪的相关性探讨

目的探讨体外授精-胚胎移植(IVF-ET)妇女婚姻质量、负性情绪状况及相关性。方法对拟进行IVF-ET治疗妇女112人,进行Olson婚姻质量(9因子)及抑郁(SDS)焦虑(SAS)问卷调查分析。结果①IVF-ET妇女婚姻质量与常模比较,婚姻满意度(t=-2.660,P<0.01)和性格相容性(t=-5.363,P<0.01)两因子显著低于常模;解决冲突方式(t=2.548,P<0.05)和角色平等性(t=2.299,P<0.05)两因子显著高于常模,其余各因子无显著差异(P>0.05);②IVF-ET妇女抑郁(t=2.377,P<0.05)、焦虑(t=9.031,P<0.01)得分显著高于常模;③婚姻质量各因子除角色平等性外都与抑郁、焦虑呈显著负相关(P<0.01);④多元线性逐步回归分析显示:影响患者抑郁的因素依次为:夫妻交流(F=50.777,P<0.01)和经济安排(F=32.989,P<0.01),影响焦虑的因素依次为:与亲友关系(F=29.373,P<0.01)和经济安排(F=19.248,P<0.05)。结论 IVF-ET妇女有较高的抑郁和焦虑症状;抑郁、焦虑情绪随婚姻质量的提高而降低。     

团体心理治疗对接受体外受精-胚胎移植者情绪的作用

目的:初步探讨团体心理治疗对接受体外受精-胚胎移植(In Vitro Fertilization and Embryo Transfer,IVF-ET)治疗者情绪的作用。方法:从接受IVF-ET治疗的门诊患者(均为女性)中选取自愿参与本研究者100名,随机分为对照组和干预组,每组各50人。对照组(脱落3例)仅接受常规IVF-ET治疗,干预组(脱落8例)除接受常规IVF-ET治疗外同时参加总计6次,每周2次的团体心理干预。用焦虑状态-特质问卷(State-Trait Anxiety Inventory,STAI)及抑郁自评量表(Self-rating Depression Scale,SDS)比较两组患者干预前后焦虑、抑郁水平的差异。结果:干预组SAI、SDS的前后测得分差异均无统计学意义(均P0.05);对照组SAI、SDS的后测得分均高于前测[(39.6±7.9)vs.(42.7±8.7),(43.8±10.1)vs.(49.0±10.4);P0.05或0.01]。干预组SAI前后测差值低于对照组[(0.6±7.8)vs.(3.2±9.9),P0.05],而SDS前后测差值在两组间差异无统计学意义(P0.05)]。干预组与对照组的临床妊娠率差异无统计学意义(35.7%vs.29.8%,P0.05)。结论:团体心理干预可以缓解接受体外受精-胚胎移植治疗患者的焦虑情绪,有临床应用价值。     

体外受精-胚胎移植妇女的心理健康状况研究

接受体外受精-胚胎移植(IVF-ET)治疗的妇女承受着不孕症及其治疗带来的心理压力,主要表现为焦虑和抑郁症状;不良的心理健康状况与IVF治疗结局存在一定的相关性.影响其心理健康的因素主要有个体因素、不孕症因素和IVF-ET治疗因素等.     

中学生高考前焦虑、抑郁情绪调查

高考对学生来说无疑是一个重大的应激源 ,有研究表明 ,考试应激使中学生心理症状明显增多 ,并影响考试成绩[1 ] 。为及时了解学生高考前的心理状况 ,笔者对福建省永安市 2 0 0 2年高考学生考前的焦虑、抑郁情绪进行了调查。对象　福建省永安市 2 0 0 2年高考学生 14 70名中 ,有 842名考生自愿参加测评 ,他们来自重点中学、普通中学和职业中学。其中男生 492名 ,女生 3 5 0名 ;年龄在 16-19岁 ,多数集中在 18岁。方法　在高考前一个月 ,采用统一指导语 ,以班级为单位集体填写自编的学生心理状况调查表、Zung氏编制的焦虑自评量表 (SAS) [2 …     

1008例孕晚期妊娠妇女焦虑、抑郁情绪调查

目的了解孕晚期妊娠妇女焦虑、抑郁情绪的发生情况。方法采用状态-特质焦虑量表(STAI)、自评抑郁量表(SDS)以及自制的孕妇基本情况调查表,对1008名孕妇在孕32～34周时进行测试,并对结果进行分析。结果 1008名孕妇状态焦虑情绪发生率为20.3%,特质焦虑情绪发生率为5.9%,状态焦虑情绪评分明显高于国内正常人群(t=5.12,P<0.01);抑郁情绪发生率为23.7%,其中轻度抑郁发生率为18.5%,中度抑郁发生率为4.8%,重度抑郁发生率为0.5%。孕期状态焦虑、特质焦虑和抑郁情绪的发生率均以户籍孕妇最低,流动孕妇最高(χ2=15.65,7.07,28.19;P<0.01或<0.05)。结论孕期焦虑、抑郁情绪普遍存在。     

乳腺癌患者术后应对方式及焦虑抑郁情绪调查

我国妇女乳腺癌的患病率占全身恶性肿瘤的7%~10%,并有逐渐上升的趋势[1].国内研究显示,乳腺癌患者普遍存在疾病不确定感与焦虑、抑郁,术后患者中有87.3%疾病不确定感处于中等水平,焦虑、抑郁发生率分别为84.1%与89.5%,且焦虑、抑郁与疾病不确定感呈正相关[2].     

癌症患者焦虑,抑郁情绪调查

随着临床医学研究模式的转变,精神免疫学（Ｐｓｙｃｈｏｉｍ－ｍｕｎｏｌｏｇｙ）首先由美国人ＡｄｅｒＲ．于１９８１年在纽约提出,我国有关专著直至１９９７年才问世。它提醒临床医师,心理社会因素与生物因素一样也可致病,影响疾病的发生、发展,而且有相互双向的联...     

淮安地区体外受精-胚胎移植75周期的临床研究

目的探讨体外受精-胚胎移植治疗不育症的妊娠率.方法选择2003年9月～2004年12月底输卵管阻塞等62例不育患者,进行控制促超排卵(COH),取卵,体外自然受精和单精子卵细胞浆内注射(ICSI),受精卵和胚胎培养,胚胎移植,黄体支持,确定临床妊娠.共研究75周期.结果临床妊娠28例,例数妊娠率45.16%,周期妊娠率37.33%.结论IVF-ET是治疗不育症妊娠成功率最高的技术.     

肿瘤病人家属焦虑抑郁情绪调查

肿瘤作为一种应激因素可导致抑郁、焦虑情绪，反之抑郁、焦虑又可促进或加速肿瘤的恶化。病人家属承担着照顾病人、财力付出、兼顾工作等诸多责任有时比患者承受着更大的压力。本文调查了128例住院恶性肿瘤病人家属的焦虑、抑郁情绪。     

体外受精-胚胎移植中的心理护理研究

目的探讨心理护理对体外受精-胚胎移植患者在治疗中的影响。方法对干预组152例患者进行心理护理,由专职心理护理小组对患者实施IVF-ET治疗全过程的及时心理干预,而对照组134例则采取常规护理,未实施心理干预,比较两组妊娠结局。结果两组患者平均年龄、FSH基础值、接受IVF治疗的第次、平均获卵数、平均移植胚胎数、移植胚胎评分、子宫内膜厚度均无显著性差异(P>0.05)。心理干预组临床妊娠率高于常规组(0.05相似文献   

Immunology: Mock embryo transfer with a full bladder immediately before the real transfer for in-vitro fertilization treatment: the Birmingham experience of 113 cases

The technique of embryo transfer can have a great impact onthe outcome of in-vitro fertilization (IVF) treatment. Transcervicalembryo transfer is a blind procedure and difficulty can unexpectedlyarise. Many IVF programmes therefore perform a ‘mock’embryo transfer prior to the treatment cycle to determine themost suitable catheter and technique for transfer. This, however,adds an extra separate procedure with time and cost implications.Moreover, as the uterus is mobile, its direction may vary onthe day of the embryo transfer from what it was during the mockembryo transfer. Performing mock embryo transfer immediatelybefore the real transfer would circumvent these problems. Wereport here on 113 embryo transfer procedures where a ‘step-wise’mock embryo transfer protocol was performed with a full bladderimmediately before the embryo transfer. The number of embryostransferred (mean ± SD) was 2.6 ± 0.67, the pregnancyrate per embryo transfer was 45.1%, and the intrauterine implantationrate per embryo transferred was 20.6%.     

Do patients need to remain in bed following embryo transfer? The Birmingham experience of 103 in-vitro fertilization cycles with no bed rest following embryo transfer

Since the early days of human in-vitro fertilization and embryotransfer, rest in bed for hours immediately following the transferhas been advocated and widely practised. However, there is noscientific validation for this practice which is both time-consumingfor the patient and increases space occupancy in the hospitalor clinic. We report here on a study of 103 in-vitro fertilizationcycles with no bed rest in hospital following the embryo transfer.The mean number of embryos transferred was 2.7 (range 1–3)and the clinical pregnancy rate per embryo transfer procedurewas 40%. These results suggest that bed rest is not necessaryfollowing embryo transfer.     

Infertility: Human decidua-associated protein hDP200 in menstrual fluid: comparison between fertile women and women after failed in-vitro fertilization/embryo transfer treatment

The concentration of human decidua-associated protein (hDP)200 was measured in 238 menstrual fluid samples obtained fromnormal fertile women and in 26 menstrual fluid samples obtainedfrom infertile women who failed to conceive and menstruatedfollowing in-vitro fertilization (IVF)/embryo transfer treatment.A significant association was observed between the concentrationof hDP200 and the age of the women. A maximal concentrationof hDP200 was observed in women aged 28–30 years, withsignificantly lower concentrations in those aged 18–20and 39–41 years. The presence of an intra-uterine devicehad no effect on menstrual fluid hDP200 concentrations. A significantlylower mean concentration of hDP200 (82 U/ml) was measured inmenstrual fluid samples obtained from failed IVF/embryo transferpatients as compared with that in menstrual fluid samples fromnormal fertile women (191 U/ml). These findings support theconcept that adequate endometrial function, as evaluated bymenstrual fluid concentration of hDP200, is important for thesuccess of the fertility process.     

Infertility: Assessments of embryo transfer after in-vitro fertilization: effects of glyceryl trinitrate

The role of embryo transfer and its associated difficultieson the outcome of human in-vitro fertilization (IVF) were examinedusing a standardized procedure and a scoring system (embryotransfer scores 1–5). This system was used to assess anyeffects of the smooth muscle relaxant glyceryl trinitrate (GTN)on embryo transfer. Patients (n = 120) were randomized in adouble-blind manner at their first embryo transfer to receivesublingual GTN or placebo before the transfer. Retrospectiveanalysis showed that higher pregnancy rates were associatedwith uncomplicated transfers (score 1; P < 0.01). The outcomemeasures included pregnancy rate, total time of cervical manipulation(embryo transfer time) and embryo transfer score. All pregnancieshad a transfer score of 1 or 2, but no recorded parameter differentiatedbetween pregnant or non-pregnant cycles, and GTN had no significanteffect on any parameter.     

Ovarian hyperstimulation syndrome and benign intracranial hypertension in pregnancy after in-vitro fertilization and embryo transfer: case report.

Ovarian hyperstimulation syndrome (OHSS) is a dangerous and sometimes life-threatening complication of ovulation induction with exogenous gonadotrophins. While many complications of severe OHSS are recognized we have only identified one review detailing neurological problems. This report concerns a 32-year-old patient with bilateral tubal blockage who achieved her first pregnancy following in-vitro fertilization (IVF) and embryo transfer. Shortly after embryo transfer she developed clinical signs of moderate OHSS with symptoms which were later diagnosed as benign intracranial hypertension (BIH). The BIH was treated effectively using repeated lumbar puncture and diuretics. Spontaneous labour and delivery occurred at 40 weeks' gestation. There was no neurological sequel and no recurrence of the BIH 2 years after the pregnancy. The possible link between OHSS and BIH is discussed as well as the risks of further pregnancy.     

体外受精-胚胎移植后异位妊娠11例临床分析

目的　探讨体外受精 -胚胎移植后异位妊娠的发生原因、诊断及治疗方法。方法　对体外受精 -胚胎移植后妊娠 10 4例临床资料进行回顾性分析。结果　 10 4例中宫内妊娠 93例 ,异位妊娠 11例 ,异位妊娠率为 10 6 %(11/10 4 )。因输卵管性不孕行IVF的异位妊娠发生率为 13 9%(10 /72 ) ,远远高于因其它原因不孕致异位妊娠发生率的 3 1%(1/32 ) (P<0 .0 5 )。宫外孕组ET时插管困难者发生率为 36 4 %(4 /11) ,而宫腔内妊娠ET时插管困难发生率为 16 1%(15 /93) ,两者之间无显著性差异 (P >0 .0 5 )。结论　 1 异位妊娠的发生与输卵管病变有关 ;2 孕早期血hCG及阴道超声检查有助于异位妊娠诊断及治疗     

Fertilization and early embryology: The applicability of the cumulative embryo score system for embryo selection and quality control in an in-vitro fertilization/embryo transfer programme

The cumulative embryo score system involves three aspects ofrelevance in pregnancy achievement during in-vitro fertilization(IVF) and embryo transfer: cleavage rates, morphological qualitiesand the number of embryos transferred. The scores of 602 IVF/embryotransfer trials were calculated and analysed to determine thesystem's relationship to pregnancy rate, pregnancy outcome andthe incidence of twin and triplet pregnancies. The system wasalso applied to cycles where endotoxins were either presentin or absent from culture medium, in order to evaluate its validityin quality control analyses. Pregnancy rates were found to increasefrom 4%, with scores between 1 and 10, to 35% in the 41–50group. The score of 20 was the criterion for separating patientsinto poor and good pregnancy prognosis groups (P = 0.00001).Biochemical abortions occurred more frequently with scores <20(P = 0.00978), but a similar relationship was not found in clinicalabortion rates (P = 0.62206). Birth rates below and above ascore of 20 (2.8 and 19.2%, respectively) differed significantly(P = 0.0005). The scores of twins overlapped extensively withthose of singleton births, but those of all triplets were >40. The system did not reflect a correlation between embryoquality and the presence of endotoxins in culture medium.     

The effect of anxiety and depression on the outcome of in-vitro fertilization.

BACKGROUND: The study aim was to clarify the role of anxiety and depression on the outcome in assisted reproductive treatment. Previous studies on this topic have shown contradicting results, which may have been caused by population characteristics, the design of the study, or small sample sizes. METHODS: In a multicentre prospective study, 291 out of 359 (81%) consecutively invited women agreed to participate. Before down-regulation by means of gonadotrophin-releasing hormone (GnRH) analogues in a long IVF protocol, patients were asked to complete the Dutch version of the State and Trait Anxiety Inventory to measure anxiety, and the Dutch version of the Beck Depression Inventory (BDI) to measure depression. Multiple logistic regression analysis was used to analyse known predictors of pregnancy and psychological factors and their relationship with treatment outcome. RESULTS: A significant relationship was shown between baseline psychological factors and the probability to become pregnant after IVF/intracytoplasmic sperm injection (ICSI) treatment, controlling for other factors. State anxiety had a slightly stronger correlation (P = 0.01) with treatment outcome than depression (P = 0.03). CONCLUSIONS: Pre-existing psychological factors are independently related to treatment outcome in IVF/ICSI, and should therefore be taken into account in patient counselling. Psychological factors may be improved by intervention, whereas demographic and gynaecological factors cannot. Future studies should be directed towards underlying mechanisms involved and the role of evidence-based distress reduction in order to improve treatment results.     

The contribution of embryo cryopreservation to in-vitro fertilization/gamete intra-Fallopian transfer: 8 years experience

In this paper, the authors summarized their experience withembryo cryopreservation over an 8-year period. The results,therefore, reflect the long-term benefit of embryo cryo-preservationto the overall in-vitro fertilization/gamete intra-Fallopiantransfer (IVF/GIFT) programme and to the women who had embryoscryopreserved. The stable survival rate of thawed embryos andpregnancy rate, especially over the past 4 years, suggests thatthe results can reliably be used to evaluate the efficacy ofthe embryo cryopreservation programme. The ongoing pregnancyrate of frozen/thawed embryo transfer is 10.9%, comparable withthe ongoing pregnancy rate of fresh IVF/embryo transfer in ourunit over the same period. In addition to those factors knownto affect the pregnancy rate in fresh IVF/GIFT cycles, suchas age of the recipients and number of embryos transferred,the major factor affecting the efficacy of the cryopreservationprogramme is the number of oocytes retrieved in the initialstimulation cycle, and the number of embryos available for cryopreservation.The storage time of cryopreserved embryos will also have a significanteffect on the realization of the total potential of embryo cryopreservation.Overall the contribution of cryopreservation to our IVF/GIFTprogramme is substantial, increasing pregnancy rate by 4%, whilethe greater net benefit, of course, is for the women who hadembryos cryopreserved (pregnancy rate increased by 7%), especiallyfor those who returned for frozen/thawed embryo transfer cycles(pregnancy rate increased by 11%).     

Multiple pregnancy after in-vitro fertilization and embryo transfer: report of a quadruplet pregnancy and delivery

The first baby from in-vitro fertilization (IVF) was born in England in 1978 as a result of retrieval of a single preovulatory oocyte in the course of a natural cycle (Steptoe and Edwards, 1978). At present most programmes of IVF throughout the world do not use natural cycles producing only one oocyte, but rather multiple oocyte cycles produced by clomiphene citrate (CC), human menopausal gonadotrophin (HMG), or pure follicle stimulating hormone (FSH), either separately or in combination, sequentially or concomitantly, for the induction of multiple follicular maturation.