| Objective To investigate the psychologic health of patients who are goingto have in vitro fertilization-embyro transfer(IVF-ET) treatments, and toobserve how their anxiety or depression affect the blood and follicular fluidconcentration of norepinephrine(NE) and pregnancy rates when infertilitypatients with fallopian causes are undergoing IVF-ET treatments.Methods This study had two parts ,one was the group psychological studyfor all women patients(N=172) who were going to have IVF/ICSI-ETtreatments between the period of September and December 2006. Wedeveloped a questionnaire to investigate their cognition about infertility andtube baby ,and used the SAS and SDS to test their anxiety or depression.The other was the clinic psychological study for the patients (N=84) who hadthe first IVF-ET treatments, fallopian causes,long GnRH agonist protocolsand were less than 35 years old. They were divided four groups includingmild depression, moderate depression, anxiety and depression and normalcontrol group by SAS,SDS .We detected blood and follicular fluidconcentration of norepinephrine(NE) using the high performance liquidchromatogram(HPLC) on the day of retrievaling oocytes, evaluated embyrosand calcuated high-quailty embyro rates, Gn days, numbers of oocytes retrievaled and pregnancy rates.Results (1) Of 172 women participating in the group psychological study,67(38%) reported their mild depression,32(19%) reported their moderatedepression,15 (9%)reportrd their anxiety and depression and 58(34%)reported their nomal emotion. There were statistcally significant differencesbetween these patients and the norm in terms of scores of SAS andSDS.Correlation analysis showed that infertility years were negatively relatedto the scores of SAS (R=-0.213, p＜0.05),and education was positivelyrelated to scores of SDS (B=4.611, Beta=0.243,P＜0.01). No association wasfound between scores of cognition and SAS or SDS(P＞0.05).(2) In the clinic psychological study, concentration of NE in the follicle fluidwere respectively 206.5±34 ng/ml,205.5±43 ng/ml,215.3±40 ng/ml133.6±33ng/ml in the mild depression group, moderate depression group,anxiety and depression group and the normal control group,and there werestatistcally significant differences between the follicle fluid and the blood interms of concentration of NE (p＜0.01), there were also statistcally significantdifferences between the former three groups(they were also called thedepression or/and anxiety groups) and the last(the normal control group) interms of concentration of NE in follicle fluid (p＜0.01). High-quailty embyrorates of four groups were respectively 29.2%, 27.7%, 34% and 40.2%, andthe correlation analysis showed that concentration of NE in follicle fluid wasnegatively related to high-quailty embyro rates (r=-0.62,p＜0.05). Pregnancyrates of four groups were respectively 31%, 35%, 10%and32%, and therewere statistcally significant differences between the anxiety and depressiongroup and the normal control in terms of pregnancy rates(P＜0.05). But there were no statistcally significant differences among four groups in terms of Gndays ,numbers. of oocyte retrievaled and blood concentration ofNE(P＞0.05).Conclusions (1) Patients who are undergoing IVF-ET treatments reporttheir anxiety or depression which is affected by infertility years and education,and they express their bad cognition of infertility and tube baby.(2) Pregnancy rates will be decreased if IVF patients report their anxietyand depression.(3) As a psychological marker of stress, norepinephrine has higherconcentration in follicular fluid than in blood,higher in depression or/andanxiety group than in normal control.It can affect high-quailty embyro rates.(4) To relieve IVF patients'anxiety or depression, correct their badcognition and improve pregnancy rates, clinicians shoud pay close attentionand give psychological consulatation as possible. |
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