支持性咨询对首次体外受精-胚胎移植失败后女性焦虑、抑郁情绪及妊娠结局的影响-现代医学

支持性咨询对首次体外受精-胚胎移植失败后女性焦虑、抑郁情绪及妊娠结局的影响

单位：东南大学附属中大医院生殖医学科, 江苏南京 210009

分类号：R714.8

出版年·卷·期（页码）：2025·53·第一期（80-86）

摘要：

目的: 探讨支持性咨询对首次体外受精-胚胎移植(IVF-ET)失败后患者焦虑、抑郁情绪及妊娠结局的影响。方法: 选取2022年5月至2023年5月在东南大学附属中大医院生殖医学科进行首次IVF-ET治疗且失败的不孕症患者80例，采用随机数字表法将患者分为对照组与试验组，每组40例。试验组患者接受为期4周的支持性咨询，每周1次，每次40 min；对照组患者接受常规护理。采用焦虑自评量表、抑郁自评量表评估患者的焦虑、抑郁程度，采用多因素Logistic回归分析临床妊娠结局的影响因素。结果: 干预前，试验组和对照组的平均焦虑和抑郁评分差异无统计学意义(均P>0.05)。经过1个月干预后，试验组的平均焦虑和抑郁评分显著低于对照组(均P＜0.05)。组内比较显示，试验组干预后的平均焦虑和抑郁评分均显著低于干预前(均P<0.001)。在第2次胚胎移植周期，试验组临床妊娠率显著高于对照组(P<0.05)。多因素Logistic回归分析表明，试验组相对于对照组，临床妊娠率提高具有统计学意义(OR=6.29，95%CI 1.70～23.28)。结论: 支持性咨询能有效缓解IVF-ET失败后患者的焦虑和抑郁情绪，显著提高后续胚胎移植的临床妊娠率。支持性咨询可作为一种经济且有效的心理干预手段，推荐并应用于经历IVF-ET失败的女性患者。

Objective: To investigate the effects of supportive counseling on anxiety, depression, and pregnancy outcomes in patients following their first in vitro fertilization-embryo transfer(IVF-ET) failure. Methods: A total of 80 infertile women who experienced their first IVF-ET failure were chosen from the Department of Reproductive Medicine at Zhongda Hospital of Southeast University between May 2022 and May 2023. The patients were divided into experimental group and control group by means of random number table, with 40 cases in each group. In the experimental group, the patients received supportive counseling sessions for four weeks with each session lasting 40 min, once every week, while in the control group routine nursing care was conducted. The Self-Rating Anxiety Scale(SAS) and Self-Rating Depression Scale(SDS) were used to evaluate the levels of anxiety and the depression for patients in the two groups. Multiple logistic regression was used to analyze the influencing factors of clinical pregnancy outcomes. Results: No statistically significant differences in mean scores of anxiety and depression between the two groups before the study were found(both P>0.05). After one month of intervention, the mean scores of anxiety and depression in the experimental group were significantly lower than those in the control group(both P<0.05). The scores of anxiety and depression after treatment in the experimental group were significantly lower than those before treatment(both P<0.001). Additionally, the clinical pregnancy rate in the second embryo transfer cycles was significantly higher in the experimental group compared to the control group(P<0.05). Multivariate logistic regression analysis showed that the experimental group had a statistically significant increase in clinical pregnancy rate compared to the control group(OR=6.29, 95%CI 1.70-23.28). Conclusion: Supportive counseling is effective in improving anxiety and depression in patients following the first IVF-ET failure, which can increase the clinical pregnancy rate in subsequent embryo transfers cycles. It is an effective, affordable and low-risk counseling approach for women who have experienced first IVF-ET failure.

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