Stressful life events are associated with a poor in-vitro fertilization (IVF) outcome: a prospective study
Stressful life events are associated with a poor in-vitro fertilization (IVF) outcome: a prospective study
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DOI：
10.1093/humrep/dep185
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发表时间：
2009-09-01
影响因子：
6.1
通讯作者：
Ingerslev, H. J.
中科院分区：
文献类型：
--
作者：
Ebbesen, S. M. S.;Zachariae, R.;Ingerslev, H. J.
有初步证据表明，压力对体外受精（IVF）怀孕的机会有影响。大多数现有的研究都集中在与不孕症相关的压力和接受试管婴儿治疗，目前还不清楚非生育相关的自然发生的压力源是否会影响试管婴儿怀孕的机会。我们的目的是探讨IVF结果与过去12个月内的负面（即压力）生活事件之间的关系。（平均年龄：31.2岁）完成了近期事件列表（LRE）和测量感知压力和抑郁症状的问卷调查。（平均值：2.5;标准差：2.5）与未获得妊娠的妇女（平均值：3.0;标准差：3.0）相比（t（465.28）= 2.390，P = 0.017）。Logistic回归分析显示，负性生活事件的数量仍然是怀孕的一个重要预测因素（OR：0.889; P = 0.02），当控制年龄、生活事件总数、前一个月内的感知压力、抑郁症状以及与患者或治疗程序相关的相关医学因素（包括不孕持续时间）时，获取卵母细胞的数量和不孕症的病因。中介分析表明，负性生活事件与IVF妊娠之间的关系部分是由取卵过程中获取的卵母细胞数量介导的。大量被认为对生活质量有负面影响的生活事件可能表明慢性应激，我们的研究结果表明，应激可能会降低IVF成功结局的机会，可能是通过影响医学终点的心理生物学机制，例如卵母细胞提取结果。
There is preliminary evidence to suggest an impact of stress on chances of achieving a pregnancy with in-vitro fertilization (IVF). The majority of the available research has focused on stress related to infertility and going through IVF-treatment, and it is still unclear whether non-fertility-related, naturally occurring stressors may influence IVF pregnancy chances. Our aim was to explore the association between IVF-outcome and negative, i.e. stressful, life-events during the previous 12 months.Prior to IVF, 809 women (mean age: 31.2 years) completed the List of Recent Events (LRE) and questionnaires measuring perceived stress and depressive symptoms.Women who became pregnant reported fewer non-fertility-related negative life-events prior to IVF (Mean: 2.5; SD: 2.5) than women who did not obtain a pregnancy (Mean: 3.0; SD: 3.0) (t(465.28) = 2.390, P = 0.017). Logistic regression analyses revealed that the number of negative life-events remained a significant predictor of pregnancy (OR: 0.889; P = 0.02), when controlling for age, total number of life-events, perceived stress within the previous month, depressive symptoms, and relevant medical factors related to the patient or treatment procedure, including duration of infertility, number of oocytes retrieved and infertility etiology. Mediation analyses indicated that the association between negative life events and IVF pregnancy was partly mediated by the number of oocytes harvested during oocyte retrieval.A large number of life-events perceived as having a negative impact on quality of life may indicate chronic stress, and the results of our study indicate that stress may reduce the chances of a successful outcome following IVF, possibly through psychobiological mechanisms affecting medical end-points such as oocyte retrieval outcome.