PSYCHOLOGICAL CONSEQUENCES OF ASSISTED REPRODUCTIVE TECHNOLOGY FAILURE

这项拟议的研究将是关于辅助生殖技术(ARTS)失败(特别是反复失败)相关心理后果的第一次大型前瞻性研究。尽管艺术失败对个人和夫妇的影响一直很受关注，但目前的研究文献包含的差距比答案更多。这项研究的具体目的是：1)确定ART失败后患者及其丈夫的心理和婚姻痛苦及可临床诊断的精神疾病(“心理结果”)的程度(S)；2)比较ART失败后仍未生育的患者和他们的丈夫(S)的心理结果，以及那些接受其他治疗的患者和他们的子女相关结果，包括不追求ART、收养孩子和由于治疗而生孩子；3)使用脆弱性-应激模型预测哪些患者和丈夫会因ART失败而经历不良的心理结果(S)，以便有针对性地进行支持性干预。620对夫妇去看ART医生，为他们的第一个ART周期进行初步咨询，他们将接受采访，并在随后的18个月内进行跟踪，无论他们的治疗轨迹如何。所有队列成员将参加任何抗逆转录病毒治疗尝试之前的初步面谈，在此期间将评估个人的脆弱性因素。所有队列成员将在第一个周期开始两周后参加结果后访谈，并在6个月、12个月和18个月后进行后续访谈，在此期间将评估心理结果。那些在初次面试后3个月内没有开始学习艺术的学生将在6个月、12个月、18个月后重新接受面试。这项研究的结果将指导为使用和考虑抗逆转录病毒疗法的夫妇制定评估和干预方案。

The proposed research will be the first large prospective study of the psychological consequences associated with failure (particularly repeated failure) of assisted reproductive technologies (ARTs). Although there has been much concern about how ART failures affect individuals and couples, the current research literature contains more gaps than answers. The specific aims of this research are to: 1) determine the extent of psychological and marital distress and of clinically diagnosable psychiatric disorders ("psychological outcomes") in patients and their husbands following ART failure(s), 2) compare the psychological outcomes of patients and their husbands who remain childless after ART failure(s) to those who experience other treatment and child-related outcomes, including not pursuing ART, adopting a child, and having a child as a result of treatment and 3) use a vulnerability-stress model to predict which patients and husbands will experience poor psychological outcomes in response to ART failure(s) so that those individuals can be targeted for supportive interventions. A cohort of 620 couples seeing an ART physician for an initial consultation for their first ART cycle will be interviewed and followed over the subsequent 18 month period regardless of their treatment trajectory. All cohort members will participate in an initial interview prior to any ART attempts during which individual vulnerability factors will be assessed. All cohort members will then participate in a post-results interview two weeks after their first cycle if one is initiated, and follow- up interviews 6, 12, and 18 months later, during which psychological outcomes will be assessed. Those not initiating ARTs within 3 months of the initial interview will be re-interviewed 6, 12, 18 months later. The findings of this study will guide the development of assessment and intervention protocols for couples using and considering ARTs.