Mental Health Status Of Women Who Plan To Have In Vitro Fertilization Embryo-transfer And Psychological Intervenetion

Objective: The International Council on Infertility Information Dissemination (INCIID) considers a couple to be infertile if they have not conceived after a year of unprotected intercourse, or after six months in women over 35. In our country, a couple who fails to conceive a pregnancy after at least two years of regular vita sexualis without any contraception is diagnosed as infertilitas feminis. Infertile women regard in vitro fertilization embryo-transfer (IVF-ET) as their last hope, and as a result, they have to bear a lot of complicated psychological stress. They are often anxious, depressed, self-blame, delusional,and less socially supported. Doctors and researchers come to emphasize on mental health status of women who plan to have IVF-ET. At present, information supply, psychological intervention of emotional problem and sex psychological counselling are the main therapies, and new methods include couple therapy, physical therapy, personalized psychotherapy and others. In this study, investigation of mental health status and psychological intervention on IVF-ETwomen were carried out, which may be meaning and valuable to infertile women.Methods(1) Experimental group: 99 women who plan to have IVF-EThave been chosen from female infertility ward on affiliated hospital of military medical university.(2) Control group: 215 women of normal childbearing age are selected and their age, educational level, urban and rural status are comparable with the experimental group.(3)Investigation methods: five scales are adopted, such as the symptom checklist (SCL-90), Eysenck Personality Questionnaire (EPQ), Social Support Scale, Coping Style Scale and anxiety scale.(4) Psychological intervention methods: 99 women who plan to have IVF-ETare divided into two groups: with or without psychological intervention. Both are educated with IVF-ETspecialist knowledge. Psychological intervention is provided for four weeks, twice every week and two hours for each time. The intervention group is taught with knowledge about relationship between emotion and endocrine, and skills of emotional regulation, such as imagination relaxation, deep breathing relaxation and music relaxation. After class, the intervention group is asked to do relaxation training at home twice a day, 15-20 minutes for every time, and take records.Results1 Compared with the control group (women of normal childbearing age), the mental health level (SCL-90 scores) in the experimental group (women who plan to have IVF-ET) is significantly lower.2 In terms of personality trait, The experimental group are more introverted than the control group.3. In terms of social support, subjective support level and the support application level in the experimental group are significantlty lower than those in the control group.4 By coping style interview, solving problem factor in the experimental group is significantly lower than that in the control group, but rationalization factor, self-blaming factor and delusion factor in the experimental group are significantlty higher than those in the control group.5 Correlation analysis indicates that nervousness, disguise, self-blaming, delusion and anxiety in the experimental group are significantly negative correlated with SCL-90 scores, while coping style is positive correlated with SCL-90 scores.6 Stepwise regression analysis of SCL-90 scores with social support, coping style and personality trait suggests that nervousness and solving problem are included into regression equation with the coefficient of dertermination 0.390, which indicates combination of these two variables may predict 39% of variations in SCL-90. According to the normalized regression coefficient, the order of influence degree on SCL-90 from high to low is nervousness, solving problem.7 Comparation of psychological intervention group with non-intervention group demonstrate that active coping style is more easily adopted after psychological intervention; Hostility and interpersonal sensitivity level in psychological intervention group are significantly lower than those in non-intervention group, also the depression and anxiety scores are markedly reduced. In addition, 6 out of 40 women in non-intervention group and 18 out of 51 women in psychological intervention group are pregnant (the pregnant rate is 13%, 35.2% respectively). This result proves that the pregnant rate in pshchological intervention group is higher than that in the non-intervention group.Conclusion: The mental health level is lower ,coping style is unhealthy in the experimental group (women who plan to have IVF-ET) than those in the control group (women of normal childbearing age). Nervousness and coping style are two effective predictive factors of mental health status in IVF-ETwomen. Women in the psychogical intervention group easily adopt more active coping style, and their interpersonal sensitivity and hostility are significantly reduced. The pregnant rate (35.2%) in the psychological intervention group is significantly higher than that (13%) in the non- intervention group.