Correlation Analysis Of Psychological Factors, Uterine Contraction And Pregnancy Outcome At IVF/ICSI Cycle

Affected by many factors, the number of patients with infertility sharply increased and pregnancy had become an urgent demand for infertility patients. As a means of progesterone, the IVF/ICSI assisted reproductive technology brought new hope for infertility patients.The IVF/ICSI technology had developed so fast all through past 30 years. The number of oocytes, fertilization rate and cleavage rate had been increased significantly,but the clinical pregnancy rate still remained between 40% and 50%. Many factors affected the clinical pregnancy rate,the impact of psychological factors and uterine contraction on the pregnancy outcome was becoming a significant concern recently. The psychological problems of infertility severely affected patients’ quality of life and physical/mental health. It also had negative effects on the treatment efficiency of infertility. The uterine contraction had impact on embryo implantation during IVF/ICSI, causing the embryo escape from the uterus and affecting the treatment outcome. Therefore, further research should be carried out to investigate the impact of psychological factors and uterine contractions on the pregnancy outcome, providing clinical reference to improve the IVF/ICSI outcome. Objective:To investigate the impact of psychological factors and uterine contraction on pregnancy outcome during IVF/ICSI. This could provide clinical ideas for improving the clinical pregnancy rate. Methods:86 Infertility patients under routine IVF/ISCI treatment in the First clinical hospital of Shan’xi Medical University were selected as research objects. On the Gn RH and ET day, questionnaires were made based on general information, SAS and SDS. On the HCG and ET day, endometrial thickness,waveform and frequency of uterine contractions were observed by transvaginal ultrasound. Serum estrogen(E2) and progesterone(P) values were measured on the embryo transfer day. Cases were divided into clinical pregnancy group and non-pregnant group according to their pregnancy outcome. Finally, we analyzed factors correlated with pregnancy outcome. Results:1.By generally comparison of the two groups including age, duration of infertility, number of oocytes, Gn dose, Gn days and serum E2 level on the ET day, the difference was not statistically significant(p>0.05). The serum P of these two groups were above 40pg/ml, which exceeded the detection upper limit. The detection methods limited the correlation comparison.2.Comparing SAS and SAS on the Gn RH and ET day respectively, the differences were statistically significant(p<0.05). This indicates the SAS and SDS scores on the ET day were higher than the Gn RH day.3.Comparing SAS and SDS of the pregnancy and non-pregnancy groups on the Gn RH and ET day, it was p<0.05 for the SAS score and p>0.05 for the SDS score. This suggests the SAS core of the non-pregnancy group was higher than that of the pregnancy group on the Gn RH and ET day.4.By logistic regression analysis of the SAS score and pregnancy outcome on the Gn RH and ET day, it was p<0.05 for the regression coefficient. This indicates that the SAS core was relevant with pregnancy and the lower the SAS core, the greater chance of pregnancy.5.There was no statistical difference(p>0.05) of the endometrial thickness, uterine contraction and contraction frequency between the clinical pregnancy group and the non-pregnant group.The endometrial thickness of the two groups on ET day had no statistically difference(p>0.05). The difference of waveform and frequency of uterine contractions had statistically significant(p<0.05). The clinical pregnancy group had more positive movements while the non-pregnant group had more irregular and negative movements. The uterine contraction frequency of the clinical pregnancy group is 4 times/minute less than that of the non-pregnant group. In the clinical pregnancy group, cases which uterine contraction frequency were less than or equal to 4 times per minute were more than that of the non-pregnant group.6.The Logistic regression analysis of uterine contraction waveform and frequency on ET day showed that the contraction waveform was p>0.05 but the contraction frequency was p<0.05. It suggested that high contraction frequency was the main cause to non-pregnancy.7.Through correlation analysis of the uterine contraction and the SAS score on the ET day, we found that the correlation efficient r=0.704 and p<0.05. This indicates that the uterine contraction frequency had positive correlation with the SAS score and the correlation is strong. Conclusions:1.Infertility patients with the first IVF/ICSI treatment had different levels of anxiety and depression. With the progress of treatment, anxiety and depression increasesd and the anxiety status affected the pregnancy outcome.2.The uterine contraction frequency on the ET day had correlation with the pregnancy outcome. Too strong uterine contraction may cause non-pregnancy.3.High anxiety on the ET day increased the uterine contraction frequency. This further affected the success rate of IVF/ICSI.