The Effect Of Anxiety And Depression On Serum Cortisol Concentration And The Outcome Of IVF-ET Treatment In Infertile Women

Objective To investigate the incidence of anxiety and depression in IVF-ET and F-ET populations,and their relationship with serum cortisol and treatment outcome.Methods From December 17,2015 to May 31,2016,the infertility women who received IVF-ET or F-ET treatment at a reproductive center in Anhui Province were selected as the study subjects.We gathered venous blood from each volenteers on the day of transplantation to test serum cortisol concentration.The anxiety level was measured using the SAS scale,The SAS questionnaire standard score ? 50 is defined as anxious state.The depression was measured by the CES-D scale.The CES-D questionnaire score ? 16 is defined as a tendency to depression.28-32 days after the transplantation we followed-up transplant outcome,clinical pregnancy is defined as seeing intrauterine fetal sac and heart beat under vaginal ultrasound.Statistical analysis had been done using statistical package SPSS10.0,with P <0.05 was statistically significant.Results1 A total of 1210 cycles were enrolled in this study.Among them,240 were freshly transplanted(IVF-ET),970 were thawed cycles(F-ET),153 of them found out to be anxiety,makes 12.64% of all cycles,157 was depression,making the detection rate13.0%.2 The probability of anxiety in patients with children were lower than those without children.The probability of depression in patients who have children was higher thanthat without children,the difference was statistically significant.3 Women succeeded after treatment in the fresh cycle group were younger than those who didn't pregnant.The level of cortisol in the pregnant group was lower than that in the untreated group.The incidence of anxiety in the pregnancy group was significantly lower than that in the untreated group,all the differences were statistically significant.However,though the SAS score of pregnant group was lower than that of the non-pregnant group,but there was no significant difference.4 Women succeeded after treatment in the frozen-thawed transferring cycle group were younger than those who didn't pregnant.The number of cycles of pregnancy group was less than that of pregnancy group.The SAS scores of the pregnancy group were lower than those in the untreated group.The incidence of anxietyin the pregnancy group was lower than that in the untreated group.All the differences were statistically significant.5 The comparision of general condition and psychological score between IVF-ET group and F-ET group: the IVF-ET groups is yonger than those in the F-ET group;The SAS score of the IVF-ET group was lower than that of F-ET group;the CES-D scoreof the IVF-ET group is lower than that ot the F-ET group,the differences were statistically significant.There was no significant difference in serum cortisol levels,anxiety and depression rates and the clinical pregnancy rate between the two groups.6 Serum cortisol levels in fresh cycle group were positively correlated with SAS score(rs = 0.217,P <0.001).There was no significant correlation between the levels of serum cortisol and the SAS score in the thawing cycle group.There was no correlation between serum cortisol levels and CES-D scores in fresh and thawed cycles.Conclusions As a psychological stress,anxiety in patients who received an IVF treatment has a negative effect on IVF-ET treatment outcomes,and the same tendencyhas been observed in the F-ET cycle.Serum cortisol levels and anxiety levels were positively correlated in IVF-ET patients.Depression levels were not associated with serum cortisol levels.Using the combination of psychological scale and serum cortisol level as a reference for treatment decision making and psychological nursing may be a more prudent way to improve IVF pregnancy rates.