Correlation Analysis Of Plasma Cortisol Level With Fertility Pressure And Pregnancy Outcome In IVF/ICSI Patients

OBJECTIVE: To explore the influencing factors of fertility pressure for infertile women,the correlation between fertility pressure and plasma cortisol level,the correlation between fertility pressure and plasma cortisol level and pregnancy outcome.METHODS: Using convenient sampling method,a total of 291 infertile women were selected from March 2019 to October 2019 at the Reproductive Medicine Center of the Second Affiliated Hospital of Chongqing Medical University to undergo in vitro fertilization/Intracytoplasmic sperm injection-embryo transfer Routine cross-sectional surveys.The subjects were investigated for general data,fertility stress was assessed by fertility problem inventory and fasting plasma cortisol level was measured in the early morning before transplantation.During the investigation,169 subjects underwent embryo transfer.Plasma cortisol was measured early in the morning on the day of transfer and their pregnancy outcomes were followed.Multiple linear regression was used to analyze the influencing factors of fertility pressure and logistic regression was used to analyze the influencing factors of pregnancy outcome.P<0.05 wasconsidered as statistically significant.RESULTS:1.During the study,320 questionnaires were distributed,291 valid questionnaires were recovered,with a recovery rate of 91%.Comparing the total scores of fertility stress among patients with different education levels,occupations,income,infertility type,infertility factors and marital status,the differences in education level and income among the subgroups were statistically significant.Regression analysis results show that education level is an independent factor affecting fertility stress.2.Spearman correlation analysis showed that Plasma cortisol levels before transplantation was positively correlated with fertility pressure before transplantation(Spearman correlation coefficient =0.234,P<0.001).3.Total fertility stress scores and plasma cortisol levels before transplantation had no effect on fertilization rate and high-quality embryo rate(P> 0.05).4.There were significant differences in plasma cortisol,assisted reproductive gestational period and number of high-quality embryos between pregnant group and non-pregnant group(P < 0.05).Regression analysis showed that plasma cortisol on the day of transplantation was an independent factor affecting pregnancy outcome.CONCLUSION: Education level is an independent influencing factor of fertility stress.Infertility patients with high education level have lowfertility stress.The level of plasma cortisol is positively correlated with fertility stress,which can reflect the fertility stress level of infertility patients.The increase of plasma cortisol level on the day of transplantation is an independent risk factor for pregnancy outcome.With the increase of plasma cortisol level,the possibility of pregnancy decreases.