| Objective1To survey the mental condition and social support of women who received IVF-ET for the first time and provide basis for psychological care during the treatments.2To intervene the psychological state of women who had anxiety and depression mood when the IVF-ET treatment cycles began, and discuss whether the intervention measures could help improve the anxiety and depression mood, and increase the clinical pregnancy rate.Methods1From the female patients that received their first IVF-ET treatment in the reproductive center of First Affiliated Hospital of Zhengzhou University during the period from June1, to December1,2011,533women were extracted to participate the study. They were asked to fill the questionnaire when the treatment cycle began. The survey contained demographic characteristics, state of anxiety, depression, social support, and attitudes to the assisted reproductive technology.2According to SAS≤50and/or SDS≥53,180women were selected from the survey. Among them,80had anxiety mood,152had depression mood, and52had both anxiety and depression. They were divided into the intervention group and control group by the method of group randomization. The control group received routine care, and the intervention group received not only the routine care but also psychological intervention from the start of the treatment to fourteen days after the transplant. Psychological counseling, group intervention and relaxation therapy were the measures taken in the psychological intervention. Evaluations of the psychological conditions were made for both the two groups on the day before ovum pick-up and the day transplanted.3Statistics software SPSS17.0was used in data analysis and statistical description. Methods included single-sample t test, independent sample t-test, single-factor analysis of variance, Pearson correlation test, logistic regression, chi-square test, and analysis of variance in repeated measures.Results1The levels of SAS(42.40±7.24) and SDS(47.11±8.79) for women receiving first IVF-ET were all higher than the normal level(P<0.01). Among them,15.01%had anxiety,28.52%had depression; and9.76%had both anxiety and depression.2When the IVF-ET treatment began, the difference of SAS and SDS for women with different education levels, place of residence, monthly income and marital relations, were all statistically significant(P<0.01). The difference of SDS for women with different occupations and family support were statistically significant(P<0.01). The difference of SAS and SDS for women with different age, infertility duration, infertility types and SDS with different occupation, family support were not statistically significant(P>0.05).3When the IVF-ET treatment began, the difference of SSRS for women with different age, education levels, place of residence, family support and marital relationship were statistically significant(P<0.01), but difference among different infertility duration, infertility type, occupation, monthly income were not statistically significant(P>0.05). The SSRS was negatively related with both SDS and SAS (P<0.05). The relationship between SAS and SDS was positive(r=0.593,P<0.01).4Logistic regression analysis showed that the main factors influencing anxiety were marital relations and social support. Good marital relations lowered the possibility of anxiety and higher social support reduced the occurrences of anxiety. The main factors affecting depression were marital relations, education and social support. Good marital relations, higher education level lowered the likelihood of depression, and higher social support reduced the occurrence of depression.5For women with anxiety, the time effects of heart rate, systolic blood pressure, diastolic blood pressure and SAS of the control group and intervention group at different time were statistically significant (P<0.05). There was interaction between time effect and group effect (P<0.05). The group effects of systolic blood pressure and SAS at different time were statistically significant(P<0.05), while the group effects of heart rate and diastolic blood pressure were not statistically significant(P>0.05). The difference of clinical pregnancy rates for the two group was not statistically significant(χ2=0.201, P=0.654).6For women with depression, the time effects of heart rate, systolic blood pressure, diastolic blood pressure and SDS of the control group and intervention group at different time were statistically significant (P<0.05). The group effects were statistically significant(P<0.05). There was interaction between time effect and group effect (P<0.05). The difference of clinical pregnancy rates for the two group was not statistically significant(χ2=0.237, P=0.626).Conclusions1Women receiving first IVF-ET treatment had anxiety and depression mood, and women with less education, rural residence, low income, and poor marital relations had even more serious anxiety and depression mood.2When the IVF-ET cycle began, women with more education, urban residence, family support, good marital relations received higher social support, and the higher the level of social support were, the lower the degree of anxiety and depression would be. 3For women receiving first IVF-ET, psychological intervention can reduce anxiety, depression, decrease the fluctuations of heart rate and blood pressure, but did not apparently affect the clinical pregnancy rate. |
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