| Objective:To evaluate the mental health status of female infertility patients with frozen embryo transfer and to explore the impact factors that affect their mental health status;to evaluate the effectiveness of implementing different mental health interventions in female infertility treatment thereby providing effective and feasible recommendations for mental health interventions and infertility treatment programs.Methods:Cross-sectional study was used to understand the mental health status of female infertility patients with frozen embryo transfer,and quasi-experiment study was used to obtain real-world data to evaluate the effects of different mental health interventions.First,we conducted the symptom checklist 90(SCL-90)to assess the mental health status of the patients.The SCL-90 scale includes 10 factors:somatization,obsessive-compulsive,interpersonal sensitivity,depression,anxiety,hostility,phobic anxiety,paranoid ideation,psychoticism,and sleep and diet.The mean±standard was used for statistical description,and t test for statistical analysis.The general demographic data,infertility-related data and clinical detection indicators collected from the hospital information system.The mean±standard,number of cases(composition ratio)and median(quartile)were used for statistical description,and t test,Wilcoxon rank sum test and Chi-square test were used for statistical analysis.Secondly,t test,ANOVA and multiple linear regression were applied to explore the possible influencing factors of their mental health status.Second,a quasi-experimental study was carried out for evaluating the effectiveness of interventions in terms of improving the mental health of patients.According to the actual situation and willingness of the patients,non-randomized groups were selected to start the intervention,and the intervention group and the control group were given different mental health interventions.Finally,the Chi-square test was used to evaluate the effectiveness of pregnancy outcome on infertility treatment.Results:(1)A total of 1393 patients were evaluated the mental health status by using the SCL-90 scale.The average age of the patients was 33.80±5.38 years old,50.6%of the patients were only educated in junior high school or below,the percentages of the patients with first transfer was 96.6%,the percentages of the patients with no children and first marriage were 92.6%and 90.3%respectively.In the intervention effect evaluation study,534 patients were selected as the intervention group,and 859 patients were control group.The number of pregnancy outcomes observed in the intervention group was 196 cases and the control group was 254 cases.There was no significant difference between the intervention group and the control group in age,spouse age,ethnicity,spouse ethnicity,education,spouse education,occupation and spouse occupation(P>0.05).(2)The average score of the SCL-90 scale for female infertility patients with frozen embryo transfer was 140.18±30.29 points,which was higher than general Chinese norms(129±38.76 points).In addition to the paranoid ideation factor,there is significant difference between the study group and norm group in the total score,the total average score and the 8 factor scores(P<0.05),especially the six factors of obsessive-compulsive,interpersonal sensitivity,depression,anxiety,hostility,sleep and diet were 0.10 points higher than the norm.In addition,about 90%of female infertility patients with frozen embryo transfer scored various factors as mild(1<X?2 points)and below.(3)There were significant differences among patients with different ages in total score,average score,somatization,obsessive-compulsive,depression,phobic anxiety,psychoticism,sleep and diet factor scores(P<0.05);There were significant differences among patients with different educational levels in somatization,obsessive-compulsive,hostility,phobic anxiety,paranoid ideation,psychoticism,sleep and diet factor scores(P<0.05);There were significant differences among patients with different occupations in the total score,total average score,depression,paranoid ideation,sleep and diet factor scores(P<0.05);There were significant differences among patients with different infertility causes in the depression and phobic anxiety factor scores(P<0.05);There were significant differences between the first and second transfer patients in the interpersonal sensitivity and psychoticism factor scores(P<0.05);There were significant differences between patients with and without children in the phobic anxiety and psychoticism factor scores(P<0.05);There was significant differences between patients with and without a history of spontaneous abortion in the sleep and diet factor scores(P<0.05).(4)There was no significant difference in biochemical pregnancy outcome between the intervention group and the control group(?2=1.634,P>0.05).But the proportion of positive biochemical pregnancy in the intervention group(56.7%)was higher than that in the control group(50.4%).The stratified analysis showed that whether the total score of the same SCL-90 scale>general Chinese norms(129.00 points)or the total score of the SCL-90 scale?general Chinese norms,there was no significant difference in between biochemical pregnancy outcome between the intervention group and the control group(P>0.05).But in the total score of SCL-90 scale>general Chinese norms,the proportion of positive biochemical pregnancy in the intervention group(54.4%)was higher than that in the control group(51.2%),In the total score of the SCL-90 scale?general Chinese norms,the proportion of positive biochemical pregnancy in the intervention group(59.7%)was higher than that in the control group(49.5%).There was no significant difference in clinical pregnancy outcome between the intervention group and the control group(?2=1.582,P>0.05).But the proportion of positive clinical pregnancy in the intervention group(48.5%)was higher than that in the control group(42.5%).The stratified analysis showed that whether the total score of the same SCL-90 scale>general Chinese norms or the total score of the SCL-90 scale?general Chinese norms,there was no significant difference in between clinical pregnancy outcome between the intervention group and the control group(P>0.05).But in the total score of SCL-90 scale>general Chinese norms,the proportion of positive clinical pregnancy in the intervention group(47.8%)was higher than that in the control group(41.8%),In the total score of the SCL-90 scale?general Chinese norms,the proportion of positive clinical pregnancy in the intervention group(49.4%)was higher than that in the control group(43.3%).Conclusion:Female infertility patients with frozen embryo transfer have mild mental health symptoms,which should arouse the concern of clinical medical workers,patients themselves and their families.To individual female infertility patients with frozen embryo transfer,they should seek medical treatment for infertility-related treatment as soon as possible,pay attention to their own mental health and seek psychological help in time.To assisted reproductive medical and health institutions,it is necessary for patients to popularize the necessary knowledge of pregnancy preparation,optimize treatment programs,conduct psychological evaluation and carry out mental health education,counseling and intervention services at the same time.The relationship between psychological health interventions and the improvement of pregnancy outcomes should be further studied. |
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