摘要
目的探讨生育压力与血浆皮质醇水平的相关性、生育压力及血浆皮质醇水平与妊娠结局的相关性。方法本研究为病例对照研究,采用便利抽样法选取2019年3月至2019年10月期间于重庆医科大学附属第二医院妇产科生殖医学中心,拟行体外受精/卵胞质内单精子注射-胚胎移植(in vitro fertilization/intracytoplasmic sperm injection and embryo transfer,IVF/ICSI-ET)助孕的不孕女性行横断面调查,将患者分为妊娠组和非妊娠组,对研究对象行一般资料调查,采用生育压力量表(fertility problem inventory,FPI)进行生育压力评估,同时测定移植前、移植日清晨空腹血浆皮质醇水平,随访IVF/ICSI-ET的妊娠结局,对妊娠结局的影响因素采用logistic回归分析。结果调查期间共有169例研究对象行胚胎移植,妊娠组患者80例,非妊娠组患者89例,两组患者的人口学特征和临床特征的基线差异均无统计学意义(均P>0.05)。研究期间共发放问卷320份,回收有效问卷291份,Spearman相关性分析结果显示血浆皮质醇与生育压力呈正相关(r=0.234,P<0.001)。回归分析结果显示移植日血浆皮质醇是妊娠结局的独立影响因素(OR=1.002,95%CI=1.001~1.004,P=0.003)。结论血浆皮质醇水平可反映不孕患者生育压力水平;移植日血浆皮质醇含量是妊娠结局的独立影响因素,随着血浆皮质醇含量的增加,妊娠的可能性减小。
Objective To explore the correlation between fertility stress and plasma cortisol level,the correlation between fertility stress and plasma cortisol level and pregnancy outcome.Methods This experiment is a case-control study.Convenience sampling method was used to select infertility women assisted by in vitro fertilization/intracytoplasmic sperm injection and embryo transfer(IVF/ICSI-ET)in the Department of Reproductive Medicine,Department of Obstetrics and Gynecology,the Second Affiliated Hospital of Chongqing Medical University between March 2019 and October 2019.A cross-sectional survey was conducted.The patients were divided into pregnancy and non-pregnancy groups and general data survey was conducted on the study subjects,and the fertility problem inventory(FPI)scale was adopted.A fertility stress assessment was performed and fasting plasma cortisol levels were measured in the morning before transplantation during the investigation.The plasma cortisol level before transplantation and the morning of the transplantation day were measured,and their pregnancy outcomes were followed up.Logistic regression analysis was used to determine the factors affecting pregnancy outcomes.Results During the investigation,a total of 169 subjects underwent embryo transfer.There were 80 patients in pregnancy group and 89 patients in non-pregnancy group.There was no statistically significant difference in demographic and clinical characteristics between the two groups at baseline(all P>0.05).A total of 320 questionnaires were issued during the study period,and 291 valid questionnaires were recovered.The Spearman correlation analysis showed that plasma cortisol was positively correlated(r=0.234,P<0.001)with fertility stress.Regression analysis showed that plasma cortisol on the day of transplantation was an independent factor affecting pregnancy outcome(OR=1.002,95%CI=1.001-1.004,P=0.003).Conclusion The level of plasma cortisol can reflect the fertility pressure of infertile patients,the content of plasma cortisol on the day of transplantation is an independent influencing factor of pregnancy outcome.With the increase of the content of plasma cortisol,the possibility of pregnancy decreases.
作者
田瑜
张觇宇
Tian Yu;Zhang Chanyu(Department of Reproductive Medicine,Department of Obstetrics and Gynecology,the Second Affiliated Hospital of Chongqing Medical University,Chongqing 400000,China)
出处
《中华生殖与避孕杂志》
CSCD
北大核心
2022年第1期30-35,共6页
Chinese Journal of Reproduction and Contraception
关键词
不孕症
生育压力
血浆皮质醇
Infertility
Fertility stress
Plasma cortisol
