Research progress on the impact of anxiety and depression on embryo transfer outcomes of in vitro fertilization

Zhejiang Da Xue Xue Bao Yi Xue Ban. 2023 Feb 25;52(1):61-67. doi: 10.3724/zdxbyxb-2022-0473.
[Article in English, Chinese]

Abstract

Infertile women who receive in vitro fertilization-embryo transfer (IVF-ET) often present psychological distress such as anxiety, depression and perceived stress. This adverse psychological state can affect the immune homeostasis at the mother-fetus interface, the incubation of blastula and the receptivity of the maternal endometrium through the psycho-neuro-immuno-endocrine network, which in turns affect the proliferation, invasion and vascular remodeling of the embryo trophoblast, and reduces the success rate of embryo transfer. This adverse outcome of embryo transfer will further aggravate the psychological pain of patients, forming a vicious circle. The positive partner effect between husband and wife or the use of cognitive behavioral therapy, acupuncture, yoga and other measures for psychological intervention before and after IVF-ET, may break the vicious cycle and improve clinical pregnancy rate, continuous pregnancy rate and live birth rate after IVF-ET by alleviating anxiety and depression. This article reviews the research progress on anxiety and depression states in women receiving IVF-ET and the impact on outcome of IVF-ET and related mechanisms, as well as the application of psychological intervention for alleviating anxiety and depression, so as to provide insights in improving the outcome of IVF-ET.

接受体外受精-胚胎移植(IVF-ET)治疗的不孕女性往往表现出焦虑、抑郁以及感知压力等心理困扰,这种不良的心理状态可通过心理-神经-免疫-内分泌网络影响母胎界面的免疫稳态、囊胚的孵化和母亲子宫内膜的容受性,进而影响胚胎滋养层的增殖、侵袭、血管重塑等,降低了胚胎移植的成功率,且进一步加重患者的心理痛苦,形成恶性循环。因此IVF-ET治疗前后应充分发挥夫妻之间积极的伴侣效应或使用认知行为疗法、针灸、瑜伽等方式来进行心理干预,通过改善焦虑、抑郁状态,提高IVF-ET治疗后的临床妊娠率、持续妊娠率和活产率。本文综述了接受IVF-ET治疗者的焦虑、抑郁状态对IVF-ET治疗结局的影响及可能的机制,以及心理干预在IVF-ET治疗实践中的应用等研究进展,以期为改善IVF-ET治疗结局提供新思路。.

Keywords: Embryo transfer outcome; In vitro fertilization-embryo transfer; Psychological factor; Psychological intervention; Review.

Publication types

  • Review

MeSH terms

  • Anxiety / therapy
  • Depression / therapy
  • Embryo Transfer
  • Female
  • Fertilization in Vitro
  • Humans
  • Infertility, Female* / therapy
  • Pregnancy
  • Pregnancy Rate