不孕不育人群生育生活质量评价及其影响因素分析

doi:10.12280/gjszjk.20230486

摘要/Abstract

摘要：

生育生活质量量表（Fertility Quality of Life Questionnaire，FertiQoL）是不孕不育人群生活质量测量的特异性量表。生育生活质量下降会影响不孕不育人群的治疗积极性及治疗依从性，从而影响患者的助孕结局。大量研究表明，不孕不育人群生育生活质量各模块及维度均有受损，但影响因素及对不同维度的影响程度尚无统一结论。中国和国外不孕不育人群生育生活质量受损情况不同，中国患者治疗模块受损更严重，国外患者核心模块受损更严重。社会支持、心理韧性是生育生活质量的保护因素，焦虑、抑郁、述情障碍、生育压力、病耻感则与生育生活质量呈负相关。除此之外，性别、年龄、居住地、受教育程度及不孕年限等一般特征也是不孕不育人群生育生活质量的重要影响因素。但目前对于提高患者生育生活质量的干预措施及干预后临床妊娠率是否得到提升的研究尚不充分。

关键词: 不育, 生活质量, 影响因素分析, 生殖技术, 辅助, 体外受精, 胚胎移植, 授精, 人工

Abstract:

Fertility Quality of Life Questionnaire (FertiQoL) is a specific scale to measure the quality of life in infertile population. The decline of fertility quality of life will affect the treatment enthusiasm and treatment compliance of infertile population, thus affecting the outcome of assisted pregnancy. A large number of studies have shown that all modules and dimensions of the quality of life of infertile people are impaired, and that there is no unified conclusion on the influencing factors and the influence degree of different dimensions. It is clear that the impaired quality of life of infertile population is different in China and abroad. The treatment FertiQoL is more seriously damaged in Chinese infertile people, while the core FertiQoL is more seriously damaged in foreign infertile people. Social support and psychological resilience were the protective factors of FertiQoL, while anxiety, depression, alexithymia, reproductive stress and infertility stigma were negatively correlated with FertiQoL. In addition, general characteristics such as sex, age, place of residence, education level and duration of infertility are also important influencing factors. The present research is not enough about what interventions improving the quality of life of patients, and whether the clinical pregnancy rate can be improved after intervention.

Key words: Infertility, Quality of life, Root cause analysis, Reproductive techniques, assisted, Fertilization in vitro, Embryo transfer, Insemination, artificial

郝佳丽, 何玉洁. 不孕不育人群生育生活质量评价及其影响因素分析[J]. 国际生殖健康/计划生育杂志, 2024, 43(2): 159-165.

HAO Jia-li, HE Yu-jie. Evaluation of Fertility Quality of Life in Infertile Population and Analysis of Influencing Factors[J]. Journal of International Reproductive Health/Family Planning, 2024, 43(2): 159-165.

参考文献 33

[1]	Boivin J, Takefman J, Braverman A. The fertility quality of life (FertiQoL) tool: development and general psychometric properties[J]. Hum Reprod, 2011, 26(8):2084-2091. doi: 10.1093/humrep/der171.
[2]	徐萌泽, 孟茜, 杨娜, 等. 中文版生育生活质量量表在辅助生殖治疗患者中的应用[J]. 广东医学, 2016, 37(20):3115-3118. doi: 10.3969/j.issn.1001-9448.2016.20.039.
[3]	倪颖, 童琛晔, 黄立敏, 等. 接受体外受精-胚胎移植女性的生育生活质量及其影响因素分析[J]. 诊断学理论与实践, 2021, 20(5):491-497. doi: 10.16150/j.1671-2870.2021.05.013.
[4]	Abulizi M, Xu H, Abuduguli A, et al. Dual mediating effects of social support and fertility stress on mindfulness and fertility quality of life in infertile men: A case-control study[J]. Front Psychol, 2023,14:1138282. doi: 10.3389/fpsyg.2023.1138282.
[5]	周飞京, 董悦芝, 孙致敏. 河南省郑州市566例不孕症患者的生育生活质量及其影响因素分析[J]. 预防医学论坛, 2023, 29(1):24-27. doi: 10.16406/j.pmt.issn.1672-9153.2023.1.06.
[6]	Wdowiak A, Anusiewicz A, Bakalczuk G, et al. Assessment of Quality of Life in Infertility Treated Women in Poland[J]. Int J Environ Res Public Health, 2021, 18(8):4275. doi: 10.3390/ijerph18084275.
[7]	Makara-Studzińska M, Limanin A, Anusiewicz A, et al. Assessment of Quality of Life in Men Treated for Infertility in Poland[J]. Int J Environ Res Public Health, 2022, 19(5):2950. doi: 10.3390/ijerph 19052950.
[8]	Warchol-Biedermann K. The Etiology of Infertility Affects Fertility Quality of Life of Males Undergoing Fertility Workup and Treatment[J]. Am J Mens Health, 2021, 15(2):1557988320982167. doi: 10.11771557988320982167.
[9]	Renzi A, Fedele F, Di Trani M. Assisted Reproductive Treatments, Quality of Life, and Alexithymia in Couples[J]. Healthcare(Basel), 2023, 11(7):1026. doi: 10.3390/healthcare11071026.
[10]	Dourou P, Gourounti K, Lykeridou A, et al. Quality of Life among Couples with a Fertility Related Diagnosis[J]. Clin Pract, 2023, 13(1):251-263. doi: 10.3390/clinpract13010023.
[11]	LoGiudice JA, Massaro J. The impact of complementary therapies on psychosocial factors in women undergoing in vitro fertilization (IVF): A systematic literature review[J]. Appl Nurs Res, 2018, 39:220-228. doi: 10.1016/j.apnr.2017.11.025. pmid: 29422163
[12]	郭启云, 陈声容. 焦虑、抑郁在体外受精—胚胎移植女性患者自我效能感与生育生活质量间的中介效应研究[J]. 中国妇幼保健, 2020, 35(17):3251-3254. doi: 10.19829/j.zgfybj.issn.1001-4411.2020.17.040.
[13]	Ni Y, Tong C, Huang L, et al. The analysis of fertility quality of life and the influencing factors of patients with repeated implantation failure[J]. Health Qual Life Outcomes, 2021, 19(1):32. doi: 10.1186/s12955-021-01666-3.
[14]	买尔哈巴·阿不力孜, 赵婉竹, 张晨, 等. 社会支持在精液质量异常男性生育压力与生育生活质量中的中介作用[J]. 现代预防医学, 2023, 50(3):525-530. doi: 10.20043/j.cnki.MPM.202206709.
[15]	Bhamani SS, Zahid N, Zahid W, et al. Association of depression and resilience with fertility quality of life among patients presenting to the infertility centre for treatment in Karachi, Pakistan[J]. BMC Public Health, 2020, 20(1):1607. doi: 10.1186/s12889-020-09706-1. pmid: 33097027
[16]	周飞京, 杜坤, 董悦芝. 不育男性的生育生活质量及相关因素[J]. 中国心理卫生杂志, 2022, 36(2):118-123. doi: 10.3969/j.issn.1000-6729.2022.02.005.
[17]	谢雷, 裴梦月, 杨媛, 等. 弱精子症患者心理弹性与生育生活质量的关系[J]. 国际生殖健康/计划生育杂志, 2022, 41(2):106-109. doi: 10.12280/gjszjk.20220002.
[18]	吴冰, 常琼, 陈迪. 不孕症女性生育压力、羞辱感、自尊与生育生活质量的相关性研究[J]. 全科护理, 2023, 21(18):2579-2583. doi: 10.12104/j.issn.1674-4748.2023.18.033.
[19]	Jing X, Gu W, Zhang L, et al. Coping strategies mediate the association between stigma and fertility quality of life in infertile women undergoing in vitro fertilization-embryo transfer[J]. BMC Womens Health, 2021, 21(1):386. doi: 10.1186/s12905-021-01525-9. pmid: 34727911
[20]	李宁, 晋雪然, 史莉, 等. 接受供精人工授精女性生育生活质量调查及影响因素分析[J]. 中国生育健康杂志, 2022, 33(5):450-454,458. doi: 10.3969/j.issn.1671-878X.2022.05.009.
[21]	Song D, Li X, Yang M, et al. Fertility quality of life (FertiQoL) among Chinese women undergoing frozen embryo transfer[J]. BMC Womens Health, 2021, 21(1):177. doi: 10.1186/s12905-021-01325-1. pmid: 33894750
[22]	Wang JY, Lv XQ, Wu JM, et al. Sexual Function, Self-Esteem, and Quality of Life in Infertile Couples Undergoing in vitro Fertilization: A Dyadic Approach[J]. Psychol Res Behav Manag, 2022, 15:2449-2459. doi: 10.2147/PRBM.S378496.
[23]	Roozitalab S, Rahimzadeh M, Mirmajidi SR, et al. The Relationship Between Infertility, Stress, and Quality of Life with Posttraumatic Stress Disorder in Infertile Women[J]. J Reprod Infertil, 2021, 22(4):282-288. doi: 10.18502/jri.v22i4.7654. pmid: 34987990
[24]	Suleiman M, August F, Nanyaro MW, et al. Quality of life and associated factors among infertile women attending infertility clinic at Mnazi Mmoja Hospital, Zanzibar[J]. BMC Womens Health, 2023, 23(1):400. doi: 10.1186/s12905-023-02536-4. pmid: 37528393
[25]	Sexty RE, Griesinger G, Kayser J, et al. Psychometric characteristics of the FertiQoL questionnaire in a German sample of infertile individuals and couples[J]. Health Qual Life Outcomes, 2018, 16(1):233. doi: 10.1186/s12955-018-1058-9.
[26]	Wadadekar GS, Inamdar DB, Nimbargi VR. Assessment of Impact of Infertility & its Treatment on Quality of Life of Infertile Couples using Fertility Quality of Life Questionnaire[J]. J Hum Reprod Sci, 2021, 14(1):3-10. doi: 10.4103/jhrs.jhrs_163_20. pmid: 34083985
[27]	张鑫, 刘丽英, 赵彬, 等. 女性不孕症患者生育生活质量影响因素的研究及护理体会[J]. 中国当代医药, 2020, 27(27):147-150. doi: 10.3969/j.issn.1674-4721.2020.27.044.
[28]	Ni Y, Shen H, Yao H, et al. Differences in Fertility-Related Quality of Life and Emotional Status Among Women Undergoing Different IVF Treatment Cycles[J]. Psychol Res Behav Manag, 2023, 16:1873-1882. doi: 10.2147/PRBM.S411740.
[29]	Suleimenova M, Lokshin V, Glushkova N, et al. Quality-of-Life Assessment of Women Undergoing In Vitro Fertilization in Kazakhstan[J]. Int J Environ Res Public Health, 2022, 19(20):13568. doi: 10.3390/ijerph192013568.
[30]	罗珩, 刘梅. 基于格林模式的健康教育结合压力接种训练对不孕症辅助生殖治疗患者FertiQoL、TCSQ评分及辅助生殖并发症的影响[J]. 临床医学研究与实践, 2023, 8(9):119-121. doi: 10.19347/j.cnki.2096-1413.202309034.
[31]	常亚丽. 渐进性肌肉放松对胚胎反复种植失败患者抑郁、睡眠及生育生活质量的影响[D]. 兰州: 兰州大学, 2020.
[32]	Mori A, Nishii O, Takai Y, et al. Influence of a patient education and care program on women undergoing non-assisted reproductive technology fertility treatment[J]. Reprod Med Biol, 2021, 20(4):513-523. doi: 10.1002/rmb2.12406. pmid: 34646080
[33]	史新宇, 孙一鑫, 刘鹏辉, 等. 以夫妻为中心的护理干预在实施体外受精-胚胎移植患者中的应用及效果观察[J]. 护士进修杂志, 2021, 36(8):725-729. doi: 10.16821/j.cnki.hsjx.2021.08.011.