Psychological depression and its association with oocyte yield and embryo outcomes in infertile women undergoing in vitro fertilization-embryo transfer.

BACKGROUND

Women undergoing in vitro fertilization-embryo transfer (IVF-ET) for infertility are at increased risk of depression; However, the association between depressive symptoms and intermediate outcomes during assisted reproductive treatment remains unclear. This study aimed to investigate the association between depressive symptoms and IVF-related intermediate reproductive outcomes.

METHODS

A total of 183 infertile women undergoing IVF-ET at the Reproductive Medicine Center of the First Affiliated Hospital of Anhui Medical University were enrolled during 2021. Depressive symptoms were assessed prior to treatment initiation using the Patient Health Questionnaire-9 (PHQ-9). Clinical data related to oocyte retrieval and embryo development were collected after completion of the IVF cycle. Multivariable linear regression models were used to examine the associations between depressive symptoms and reproductive outcomes. Restricted cubic spline (RCS) models were applied to explore dose-response relationships.

RESULTS

The mean age of participants was 30.80 years, and 18.1% met the criteria for moderate or severe depressive symptoms. After adjustment for potential confounders, higher PHQ-9 scores were associated with a reduced number of transferable embryos (β = -2.17, 95% CI: -3.64, -0.69), while the association with retrieved oocyte number was of borderline statistical significance (β = -3.02, 95% CI: -6.05, -0.002). RCS analyses demonstrated a negative dose-response association between depression severity and IVF-related intermediate reproductive outcomes, with no evidence of nonlinearity (P nonlinear > 0.05).

CONCLUSION

Depressive symptoms among infertile women undergoing IVF-ET are significantly associated with a reduced number of transferable embryos, suggesting that mental health status may play an important role in intermediate assisted reproductive outcomes.