Effect of cognitive-behavioral therapy on psychological status and assisted reproductive outcomes in infertile women with obese polycystic ovary syndrome

Abstract

Objective To investigate the effect of cognitive-behavioral therapy on psychological status and assisted reproductive outcomes among infertile women with obese polycystic ovary syndrome (PCOS). Methods This was a prospective cohort study. Eighty-four obese PCOS women undergoing assisted reproductive technology (ART) treatment from September 2015 to June 2018 were divided into two groups: control group (n=35) received routine nursing care and healthy education, while treatment group (n=49) accepted cognitive-behavioral therapy which included recognition, emotional and behavioral interventions. The cognitive-behavioral therapy was performed through small group workshop and intercommunication via wechat. The psychological status before and after ART cycles and ART outcomes were compared between the two groups. Results The anxiety score (28.5±7.6) and depression score (13.8±7.0) were significantly lower among patients in treatment group than in control group (43.2±8.6, P=0.008; 17.2±6.3, P=0.021) . The score of treatment environment (79.7±18.0)and treatment tolerance of fertility-related quality of life (85.6±21.1) were significantly higher in the treatment group than in control group (64.2±20.2, P=0.015; 64.9±22.3, P=0.023). No significant differences were identified considering the number of retrieved oocytes, miscarriage rate and ectopic pregnancy rate between the two groups (P>0.05). The implantation rate and clinical pregnancy rate were slightly higher in treatment group than control group, but failed to reach significant differences (P>0.05). Conclusion Cognitive-behavioral therapy could effectively decrease the anxiety and depression status, improve treatment-related fertility quality of life, and might improve ART outcomes of obese PCOS infertile women. Key words: Obesity; Polycystic ovary syndrome (PCOS); Infertility; Assisted reproductive technology (ART); Cognitive-behavioral therapy