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Zhang Q, Wang Z, Ding J, Yan S, Hao Y, Chen H, Yang J, Hu K. Effect of obstructive sleep apnea on in vitro fertilization outcomes in women with polycystic ovary syndrome. J Clin Sleep Med 2024; 20:31-38. [PMID: 37593900 PMCID: PMC10758552 DOI: 10.5664/jcsm.10780] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 08/16/2023] [Accepted: 08/16/2023] [Indexed: 08/19/2023]
Abstract
STUDY OBJECTIVES Polycystic ovary syndrome (PCOS) confers a high risk of obstructive sleep apnea (OSA). Here we investigated the effect of OSA on first in vitro fertilization (IVF) cycle metrics and outcomes in patients with PCOS. METHODS This was a prospective cohort study of patients with PCOS undergoing their first IVF at a single tertiary center between October 1, 2021, and September 30, 2022. Patients were screened for OSA before IVF and grouped accordingly. Clinical and IVF cycle data were compared between groups. RESULTS OSA was found in 37.2% of 156 patients with PCOS, with longer infertility duration (4.3 ± 2.5 vs. 3.4 ± 2.0 years) and lower levels of anti-Müllerian and luteinizing hormones than patients without OSA (6.44 ± 2.96 vs 8.69 ± 4.03 µg/L and 6.30 ± 5.02 vs 8.46 ± 6.09 U/L). Antral follicle count was lower in patients with OSA (28.9 ± 12.4 vs 33.2 ± 12.9). During ovarian stimulation, patients with OSA required significantly higher doses of gonadotropin (2080.8 ± 1008.7 vs 1682.8 ± 619.9 U) and had lower peak estradiol level (4473.5 ± 2693.0 vs 5455.7 ± 2955.1 pmol/L) and fewer retrieved oocytes, high-quality, and available embryos (17.8 ± 7.2 vs 21.9 ± 10.5, 4.5 ± 4.4 vs 6.2 ± 4.6, 5.2 ± 4.3 vs 7.4 ± 5.0). Eleven patients were excluded for having no embryos or missing transfer. Therefore, we analyzed the outcome of the first embryo transfer in 145 patients. The biochemical and clinical pregnancy rates were lower in patients with OSA than patients without OSA (51.9% vs 66.7% and 42.3% vs 60.2%). OSA was independently associated with clinical pregnancy rate after controlling for several confounders (P = .043). CONCLUSIONS OSA impairs female fertility in patients with polycystic ovary syndrome, suggesting an adverse effect on in vitro fertilization cycle stimulation characteristics and clinical outcomes. CITATION Zhang Q, Wang Z, Ding J, et al. Effect of obstructive sleep apnea on in vitro fertilization outcomes in women with polycystic ovary syndrome. J Clin Sleep Med. 2024;20(1):31-38.
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Affiliation(s)
- Qingfeng Zhang
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, China
| | - Zehao Wang
- Reproductive Medicine Center, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Clinic Research Center for Assisted Reproductive Technology and Embryonic Development, Wuhan, China
| | - Jinli Ding
- Reproductive Medicine Center, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Clinic Research Center for Assisted Reproductive Technology and Embryonic Development, Wuhan, China
| | - Sisi Yan
- Reproductive Medicine Center, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Clinic Research Center for Assisted Reproductive Technology and Embryonic Development, Wuhan, China
| | - Yueying Hao
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, China
| | - Hao Chen
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, China
| | - Jing Yang
- Reproductive Medicine Center, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Clinic Research Center for Assisted Reproductive Technology and Embryonic Development, Wuhan, China
| | - Ke Hu
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, China
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Li QL, Wang C, Cao KX, Zhang L, Xu YS, Chang L, Liu ZH, Yang AJ, Xue YX. Sleep characteristics before assisted reproductive technology treatment predict reproductive outcomes: a prospective cohort study of Chinese infertile women. Front Endocrinol (Lausanne) 2023; 14:1178396. [PMID: 37908752 PMCID: PMC10614022 DOI: 10.3389/fendo.2023.1178396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 09/06/2023] [Indexed: 11/02/2023] Open
Abstract
Sleep disorders affect mental and physical health. Infertile women undergoing assisted reproductive technology (ART) treatment are prone to sleep disorders. Sleep condition, its influencing factors, and the association between sleep condition and ART treatment outcomes before treatment have not been explored within a population with a large sample size. Therefore, we investigated the sleep characteristics of 1002 Chinese infertile women before ovulation induction and investigated the influencing factors (negative and positive psychological factors, demographics, and fertility characteristics). We also examined whether sleep conditions before treatment predicted reproductive outcomes. We found that 24.1% of participants reported poor sleep quality. Women with primary infertility reported poorer sleep than women with secondary infertility. Negative psychological factors, including depression, anxiety, and perceived stress were associated with poor sleep, whereas positive affect was linked with good sleep. Adverse sleep characteristics, including poor subjective sleep quality, sleep disturbances, and poor sleep efficiency, decreased the quantity and quality of oocytes retrieved, fertilization rates, and clinical pregnancy rates. This study indicates that before ART treatment, a large number of females with infertility suffer from sleep problems, which are affected by psychological factors and infertility type, and unhealthy sleep characteristics may impair treatment outcomes. Our findings highlight the importance of screening and treatment for sleep disorders before the enrollment of ART treatment in infertile women.
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Affiliation(s)
- Qian-Ling Li
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
- Center for Reproductive Medicine, Affiliated Hospital of Jining Medical University, Jining, China
| | - Chao Wang
- Reproductive Medical Center, Department of Obstetrics and Gynecology, Peking University International Hospital, Beijing, China
| | - Ke-Xin Cao
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
- Department of Pharmacology, School of Basic Medical Sciences, Peking University, Beijing, China
| | - Lin Zhang
- Center for Reproductive Medicine, Affiliated Hospital of Jining Medical University, Jining, China
| | - Yun-Shuai Xu
- Department of Psychiatry, Shandong Daizhuang Hospital, Jining, China
| | - Liang Chang
- Henan Key Laboratory of Medical Tissue Regeneration, School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, China
| | - Zhen-Hui Liu
- Center for Reproductive Medicine, Affiliated Hospital of Jining Medical University, Jining, China
| | - Ai-Jun Yang
- Center for Reproductive Medicine, Affiliated Hospital of Jining Medical University, Jining, China
| | - Yan-Xue Xue
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
- Chinese Institute for Brain Research, Beijing, China
- Key Laboratory for Neuroscience, Ministry of Education/National Health Commission, Peking University, Beijing, China
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Rafati F, Mangolian Shahrbabaki P, Dastyar N, Pilevarzadeh M, Mehralizadeh A. Relationship Between the Psychological Distress and Spiritual Well-Being in Pregnant Women Exposed to Domestic Violence: A Cross-Sectional Study in Iran. JOURNAL OF RELIGION AND HEALTH 2023; 62:3252-3266. [PMID: 36894696 DOI: 10.1007/s10943-023-01785-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
Maternal psychological distress is often associated with domestic violence. Spiritual well-being can affect the psychological capacity to deal with distress. This study aimed to investigate the relationship between psychological distress and spiritual well-being in pregnant women exposed to domestic violence. This cross-sectional study was conducted on 305 pregnant women subjected to domestic violence in southern Iran. The participants were selected using the census method. Data were collected using the Spiritual Well-being Scale (SWB), the Kessler Psychological Distress Scale (K10), and the Hurt, Insult, Threaten, Scream (HITS) screening tool (short form) and were analyzed with descriptive and inferential statistics (t-test, ANOVA, the Spearman correlation coefficient, and multiple linear regression) in SPSS software version 24. The mean scores ± standard deviation of the participants' psychological distress, spiritual well-being, and domestic violence were 24.68 ± 6.43, 79.89 ± 18.98, and 11.24 ± 1.5, respectively. The results showed that psychological distress had a significant negative correlation with spiritual well-being (ρ = - 0.84, P < 0.001) and domestic violence (ρ = - 0.73, P < 0.001). The results of the multiple linear regression analysis also showed that spiritual well-being and domestic violence could predict the psychological distress of pregnant women who were exposed to domestic violence, which explained 73% of the psychological distress in the participants. According to the study results, spiritually oriented education can be provided for women to reduce their psychological distress. Also, it is recommended that necessary interventions be used to reduce domestic violence and empower women to prevent it.
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Affiliation(s)
- Foozieh Rafati
- Department of Nursing, School of Nursing and Midwifery, Jiroft University of Medical Sciences, Sabzevaran Square, PO Box: 7861763730, Jiroft, Kerman, Iran
| | - Parvin Mangolian Shahrbabaki
- Department of Nursing, Razi Faculty of Nursing and Midwifery, Nursing Research Center, Kerman University of Medical Sciences, Haft-Bagh Highway, PO Box: 7861763730, Kerman, Iran
| | - Neda Dastyar
- Department of Midwifery, Nursing and Midwifery School, Jiroft University of Medical Sciences, Sabzevaran Square, PO Box: 7861763730, Jiroft, Kerman, Iran.
| | - Motahareh Pilevarzadeh
- Department of Nursing, School of Nursing and Midwifery, Jiroft University of Medical Sciences, Sabzevaran Square, PO Box: 7861763730, Jiroft, Kerman, Iran
| | - Akbar Mehralizadeh
- Department of Statistics and Epidemiology, School of Medicine, Jiroft University of Medical Sciences, Sabzevaran Square, PO Box: 7861763730, Jiroft, Kerman, Iran
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Liu Z, Zheng Y, Wang B, Li J, Qin L, Li X, Liu X, Bian Y, Chen Z, Zhao H, Zhao S. The impact of sleep on in vitro fertilization embryo transfer outcomes: a prospective study. Fertil Steril 2023; 119:47-55. [PMID: 36435629 DOI: 10.1016/j.fertnstert.2022.10.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 10/08/2022] [Accepted: 10/11/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To prospectively examine the association between sleep quality before embryo transfer with pregnancy outcomes in a population with infertility. DESIGN Prospective observational cohort study. SETTING Center for Reproductive Medicine, Shandong University. PATIENT(S) From 7,847 women who enrolled from July 2019 to July 2020, 3,183 were eligible. INTERVENTION(S) Information about sleep, including sleep quality, sleep duration, and sleep chronology, were collected before embryo transfer using an integrated questionnaire. Sleep quality is quantified by the Pittsburgh Sleep Quality Index (PSQI) with a cut-point of 5 (PSQI >5 identifying poor sleep vs. PSQI ≤5 identifying good sleep). Average weekly sleep duration was calculated and divided into 5 groups (≤7, 7-8, 8-9, 9-10, and >10 h/d). In defining sleep chronotype, women with a sleep midpoint earlier than 2:30 AM were defined as morningness type, whereas those with a sleep midpoint later than 3:30 AM were defined as eveningness type, and the remainder were defined as an intermediate type. MAIN OUTCOME MEASURE(S) Rate of clinical pregnancy and live birth. RESULT(S) Compared with those reporting poor sleep quality, those reporting good sleep quality showed higher clinical pregnancy (69.3% vs. 65.1%) and live birth rates (50.5% vs. 45.7%). After adjusting for confounding factors, women who self-reported good sleep had a higher probability of acquiring clinical pregnancy (RR, 1.07; 95% confidence interval, 1.01-1.13) and of live birth (RR, 1.12; 95% confidence interval, 1.02-1.23). Women with the morningness chronotype had the lowest rates of clinical pregnancy and live birth and had the highest rate of miscarriage. Sleep duration was found to have no significant association with any outcomes. In the stratified analyses, the positive associations of good sleep quality with clinical pregnancy and live birth existed only among women younger than 35 years old or who had undergone fresh embryo transfer. CONCLUSION(S) Good sleep quality was positively associated with outcomes in in vitro fertilization embryo transfer (IVF-ET), particularly with clinical pregnancy and live birth. Poor sleep quality may be a risk factor for adverse IVF-ET outcomes for women <35 years old. Treating sleep disorders and providing sleep behavior guidance to patients receiving IVF-ET may improve pregnancy outcomes.
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Affiliation(s)
- Zheng Liu
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, People's Republic of China; Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, People's Republic of China; Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, People's Republic of China; Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, People's Republic of China; Shandong Technology Innovation Center for Reproductive Health, Jinan, Shandong, People's Republic of China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, People's Republic of China
| | - Yukun Zheng
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, People's Republic of China; Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, People's Republic of China; Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, People's Republic of China; Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, People's Republic of China; Shandong Technology Innovation Center for Reproductive Health, Jinan, Shandong, People's Republic of China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, People's Republic of China
| | - Bingyu Wang
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, People's Republic of China; Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, People's Republic of China; Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, People's Republic of China; Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, People's Republic of China; Shandong Technology Innovation Center for Reproductive Health, Jinan, Shandong, People's Republic of China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, People's Republic of China
| | - Jialin Li
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, People's Republic of China; Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, People's Republic of China; Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, People's Republic of China; Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, People's Republic of China; Shandong Technology Innovation Center for Reproductive Health, Jinan, Shandong, People's Republic of China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, People's Republic of China
| | - Lang Qin
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, People's Republic of China; Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, People's Republic of China; Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, People's Republic of China; Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, People's Republic of China; Shandong Technology Innovation Center for Reproductive Health, Jinan, Shandong, People's Republic of China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, People's Republic of China
| | - Xiao Li
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, People's Republic of China; Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, People's Republic of China; Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, People's Republic of China; Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, People's Republic of China; Shandong Technology Innovation Center for Reproductive Health, Jinan, Shandong, People's Republic of China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, People's Republic of China
| | - Xin Liu
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, People's Republic of China; Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, People's Republic of China; Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, People's Republic of China; Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, People's Republic of China; Shandong Technology Innovation Center for Reproductive Health, Jinan, Shandong, People's Republic of China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, People's Republic of China
| | - Yuehong Bian
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, People's Republic of China; Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, People's Republic of China; Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, People's Republic of China; Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, People's Republic of China; Shandong Technology Innovation Center for Reproductive Health, Jinan, Shandong, People's Republic of China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, People's Republic of China
| | - Zijiang Chen
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, People's Republic of China; Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, People's Republic of China; Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, People's Republic of China; Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, People's Republic of China; Shandong Technology Innovation Center for Reproductive Health, Jinan, Shandong, People's Republic of China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, People's Republic of China; Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, People's Republic of China; Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Han Zhao
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, People's Republic of China; Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, People's Republic of China; Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, People's Republic of China; Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, People's Republic of China; Shandong Technology Innovation Center for Reproductive Health, Jinan, Shandong, People's Republic of China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, People's Republic of China
| | - Shigang Zhao
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, People's Republic of China; Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, People's Republic of China; Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, People's Republic of China; Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, People's Republic of China; Shandong Technology Innovation Center for Reproductive Health, Jinan, Shandong, People's Republic of China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, People's Republic of China.
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