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Objective:To determine the effects of menopausal stage, age and other associated risk factors on symptoms of anxiety and depression among women in a community in Beijing.Methods:This study was a community-based prospective cohort. Participants who had transitioned through natural menopause, completed two or more depressive and anxiety symptoms evaluations, aged 35 to 64 years, and did not use hormone therapy were selected from the Peking Union Medical College Hospital aging longitudinal cohort of women in midlife to this analysis. The primary outcome variables were depressive and anxiety symptoms, assessed by hospital anxiety and depression scale (HADS). The generalized estimation equation was used in the statistical analysis.Results:Followed up from 2006 to 2014, 430 women and 2 533 HADS assessments were retained in the cohort. Depressive symptoms were more common than anxiety symptoms during all menopausal stages. The incidences of depressive and anxiety symptoms were 14.5% (19/191) and 3.1% (4/191) in the premenopausal -3 stage, respectively. The incidence increased in both menopausal transition and postmenopausal stage, with the highest incidence in the +1c stage [20.6% (155/751) and 8.8% (66/751), respectively]. However, these differences were not statistically significant (all P>0.05). Depressive symptoms were highest in the ≥60-<65 age group [20.8% (74/355)], and anxiety symptoms were highest in the ≥50-<55 age group [8.2% (62/754)]; but there were no statistical significances between different age groups and depressive and anxiety symptoms (all P>0.05). Multivariable analysis showed that high body mass index, low education status, and poor health status were independently associated with depressive symptoms (all P<0.05), and that poor health status, trouble falling asleep, and early awakening were independently associated with anxiety symptoms (all P<0.01). Conclusions:Depressive and anxiety symptoms are more common during menopausal transition and postmenopausal stage compared with reproductive stage. Depressive symptoms are more common than anxiety symptoms. To screen and assess depressive and anxiety symptoms in perimenopausal women is essential, especially for women with high risk factors.
RESUMO
Objective:To figure out the clinical factors contributing to the oocytes utility rate (OUR) of high responders in in vitro fertilization (IVF)-embryo transfer treatment.Methods:OUR was defined by the number of usable embryos for transfer and (or) cryopreservation divided by the number of oocytes retrieved in a freeze-all cycle. The cycles with ≥15 eggs were included from January 2013 to December 2019. Those with OUR at the top 10% (Group A) and the bottom 10% (Group B) were picked and compared for patients′ characteristics, parameters relating to ovary stimulation and pregnant outcomes. Multifactorial logistic regression was applied to reveal the risk factors affecting OUR in them.Results:A total of 43 patients were included in Group A (OUR: 77.4%, 601/776) and 47 for Group B (OUR: 11.9%, 104/874). Previous IVF/intracytoplasmic sperm injection (ICSI; OR=0.10, 95% CI: 0.01-0.81) and endometriosis ( OR=0.16, 95% CI: 0.03-0.84) were negative factors for OUR ( P<0.05); dual suppression protocol ( OR=3.74, 95% CI: 1.06-26.86) and longer days of stimulation ( OR=3.24, 95% CI: 1.25-8.42) were protective factors in terms of ovarian stimulation ( P<0.05), on contrary to that, any decline of estradiol during the stimulation led to poorer OUR ( OR=0.16, 95% CI: 0.04-0.64). Although two groups had similar quantities of eggs and metaphase of meiosis Ⅱ (MⅡ) oocytes, distinguished cumulative clinical pregnancy rate and cumulative live birth rate were seen in Group A and group B respectively [95.3% (41/43) vs 40.4% (19/47) and 90.7% (39/43) vs 31.9% (15/47), all P<0.01]. Conclusions:High responders with attempted IVF/ICSI and endometriosis should be considered as risk factors for OUR. Over ovarian stimulation, dual suppression and a slightly longer stimulating duration could be tried; besides, estradiol decline should be prevented for a better OUR.