Isaksson Rita, Gissler M, Tiitinen A
Department of Obstetrics and Gynaecology, Helsinki University Central Hospital, PO Box 140, FIN-00029 HUS, Finland.
Hum Reprod. 2002 Jul;17(7):1755-61. doi: 10.1093/humrep/17.7.1755.
Infertility itself and also assisted reproductive treatment increase the incidence of some obstetric complications. Women with unexplained infertility are reported to be at an increased risk of intrauterine growth restriction during pregnancy, but not for other perinatal complications.
A matched case-control study was performed on care during pregnancy and delivery, obstetric complications and infant perinatal outcomes of 107 women with unexplained infertility, with 118 clinical pregnancies after IVF or ICSI treatment. These resulted in 90 deliveries; of these, 69 were singleton, 20 twin and one triplet. Two control groups were chosen from the Finnish Medical Birth Register, one group for spontaneous pregnancies (including 445 women and 545 children), matched according to maternal age, parity, year of birth, mother's residence and number of children at birth, and the other group for all pregnancies after IVF, ICSI or frozen embryo transfer treatment (FET) during the study period (including 2377 women and 2853 children).
Among singletons, no difference was found in the mean birthweight, and the incidence of low birthweight (<2500 g) was comparable with that of the control groups. No differences were found in gestational duration, major congenital malformations or perinatal mortality among the groups studied. Among singletons in the study group, there were more term breech presentations (10.1%) compared with both spontaneously conceiving women and all IVF women (P < 0.01). The rate of pregnancy-induced hypertension was significantly lower among singletons in the study group (P < 0.05) compared with other IVF singletons. The multiple pregnancy rate was 23.3% in the study group. The obstetric outcome of the IVF twins was similar to both control groups.
The overall obstetric outcome among couples with unexplained infertility treated with IVF was good, with similar outcome compared with spontaneous pregnancies and IVF pregnancies generally.
不孕症本身以及辅助生殖治疗会增加某些产科并发症的发生率。据报道，不明原因不孕症女性在孕期发生胎儿生长受限的风险增加，但其他围产期并发症的风险并未增加。
对107例不明原因不孕症女性进行了一项配对病例对照研究，这些女性经体外受精（IVF）或卵胞浆内单精子注射（ICSI）治疗后有118次临床妊娠。这些妊娠共分娩90例；其中，69例为单胎，20例为双胎，1例为三胎。从芬兰医学出生登记处选取了两个对照组，一组为自然妊娠组（包括445名女性和545名儿童），根据产妇年龄、产次、出生年份、母亲居住地和出生时子女数量进行匹配；另一组为研究期间接受IVF、ICSI或冻融胚胎移植治疗（FET）后的所有妊娠组（包括2377名女性和2853名儿童）。
在单胎中，平均出生体重未发现差异，低出生体重（<2500g）的发生率与对照组相当。研究组之间在孕周、主要先天性畸形或围产期死亡率方面未发现差异。研究组的单胎中，足月臀位产的比例（10.1%）高于自然受孕女性和所有IVF女性（P<0.01）。与其他IVF单胎相比，研究组单胎中妊娠高血压的发生率显著较低（P<0.05）。研究组的多胎妊娠率为23.3%。IVF双胎的产科结局与两个对照组相似。
接受IVF治疗的不明原因不孕症夫妇的总体产科结局良好，与自然妊娠和一般IVF妊娠的结局相似。
