1999年至2004年期间在泰国国立法政大学医院对不孕夫妇的病因及治疗结果进行的研究。

Study of the causes and the results of treatment in infertile couples at Thammasat Hospital between 1999-2004.

作者信息

Chiamchanya Charoenchai, Su-angkawatin Wanasaya

机构信息

Department of Obstetric and Gynecology, Medical Faculty, Thammasat University, Pathumthani, Thailand.

出版信息

J Med Assoc Thai. 2008 Jun;91(6):805-12.

PMID:18697377

Abstract

OBJECTIVE

To study the type, cause, pregnancy rate, and pregnancy outcome of infertile couple in Fertility Clinic of Thammasat Hospital, Thammasat University.

MATERIAL AND METHOD

The retrospective study was performed by reviewing the data of infertile couples attending the Fertility Clinic of Thammasat Hospital from 1999 until 2004. The data included age, type of infertility, duration, causes, treatments, and results of treatment of the infertile couples and excluded the data from the cancellation treatment cycles.

RESULTS

One thousand seventy two infertile couples revealed 61.8% of primary infertility, 35.6% ofsecondary infertility, and 2.5% of incomplete data record. The overall duration of infertility was mostly between 1-4 years in 58.3%. The age of 65.9% of female partners and 61.2% of male partners were between 30-39 years. The causes of infertility were found in both partners (55.6%), only in male partners (19.4%), only in female partners (17.5%), in unexplained cause (4.7%), and in incomplete data group (2.8%). The causes of female infertility were endometriosis, tubal, ovulatory, uterine, endocrinnological, pelvic factors, and unexplained causes were found in 25.6%, 12.4%, 11.8%, 9.1%, 9.0%, 1.7%, and 25.7% of cases respectively. The causes of male infertility were terato, oligoasthenoterato, asthenoterato, astheno, oligoterato, oligo, asthenooligo, azoospermia, and unexplained causes found in 25.4%, 14.4%, 12%, 2.0%, 1.0%, 0.4%, 0.3%, 4.5%, and 24.2%, respectively. The pregnancy rate of IUI was 14.8% of which 95.5% succeeded in three attempts, where those of IVF, ICSI and ICSI- PESA were 32.3%, 28.0%, and 35.3%, respectively. The outcomes of pregnancy from IUI were 71.6% singleton, 1.5% twins, 1.5% triplets, 19.4% abortion, and 6.0% ectopic pregnancy. The outcomes of pregnancy from IVF were 30% singleton, 20% twins, 40% abortion, and 10% ectopic pregnancy. The outcomes of pregnancy from ICSI were 56.5% singleton, 17.4% twins, 13% triplets, and 13% abortion. Finally, the outcomes of pregnancy from ICSI-PESA were 66.7% singleton, 16.7% twins, and 16.7% abortion.

CONCLUSION

Primary infertility cases were more common than secondary infertility cases. More than half of the infertile couples causes were from both male and female partners. The causes of male and female factors were similar to other reports, such as abnormal semen analysis, endometriosis, tubal factor and ovulatory factor The pregnancy rate and pregnancy outcome of IUI, IVF and ICSI were comparable with the other reports.

摘要

目的

研究泰国国立法政大学诗纳卡琳威洛医院生殖医学科不孕夫妇的类型、病因、妊娠率及妊娠结局。

材料与方法

采用回顾性研究方法，回顾1999年至2004年期间在泰国国立法政大学诗纳卡琳威洛医院生殖医学科就诊的不孕夫妇的数据。数据包括不孕夫妇的年龄、不孕类型、病程、病因、治疗方法及治疗结果，不包括取消治疗周期的数据。

结果

1072对不孕夫妇中，原发性不孕占61.8%，继发性不孕占35.6%，数据记录不完整的占2.5%。不孕的总体病程大多在1 - 4年，占58.3%。65.9%的女性伴侣和61.2%的男性伴侣年龄在30 - 39岁之间。不孕原因在双方的占55.6%，仅在男性的占19.4%，仅在女性的占17.5%，不明原因的占4.7%，数据组不完整的占2.8%。女性不孕原因中，子宫内膜异位症、输卵管因素、排卵因素、子宫因素、内分泌因素、盆腔因素及不明原因分别占25.6%、12.4%、11.8%、9.1%、9.0%、1.7%和25.7%。男性不孕原因中（精子）畸形、少弱畸形、弱畸形、弱精、少畸形、少精、少弱精、无精子症及不明原因分别占25.4%、14.4%、12%、2.0%、1.0%、0.4%、0.3%、4.5%和24.2%。宫腔内人工授精（IUI）的妊娠率为14.8%，其中95.5%在三次尝试中成功；体外受精（IVF）、卵胞浆内单精子注射（ICSI）及经皮附睾精子抽吸术联合卵胞浆内单精子注射（ICSI - PESA）的妊娠率分别为32.3%、28.0%和35.3%。IUI妊娠结局为单胎占71.6%，双胎占1.5%，三胎占1.5%，流产占19.4%，异位妊娠占6.0%。IVF妊娠结局为单胎占30%，双胎占20%，流产占40%，异位妊娠占10%。ICSI妊娠结局为单胎占56.5%，双胎占17.4%，三胎占13%，流产占13%。最后，ICSI - PESA妊娠结局为单胎占66.7%，双胎占16.7%，流产占16.7%。