Stanford Joseph B, Parnell Tracey A, Boyle Phil C
Department of Family and Preventive Medicine, University of Utah, 375 Chipeta Way, Salt Lake City, UT 84108, USA.
J Am Board Fam Med. 2008 Sep-Oct;21(5):375-84. doi: 10.3122/jabfm.2008.05.070239.
We evaluated outcomes in couples treated for infertility with natural procreative technology (NaProTechnology [corrected] NPT), a systematic medical approach for optimizing physiologic conditions for conception in vivo, from an Irish general practice.
All couples receiving treatment from 2 NPT-trained family physicians between February 1998 and January 2002 were studied. The main outcome was live birth, and secondary outcomes included conceptions and multiple births. Crude proportions and adjusted life-table proportions were calculated per 100 couples.
A total of 1239 couples had an initial consult for NPT, of which 1072 had been trying for at least a year to conceive and initiated treatment. The average female age was 35.8 years, the mean duration of attempting to conceive was 5.6 years, 24% had a prior birth, and 33% had previously attempted treatment with assisted reproductive technology (ART). All couples were taught to identify the fertile days of the menstrual cycle with the Creighton Model FertilityCare System, and most received additional medical treatment, including clomiphene (75%). In life-table analysis, the cumulative proportion of first live births for those completing up to 24 months of NPT treatment was 52.8 per 100 couples. The crude proportion was 25.5. Younger couples and couples without previous ART attempts had higher rates of live birth. Among live births, there were 4.6% twin births.
NPT provided by trained general practitioners had live birth rates comparable to cohort studies of more invasive treatments, including ART. Further studies are warranted to compare NPT directly to other treatments.
我们评估了采用自然生殖技术(NaProTechnology [校正后] NPT)治疗不孕症的夫妇的治疗结果,NPT是一种优化体内受孕生理条件的系统性医学方法,研究对象来自爱尔兰的一家普通诊所。
对1998年2月至2002年1月间接受两名接受过NPT培训的家庭医生治疗的所有夫妇进行了研究。主要结局是活产,次要结局包括受孕和多胎分娩。计算每100对夫妇的粗比例和调整后的生命表比例。
共有1239对夫妇首次咨询NPT,其中1072对夫妇已尝试受孕至少一年并开始治疗。女性平均年龄为35.8岁,平均受孕尝试时间为5.6年,24%的夫妇曾生育过,33%的夫妇此前曾尝试过辅助生殖技术(ART)治疗。所有夫妇都学会了使用克里顿模式生育护理系统识别月经周期中的易孕期,大多数夫妇还接受了额外的医学治疗,包括克罗米芬(75%)。在生命表分析中,完成长达24个月NPT治疗的夫妇中首次活产的累积比例为每100对夫妇52.8例。粗比例为25.5。年轻夫妇和未曾尝试过ART治疗的夫妇活产率更高。在活产中,双胎分娩率为4.6%。
由经过培训的全科医生提供的NPT的活产率与包括ART在内的侵入性更强的治疗的队列研究相当。有必要进行进一步研究以直接比较NPT与其他治疗方法。