Bablok Leszek, Dziadecki Wojciech, Szymusik Iwona, Wolczynski Slawomir, Kurzawa Rafal, Pawelczyk Leszek, Jedrzejczak Piotr, Hanke Wojciech, Kaminski Pawel, Wielgos Miroslaw
1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland.
Neuro Endocrinol Lett. 2011;32(6):799-804.
Infertility seems to be a great worldwide problem. Many publications present the epidemiology of infertility, but the percentage distribution of factors responsible for infertility varies significantly. The objective was to define infertility profiles in Poland assessed according to the information provided by 4 large infertility centers: Bialystok, Poznan, Szczecin and Warsaw.
Multicenter study was performed. Couples with primary infertility, attending one of the four centers in Poland, were asked to fulfill a questionnaire. Overall 1517 questionaires were analysed: Bialystok - 468, Poznan - 325, Szczecin - 341, Warsaw - 383. Only semen analyses fulfilling WHO Manual 1999 criteria were used in the study and were afterwards compared with 2010 WHO standards.
Results from 4 Polish centers showed that the average age of infertile women was 31.41 years and of infertile men 33.2 years. The mean duration of infertility equaled 3.31 years. Among 1517 surveyed women, no pathological findings concerning reproductive abilities were observed in 1088 cases (71.72%). In the remaining patients the following were diagnosed: uterine factor in 26 (6.02%) women, ovulation disorders in 134 (31.33%), including 70 (16.27%) of PCOS patients, tubal factor in 165 (38.55%) and endometriosis in 145 (33.73%). The average of 18.9% of couples had a mixed cause of infertility, while idiopathic factor was assigned to 15.99%. In the study male factor accounted for 55.73% of cases. Change of reference values for semen analysis implemented in 2010 caused an increase in the number of normal results and asthenozoospermia.
According to the data provided by Polish infertility centers the rate of male factor as a reason of infertility has reached 55.73%. However, the implementation of new reference values for semen analysis in 2010 led to the decrease in male factor frequency and the increase in the rate of idiophatic infertility. Anovulatory cycles and endometriosis are the main reasons affecting the female reproductive potential.
不孕不育似乎是一个全球性的重大问题。许多出版物介绍了不孕不育的流行病学情况，但导致不孕不育的因素所占百分比分布差异很大。目的是根据波兰4家大型不孕不育中心（比亚韦斯托克、波兹南、什切青和华沙）提供的信息来确定波兰的不孕不育情况。
进行了多中心研究。要求在波兰这四家中心之一就诊的原发性不孕不育夫妇填写一份问卷。共分析了1517份问卷：比亚韦斯托克468份、波兹南325份、什切青341份、华沙383份。该研究仅采用符合世界卫生组织1999年手册标准的精液分析结果，之后与世界卫生组织2010年标准进行比较。
波兰4家中心的结果显示，不孕不育女性的平均年龄为31.41岁，不孕不育男性为33.2岁。不孕不育的平均持续时间为3.31年。在1517名接受调查的女性中，1088例（71.72%）未观察到与生殖能力相关的病理结果。在其余患者中，诊断出以下情况：26例（6.02%）女性存在子宫因素，134例（31.33%）存在排卵障碍，其中70例（16.27%）为多囊卵巢综合征患者，165例（38.55%）存在输卵管因素，145例（33.73%）存在子宫内膜异位症。平均18.9%的夫妇存在混合性不孕原因，而特发性因素占15.99%。在该研究中，男性因素占病例的55.73%。2010年实施的精液分析参考值变化导致正常结果和弱精子症的数量增加。
根据波兰不孕不育中心提供的数据，男性因素作为不孕不育原因的比例已达55.73%。然而，2010年精液分析新参考值的实施导致男性因素频率降低，特发性不孕不育率上升。无排卵周期和子宫内膜异位症是影响女性生殖潜力的主要原因。
