Milewski Robert, Milewska Anna Justyna, Czerniecki Jan, Leśniewska Monika, Wołczyński Sławomir
Zakład Statystyki i Informatyki Medycznej, Uniwersytet Medyczny w Białymstoku, Polska.
Ginekol Pol. 2013 Jul;84(7):609-14. doi: 10.17772/gp/1612.
Analysis of the demographic profile of patients, causes for infertility and effectiveness of infertility treatment methods in the years 2005-2010.
Retrospective research was conducted to analyze data of 1705 randomly selected couples who underwent in vitro fertilization procedure at the Department of Reproduction and Gynecological Endocrinology Medical University of Bialystok, between 2005 and 2010. The analyzed data included mainly causes for infertility age of the female and male subjects, place of residence and final treatment results.
The percentage of pregnancy rate increased significantly to approximately 40% in 2007. The contribution of male and female infertility factors remained at a similar level, but the idiopathic factor continued to steadily increase (to 20% in the last years of the study). We observed a greater prevalence of the male factor among couples living in cities compared to inhabitants of rural areas (42.3% vs. 34.3%, p = 0.004), whereas the tubal factor dominated among couples living in the countryside when compared to city dwellers (29.7% vs. 21.6%, p = 0.001). The average age of women entering treatment was significantly higher in cities than the countryside (p < 0.001), thus, consequently treatment efficacy was also lower (33.9% vs. 38.9%, p = 0.04). Comparison of treatment efficacy and cause of infertility revealed statistically significant differences only with regard to the idiopathic factor (p = 0.03). In the group of patients with idiopathic infertility the treatment efficacy was higher than in the rest of patients (40.2% vs. 33.8%). Apart from the idiopathic infertility only the presence of the male factor was associated with a higher (but statistically insignificant) pregnancy rate (36.2% vs. 33.9%). For the other factors, their presence was associated with a lower percentage of pregnancy and the greatest differences (but still statistically insignificant) were observed for the polycystic ovary syndrome (31.5% vs. 35.1%) and for other ovulation disorders (31.3% vs. 35%).
Advances in assisted reproductive techniques led to an increase in the efficacy of infertility treatment. Environmental factors, availability of treatment and level of awareness about womens health proved to have the strongest effect on the distribution of infertility causes between urban and rural areas. Significant efforts should be made, especially in cities, to decrease the average age of women's reproductive decisions and also to shorten the time to the first contact with the specialist after unsuccessful attempts at conception. It is also crucial to initiate the reimbursement of infertility treatment using ART (Assisted Reproductive Technology).
分析2005 - 2010年间患者的人口统计学特征、不孕原因及不孕治疗方法的有效性。
进行回顾性研究，分析2005年至2010年间在比亚韦斯托克医科大学生殖与妇科内分泌科接受体外受精程序的1705对随机选择的夫妇的数据。分析的数据主要包括不孕原因、男女受试者年龄、居住地及最终治疗结果。
2007年妊娠率显著提高至约40%。男性和女性不孕因素的占比保持在相似水平，但特发性因素持续稳步上升（在研究的最后几年达到20%）。我们观察到，与农村居民相比，城市夫妇中男性因素的患病率更高（42.3%对34.3%，p = 0.004），而与城市居民相比，农村夫妇中输卵管因素占主导（29.7%对21.6%，p = 0.001）。城市中接受治疗的女性平均年龄显著高于农村（p < 0.001），因此治疗效果也较低（33.9%对38.9%，p = 0.04）。治疗效果与不孕原因的比较仅在特发性因素方面显示出统计学上的显著差异（p = 0.03）。在特发性不孕患者组中，治疗效果高于其他患者（40.2%对33.8%）。除特发性不孕外，仅男性因素的存在与较高（但无统计学意义）的妊娠率相关（36.2%对33.9%）。对于其他因素，它们的存在与较低的妊娠率相关，多囊卵巢综合征（31.5%对35.1%）和其他排卵障碍（31.3%对35%）的差异最大（但仍无统计学意义）。
辅助生殖技术的进步导致不孕治疗效果提高。环境因素、治疗的可及性以及对女性健康的认知水平对城乡不孕原因的分布影响最大。应做出重大努力，特别是在城市，以降低女性生殖决策的平均年龄，并缩短在受孕尝试失败后首次与专家接触的时间。启动辅助生殖技术（ART）不孕治疗的报销也至关重要。
