Collins J A, Rowe T C
Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada.
Fertil Steril. 1989 Jul;52(1):15-20. doi: 10.1016/s0015-0282(16)60781-1.
Among 2,106 couples registered in 12 Canadian infertility clinics, 470 (22.3%) were classed as unexplained infertility after a uniform evaluation of the male ejaculate, ovulation, and tubal patency. The unexplained group included more older female partners; 44% were over 30 years of age at registration in the participating clinics, compared with 36% in other infertility diagnostic groups. The mean duration of infertility was 40.1 months, and the cumulative pregnancy rate was 36.6 +/- 2.9% at 2 years after registration. When the variables were examined with the use of proportional hazards analysis, each additional month of duration of infertility reduced the expected prognosis by 2%, and a history of pregnancy in the partnership improved the prognosis by 80%. Among couples with 3 years or more duration of infertility (cumulative pregnancy rate, 27.5 +/- 3.9%), an additional year in the age of the female partner when conception was first attempted (mean, 26.8 years) reduces the prognosis by 9%.
在加拿大12家不孕不育诊所登记的2106对夫妇中,在对男性射精、排卵及输卵管通畅情况进行统一评估后,470对(22.3%)被归类为不明原因不孕。不明原因组中有更多年龄较大的女性伴侣;在参与研究的诊所登记时,44%的女性伴侣年龄超过30岁,而在其他不孕诊断组中这一比例为36%。不孕的平均时长为40.1个月,登记后2年的累积妊娠率为36.6±2.9%。当使用比例风险分析来检验这些变量时,不孕时长每增加一个月,预期预后就降低2%,伴侣双方有妊娠史则预后改善80%。在不孕时长为3年或更长时间的夫妇中(累积妊娠率为27.5±3.9%),首次尝试受孕时女性伴侣年龄每增加一岁(平均为26.8岁),预后就降低9%。