Hansen Karl R, He Amy Linnea W, Styer Aaron K, Wild Robert A, Butts Samantha, Engmann Lawrence, Diamond Michael P, Legro Richard S, Coutifaris Christos, Alvero Ruben, Robinson Randal D, Casson Peter, Christman Gregory M, Huang Hao, Santoro Nanette, Eisenberg Esther, Zhang Heping
Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
Department of Biostatistics, Yale University School of Public Health, New Haven, Connecticut.
Fertil Steril. 2016 Jun;105(6):1575-1583.e2. doi: 10.1016/j.fertnstert.2016.02.020. Epub 2016 Mar 3.
To identify baseline characteristics of couples that are likely to predict conception, clinical pregnancy, and live birth after up to four cycles of ovarian stimulation with IUI in couples with unexplained infertility.
Secondary analyses of data from a prospective, randomized, multicenter clinical trial investigating pregnancy, live birth, and multiple pregnancy rates after ovarian stimulation-IUI with clomiphene citrate, letrozole, or gonadotropins.
Outpatient clinical units.
PATIENT(S): Nine-hundred couples with unexplained infertility who participated in the Assessment of Multiple Intrauterine Gestations from Ovarian Stimulation clinical trial.
INTERVENTION(S): As part of the clinical trial, treatment was randomized equally to one of three arms and continued for up to four cycles or until pregnancy was achieved.
MAIN OUTCOME MEASURE(S): Conception, clinical pregnancy, and live-birth rates.
RESULT(S): In a multivariable logistic regression analysis, after adjustment for other covariates, age, waist circumference, income level, duration of infertility, and a history of prior pregnancy loss were significantly associated with at least one pregnancy outcome. Other baseline demographic and lifestyle characteristics including smoking, alcohol use, and serum levels of antimüllerian hormone were not significantly associated with pregnancy outcomes.
CONCLUSION(S): While age and duration of infertility were significant predictors of all pregnancy outcomes, many other baseline characteristics were not. The identification of level of income as a significant predictor of outcomes independent of race and education may reflect differences in the underlying etiologies of unexplained infertility or could reveal disparities in access to fertility and/or obstetrical care.
NCT01044862.
确定不明原因不孕夫妇在接受多达四个周期的卵巢刺激联合宫腔内人工授精（IUI）后，可能预测受孕、临床妊娠和活产的夫妇基线特征。
对一项前瞻性、随机、多中心临床试验的数据进行二次分析，该试验调查了使用枸橼酸氯米芬、来曲唑或促性腺激素进行卵巢刺激-IUI后的妊娠、活产和多胎妊娠率。
门诊临床单位。
900对不明原因不孕的夫妇，他们参与了卵巢刺激多胎宫内妊娠评估临床试验。
作为临床试验的一部分，治疗被随机均分为三组之一，并持续进行多达四个周期或直至受孕。
受孕率、临床妊娠率和活产率。
在多变量逻辑回归分析中，在调整其他协变量后，年龄、腰围、收入水平、不孕持续时间和既往流产史与至少一种妊娠结局显著相关。其他基线人口统计学和生活方式特征，包括吸烟、饮酒和抗苗勒管激素血清水平，与妊娠结局无显著相关性。
虽然年龄和不孕持续时间是所有妊娠结局的重要预测因素，但许多其他基线特征并非如此。将收入水平确定为独立于种族和教育程度的结局重要预测因素，可能反映了不明原因不孕潜在病因的差异，或者可能揭示了获得生育和/或产科护理方面的差异。
NCT01044862。
