Stanford Joseph B, Sanders Jessica N, Simonsen Sara E, Hammoud Ahmad, Gibson Mark, Smith Ken R
Office of Cooperative Reproductive Health, Division of Public Health, Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT.
Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, UT.
Paediatr Perinat Epidemiol. 2016 Jul;30(4):397-407. doi: 10.1111/ppe.12291. Epub 2016 Mar 23.
Most cohort-based research for subfertility has been conducted in clinic-based cohorts, which may differ from population-based cohorts.
We retrospectively recruited parallel cohorts of subfertile women: one by sampling two specialty fertility clinics in Utah, and one by population-based sampling based on marriage and birth records. The index date (of first clinic visit or subfertility status) was between 2000 and 2009, and we linked the women recruited to subsequent birth certificate records through December 2010.
We enrolled 459 women through clinic-based sampling and 501 women through population-based sampling. Clinic-based women were older, had higher annual household income and more likely to have had a most intensive treatment of intrauterine insemination (31%) or in vitro fertilisation (46%) than women from population recruitment (19% and 14% respectively). Conversely, they were less likely to have received no medical treatment (9%) compared to women from population recruitment (41%). For both types of sampling, prior to eligibility screening, non-responders were less likely to link to a live birth than responders: 51% vs. 58% for clinic-based, and 69% vs. 76% for the population-based with an index date in 2004.
Population-based sampling for subfertility cohort research identifies women who were more likely to have had less intensive treatment or no treatment. However, in both clinic-based and population-based sampling, women who have had a live birth are more likely to respond to retrospective recruitment.
大多数基于队列的不孕症研究是在基于诊所的队列中进行的,这可能与基于人群的队列有所不同。
我们回顾性招募了不孕症女性的平行队列:一组通过对犹他州的两家专科生育诊所进行抽样,另一组通过基于婚姻和出生记录的人群抽样。索引日期(首次诊所就诊或不孕症状态)在2000年至2009年之间,我们将招募的女性与截至2010年12月的后续出生证明记录进行了关联。
我们通过基于诊所的抽样招募了459名女性,通过基于人群的抽样招募了501名女性。与通过人群招募的女性(分别为19%和14%)相比,基于诊所的女性年龄更大,家庭年收入更高,更有可能接受过最强化的宫内人工授精治疗(31%)或体外受精治疗(46%)。相反,与通过人群招募的女性(41%)相比,她们接受无医疗治疗的可能性较小(9%)。对于两种抽样类型,在资格筛选之前,未响应者与活产关联的可能性低于响应者:基于诊所的为51%对58%,基于人群且索引日期为2004年的为69%对76%。
基于人群的不孕症队列研究抽样识别出的女性更有可能接受过强度较低的治疗或未接受治疗。然而,在基于诊所的抽样和基于人群的抽样中,有活产经历的女性对回顾性招募的响应可能性更大。