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接受体外受精/卵胞浆内单精子注射-胚胎移植的宫颈解脲脲原体和沙眼衣原体感染患者:对新范式的需求

Patients with cervical Ureaplasma Urealyticum and Chlamydia Trachomatis infection undergoing IVF/ICSI-ET: The need for new paradigm.

作者信息

Xie Qing-Zhen, Xu Wang-Ming, Qi Qian-Rong, Luo Zeng-Li, Dong Lan

机构信息

Center for Reproductive Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China.

出版信息

J Huazhong Univ Sci Technolog Med Sci. 2016 Oct;36(5):716-722. doi: 10.1007/s11596-016-1650-3. Epub 2016 Oct 18.

Abstract

Genital tract infections with ureaplasma urealyticum (UU) and chlamydia trachomatis (CT) are the most frequent sexually-transmitted disease worldwide. UU and CT infections are considered to be the leading cause for infertility and adverse pregnancy outcomes. However, little is known about the specific effect of cervical UU and CT infections on the etiology of female infertility, as well as the pregnancy outcomes of the patients undergoing in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET). In order to find the association between cervical UU and/or CT infection and pregnancy outcomes, we conducted a retrospective case-control study on the patients undergoing IVF/ICSI-ET with cervical UU and/or CT infection. A total of 2208 patients who received IVF/ICSI-ET were enrolled in this study. Data on the general conditions, pregnancy history and clinical pregnant outcomes were analyzed in terms of the cervical UU and CT detection. Our results revealed that cervical UU and CT infections were the risk factors for ectopic pregnancy and tubal factor-induced infertility. Moreover, the pregnancy rate, abortion rate, ectopic pregnancy rate and premature birth rate in patients with UU and/or CT infections showed no significant difference when compared with the control group. We recommend that cervical UU and CT detection should be an optional item for infertility patients and clinical UU detection should differentiate the subtypes of cervical UU. Positive cervical UU and CT infections should not be taken as strict contraindications for IVF/ICSI-ET.

摘要

解脲脲原体(UU)和沙眼衣原体(CT)引起的生殖道感染是全球最常见的性传播疾病。UU和CT感染被认为是导致不孕和不良妊娠结局的主要原因。然而,关于宫颈UU和CT感染对女性不孕病因的具体影响,以及接受体外受精/卵胞浆内单精子注射-胚胎移植(IVF/ICSI-ET)患者的妊娠结局,人们所知甚少。为了找出宫颈UU和/或CT感染与妊娠结局之间的关联,我们对接受IVF/ICSI-ET且伴有宫颈UU和/或CT感染的患者进行了一项回顾性病例对照研究。本研究共纳入2208例接受IVF/ICSI-ET的患者。根据宫颈UU和CT检测结果,分析了患者的一般情况、妊娠史和临床妊娠结局数据。我们的结果显示,宫颈UU和CT感染是异位妊娠和输卵管因素所致不孕的危险因素。此外,UU和/或CT感染患者的妊娠率、流产率、异位妊娠率和早产率与对照组相比无显著差异。我们建议,宫颈UU和CT检测应作为不孕患者的一项可选检查项目,临床UU检测应区分宫颈UU的亚型。宫颈UU和CT感染阳性不应被视为IVF/ICSI-ET的严格禁忌证。

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