Egbe Thomas Obinchemti, Sandjon Guy, Ourtchingh Clovis, Simo André, Priso Eugene Belley, Benifla Jean-Louis
Faculty of Health Sciences, University of Buea; Department of Obstetrics and Gynecology, Douala General Hospital, Douala, Cameroon.
Clinique de l'Aéroport, Douala, Cameroon.
Fertil Res Pract. 2016 Jan 19;2:1. doi: 10.1186/s40738-015-0013-2. eCollection 2016.
Couples are considered infertile if they do not conceive over a 12-month period of unprotected intercourse. Studies have shown that female causes accounted for between 25 to 37 percent of infertility worldwide (with larger proportions in sub-Saharan Africa and Southeast Asia) and male causes accounted for between 8 to 22 percent. Both male and female causes accounted for between 21 to 38 percent. Although the majority of ART children are normal, there are concerns about the increased risk for adverse pregnancy outcomes. More than 30 % of ART pregnancies are twins or higher-order multiple gestations (triplets or greater) and more than one half of all ART neonates are the products of multifetal gestations, with an attendant increase in prematurity complications. The aim of this study was to evaiuate the outcome of pregnancies conceived by In-vitro fertilisation compared to those conceived naturally in two hospitals in Douala, Cameroon.
This was a prospective study carried out from October 1, 2011 to September 30, 2012. Participants were recruited from two hospitals: the Douala General Hospital (DGH) and the Clinique de l' Aéroport (CDA), also in Douala. A total of 102 women were recruited for study: 51 who conceived by IVF (cases) and 51 who conceived naturally (controls). Of the 102 women, 52.9 % were between 31 - 39 years of age, while 21.6 % were above 40.
Participants who conceived through IVF-ET were 4.1 times more likely to undergo cesarean delivery than those who conceived naturally [OR 4.10, 95 % CI 1.78-9.42]. Similarly, a higher percentage of patients in the IVF group than those in the control group have never given birth (33.3 % vs 2.0 %) ( < 0.0001). The percentage of multiple pregnancies was 7.5 times higher in the IVF group than in the control group (14.7 % vs.1.96 %) ( = 0.000). The leading indication for cesarean delivery was advanced maternal age (27.3 %) followed by IVF or precious pregnancy (18.2 %).
Cesarean delivery was more frequent amongst the IVF group than in the control group. The leading indications for cesarean delivery were advanced maternal age and IVF or precious pregnancy. The long-term neonatal outcomes of IVF babies beyond 5-min Apgar scores should be studied in Cameroon and follow-up beyond 1 year encouraged.
如果夫妻在12个月无保护性交期间未受孕，则被视为不孕。研究表明，在全球范围内，女性因素导致的不孕占25%至37%（在撒哈拉以南非洲和东南亚所占比例更高），男性因素导致的不孕占8%至22%。男女双方因素导致的不孕占21%至38%。尽管大多数辅助生殖技术（ART）所育儿童正常，但人们担心不良妊娠结局的风险会增加。超过30%的ART妊娠为双胞胎或更高阶多胎妊娠（三胞胎或更多），所有ART新生儿中有一半以上是多胎妊娠的产物，随之而来的是早产并发症增加。本研究的目的是评估在喀麦隆杜阿拉的两家医院中，通过体外受精受孕的妊娠结局与自然受孕的妊娠结局相比情况如何。
这是一项从2011年10月1日至2012年9月30日进行的前瞻性研究。参与者从两家医院招募：杜阿拉总医院（DGH）和同样位于杜阿拉的机场诊所（CDA）。总共招募了102名女性进行研究：51名通过体外受精受孕（病例组）和51名自然受孕（对照组）。在这102名女性中，52.9%年龄在31至39岁之间，而21.6%年龄在40岁以上。
通过体外受精-胚胎移植（IVF-ET）受孕的参与者进行剖宫产的可能性是自然受孕者的4.1倍[比值比（OR）4.10，95%可信区间（CI）1.78 - 9.42]。同样，IVF组中从未生育的患者百分比高于对照组（33.3%对2.0%）（P < 0.0001）。IVF组多胎妊娠的百分比比对照组高7.5倍（14.7%对1.96%）（P = 0.000）。剖宫产的主要指征是产妇年龄偏大（27.3%），其次是IVF或珍贵妊娠（18.2%）。
IVF组剖宫产比对照组更频繁。剖宫产的主要指征是产妇年龄偏大以及IVF或珍贵妊娠。喀麦隆应研究IVF婴儿5分钟阿氏评分以外的长期新生儿结局，并鼓励进行1年以上的随访。
