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报告患有子宫内膜异位症的女性的生育经历:来自《当代澳大利亚生育管理认知调查》的结果

Fertility experiences in women reporting endometriosis: findings from the Understanding Fertility Management in Contemporary Australia survey.

作者信息

Young Kate, Kirkman Maggie, Holton Sara, Rowe Heather, Fisher Jane

机构信息

a School of Public Health and Preventive Medicine , Monash University , Melbourne , Australia.

出版信息

Eur J Contracept Reprod Health Care. 2018 Dec;23(6):434-440. doi: 10.1080/13625187.2018.1539163. Epub 2018 Nov 27.

Abstract

PURPOSE

To examine the fertility experiences of women reporting and not reporting endometriosis in a population-based survey.

MATERIALS AND METHODS

A cross-sectional survey among a community sample of 1543 women in Australia. Data were analysed to compare fertility management between women who did and did not report endometriosis. Factors associated with unintended pregnancy, infertility diagnosis, time to conception and live birth were identified through multivariable analyses.

RESULTS

While individual contraceptive use did not differ by endometriosis status, avoiding pregnancy was less important to women reporting endometriosis (50.5%) than to others (68.7%; p < .001). Women reporting endometriosis were approximately three times more likely to report an infertility diagnosis-the majority (39.7%) of which were 'unexplained female or male infertility'-(p < .001) and six times more likely to report taking longer than 12 months to conceive than those who did not report endometriosis (p < .001). Although more women reporting a diagnosis of endometriosis also reported never having been pregnant (11.9%) than those who did not report a diagnosis (6.0%), this difference was not statistically significant (p = .060). There were also no endometriosis-associated differences in women's reports of unintended pregnancy, abortion, having been pregnant, or having had a live birth.

CONCLUSIONS

Our findings counter the common assertion that women with endometriosis are unlikely to conceive, and support the need for health care and information that addresses all aspects of fertility management (not just infertility) for women with endometriosis.

摘要

目的

在一项基于人群的调查中,研究报告和未报告子宫内膜异位症的女性的生育经历。

材料与方法

对澳大利亚1543名女性的社区样本进行横断面调查。分析数据以比较报告和未报告子宫内膜异位症的女性之间的生育管理情况。通过多变量分析确定与意外怀孕、不孕诊断、受孕时间和活产相关的因素。

结果

虽然个体避孕措施的使用情况在有无子宫内膜异位症的女性中并无差异,但对于报告有子宫内膜异位症的女性而言,避免怀孕的重要性(50.5%)低于其他女性(68.7%;p < 0.001)。报告有子宫内膜异位症的女性报告不孕诊断的可能性大约是其他女性的三倍——其中大多数(39.7%)为“不明原因的女性或男性不孕”——(p < 0.001),且报告受孕时间超过12个月的可能性是未报告子宫内膜异位症女性的六倍(p < 0.001)。尽管报告诊断为子宫内膜异位症的女性中从未怀孕的比例(11.9%)高于未报告诊断的女性(6.0%),但这一差异无统计学意义(p = 0.060)。在意外怀孕、流产、怀孕或活产的报告方面,也不存在与子宫内膜异位症相关的差异。

结论

我们的研究结果与“患有子宫内膜异位症的女性不太可能受孕”这一普遍观点相悖,并支持为患有子宫内膜异位症的女性提供涵盖生育管理各个方面(而不仅仅是不孕)的医疗保健和信息的必要性。

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