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亚生育男性辅助生殖治疗的成功率及影响治疗结果的因素

The Success Rate and Factors Affecting the Outcome of Assisted Reproductive Treatment in Subfertile Men.

作者信息

Zarinara Alireza, Zeraati Hojjat, Kamali Koorosh, Mohammad Kazem, Rahmati Maryam, Akhondi Mohammad Mahdi

机构信息

Reproductive Biotechnology Research Center, Avicenna Research Institute, Tehran, Iran.

Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Iran J Public Health. 2020 Feb;49(2):332-340.

Abstract

BACKGROUND

This study was conducted to evaluate the success rate of male infertility treatment and the factors affecting its outcome.

METHODS

In a historical cohort study, from Mar 2013 to Mar 2014, 323 couples with male factor were investigated. Couples had treated with IUI or/and ICSI were included randomly. Assisted reproduction technology (ART) outcome (treatment success) was defined as a live birth. Age, duration of infertility, type of infertility, treatment history and clinical examination results were investigated. The logistic regression and survival analysis were applied.

RESULTS

The average of men age, duration of infertility and BMI were 33.5, 4.7 (yr) and 26.6 (kg/m) respectively. 87.9% of men have primary infertility and average duration of treatment was 14.1(month). Previous treatment, type of infertility, treatment method, man's BMI, normality of sperm and sperm head were important variable that affecting outcome. The rate of live birth in the first attempt was 29.7%, and 44.9% of the couples succeeded to give live birth after several treatment cycles. Couples who had no previous history of treatment were 8.5 times more successful in live birth. The Cox analysis showed that "BMI of man" and percentage of "Sperm with normal head" are predictors that had a significant effect on live birth.

CONCLUSION

Live birth in the first treatment cycles was influenced by four variables but two other variable were affecting several treatment cycles outcome. The chances of successful treatment were higher with taking into account the length of time and having live birth was determined as 78% for five years of continuous treatment.

摘要

背景

本研究旨在评估男性不育治疗的成功率及其影响因素。

方法

在一项历史性队列研究中,于2013年3月至2014年3月对323对男性因素不育的夫妇进行了调查。随机纳入接受过宫腔内人工授精(IUI)或/和卵胞浆内单精子注射(ICSI)治疗的夫妇。辅助生殖技术(ART)结局(治疗成功)定义为活产。调查了年龄、不孕持续时间、不孕类型、治疗史和临床检查结果。应用逻辑回归和生存分析。

结果

男性的平均年龄、不孕持续时间和体重指数(BMI)分别为33.5岁、4.7年和26.6kg/m²。87.9%的男性为原发性不孕,平均治疗时间为14.1个月。既往治疗、不孕类型、治疗方法、男性BMI、精子正常率和精子头部正常率是影响结局的重要变量。首次尝试的活产率为29.7%,44.9%的夫妇在经过几个治疗周期后成功活产。既往无治疗史的夫妇活产成功的可能性高8.5倍。Cox分析显示,“男性BMI”和“头部正常精子百分比”是对活产有显著影响的预测因素。

结论

首次治疗周期的活产受四个变量影响,但另外两个变量影响多个治疗周期的结局。考虑到治疗时间,成功治疗的机会更高,连续治疗五年的活产率确定为78%。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da4f/7231713/bd8e27d81b6f/IJPH-49-332-g001.jpg

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