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特殊特征、生殖和不明原因不孕与其他不孕原因的临床特征:一项比较研究。

Special characteristics, reproductive, and clinical profile of women with unexplained infertility versus other causes of infertility: a comparative study.

机构信息

Assisted Reproduction Unit, Third Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, "Attikon" University Hospital, 1 Rimini Street, Chaidari, 12642, Athens, Greece.

Assisted Reproducton Unit, Second Department of Obstetrics and Gynecology, Aretaieion Hospital, National and Kapodistrian University of Athens, Athens, Greece.

出版信息

J Assist Reprod Genet. 2020 Aug;37(8):1923-1930. doi: 10.1007/s10815-020-01845-z. Epub 2020 Jun 5.

Abstract

PURPOSE

To investigate whether women with unexplained infertility (UI) demonstrate different demographic and IVF characteristics compared to those with other causes of infertility.

METHODS

Data on 245 couples that underwent a total of 413 IVF/ICSI cycles were analyzed (UI 114 cycles, 73 women; anovulation (PCO/PCOS) 83 cycles, 51 women; tubal factor 85 cycles, 47 women; male factor 131 cycles, 74 women). Features of UI were compared versus other infertility groups, after adjustment for multiple comparisons. Generalized least squares (GLS) and random-effects logistic regression analysis were also performed.

RESULTS

Live birth rates, consisting of the primary outcome, were similar in all compared infertility groups. Compared to male infertility, UI was associated with woman's older age at cycle, lower body mass index (BMI), and higher follicle-stimulating hormone (FSH). Compared to tubal infertility, UI was linked to lower endometrial thickness at oocyte retrieval and lower BMI; compared to anovulatory infertility related to PCO/PCOS, UI was linked to woman's older age, more frequent smoking, and poorer ovarian reserve tests (FSH and antral follicle count). After adjustment for other types of infertility, woman's age, age at menarche, and FSH levels, anovulatory infertility presented with higher odds of clinical pregnancy compared to UI (adjusted OR = 2.13, 95% C: 1.01-4.52).

CONCLUSIONS

Infertile women with UI undergoing assisted reproduction demonstrate different demographic and clinical characteristics compared to those of other causes of infertility, albeit live birth rates are similar.

摘要

目的

探究不明原因不孕(UI)女性与其他不孕原因女性相比,在人口统计学和 IVF 特征方面是否存在差异。

方法

对 245 对夫妇共 413 个 IVF/ICSI 周期的数据进行了分析(UI 组 114 个周期,73 名女性;排卵障碍(PCO/PCOS)组 83 个周期,51 名女性;输卵管因素组 85 个周期,47 名女性;男性因素组 131 个周期,74 名女性)。对 UI 特征进行了调整多重比较后的比较,还进行了广义最小二乘法(GLS)和随机效应逻辑回归分析。

结果

活产率(主要结局)在所有比较的不孕组中相似。与男性不育相比,UI 与女性周期时的年龄较大、体重指数(BMI)较低和卵泡刺激素(FSH)较高相关。与输卵管不孕相比,UI 与取卵时的子宫内膜较薄和 BMI 较低相关;与与 PCO/PCOS 相关的排卵障碍不孕相比,UI 与女性年龄较大、吸烟更频繁和卵巢储备测试(FSH 和窦卵泡计数)较差相关。在调整其他类型的不孕后,与 UI 相比,排卵障碍不孕的临床妊娠几率更高(调整后的 OR = 2.13,95%CI:1.01-4.52)。

结论

接受辅助生殖的不明原因不孕的不孕女性与其他不孕原因的女性相比,具有不同的人口统计学和临床特征,尽管活产率相似。

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