Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing 100191, China.
Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China;National Clinical Research Center for Obstetrics and Gynecology, Beijing 100191, China.
Biomed Environ Sci. 2021 Feb 20;34(2):130-138. doi: 10.3967/bes2021.019.
Prior pulmonary tuberculosis (PTB) on chest X-ray (CXR) was commonly found in infertile patients receiving examinations before fertilization and embryo transfer (IVF-ET). It was unclear whether untreated PTB would affect pregnancy outcomes after IVF-ET.
We conducted a retrospective cohort study of 14,254 infertile patients who had received IVF-ET at Peking University Third Hospital in 2017. Prior PTB was defined as the presence of signs suggestive of old or inactive PTB on CXR, with or without a clinical TB history. Patients who had prior PTB on CXR but had not received a clinical diagnosis and anti-TB therapy were included for analysis. Live birth, clinical pregnancy, and miscarriage rates were compared between the untreated PTB and non-PTB groups.
The untreated PTB group had significantly lower clinical pregnancy (31.7% . 38.1%) and live birth (23.8% . 30.6%) rates than the non-PTB group (both < 0.001). Multivariate analysis revealed that untreated PTB was a risk factor for decreased live birth rate [odds ratio ( ), 0.80; 95% confidence interval ( ), 0.66-0.98; = 0.028] in all patients and for increased miscarriage ( , 4.19; 95% , 1.69-10.39; = 0.002) and decreased live birth ( , 0.45; 95% , 0.24-0.83; = 0.011) rates in patients with unexplained infertility.
Untreated PTB was associated with adverse pregnancy outcomes after IVF-ET, especially in patients with unexplained infertility, highlighting the clinical significance of PTB in this specific patient population.
在接受体外受精-胚胎移植（IVF-ET）前检查的不孕患者中，胸部 X 光（CXR）上常发现既往肺结核（PTB）。未治疗的 PTB 是否会影响 IVF-ET 后的妊娠结局尚不清楚。
我们对 2017 年在北京大学第三医院接受 IVF-ET 的 14254 名不孕患者进行了回顾性队列研究。CXR 上存在提示陈旧或不活动 PTB 的征象，无论是否有临床 TB 病史，均定义为既往 PTB。将 CXR 上存在既往 PTB 但未接受临床诊断和抗结核治疗的患者纳入分析。比较未治疗的 PTB 组和非 PTB 组的活产率、临床妊娠率和流产率。
未治疗的 PTB 组的临床妊娠率（31.7%比 38.1%，均 < 0.001）和活产率（23.8%比 30.6%，均 < 0.001）明显低于非 PTB 组。多变量分析显示，在所有患者中，未经治疗的 PTB 是活产率降低的危险因素（比值比[OR]，0.80；95%置信区间[CI]，0.66-0.98； = 0.028），在不明原因不孕患者中，流产（OR，4.19；95%CI，1.69-10.39； = 0.002）和活产率降低（OR，0.45；95%CI，0.24-0.83； = 0.011）的风险也增加。
未经治疗的 PTB 与 IVF-ET 后的不良妊娠结局相关，尤其是在不明原因不孕患者中，这突出了 PTB 在这一特定患者群体中的临床意义。
