Department of OB/GYN, Massachusetts General Hospital and Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
Center for Outcomes Research, Department of OB/GYN, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
J Assist Reprod Genet. 2021 Dec;38(12):3223-3232. doi: 10.1007/s10815-021-02344-5. Epub 2021 Oct 26.
We sought to determine whether pregnancies conceived in those with male factor infertility have unique placental pathology profiles compared to those undergoing infertility treatments for other indications.
This was a retrospective cohort study of placental pathology from 464 live births conceived from autologous fresh IVF cycles at an academic fertility center from 2004 to 2017. Placental pathology was compared between live births arising from patients with male factor infertility alone and those with another infertility diagnosis. Placental outcomes were compared with parametric or non-parametric tests; logistic regression was performed to account for potential confounders.
Compared to cycles performed for a non-male factor diagnosis, male factor infertility cycles had a higher mean paternal age (38.2 years vs. 36.5 years, p < 0.001), a higher female mean BMI (24.3 vs. 23.3 kg/m, p = 0.01), and a lower day 3 follicle stimulating hormone (FSH) level (6.8 vs. 7.3 IU/mL, p = 0.02). The mean numbers of embryos transferred, and day of transfer were similar between groups, and more cycles used ICSI in the male factor infertility group (90.6% vs. 22.5%, p < 0.001). Placental pathology in our adjusted model was similar between the male factor and non-male factor groups. In our unadjusted subgroup analysis, cycles for male factor using ICSI appeared to lead to more small placentas by weight compared to cycles performed with conventional insemination (45.8% < 10th percentile vs. 18.8%, p = 0.04).
Male factor infertility is not associated with significantly different placental pathology compared to other infertility diagnoses.
我们旨在确定与因其他原因导致不孕而接受治疗的患者相比，男性因素不孕患者妊娠的胎盘病理特征是否存在差异。
这是一项回顾性队列研究，纳入了 2004 年至 2017 年期间在一家学术生育中心进行的 464 例采用自体新鲜 IVF 周期妊娠的活产儿的胎盘病理资料。比较了单纯男性因素不孕患者与其他不孕诊断患者的活产儿胎盘病理。采用参数或非参数检验比较胎盘结局；采用逻辑回归校正潜在混杂因素。
与因非男性因素诊断而进行的周期相比，男性因素不孕周期中父亲的平均年龄更高（38.2 岁比 36.5 岁，p<0.001），女性的平均 BMI 更高（24.3 千克/平方米比 23.3 千克/平方米，p=0.01），且第三天卵泡刺激素（FSH）水平更低（6.8 国际单位/毫升比 7.3 国际单位/毫升，p=0.02）。两组间胚胎移植的平均数量和移植日相似，而男性因素不孕组中更多的周期使用了卵胞浆内单精子注射（ICSI）（90.6%比 22.5%，p<0.001）。在调整后的模型中，男性因素和非男性因素组的胎盘病理相似。在未调整的亚组分析中，与采用常规授精的周期相比，男性因素不孕且使用 ICSI 的周期似乎导致更小的胎盘重量比例（45.8%<第 10 百分位数比 18.8%，p=0.04）。
与其他不孕诊断相比，男性因素不孕与明显不同的胎盘病理特征无关。
