输卵管检查中经阴道注水腹腔镜检查与子宫输卵管造影对不孕女性生育相关生活质量的影响。

Fertility-related quality of life in subfertile women undergoing tubal testing with transvaginal hydrolaparoscopy or hysterosalpingography.

机构信息

Department of Obstetrics and Gynaecology, Dr. Horacio E. Oduber Hospital Aruba, Oranjestad, Aruba.

Department of Obstetrics and Gynaecology, Maastricht University Medical Center, Maastricht, the Netherlands.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2022 Jul;274:19-22. doi: 10.1016/j.ejogrb.2022.04.005. Epub 2022 Apr 13.

DOI:10.1016/j.ejogrb.2022.04.005

PMID:35561566

Abstract

OBJECTIVE

Both subfertility and its management can have significant impact on quality of life (QoL). Tubal patency testing as part of the fertility work-up, is considered to cause more physical complaints and stress than other tests. Pain scores for HSG are higher than for THL, but acceptability of the procedures was found to be comparable. Fertility-related QoL has not yet been studied in women undergoing tubal patency testing.

STUDY DESIGN

We performed a standardized questionnaire study alongside a previously reported randomized controlled trial comparing THL and HSG in subfertile women, in which 24-month live birth rates occurred in 58.5% versus 55.4%, respectively. We randomly assigned 300 subfertile women to THL or HSG between May 2013 and October 2016. Women were eligible if they were undergoing a fertility work-up with an indication for evaluation of tubal patency. Fertility-related QoL was measured six weeks after the procedure with the validated FertiQoL questionnaire. The scores for the Core scale and subscales between THL and HSG were compared using Mann-Whitney-U test and multiple linear regression analysis.

RESULTS

The questionnaire was completed by 84 women in the THL group (56%) and 96 women in the HSG group (64%). Core scores were 74.6 ± 12.8 for THL and 73.4 ± 12.4 for HSG (p = 0.39). Scores for the Emotional domain were 64.5 ± 19.0 for THL versus 66.0 ± 16.3 (p = 0.67) for HSG. Scores for the 'Mind-body' domain for THL were 76.9 ± 15.6 versus 74.1 ± 18.0 for HSG (p = 0.42), while scores for the Relational domain were 79.2 ± 12.9 for THL and 76.9 ± 15.6 for HSG (p = 0.21). Scores for the Social domain for THL were 77.9 ± 15.1 versus 76.7 ± 14.1, (p = 0.42). The multiple linear regression analysis showed only a statistical significant positive effect of older age on the score for the Emotional domain (p = 0.015).

CONCLUSION

In a preselected group of women with low risk for tubal pathology we did not find differences in fertility-related QoL between tubal patency testing with THL versus HSG.

摘要

目的

不孕及其治疗都会对生活质量（QoL）产生重大影响。作为生育评估的一部分，输卵管通畅性检查被认为比其他检查引起更多的身体不适和压力。HSG 的疼痛评分高于 THL，但发现两种检查的可接受性相当。尚未研究接受输卵管通畅性检查的女性的生育相关 QoL。

研究设计

我们在一项先前报道的随机对照试验中进行了标准化问卷调查研究，该试验比较了 THL 和 HSG 在不孕女性中的应用，24 个月的活产率分别为 58.5%和 55.4%。我们于 2013 年 5 月至 2016 年 10 月间随机分配 300 名不孕女性进行 THL 或 HSG。如果女性正在接受生育评估并需要评估输卵管通畅性，则符合条件。在术后 6 周使用经过验证的 FertiQoL 问卷测量与生育相关的 QoL。使用 Mann-Whitney-U 检验和多元线性回归分析比较 THL 和 HSG 之间的核心量表和子量表评分。

结果

THL 组有 84 名女性（56%）和 HSG 组有 96 名女性（64%）完成了问卷。THL 的核心评分是 74.6±12.8，HSG 的核心评分是 73.4±12.4（p=0.39）。THL 的情绪域评分是 64.5±19.0，HSG 的情绪域评分是 66.0±16.3（p=0.67）。THL 的“身心”域评分是 76.9±15.6，HSG 的“身心”域评分是 74.1±18.0（p=0.42），而 THL 的关系域评分是 79.2±12.9，HSG 的关系域评分是 76.9±15.6（p=0.21）。THL 的社交域评分是 77.9±15.1，HSG 的社交域评分是 76.7±14.1（p=0.42）。多元线性回归分析显示，仅年龄较大对情绪域评分有统计学显著的正向影响（p=0.015）。