油基造影剂在子宫内膜异位症子宫输卵管造影中对生育结局的影响：一项回顾性队列研究。

Impact of oil-based contrast agents in hysterosalpingography on fertility outcomes in endometriosis: a retrospective cohort study.

机构信息

Center of Reproductive Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, China.

Center for Reproductive Medicine, Maternal and Child Health Hospital in Guangxi, Guangxi, 530021, China.

出版信息

Reprod Biol Endocrinol. 2024 Feb 3;22(1):19. doi: 10.1186/s12958-024-01190-1.

DOI:10.1186/s12958-024-01190-1

PMID:38308329

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10837917/

Abstract

BACKGROUND

Previous studies have suggested that oil-based contrast agents used during hysterosalpingography (HSG) in infertile patients can enhance fertility. However, limited research has investigated the effect of oil-based contrast medium specifically in individuals with endometriosis-related infertility.

OBJECTIVE

This study aims to explore the impact of oil-based contrast medium on fertility outcomes in women with endometriosis-related infertility.

METHODS

Conducted at the First Affiliated Hospital of Guangxi Medical University (January 2020 to June 2022), the study included 512 patients undergoing HSG. Patients were categorized into oil-based and non-oil-based groups, and after propensity score matching, demographic characteristics were compared. Main outcomes included clinical pregnancy rates, live birth rates, early miscarriage rates, and ectopic pregnancy rates.

RESULTS

In our analysis, the Oil-based group showed significantly better outcomes compared to the Non-oil-based group. Specifically, the Oil-based group had higher clinical pregnancy rates (51.39% vs. 27.36%) and increased live birth rates (31.48% vs. 19.93%). This trend held true for expectant treatment, IUI, and IVF/ICSI, except for surgical treatment where no significant difference was observed. After adjusting for various factors using propensity score matching, the Non-oil-based group consistently exhibited lower clinical pregnancy rates compared to the Oil-based group. The Odds Ratio (OR) was 0.38 (95%CI: 0.27-0.55) without adjustment, 0.34 (0.22-0.51) in multivariable analysis, 0.39 (0.27-0.57) using inverse probability of treatment weighting (IPTW), and 0.22 (0.14-0.35) in propensity score matching.

CONCLUSION

Oil-based contrast medium used in HSG for women with endometriosis-related infertility is associated with higher clinical pregnancy rates and live birth rates compared to Non-oil-based contrast medium.

摘要

背景

既往研究表明，在不孕患者的子宫输卵管造影（HSG）中使用油基造影剂可以提高生育能力。然而，针对油基造影剂在子宫内膜异位症相关不孕患者中的具体作用，相关研究较少。

目的

本研究旨在探讨油基造影剂对子宫内膜异位症相关不孕患者生育结局的影响。

方法

该研究于 2020 年 1 月至 2022 年 6 月在广西医科大学第一附属医院进行，共纳入 512 例行 HSG 的患者。患者分为油基组和非油基组，经倾向性评分匹配后，比较两组患者的人口统计学特征。主要结局包括临床妊娠率、活产率、早期流产率和异位妊娠率。

结果

在本研究中，油基组的结果明显优于非油基组。具体而言，油基组的临床妊娠率（51.39% vs. 27.36%）和活产率（31.48% vs. 19.93%）更高。这种趋势在期待治疗、宫腔内人工授精和体外受精/卵胞浆内单精子注射中成立，但在手术治疗中未观察到显著差异。经倾向性评分匹配调整各种因素后，非油基组的临床妊娠率始终低于油基组。未调整时的比值比（OR）为 0.38（95%CI：0.27-0.55），多变量分析时为 0.34（0.22-0.51），逆概率处理权重（IPTW）时为 0.39（0.27-0.57），倾向性评分匹配时为 0.22（0.14-0.35）。