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三级医疗中心不孕患者的临床概况:一项观察性研究。

Clinical Profile of Patients with Infertility Presenting to Tertiary Care Center: An Observational Study.

作者信息

Sharma Jyotshna, Shrestha Dipty, Thapa Durga, Rawal Sirjana, Kafle Rijan

机构信息

Department of Obstetri cs and Gynecology, Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal.

Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal.

出版信息

JNMA J Nepal Med Assoc. 2025 Mar;63(283):175-178. doi: 10.31729/jnma.8925. Epub 2025 Mar 31.

Abstract

INTRODUCTION

Infertility, defined as the inability to conceive after a year of regular unprotected sexual activity, is a significant global health concern. It affects couples across the world, with prevalence rates varying between 3.5-16.7% in developed countries and 6.9-9.3% in developing nations. This study aims to explore the sociodemographic profiles and contributing factors in both men and women among infertility patients at a tertiary care center.

METHODS

An observational cross-section study was conducted at a tertiary care center and participants were between 18 and 42 years old with infertility for one year or longer, excluding those who had received treatment or were pregnant. The data was collected from December 2023 to May 2024. Ethical approval and informed consent were obtained. Data were collected using a structure proforma through in-person interviews or telephone calls and analyzed using Statistical Package for the Social Sciences with descriptive statistics.

RESULTS

Among 170 couples with infertility, primary infertility was observed in 124 (72.94%) and secondary infertility in 46 (27.06%). The median duration of marriage was 5 years (IQR: 4-7). Among women, 37 (21.76%) had tubal blockages, 16 (9.41%) had polycystic ovarian disease, and 6 (3.53%) had fibroids. Among men, 58 (34.12%) had semen abnormalities, with oligospermia being the most common in 25 (14.71%). Hormonal analysis revealed that 68 (40%) of women had elevated anti-Müllerian hormone levels, frequently linked to polycystic ovarian syndrome.

CONCLUSIONS

These findings show that infertility is rarely due to a single cause. It commonly involves both partners and requires a comprehensive approach to diagnosis and treatment.

摘要

引言

不孕症被定义为在一年规律无保护性行为后仍无法受孕,是一个重大的全球健康问题。它影响着世界各地的夫妇,发达国家的患病率在3.5%-16.7%之间,发展中国家在6.9%-9.3%之间。本研究旨在探讨一家三级医疗中心不孕症患者中男性和女性的社会人口学特征及影响因素。

方法

在一家三级医疗中心进行了一项观察性横断面研究,参与者年龄在18至42岁之间,患有不孕症一年或更长时间,排除已接受治疗或怀孕的患者。数据收集于2023年12月至2024年5月。获得了伦理批准和知情同意。通过面对面访谈或电话使用结构化表格收集数据,并使用社会科学统计软件包进行描述性统计分析。

结果

在170对不孕夫妇中,124对(72.94%)为原发性不孕,46对(27.06%)为继发性不孕。中位结婚年限为5年(四分位间距:4-7年)。女性中,37例(21.76%)有输卵管堵塞,16例(9.41%)有多囊卵巢疾病,6例(3.53%)有子宫肌瘤。男性中,58例(34.12%)有精液异常,其中少精子症最为常见,有25例(14.71%)。激素分析显示,68例(40%)女性抗苗勒管激素水平升高,这通常与多囊卵巢综合征有关。

结论

这些发现表明,不孕症很少是由单一原因引起的。它通常涉及夫妻双方,需要综合的诊断和治疗方法。

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本文引用的文献

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International disparities in access to infertility services.获得不孕不育服务方面的国际差异。
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