Gai Xiaoyan, Chi Hongbin, Zeng Lin, Chen Lixue, Sheng Zikang, Cao Wenli, Zhang Chen, Qu Jingge, Zhang Yue, Zhang Weixia, Zhou Qingtao, Liu Ping, Sun Yongchang, Li Rong, Qiao Jie
Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, China.
Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, National Clinical Research Center for Obstetrics and Gynecology, Beijing, China.
Front Med (Lausanne). 2025 Jul 24;12:1626519. doi: 10.3389/fmed.2025.1626519. eCollection 2025.
Tuberculosis can negatively impact both overall health and female reproductive function. This study investigated the relationship between the interferon-gamma release assay (IGRA) status and pregnancy outcomes in infertile women, with untreated "inactive" tuberculosis lesions observed on chest radiography, who are undergoing fertilization and embryo transfer (IVF-ET).
This ambispective cohort study, which includes retrospective (2012-2019) and prospective (2020-2024) cohorts, enrolled infertile women with untreated inactive tuberculosis lesions visible on chest imaging who are planning to undergo IVF-ET. All patients underwent IGRA testing. Baseline characteristics, such as age, body mass index (BMI), infertility factors, ultrasound follicle count, and hormone levels, were collected. Pregnancy outcomes, including live birth rates, oocyte retrieval numbers, embryo quality, clinical pregnancy, miscarriage, and preterm birth rates, were followed and compared between the IGRA-positive and IGRA-negative groups.
Among 836 patients, the IGRA positivity rate was 42.5%. The cumulative miscarriage rate was higher in the IGRA-positive group than in the IGRA-negative group (21.5% vs. 15.0%, = 0.047). No significant differences were found in clinical pregnancy or live birth rates. Age, BMI, and endometrial thickness were independent risk factors influencing clinical pregnancy and live birth rates, while the IGRA status was not.
In infertile women with untreated inactive tuberculosis lesions on chest radiography, IGRA positivity is associated with higher cumulative miscarriage rates following IVF-ET. Early IGRA screening and intervention may help improve pregnancy outcomes.
结核病会对整体健康和女性生殖功能产生负面影响。本研究调查了在接受体外受精-胚胎移植（IVF-ET）的不孕女性中，干扰素-γ释放试验（IGRA）结果与妊娠结局之间的关系，这些女性胸部X线检查显示有未经治疗的“非活动性”结核病灶。
这项前瞻性队列研究纳入了回顾性队列（2012 - 2019年）和前瞻性队列（2020 - 2024年），研究对象为计划接受IVF-ET且胸部影像学检查可见未经治疗的非活动性结核病灶的不孕女性。所有患者均接受IGRA检测。收集年龄、体重指数（BMI）、不孕因素、超声卵泡计数和激素水平等基线特征。随访并比较IGRA阳性组和IGRA阴性组的妊娠结局，包括活产率、取卵数、胚胎质量、临床妊娠率、流产率和早产率。
在836例患者中，IGRA阳性率为42.5%。IGRA阳性组的累积流产率高于IGRA阴性组（21.5%对15.0%，P = 0.047）。临床妊娠率或活产率未发现显著差异。年龄、BMI和子宫内膜厚度是影响临床妊娠率和活产率的独立危险因素，而IGRA结果不是。
对于胸部X线检查有未经治疗的非活动性结核病灶的不孕女性，IGRA阳性与IVF-ET后较高的累积流产率相关。早期IGRA筛查和干预可能有助于改善妊娠结局。
