Bahamondes L, Bueno J G, Hardy E, Vera S, Pimentel E, Ramos M
Centro de Pesquisas e Controle das Doencas Materno-Infantis, Campinas, Brazil.
Fertil Steril. 1994 Mar;61(3):478-82.
To determine the relationship between some reproductive variables and infertility caused by tubal obstruction.
A retrospective, case-control study.
A tertiary care university hospital that is a referral center for infertility patients.
Subjects were interviewed between March 1990 and December 1991. Cases were 215 consecutively recruited infertile women with either evidence of tubal obstruction found at laparoscopy or hydrosalpinx diagnosed by hysterosalpingography. Women with a history of surgical sterilization were excluded. Controls, selected in the same hospital, were women in the puerperium who had no history of infertility. Two controls were matched by age at the time of tubal obstruction diagnosis to each case.
History of pelvic surgery and use of alcohol were significantly associated with the risk of infertility caused by tubal obstruction. The use of barrier, oral, and medroxyprogesterone acetate (MPA) contraceptives was associated with a protective effect. When only women with secondary infertility were analyzed, history of pelvic surgery and number of lifetime sexual partners were significant risk factors, and the previous use of oral contraceptives was the only protective factor.
History of pelvic surgery was the most important risk factor for tubal infertility. All precautions must be taken to avoid infection and adhesion formation when pelvic surgery is performed. In addition, women can be protected from tubal infertility by using barrier, oral, or MPA contraceptive methods.
确定一些生殖变量与输卵管阻塞所致不孕症之间的关系。
一项回顾性病例对照研究。
一所三级护理大学医院，该医院是不孕症患者的转诊中心。
研究对象于1990年3月至1991年12月接受访谈。病例为连续招募的215名不孕女性，她们要么在腹腔镜检查中发现有输卵管阻塞的证据，要么经子宫输卵管造影诊断为输卵管积水。有手术绝育史的女性被排除在外。在同一医院选取的对照组为产后无不孕史的女性。每例病例按输卵管阻塞诊断时的年龄匹配两名对照。
盆腔手术史和饮酒与输卵管阻塞所致不孕风险显著相关。使用屏障避孕法、口服避孕药和醋酸甲羟孕酮（MPA）避孕药具有保护作用。仅分析继发性不孕女性时，盆腔手术史和终身性伴侣数量是显著的危险因素，而既往使用口服避孕药是唯一的保护因素。
盆腔手术史是输卵管性不孕最重要的危险因素。进行盆腔手术时必须采取一切预防措施以避免感染和粘连形成。此外，使用屏障避孕法、口服避孕药或MPA避孕方法可使女性免受输卵管性不孕的影响。
