体外受精/卵胞浆内单精子注射术后宫内单胎妊娠早期自然流产的相关因素

目的：探讨体外受精(in vitro fertilization，IVF)/卵胞浆内单精子注射(intracytoplasmic sperm injection，ICSI)术后宫内单胎妊娠病例发生早期自然流产的相关因素，为早期自然流产的预防提供可行依据。方法：采用成组病例-对照研究，对2013年1月至2014年5月在湘雅医院生殖医学中心行IVF/ICSI术后的单胎妊娠病例进行回顾性分析，以早期自然流产夫妇(96对)为病例组，足月活产分娩夫妇(593对)为对照组，分析早期自然流产的相关因素。结果：多因素分析显示女方年龄大、有自然流产史以及男方精子DNA碎片指数(DAN fragmentation index，DFI)高为IVF/ICSI术后早期自然流产的独立危险因素(P<0.05)。结论：IVF/ICSI术后发生早期自然流产受多因素的影响。女方年龄越大(>30岁)、有自然流产史或男方精子DFI越高(≥15%)，IVF/ICSI术后发生早期自然流产的风险越大。

Risk factors for early miscarriage among intrauterine singleton pregnancies after treatment with in vitro fertilization/intracytoplasmic sperm injection

Objective: To investigate the risk factors associated with early miscarriage among intrauterine singleton pregnancies after treatment with in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI). Methods: A retrospective case-control study was performed on all singleton pregnancies underwent IVF/ICSI from January, 2013 to May, 2014, in Xiangya Hospital. Ninety-six early miscarriage patients served as a case group and 593 pregnancies with live birth served as a control group. We analyzed factors for early miscarriage after IVF/ICSI in two groups. Results: Multivariate logistic regression analysis demonstrated that the women age, miscarriage history, and sperm DAN fragmentation index (DFI) were the risk factors for early miscarriage (P<0.05). Conclusion: Miscarriage after treatment with IVF/ICSI is affected by multiple factors. Women at elder age (>30 years old), women with a history of miscarriage or men with higher sperm DFI (≥15%) are the risk.