原发性不育患者行体外受精-胚胎移植的病因及妊娠结局分析

目的对行体外受精助孕的原发性不育患者的病因进行分析,了解各病因所占的比例,并比较各组患者妊娠结局。方法对行体外受精的原发性不育患者按病因分为输卵管因素、男方因素、子宫内膜异位症(内异症)、排卵障碍和不明原因不育组,计算各组患者在总患者中的比例;比较各组卵泡刺激素(Gn)用量、获卵数、受精率、卵裂率、优质胚胎率、胚胎种植率、临床妊娠率及流产率。结果输卵管因素在原发性不育患者中比例最高(46.14%),其次是男方因素(30.48%);Gn用量男方因素组和排卵障碍组较少,与输卵管因素组比较有显著性差异(P<0.05);获卵数男方因素组最高,其次是排卵障碍组,与输卵管因素组比较无显著差异(P>0.05),内异症组获卵数最低,与输卵管因素组相比有显著性差异(P<0.05);排卵障碍组的受精率、卵裂率、优质胚胎率均最高,内异症组最低,但各组之间无显著性差异(P>0.05);胚胎种植率排卵障碍组最高(40.44%),输卵管因素组最低(18.44%);临床妊娠率内异症组和排卵障碍组分别为40.43%和36.67%,其次是男方因素组为34.50%,不明原因不育组为29.63%和输卵管因素组最低为26.86%;不明原因不育组的流产率最高为25%,内异症组和输卵管因素组各发生1例异位妊娠。结论输卵管因素在原发性不育患者中比例最高,其临床妊娠率低可能与内膜炎症和输卵管积水有关,子宫内膜异位症行预处理可获得较高的临床妊娠率。

Analysis of etiological factors of primarily infertility and its pregnancy outcome following in vitro fertilization-embryo transfer

Objective:To rank the causes of the primary infertility and compare the pregnancy outcomes of the patients with different etiology following in vitro fertilization and embryo transfer(IVF-ET).Methods:According to the cause of infertility,the patients were divided into five groups:tubal factor,male factor,endometriosis,ovulation failure and unexplained infertility.Then we calculated the constituent ratio of each group and recorded the dose of gonadotrophin administrated,the number of oocytes retrieved,fertil...