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目的探讨体外受精-胚胎移植(IVF-EI)治疗原发性不孕症患者病因及妊娠结局。方法 110例原发性不孕症患者,根据不孕单一病因分为男方因素组(26例)、输卵管因素组(41例)、子宫内膜异位症组(19例)、不明原因组(8例)、排卵障碍组(16例),均实施IVF-ET治疗,对比分析5组妊娠并发症及妊娠结局。结果原发性不孕单一病因中主要病因为男方因素和女方输卵管因素;甲状腺功能减退症、贫血、妊娠期糖尿病(GDM)在输卵管因素组中占比分别为2.4%、17.1%、14.6%;妊娠期高血压疾病(HDCP)在子宫内膜异位症组中占比例最高,为21.1%;妊娠率、胚胎种植率均在输卵管因素组中最高,分别占58.5%、61.0%;流产率在子宫内膜异位症组中比例最高,占42.1%;剖宫产率在不明原因组中比例最高,占75.0%;异位妊娠率在输卵管因素组中比例最高,占2.4%。结论 IVF-ET治疗原发性不孕症患者的病因较多,其中男方因素和女方输卵管因素对妊娠结局影响较大,因而针对病因行预防性治疗,可改善妊娠结局。
Objective To investigate the etiology and pregnancy outcome of IVF-EI in the treatment of primary infertility. Methods One hundred and ten patients with primary infertility were divided into male factor group (n = 26), tubal factor group (n = 41), endometriosis group (n = 19), unexplained group 8 cases) and ovulation disorder group (16 cases). All of them were treated with IVF-ET. Complications and pregnancy outcomes in 5 groups were compared. Results The main cause of primary infertility was male factor and female tubal factor. Hypothyroidism, anemia, gestational diabetes mellitus (GDM) accounted for 2.4%, 17.1% and 14.6% respectively of tubal factor group. HDCP accounted for the highest proportion in endometriosis group (21.1%). Pregnancy rate and embryo implantation rate were the highest in tubal factor group, accounting for 58.5% and 61.0% respectively. Abortion rate was The proportion of endometriosis group was the highest (42.1%). The rate of cesarean section was the highest in unexplained group (75.0%). The rate of ectopic pregnancy was the highest in tubal factor group (2.4%). Conclusion IVF-ET treatment of primary infertility causes more malefactors and the female tubal factors have a greater impact on pregnancy outcomes, so the preventive treatment for the cause of the line can improve pregnancy outcomes.