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目的探讨体外受精助孕的原发性不孕症患者的病因及各因素对妊娠结局的影响。方法回顾性分析2012年1月~2014年1月海南省农垦总医院收治的176例体外受精助孕的原发性不孕症患者,根据不孕的主要因素分为输卵管因素组、排卵障碍组、子宫内膜异位症组、男方因素组及不明原因组。比较5组患者妊娠期间并发症及妊娠结局情况。结果原发性不孕症患者的患病原因以女方因素中的输尿管因素和男方因素为主要病因。患者妊娠并发症中,妊娠期高血压疾病以子宫内膜异位症组最高,妊娠期糖尿病以输卵管因素组最高,分别占20.00%和11.76%;贫血及甲状腺功能减退症以输卵管因素组最高,分别占11.76%及1.47%。患者妊娠结局中,胚胎种植率以输卵管因素组最高,占60.29%;临床妊娠率以输卵管因素组最高,占57.35%;剖宫产率以不明原因组最高,占80.00%;流产率以子宫内膜异位症组最高,占40.00%;异位妊娠率以输卵管因素组最高,占4.41%。结论体外受精助孕的原发性不孕症患者的病因较多,以输卵管因素、排卵障碍、子宫内膜异位症、不明原因及男方因素对妊娠结局的影响较大,且影响各有不同,针对病因进行预防性治疗可以明显提高体外受精助孕的成功率,减少妊娠并发症,从而改善妊娠结局。
Objective To investigate the etiology and factors influencing pregnancy outcome in patients with primary infertility who are assisted by in vitro fertilization. Methods A retrospective analysis of 176 cases of primary infertility patients who underwent in vitro fertilization and pregnancy from January 2012 to January 2014 in Hainan General Hospital of Land Reclamation was divided into tubal factor group and ovulation disorder group according to the main factors of infertility, , Endometriosis group, male factor group and unexplained group. The complication and pregnancy outcome were compared between the 5 groups during pregnancy. Results Primary infertility patients with causes of female factors in the ureter and male factors as the main cause. Patients with pregnancy complications, pregnancy-induced hypertension in patients with endometriosis group highest, gestational diabetes with tubal factor group was the highest, accounting for 20.00% and 11.76% respectively; anemia and hypothyroidism in tubal factor group was the highest, Accounting for 11.76% and 1.47% respectively. In pregnancy outcome, the rate of embryo implantation was the highest in tubal factor group, accounting for 60.29%; the clinical pregnancy rate was the highest in tubal factor group, accounting for 57.35%; the rate of cesarean section was the highest in unknown reason group, accounting for 80.00%; the abortion rate was intrauterine Membranous ectopic group was the highest, accounting for 40.00%; ectopic pregnancy rate was highest in tubal factor group, accounting for 4.41%. Conclusion Infertility patients with primary infertility due to in vitro fertilization have many causes. The effects of tubal factors, ovulation disorders, endometriosis, unexplained causes and male factors on pregnancy outcomes are large and have different effects , For the cause of prophylactic treatment can significantly improve the success rate of in vitro fertilization and pregnancy, reduce pregnancy complications, thereby improving the pregnancy outcome.