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

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

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。

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.