意外妊娠终止后继发不孕的原因及影响因素分析

Analysis of the Reasons and Influencing Factors of Secondary Infertility After Unexpected Pregnancy

目的探讨意外妊娠终止后继发不孕的原因及影响因素。方法以2006年8月～2008年8月到怀化市第一人民医院就诊的82例意外妊娠后继发不孕的妇女作为观察组，进行问卷调查，以同期入院的58例原发性不孕妇女作为对照组，采用SPSS13．0软件进行统计分析。结果观察组初次性生活年龄早于对照组（P〈0．01）；避孕失败主要原因依次为未避孕（占57．32％）、避孕套失败（占18．29％）、安全期避孕（占10．97％）、体外排精（占9．76％）；避孕失败后终止妊娠的方式主要为人工流产、药物流产，而输卵管妊娠后继发不孕者亦占一定比例；继发不孕的原因居前4位的分别是输卵管梗阻、慢性输卵管炎、慢性盆腔炎、输卵管积水。结论意外妊娠终止后继发不孕的主要原因是盆腔炎性疾病后遗症，导致输卵管梗阻或不通畅。初次性生活年龄过早，未避孕或避孕方法不当，多次人工流产、药物流产、输卵管妊娠史，是意外妊娠后继发不孕的重要影响因素。

Objective To explore the reasons and influencing factors of secondary infertility after unexpected pregnancy. Methods 82 cases with secondary infertility after unexpected pregnancy who had visited the First People＇ s Hospital of Huai Hua from August of 2006 to August of 2008 were chosen as an doserved group, and given a question- naire survey, and another 58 cases with of primary infertility in the hospital at in the same time were chosen as a control group. Statistical analysis was made SPSS13.0. Results The observed group＇ s age of first sexual life was earlier than the control group＇s （ P 〈 0.01 ） ; the reasons of contraception failure were having no contraception （ 57. 32 % ）, failure of condom （18. 29% ）, taking safe period contraception （ 10. 97%）, or spermiated out of body （9. 76% ）. The ways of terminating pregnancy after contraception failure were artificial abortion, induced abortion with medicine. And tubal pregnancy after secondary infertility is also accounted for a certain proportion. The top four reasons of Secondary in- fertility are fallopian tube obstruction, chronic salpingitis, chronic pelvic inflammation, and salpingian dropsy. Con- clusion The reasons of secondary infertility after the termination of unexpected pregnancy is mainly due to sequelae of pelvic inflammatory disease, which led to fallopian tube obstructed. The premature sexual life, no contraception or im- proper methods of contraception, abortion many times, medical abortion, and tubal pregnancy history are the important factors of secondary infertility after the termination of unexpected pregnancy.