育龄女性不孕的影响因素及治疗方式研究

Influence factor and treatment method study of childbearing age women with infertility

目的分析育龄女性不孕的影响因素,探讨其治疗方式。方法选取2012年1月-2014年1月本站妇产科收治的120例育龄不孕症女性作为研究对象,经问卷调查、临床检查分析所有患者不孕的影响因素,并针对不孕的原因采取对应的治疗方式,治疗后随访2年,了解患者的怀孕成功率。结果 120例育龄女性不孕的影响因素所占比重依次为排卵功能障碍（38.33%）、输卵管阻塞（35.00%）、排卵功能异常的其他因素（8.33%）、子宫内膜异位（8.33%）、输卵管异常的其他因素（5.00%）、子宫或宫颈发育不良（2.50%）、其他原因（1.67%）、不明原因（0.83%）,其中排卵功能障碍与输卵管阻塞导致的不孕为73.33%,显著高于其他各影响因素的26.66%,差异有统计学意义（P〈0.05）。患者通过雌孕激素调理月经、HCG诱导排卵治疗后的怀孕成功率为53.57%,通过输卵管通液术、常规输卵管吻合术、体外受精-胚胎移植术治疗后的怀孕成功率为70.83%,通过激素类药物治疗后的怀孕成功率为50.00%,通过微创手术、激素类药物治疗后的怀孕成功率为70.00%,综合性对症治疗、纠正及指导不良生活习惯治疗的怀孕成功率为33.33%。确定不孕的主要影响因素后对症治疗,其怀孕成功率均≥50%。结论输卵管阻塞、排卵功能障碍及输卵管和排卵功能异常是导致育龄女性不孕的主要因素,子宫内膜异位、子宫或宫颈发育不良等是导致育龄女性不孕的影响因素,临床上主要使用输卵管通液术、常规输卵管吻合术、体外受精-胚胎移植术、药物、综合性治疗等方式对症治疗。确定不孕的影响因素后采取对症治疗,其成功怀孕率较为可观,但仍有待提升,因此治疗方式有待进一步的临床探索及实践。

Objective To analyze the influence factor of childbearing age women with infertility,and to explore the treatment method. Methods 120 childbearing age women with infertility from January 2012 to January 2014 in our obstetrics and gynecology department were selected as the research group.Questionnaire and clinical examination were used to analyze the impact factors of infertility.Corresponding treatments were conducted for the reasons of infertility.With 2 years followed-up after treatment,pregnancy success rate was understood. Results Influence factors of 120 childbearing age women with infertility were as follows,ovulation disturbance was 38.33%,fallopian tube obstruction was35.00%,other factors of ovulation dysfunction was 8.33%,endometriosis was 8.33%,other factors of tubal abnormality was 5.00%,uterus or the cervical dysplasia was 2.50%,other reasons was 1.67% and unknown reason was 0.83%.Among that,infertility resulted from ovulation disturbance and fallopian tube obstruction was 73.33%,which was higher than26.66% from other impact factors,with significant difference（P〈0.05）.The pregnancy success rate was 53.57% by using female pregnancy hormones regulated menstruation and HCG induced ovulation,the pregnancy success rate was 70.83%by using hydrotubation,conventional fallopian tube anastomosis and in vitro fertilization-embryo transplantation,the pregnancy success rate was 50.00% by using hormone drugs,the pregnancy success rate was 70.00% by using minimally invasive and hormone drugs,the pregnancy success rate was 33.33% by comprehensive symptomatic treatment,correcting and guiding the bad living habits.When the main influencing factors of infertility was determined,the symptomatic treatment was given,the pregnancy success rate was more than or equal to 50%. Conclusion Fallopian tube obstruction,ovulation disturbance,tubal and ovulation dysfunction are the main reasons that results childbearing agewomen with infertility.Endometriosis,uterus or the cervical dysplasia are impact factors of childbearing age women with infertility.Hydrotubation,conventional fallopian tube anastomosis and in vitro fertilization-embryo transplantation,drugs and comprehensive symptomatic treatment are main method in clinical.After determining the influence factors of infertility to take symptomatic treatment,the successful pregnancy rate is more considerable,but still need to be improved,so the treatment method still need to be further clinical exploration and Practice.