宫内节育器避孕后继发不孕不育问题的流行病学研究

Secondary infertility caused by intrauterine contraceptive device: an epidemiological study

目的探讨宫内节育器避孕后继发不孕不育的流行病学因素。方法选择在郑州大学第三附属医院生殖医学中心就诊的300例宫内节育器取出后继发不孕不育的妇女为研究对象,采取门诊问卷调查、进行相关检查并记录结果,分析宫内节育器避孕后继发不孕不育的流行病学因素与放置宫内节育器后的不良反应。结果结果显示放置宫内节育器继发不孕不育的主要因素中女性输卵管因素占41.00%,卵巢储备功能下降占10.33%,男方精液质量问题占11.67%,其次卵泡发育不良、排卵障碍、宫腔粘连、再次妊娠后自然流产等也是影响因素。宫内节育器放置后的并发症主要是放置宫内节育器早期月经增多(10.67%)、腰腹疼痛(8.33%)、移位脱落(5.00%)、月经不调(4.67%)、白带异味及外阴瘙痒(3.33%)、白带增多(2.33%)等。结论本研究显示女性输卵管因素为宫内节育器避孕后继发不孕的首要因素,早期月经增多为置环后主要不良反应,提示应对放置宫内节育器继发不孕不育的流行病学因素给予高度重视,及时发现、及时治疗。

Objective To explore the epidemiological factors of secondary infertility caused by intrauterine contraceptive device （IUD）. Methods Three hundred secondary infertility women after extracting IU D in Reproductive Medicine Center of the hospital were selected as research subjects, a questionnaire survey was conducted, related examinations were carried out, the results were recorded, the epidemiological factors of secondary infertility caused by 1UD and adverse reactions after placing IUD were analyzed. Results The main factors of secondary infertility caused by IUD were tubal factor （41.00%）, ovarian reserve function （ 10. 33% ） , the quality problems of male semen （ 11.67% ）, followed by follicular dysplasia, ovulatory dysfunction, intrauterine adhesion, spontaneous abortion after pregnancy. The main adverse reactions after placing IUD were hypermenorrhea （ 10. 67% ） , waist and abdomen ache （8.33%） , shifting and displacement （5.00%） , irregular menstruation （4. 67% ） , leucorrhoea with peculiar smell and vagina pruritus （3.33%） , leukorrhagia （2. 33 % ） . Conclusion The data showed that tubal factor is one the main factors of secondary infertility caused by IUD, hypermenorrhea is one of the main adverse reactions after placing IUD. It is suggested that more attention should be paid to epidemiological factors of secondary infertility caused by IUD, early detection and early treatment are necessary.