宫内病变、子宫内膜与不孕症的相关性分析

Correlation between intrauterine lesions,endometrium and infertility

目的分析宫内病变、子宫内膜与不孕症的相关性。方法回顾性分析2014年6月至2016年6月我院200例女性不孕症患者临床资料,纳入不孕组,分为原发不孕组(n=138)和继发不孕组(n=62)两个亚组;另收集同期60例已生育、无妇科病史育龄女性临床资料,纳入对照组。观察不孕组患者宫内病变情况,比较不孕组与对照组受试者月经周期中子宫内膜差异,分析宫内病变、子宫内膜与不孕症的相关性。结果原发不孕组子宫内膜息肉(endometrial polyp,EP)发生率高于继发不孕组,宫腔粘连发生率低于继发不孕组(P<0.05)。Logistics回归分析显示:EP是原发不孕发生的独立危险因素,宫腔粘连为继发不孕发生的独立危险因素(P<0.05)。月经周期中个时间段不孕组子宫内膜均小于对照组(P<0.05),子宫内膜与不孕症发生呈正相关(r值分别为0.721、0.730、0.729,P<0.05)。结论宫内病变致不孕中,子宫内膜息肉、宫腔粘连分别为导致原发不孕和继发不孕的常见病变类型,月经周期中子宫内膜较小亦为不孕症患者的特征性表现,加强对上述情况的检查对不孕症的诊断治疗有一定意义。

Objective To investigate the correlation between intrauterine lesions,endometrium and infertility.Methods The clinical data of 200 female patients with infertility who were treated in our hospital from June 2014 to June 2016 were retrospectively analyzed,who were divided into primary infertility group(n=138)and secondary infertility group(n=62).Moreover the other 60 reproductive age women who had childbearing history and did not have gynecological history were enrolled as control group.The intrauterine lesions in infertility group were observed.The differences of endometrium during menstrual cycle were observed and compared between infertile group and control group.In addition the correlation between intrauterine lesions,endometrium and infertility was analyzed.Results The incidence rate of endometrial polyp(EP)in primary infertility group was significantly higher than that in secondary infertility group,and the incidence rate of intrauterine adhesions was significantly lower than that in secondary infertility group(P<0.05).Logistics regression analysis showed that endometrial polyps was an independent risk factor of primary infertility,and intrauterine adhesion was an independent risk factor of secondary infertility(P<0.05).The endometrium during menstrual cycle in infertile group was significantly smaller than that in control group(P<0.05),and the endometrium was closely positively correlated with infertility(P<0.05).Conclusion In the infertility caused by intrauterine lesions,EP and intrauterine adhesion are common types of lesions leading to primary infertility and secondary infertility.The smaller endometrium during menstrual cycle is also characteristic manifestation of patients with infertility,therefor,to strengthen the examination for the above condition has a certain significance for the diagnosis and treatment of infertility.