宫内节育器避孕妇女出现继发性不孕的危险因素分析

Risk factors of secondary infertility in women with intrauterine device

目的探讨宫内节育器(IUD)避孕妇女出现继发性不孕的危险因素。方法随机选择2016年4月至2018年4月汾西矿业(集团)有限责任公司职工总医院收治的128例IUD取出后备孕妇女为研究对象,观察其取出IUD后1内年继发性不孕发生情况,从年龄、体质指数(BMI)、宫腔操作次数、放置IUD年限、输卵管情况、阴道炎、子宫内膜炎、盆腔炎症、排卵情况、月经紊乱等方面,分析IUD避孕妇女出现继发性不孕的高危因素。结果影响IUD避孕妇女出现继发性不孕的单因素有宫腔操作次数、放置IUD年限、输卵管情况及排卵情况(P<0.05),与年龄、BMI、阴道炎、子宫内膜炎、盆腔炎症无关(P>0.05);影响IUD避孕妇女出现继发性不孕的独立危险因素有宫腔操作次数≥3次、放置IUD年限长、输卵管阻塞、排卵障碍(P<0.05)。结论宫腔操作次数过多、放置IUD年限长、输卵管阻塞、排卵障碍是导致IUD避孕妇女出现继发性不孕的独立危险因素,提示临床工作中应针对不同因素导致的继发性不孕采取相应防治措施,以降低继发性不孕发生风险。

Objective To investigate the risk factors of secondary infertility in women with intrauterine device(IUD).Methods A total of 128 women who had plan for pregnancy after IUD removal in General Hospital of Fenxi Mining Group Corporation from April 2016 to April 2018 were enrolled.The secondary infertility rate within one year after IUD removal was recorded.Then the high-risk factors of infertility after IUD removal were analyzed in terms of age,body mass index(BMI),times of uterine cavity operation,duration of IUD placement,fallopian tube condition,vaginitis,endometritis,pelvic inflammation,ovulation,and menstrual disorder.Results The single factors influencing infertility after IUD removal were times of uterine cavity operation,duration of IUD placement,fallopian tube condition and ovulation(P<0.05).And the infertility after IUD removal had no relation with age,BMI,vaginitis,endometritis and pelvic inflammation(P>0.05).The independent risk factors of infertility after IUD removal were times of uterine cavity operation≥3,long duration of IUD placement,fallopian tube obstruction and ovulatory dysfunction(P<0.05).Conclusions Excessive intrauterine operation,long IUD placement,fallopian tube obstruction and ovulatory dysfunction are independent risk factors of infertility after IUD removal in women,so the corresponding preventive measures are of vital importance to decrease the incidence of secondary infertility.