摘要
目的比较多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者与非PCOS患者行体外受精/卵胞质内单精子显微注射-胚胎移植(in vitro fertilization/intracytoplasmic sperm injection-embryo transfer,IVF/ICSI-ET)助孕的流产率并分析其影响因素。方法回顾性队列研究分析2014年1月至2019年6月期间于江西省妇幼保健院辅助生殖中心行IVF/ICSI-ET助孕后获临床妊娠的3556例患者,其中PCOS患者889例(PCOS组),单纯输卵管因素不孕患者2667例(对照组)。比较两组妊娠后临床结局,并通过单/多因素logistic回归分析流产的影响因素,最后按照单/双胎妊娠、体质量指数(body mass index,BMI)进行亚组分析。结果PCOS组流产率[11.81%(105/889)]、晚期流产率[5.29%(47/889)]显著高于对照组[9.19%(245/2667),P=0.023;3.64%(97/2667),P=0.031]。单因素logistic回归显示PCOS、双胎妊娠、高BMI、不孕年限延长是流产的风险因素。多因素logistics回归显示影响流产率的主要风险因素是双胎妊娠、PCOS以及两者的交互作用。亚组分析显示单胎妊娠时两组患者早期、晚期流产率没有区别;双胎妊娠时PCOS组患者早期流产率差异无统计学意义,晚期流产率[8.58%(29/338)]显著高于对照组[3.11%(37/1188),P<0.001]。结论行IVF/ICSI-ET助孕的PCOS患者单胎妊娠时流产率与单纯输卵管因素不孕患者相似,双胎妊娠时早期流产率与单纯输卵管因素不孕患者相似而晚期流产率显著增加。
Objective To explore the risk factors of abortion and their interactions in patients with polycystic ovary syndrome(PCOS)undergoing in vitro fertilization/intracytoplasmic sperm injection-embryo transfer(IVF/ICSI-ET).Methods A total of 3556 pregnant women who underwent IVF/ICSI-ET in Jiangxi Maternal and Child Health Hospital from January 2014 to June 2019 were analyzed,among which 889 women were diagnosed with PCOS(PCOS group)and 2667 women were diagnosed with infertility due to simple tube factors(control group).The clinical outcomes after pregnancy were compared between the two groups.Single and multiple logistic regression were used to find the influencing factors of abortion.Finally,subgroup analysis was conducted according to single/twin pregnancy and body mass index(BMI).Results The abortion rate[11.81%(105/889)]and the late abortion rate[5.29%(47/889)]in PCOS group were significantly higher than those in control group[9.19%(245/2667),P=0.023;3.64%(97/2667),P=0.031].Univariate logistic regression showed that PCOS,twin pregnancy,high BMI,long duration of infertility were the risk factors of abortion.Multivariate logistics regression showed that the main risk factors affecting abortion rate were twin pregnancy,PCOS,and the interaction between the two factors.Subgroup analysis found that there were no differences in the early and late abortion rates between the two groups when women were singleton pregnancy.When women were twin pregnancy,the rate of early abortion was similar between the two groups,while the late abortion rate[8.58%(29/338)]in PCOS group was significantly higher than that in control group[3.11%(37/1188),P<0.001].Conclusion The rate of abortion is similar for PCOS women and simple tube factor infertility women when they were singleton pregnancy after IVF/ICSI-ET treatment.PCOS women have a similar rate of early abortion and higher rate of late abortion than simple tube factor infertility women when they were twin pregnancy.
作者
夏雷震
伍琼芳
赵琰
胡毅娜
田莉峰
Xia Leizhen;Wu Qiongfang;Zhao Yan;Hu Yina;Tian Lifeng(Assisted Reproductive Center,Jiangxi Maternal and Child Health Hospital,Nanchang 330006,China)
出处
《中华生殖与避孕杂志》
CSCD
北大核心
2022年第2期142-149,共8页
Chinese Journal of Reproduction and Contraception
关键词
多囊卵巢综合征
受精
体外
单精子注射
卵胞质内
流产
自然
双胎妊娠
交互作用
Polycystic ovary syndrome
Fertilization in vitro
Sperm injection,intracytoplasmic
Abortion,spontaneous
Twin pregnancy
Interaction