绍兴地区育龄期女性不孕症流行特征及病因调查

Epidemiological characteristics and etiology of reproductive age women with infertility in Shaoxing area

目的了解绍兴地区育龄期女性不孕症的流行特征及病因情况。方法回顾性分析2016年1月至2021年6月绍兴市4家医院接诊的1437例不孕症女性患者的相关临床资料,分析流行特征,并比较原发不孕患者(原发组,490例)和继发不孕患者(继发组,947例)的病因特点和感染情况。结果不孕症患者以25~<40岁年龄组分布最多,占85.11%。原发组和继发组患者在年龄分布以及初潮年龄<12岁、月经不规律和肥胖占比间的差异有统计学意义(χ^(2)=61.89、3.85、10.34和4.13,P均<0.05)。不孕症患者病因分布从高到低依次为输卵管因素占(38.48%)、宫颈因素(34.31%)、排卵因素(24.98%)和子宫因素(19.76%)。继发组输卵管因素和宫颈因素分别占50.48%和36.11%,均高于原发组(15.31%和30.82%),而原发组排卵因素和子宫因素分别占34.69%和28.78%,均高于继发组(19.96%和15.10%),组间比较差异均有统计学意义(χ^(2)=168.71、37.42、38.08和4.02,P均<0.05)。继发组支原体总感染率、单一和混合感染率分别为49.74%、39.60%和10.14%,均明显高于原发组的38.57%,32.65%和5.92%(χ^(2)=16.21、6.67和7.24,P均<0.05)。结论输卵管因素和宫颈因素是绍兴地区继发不孕的常见病因,尤其是支原体感染与继发不孕关系密切;初潮年龄<12岁、月经不规律、肥胖、排卵因素和子宫因素等在原发不孕患者中更常见。

Objective To understand the epidemiological characteristics and etiology of reproductive age women with infertility in Shaoxing area.Methods The clinical data of 1437 female cases with infertility treated in 4 hospitals in Shaoxing from January 2016 to June 2021 were retrospectively analyzed and statistically analyzed.The etiology and pathogen infection between primary infertility patients(primary infertility group,490 cases)and secondary infertility patients(secondary infertility group,947 cases)were compared.Results The majority of infertile patients were in the age of 25-40,accounting for 85.11%.There were significant differences in the proportions of age distribution,menarche age<12 years old,irregular menstruation and obesity between primary infertility group and the secondary infertility group(χ^(2)=61.89,3.85,10.34 and 4.13,P all<0.05).The distributions of etiology from high to low were oviduct factor(38.48%),cervical factor(34.31%)ovulation factor(24.98%)and uterine factor(19.76%).The proportions of oviduct factor and cervical factor in secondary infertility group accounted for 50.48%and 36.11%,respectively,which were higher than those of 15.31%and 30.82%in primary infertility group.While the proportions of ovulation factor and uterine factor in primary infertility group were 34.69%and 28.78%,respectively,which were higher than those of 19.96%and 15.10%in secondary infertility group.The differences were statistically significant(χ^(2)=168.71,37.42,38.08 and 4.02,P all<0.05).The total,single and mixed infection rates of mycoplasma in secondary infertility group were 49.74%,39.60%and 10.14%,respectively,which were all higher than those of 38.57%,32.65%and 5.92%in primary infertility group.The differences were statistically significant(χ^(2)=16.21,6.67 and 7.24,P all<0.05).Conclusions Fallopian tube factor and cervical factor are the common causes for secondary infertility in Shaoxing area,especially mycoplasma infection.Menarche age<12 years old,irregular menstruation,obesity,ovulation factor and uterine factor are main causes for primary infertility.