排卵障碍所致不孕症患者卵巢储备功能下降情况及其影响因素分析

Analysis of the decline of ovarian reserve function and its influencing factors in patients with infertility due to ovulation disorders

目的观察排卵障碍所致不孕症患者卵巢储备功能下降(DOR)情况,并分析其影响因素,为提高患者妊娠率提供参考数据。方法回顾性分析河南省息县人民医院2018年10月至2020年10月收治的116例不孕症患者的临床资料,根据资料中患者卵巢储备功能检测结果,将发生DOR的患者纳入发生组,未发生DOR患者纳入未发生组。查阅资料,统计两组基线资料(年龄、不孕年限、月经周期等)与实验室指标[游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)、卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)、抗苗勒管激素(AMH)],结合统计结果,分析排卵障碍所致不孕症患者DOR的影响因素。结果经统计,资料中116例不孕症患者DOR的发生率为55.17%;发生组流产次数、促排卵次数多于未发生组,子宫内膜异位症史患者占比多于未发生组,差异有统计学意义(P<0.05)。发生组血清FT3、FT4、TSH、FSH水平高于未发生组,AMH水平低于未发生组,差异有统计学意义(P<0.05)。构建Logistic回归模型得出,血清FT3、FT4、TSH过表达、流产≥3次、促排卵≥3次、子宫内膜异位症史、血清AMH低表达是排卵障碍所致不孕症患者发生DOR的危险因素(P<0.05)。结论排卵障碍所致不孕症患者普遍伴有DOR,血清FT3、FT4、TSH过表达、流产≥3次、促排卵≥3次、子宫内膜异位症史、血清AMH低表达均是导致DOR的危险因素。

Objective To observe the decline of ovarian reserve(DOR)in patients with infertility caused by ovulation disorder and analyze its influencing factors,so as to provide reference data for improving pregnancy rate.Methods The clinical data of 116 infertility patients admitted to Xixian People’s Hospital of Henan Province from October 2018 to October 2020 were retrospectively analyzed.According to the ovarian reserve function test results of patients in the data,patients with DOR were included in the occurrence group,and patients without DOR were included in the non-occurrence group.The baseline data(age,infertility years,menstrual cycle,etc.)and laboratory indicators[free triiodothyronine(FT3),free thyroxine(FT4),thyroid stimulating hormone(TSH),follicle stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2),anti-Mullerian hormone(AMH)]of the two groups were statistically analyzed.Combined with the statistical results,the influencing factors of DOR in patients with infertility caused by ovulation disorders were analyzed.Results The incidence of DOR in 116 infertility patients was 55.17%.The frequency of abortion and ovulation induction in the occurrence group was higher than that in the nonoccurrence group,and the proportion of patients with history of endometriosis was higher than that in the non-occurrence group,and the differences were statistically significant(P<0.05).The levels of serum FT3,FT4,TSH and FSH in the occurrence group were higher than those in the non-occurrence group,and the level of AMH was lower than that in the non-occurrence group,and the differences were statistically significant(P<0.05).The Logistic regression model showed that overexpression of serum FT3,FT4,TSH,abortion≥3 times,ovulation induction≥3 times,history of endometriosis,and low expression of serum AMH were risk factors for DOR in infertility patients with ovulation disorders(P<0.05).Conclusion Patients with infertility caused by ovulation disorders are generally accompanied by DOR.The over-expression of serum FT3,FT4,TSH,abortion≥3 times,ovulation induction≥3 times,history of endometriosis,and low expression of serum AMH are risk factors for DOR.