结核菌素皮肤试验阳性对宫腔内人工授精妊娠结局的影响

Effect of tuberculin skin test positive on pregnancy outcome of intrauterine insemination

目的探讨结核菌素皮肤试验(TST)阳性对宫腔内人工授精(IUI)妊娠结局的影响。方法回顾性分析2021年1—5月因不孕症于西北妇女儿童医院生殖中心行首次IUI患者的临床资料,共纳入257例患者。根据TST结果阳性与否分为TST阴性组(180例)和TST阳性组(77例),比较两组患者的一般资料、IUI资料和妊娠结局;又根据TST结果程度不同分为TST强阳性组(17例)和非强阳性组(240例),比较两组患者的妊娠结局。结果TST阴性组和阳性组患者年龄、不孕年限、体质量指数(BMI)、基础窦卵泡计数(AFC)、基础卵泡刺激素(FSH)、基础黄体生成素(LH)、不孕类型、输卵管因素性不孕占比、自然流产史及异位妊娠史占比均无显著性差异(P>0.05)。两组患者的卵泡生长方式和排卵前子宫内膜厚度均无显著性差异(P>0.05)。TST阴性组患者的HCG阳性率(23.89%vs.20.78%)和临床妊娠率(22.78%vs.20.78%)略高于对照组,但尚无显著性差异(P>0.05)。本研究随访至孕28周,两组患者流产率比较亦无显著性差异(17.07%vs.6.25%,P>0.05),且两组患者均未发生异位妊娠。TST强阳性组和非强阳性组的临床妊娠率、HCG阳性率和流产率亦无显著性差异(P>0.05)。结论TST结果阳性对IUI妊娠结局无明显影响。

Objective:To investigate the effect of tuberculin skin test(TST)positive on pregnancy outcome of intrauterine insemination(IUI).Methods:A retrospective cohort study was conducted to analyze 257 infertile patients who underwent IUI for the first time in Northwest Women’s and Children’s Hospital from January 2021 to May 2021.The patients were divided into TST negative group(n=180)and TST positive group(n=77)according to the results of TST test.The general information,IUI information and pregnancy outcomes of the two groups were compared.The patients were further divided into strong positive group(n=17)and non-strong positive group(n=240)according on the degree of TST positive result,and the pregnancy outcomes between the two groups were further analyzed.Results:There were no significant differences in age,infertility years,body mass index,basal antral follicle count,basal FSH,basal LH,infertility type,the proportion of tubal factor infertility,history of spontaneous abortion and history of ectopic pregnancy between TST negative group and TST positive group(P>0.05).There was no significant difference in follicular growth pattern and endometrial thickness before ovulation between the two groups(P>0.05).The HCG positive rate(23.89%vs.20.78%)and clinical pregnancy rate(22.78%vs.20.78%)in TST negative group were slightly higher than those in control group,but there was no significant difference(P>0.05).The study was followed up to 28 weeks of pregnancy.There was no significant difference in the abortion rate between the two groups(17.07%vs.6.25%,P>0.05),and no ectopic pregnancy occurred in the two groups.There was no significant difference in clinical pregnancy rate,HCG positive rate and abortion rate between the strong positive group and non-strong positive group.Conclusions:The TST positive result does not significantly affect the pregnancy outcome of IUI.