育龄期女性宫内节育器取出后继发不孕的影响因素

Influencing factors of secondary infertility after removal of intrauterine device in women of childbearing age

目的:分析育龄期女性宫内节育器(IUD)取出后继发不孕的影响因素。方法:回顾性分析2018年2月至2021年2月该院收治416例育龄期女性的临床资料,统计育龄期女性IUD取出后继发性不孕症的发生情况,根据育龄期女性IUD取出后备孕1年内是否妊娠分为不孕组80例和正常妊娠组336例,采用Logistic回归分析育龄期女性IUD取出后继发不孕的影响因素。结果:不孕组血浆同型半胱氨酸(Hcy)水平、宫腔操作次数>2次、合并输卵管阻塞、合并排卵障碍、合并子宫内膜炎、合并盆腔炎占比均高于正常妊娠组,差异有统计学意义(P<0.05);Logistic回归分析结果显示,Hcy水平高、宫腔操作次数>2次、合并输卵管阻塞、合并排卵障碍、合并子宫内膜炎、合并盆腔炎均为影响育龄期女性IUD取出后继发不孕的危险因素(OR>1,P<0.05)。结论:血浆Hcy水平高、宫腔操作次数>2次、合并输卵管阻塞、排卵障碍、子宫内膜炎、盆腔炎均为影响IUD取出后患者继发不孕的危险因素。

Objective:To analyze influencing factors of secondary infertility after removal of intrauterine device(IUD)in women of childbearing age.Methods:The clinical data of 416 women of childbearing age admitted to the hospital from February 2018 to February 2021 were retrospectively analyzed.The incidence of secondary infertility after IUD removal in them was analyzed.According to whether the women of childbearing age were pregnant within one year after IUD removal,they were divided into infertility group(80 cases)and normal pregnancy group(336 cases).Logistic regression was used to analyze the influencing factors of secondary infertility after IUD removal in the women of childbearing age.Results:The plasma homocysteine(Hcy)level,the number of intrauterine operation>2 times and the proportions of combined fallopian tube obstruction,combined ovulation disorder,combined endometritis,and combined pelvic inflammatory disease in the infertility group were higher than those in the normal pregnancy group,and the differences were statistically significant(P<0.05).Logistic regression analysis showed that high Hcy level,the number of intrauterine operation>2 times,combined fallopian tube obstruction,combined ovulation disorder,combined endometritis,and combined pelvic inflammatory disease were all risk factors for secondary infertility after IUD removal in the women of childbearing age(OR>1,P<0.05).Conclusions:High Hcy level,the number of intrauterine operation>2 times,combined fallopian tube obstruction,combined ovulation disorder,combined endometritis,and combined pelvic inflammatory disease are the risk factors for secondary infertility after IUD removal in the women of childbearing age.