Prevalence and risk factors of infertility in a Mongolian population

Objective:To investigate and analyze the prevalence and risk factors of infertility in a Mongolian population.Methods:We conducted a population-based cross-sectional study between September 2016 and November 2021.Our study population of 1919 participants consisted of residents of Ulaanbaatar city and four regions of Mongolia.A pretested standardized and structured questionnaire was used to gather data from the participants.Our questionnaire comprised categories influencing infertility,such as socioeconomic status,lifestyle factors,health,reproductive history,present status,and sexual function.In addition,trained staff conducted face-to-face interviews with the participants.Results:Our study showed an infertility incidence of 8.2%,with primary infertility at 2.76%and secondary infertility at 5.47%.Compared with the urban area of Ulaanbaatar,the prevalence of infertility was significantly higher amongst the rural population(P<0.001).Risk factors of infertility included advanced age(35-39 years,OR 1.8,95%CI 1.99-6.55;>40 years,OR 2.1,95%CI 2.62-8.55),living rural region(aOR 2.4,95%CI 1.62-3.69),alcohol consumption(aOR 1.6,95%CI 1.11-2.44),chronic diseases(aOR 1.6,95%CI 1.20-2.38),reproductive disease(aOR 2.6,95%CI 1.86-3.88),gynecological operative history(aOR 2.1,95%CI 1.38-3.21),ovarian cyst(aOR 4.2,95%CI 2.70-6.40),gonorrhea(aOR 2.4,95%CI 1.01-6.16),non-malignant uterine cancer(aOR 2.9,95%CI 1.40-6.70),and endometriosis(aOR 4.7,95%CI 1.41-15.62).Conclusions:In Mongolia,the average infertility rate is 8.2%,similar to the average worldwide and is significantly higher in rural communities.Our study shows the most significant risk factors for infertility are age,alcohol consumption,and rural living.In addition,an unfavorable gynecological history and some diseases also pose a risk to fertility.

Characterization and risk factors for unexplained female infertility in Sudan:A case-control study

BACKGROUND Female infertility with unknown causes(unexplained)remains one of the mysteries in the reproductive health field,where the diagnostic evidence is still weak and the proposed treatments still work with unknown methods.However,several studies have proposed some possible causes and risk factors for unexplained female infertility.AIM To characterize and identify factors associated with unexplained infertility in Sudanese women.METHODS A matched(age and body mass index)case-control study was conducted from March 2021 to February 2022.The study samples were 210 women with unexplained infertility(UI)and 190 fertile women of reproductive age who were attending the maternity hospitals and fertility clinics in Khartoum,Sudan.The risk factors of unexplained infertility were identified using a structured,pretested questionnaire containing information on socio-demographic variables,anthropometrics,clinical diagnosis of infertility,behavioral factors,physical activity assessment,diversity,and consumption of different food groups by the study participants.RESULTS The results showed a higher proportion of women diagnosed with UI were residents of rural areas than controls(21.4%vs 11.1%,P<0.05),and previous miscarriages and/or abortions were more common in fertile women compared with infertile women(13.16%vs 5.71%,P<0.05).Additionally,infertile women had a significantly(P<0.05)higher proportion of family history of infertility(explained and unexplained)compared with controls.Finally,after controlling for the effects of potentially confounding variables using multivariable logistic regression analysis,only marital status,family history of infertility,use of modern contraceptives,smoking,caffeine consumption,physical activity level,meals consumed,other vitamin-A-rich fruits and vegetables,and other vegetables were found to be significant(P<0.05)factors associated with unexplained infertility among Sudanese women.CONCLUSION Married women with a family history of infertility who smoke and consume a high amount of caffeine,who live a sedentary lifestyle,and who consume more than two meals free of vitamin-Arich fruits and/or vegetables and/or other vegetables per day are at the highest risk of developing unexplained infertility.

Outcomes for offspring of men having ICSI for male factor infertility

Since the introduction of intracytoplasmic sperm injection （ICSI） using single sperm isolated from testicular tissue in men with obstructive and non-obstructive azoospermia, or using ejaculated sperm in those with poor semen quality, there have been concerns that this might have adverse effects on the offspring compared to conventional in vitrofertilisation （IVF） and natural conceptions. ICSI is done for reasons other than male factor infertility, and on the whole has not been shown to have any more negative effects than those seen with IVF. There have however, been very few studies of ICSI with a focus on, or large enough numbers to examine, the specific outcomes associated with male factor infertility. From the limited information available in relation to the source of the sperm and aetiology of infertility in the presence of ICSI, there appears to be no increased risk of congenital malformations. There is, however, a small increase in both de novoand inherited chromosome abnormalities. In terms of growth and neurodevelopment, there are very few studies, and so far, no adverse outcomes have been found in young children whose fathers have a sperm defect. The origin of the sperm used in ICSI does not have a major influence on the early life outcomes for the offspring, but transgenerational and epigenetic effects remain unknown. When the male factor infertility is known or thought to be due to a Y-chromosome deletion, this information should be given to the young male offspring at a time that will ensure his own reproductive health and plans are optimized.

Male infertility: risk factors in Mongolian men

Aim: To determine the most common risk factors of male infertility in Mongolian men attending an infertility clinic. Methods: A prospective, case-control study was conducted in which 430 men were enrolled. All the men had sought their first infertility evaluation between 1998-2002 in the State Research Center on Maternal Child Health, Ulaanbaatar, Mongolia. They were divided into two groups depending on the results of their semen analysis: 191 with abnormal semen and 239 with normal semen profile. Univariate and multivariate analyses were performed to determine any association between risk factors and semen abnormality. Results: Logistic regression analysis demonstrated that the testicular volume, a history of sexually transmitted infections (STI), epididymitis and testicular damage all have statistically significant associations with semen abnormality, when controlled for multiple risk factors. Adjusted odds ratios of 3.4 for mumps orchitis, 2.3 for other orchitis and 3.9 for testicular injury were found. Gonorrhoea, the most commonly reported STIs in this study, gave an adjusted odds ratio of 1.0 for having one or more sperm abnormality. An adjusted odds ratio for subjects with a history of other STIs was 2.7. However, as a predictor of azoospermia, STIs had very high odds ratio, being 5.6 in patients with gonorrhoea and 7.6 in patients with other STIs. Conclusion: A history of pathology involving testicular damage appeared to have the strongest impact on male infertility in Mongolia. STIs have less impact on semen quality except when complicated by orchitis, epididymitis and vasal obstruction.

Clinical and investigative correlates of etiologic risk factors on treatment outcome of intrauterine adhesion in women with infertility: A descriptive study

Background: Intrauterine adhesion is a clinical entity that may present with subfertility. However, outcome of management depends on severity of intrauterine adhesion and type of treatment intervention employed. Objective: To evaluate clinical and investigative correlation of etiologic risk factors of intrauterine adhesion on fertility and pregnancy outcome following treatment. Patients and Methods: A 5 years prospective observational study. Treatment employed includes transvaginal blind intrauterine adhesiolysis, insertion of inert intrauterine device or inflated Foley’s catheter balloon and oestrogen therapy. Inclusion criteria are intrauterine adhesion as the only identifiable cause of infertility and post treatment follows up for at least a year. Results: Over a period of 5 years, 63 patients with mean age of 31.6 years and age range of 21 to 42 years were managed. Etiologic risk factors were dilatation and curettage 33 (52.4%), vacuum aspiration 13 (20.6%), myomectomy 11 (17.5%) and caesarean section in 6 (9.5%) patients. Of the 63 patients, 28 conceived giving a pregnancy rate of 44.4%. Nine out of the 28 patients that conceived had miscarriage, giving a miscarriage rate of 32.1%. The highest pregnancy rate and lowest miscarriage rate were recorded in the subgroup that had vacuum aspiration as their etiologic risk factor. Late pregnancy complications encountered are preterm contractions 5 (26.3%), placenta praevia 4 (21.1%), morbidly adherent placenta 5 (26.3%) and preterm delivery in 2 (10.5%) patients. Route of delivery was per vaginum in 13 (68.4%) patients and by caesarean section in 6 (31.6%) patients. Live birth rate was 89.5% (17/19 deliveries). There was no maternal mortality recorded. Conclusion: Compared to other risk factors, uterine vacuum aspiration was associated with higher fertility rate and better pregnancy outcome.

A case-control study of risk factors for male infertility in Nigeria

Aim： To evaluate the association between selected potential socio-demographic and behavioral risk factors and infertility in Nigerian men. Methods： There were two groups in this study. One group consisted of 150 men with proven male infertility, and the other consisted of 150 fertile men with normal semen parameters. Both were matched for age, place of residence and key socio-demographic variables. They were compared for sexual history, past medical and surgical history, past exposures to sexually transmitted infections and treatment, past and current use of drugs as well as smoking and alcohol intake history. Results： Infertile men were significantly more likely than fertile men to report having experienced penile discharge, painful micturition and genital ulcers, less likely to seek treatment for these symptoms and more likely to seek treatment with informal sector providers. Multivariate analysis showed that male infertility was significantly associated with bacteria in semen cultures, self-reporting of previous use of traditional medications and moderate to heavy alcohol intake, but not with smoking and occupational types. Conclusion： Infertility is associated with various proxies of sexually transmitted infections （STIs） and poor healthcare-seeking behavior for STIs in Nigerian men.

Types of Infertility and Its Risk Factors among Infertile Women: A Prospective Study in Dhaka City

Background: Infertility is a global health issue, and it is a multidimensional problem with social, economic, and cultural influences. Objectives: The study aimed to determine types of infertility and their contributing factors among the respondent infertile women. Methods: This prospective cross-sectional study was conducted among infertile women visiting Sir Salimullah Medical College and Hospital, Dhaka. From January to December 2020, 111 infertile women were included and evaluated for infertility types and their contributing factors. Data were collected by face-to-face interviewing, and data were analyzed statistically. Results: Primary infertility was found among 90 (81%) and secondary infertility among 21 (18.9%). Among the direct risk factors of female infertility, ovulation failure was the majority of the cases, 74 (35.1%), and its mainly observed in primarily infertile women 58 (33.9%). These observations were statistically significant. Conclusions: Infertility should be treated as a public health problem, government and non-government organizations should develop a basic policy to create effective fertility centers.

The effect of Chinese herbal medicine“heche assisted pregnancy recipe”on endometrial estrogen and progesterone receptor,proliferating cell nuclear antigen and vascular endothelial growth factor in the patients with infertility

Objectives:To investigate the effect of Chinese herbal medicine"heche assisted preg-nancy recipe (HCAPR)" on estrogen receptor(ER), progesterone receptor (PR), pro-lifierating cell nuclear antigen(PCNA) and vascular endothelial growth factor (VEGF)in endometrium of infertile women.Methods: The S-P immunohistochemical assay was used to observe expression ofER, PR , PCNA and VEGF in late proliferative phase before and after the HCAPR treat-ment.Results: After the treatment, the expression of ER,PR,PCNA and VEGF in nucleiof glandular epithelium and stromal cells was significantly stronger (all P＜0. 001) re-spectively than that before treatment , especially the expression of PCNA and VEGF.Conclusions: These results suggest that traditional Chinese medicine HCAPR oftonifying kidney and regulating menstruation increased the synthesis of ER,PR, PCNAand VEGF, which may promote normal growth and development of the endometrium ,improve the micro-environment of the endometrium, and enhance uterine receptivity.The evidence may provide theoretical basis for therapy infertility with Chinese herbalmedicine.

The prevalence of azoospermia factor microdeletion on the Y chromosome of Chinese infertile men detected by multi-analyte suspension array technology

Aim： To develop a high-throughput multiplex, fast and simple assay to scan azoospermia factor （AZF） region microdeletions on the Y chromosome and establish the prevalence of Y chromosomal microdeletions in Chinese infertile males with azoospermia or oligozoospermia. Methods： In total, 178 infertile patients with azoospermia （nonobstructed）, 134 infertile patients with oligozoospermia as well as 40 fertile man controls were included in the present study. The samples were screened for AZF microdeletion using optimized multi-analyte suspension array （MASA） technology. Results： Of the 312 patients, 36 （11.5%） were found to have deletions in the AZF region. The rnicrodeletion frequency was 14% （25/178） in the azoospermia group and 8.2% （11/134） in the oligospermia group. Among 36 patients with microdeletions, 19 had deletions in the AZFc region, seven had deletions in AZFa and six had deletions in AZFb. In addition, four patients had both AZFb and AZFc deletions. No deletion in the AZF region was found in the 40 fertile controls. Conclusion： There is a high prevalence of Y chromosomal microdeletions in Chinese infertile males with azoospermia or oligozoospermia. The MASA technology, which has been established in the present study, provides a sensitive and high-throughput method for detecting the deletion of the Y chromosome. And the results suggest that genetic screening should be advised to infertile men before starting assisted reproductive treatments.

Psychometric properties of the Chinese version of the Infertility Self-Efficacy Scale

Objective:To translate the English version of Infertility Self-Efficacy Scale into Chinese and to validate the psychometric properties of the Chinese version of the Infertility Self-Efficacy Scale(CISE).Method(s):Participants were recruited from the Gynecology Department of two city hospitals.Five main processes were involved in the formation of CISE[1]:scale translation based on expert consultation[2];pre-test questionnaire development with infertile women's feedback(N=20)[3];factor structure assessed by exploratory and confirmatory factor analysis(N=177)[4];assessment of reliability by internal consistency(N=177)and test-retest reliability(N=21);and[5]assessment of convergent validity with Self-rating Anxiety Scale,Self-rating Depression Scale,and Simplified Coping Style Questionnaire(N=177).Results:This study established a 16-item CISE.Factor analyses confirmed a onecomponent solution,which explained 54.59% of total variances and showed an acceptable model fit.Cronbach's a and test-retest correlation coefficients for the scale were 0.94 and 0.84,respectively.The CISE score was significantly correlated with anxiety(r=0.47),depression(r=0.60),positive coping style(r=0.37),and certain negative coping style items.Conclusion:This 16-item CISE is a reliable and valid measure to evaluate perceived selfefficacy among a sample of Chinese women who underwent infertility treatment.

Infertility in China: Culture, society and a need for fertility counselling

With a high rate of infertility, it is important to understand the context of fertility and family planning in China, to inform the necessity of supportive care. A literature review was undertaken to explore the societal constructs informing perspectives of childbearing, family planning and infertility, alongside Chinese considerations of fertility treatments, including assisted reproductive technologies and fertility counselling. In China, childbearing attitudes and behaviours are shaped by tensions between traditional cultural values of the filial piety originating from Confucianism, the history of strict family planning policy, the recent termination of one-child policy and the socioeconomic circumstance. For infertile Chinese individuals, the inability to meet these childbearing expectations gives rise to significant pressure and consequent psychological distress, particularly depressive symptoms. Demographic factors such as gender, education, income and geographical location have been found to influence prevalence and degree of depression in infertile Chinese men and women. These difficulties are compounded by barriers of cultural acceptance, legislative restrictions and availability of resources for alternative options such as adoption and surrogacy. It is important that these fertility sociocultural factors are taken into consideration when assisting Chinese patients to access and utilise fertility treatment services.

Yq AZF microdeletions in male infertility:An update on the phenotypic spectrum,epidemiology and diagnostics

According to the latest data,globally 15%of couples have infertility and male infertility contributes to 10%of all cases.Infertility can be caused by certain biological changes in the gonads and the reproductive system like azoospermia,oligospermia,asthenospermia,teratozoospermia and hypospermatogenesis.Genetic causes of azoospermia include chromosomal abnormalities,Y chromosome microdeletions and deletion or other mutations of Y-linked genes.The maximum number of the genes are located in the azoospermia factor region of the long arm(Yq)of the Y chromosome.Y chromosome microdeletion is known as the second major genetic cause of spermatogenetic failure.This article aims to review the latest updates on the involvement of Yq microdeletions in male infertility.The diagnostics,prevalence and phenotypic spectrum related to Yq gene microdeletions are discussed.

Genetics and male infertility

The goal of this review is to explain the requirement for understanding the genetic structure of infertility arising from male factor and to discuss the essentials of these genetic elements(2). The majority of the population is affected by this disorder caused by male factor infertility(1); but the etiologies are still unknown. After the primary genetic structure in infertile phenotypes is searched, an evaluation can be made. Thus the reasons causing infertility can be discovered and patients can benefit from effective therapies(1). Publications about male infertility within the recent 10 years in the Pubmed database were discussed(1). There are some approachments for describing the function of specificgenes, but no adequate study is present to be useful for diagnosing and treating male infertility(1). Male fertility and fertility in offspring of males are considerably affected by the exact transition of epigenetic information(1). When the genetic factors playing a role in male infertility were analysed, significant steps will be taken for treating patients and determining the reasons of idiopathic infertility(1). Developments in technology associated with the impact of genetics may enable to specify the etiology of male infertility by determining specific infertile phenotype marks(1).

女性不孕症影响因素分析及应对策略

目的探讨女性不孕症及生育力影响因素。方法对2021年7月至2023年6月到昆明市妇幼保健院就诊的776例符合纳入条件的不孕女性进行一般情况、既往病史、辅助检查结果等相关数据采集,采用多因素Logistic回归模型探讨不孕症的影响因素。结果女性不孕症患病率较高年龄段集中在26~35岁,病因复杂、相互影响,其中输卵管因素、排卵障碍、卵巢储备功能低下为主要原因,分别占不孕患者的48.32%、19.20%、10.57%,原发性和继发性不孕患者上述3类病因占比P值分别为<0.001,<0.001,0.42。多因素Logistic回归模型结果提示,年龄(95%CI:1.14~1.21)、孕前体质指数(95%CI:0.74~10.83,1.28~2.30)、吸烟史(95%CI:1.27~17.66)、月经紊乱(95%CI:3.52~8.68)、人工流产史(95%CI:1.08~2.19,5.52~15.22)、泌尿/生殖道感染史(95%CI:3.74~6.42)和宫腹腔手术史(95%CI:3.99~7.40)是女性生育力的主要影响因素。女性不孕的首要影响原因是输卵管阻塞,其与不洁性生活史、流产及盆腔手术操作等有关;次要原因包括排卵障碍,其与卵巢储备功能低下、内分泌紊乱、生育延迟等有关。结论女性不孕症的主要影响因素包括输卵管因素、排卵障碍及卵巢储备功能低下,同时,年龄、孕前体质指数、居住地、吸烟史、月经周期、人工流产次数、泌尿生殖道感染史、宫腹腔手术史和全身疾病史均是生育力的影响因素,需针对病因及影响因素,积极预防、治疗。

105例不孕症患者子宫输卵管造影结果影响因素的Logistic回归分析

目的探讨不孕症患者子宫输卵管造影结果发生异常的影响因素。方法选取2021年1月至2023年5月在湖南中医药大学第二附属医院妇科门诊就诊并接受X线子宫输卵管造影(X-ray hysterosalpingography,X-HSG)检查的105例不孕症患者,收集患者临床资料包括年龄、月经周期、不孕症类型、支原体感染史、衣原体感染史、淋病奈瑟球菌感染史、盆腔炎相关病史、输卵管相关病史等,并填写《中医体质调查问卷表》,采用Logistic回归方程分析不孕症患者X-HSG结果的影响因素。结果X-HSG结果异常与盆腔炎相关病史、输卵管相关病史、年龄、气郁质及湿热质呈正相关(P<0.05),与不孕症类型、月经周期规律与否无相关性(P>0.05)。多因素Logistic回归分析结果显示:不孕症类型、月经周期、气郁质、湿热质是HSG发生异常的危险因素(OR>1),年龄、盆腔炎相关病史、输卵管相关病史是HSG发生异常的保护因素(OR<1)。结论适龄生育、减少盆腔炎相关病史、减少输卵管相关病史、调畅情志、忌食肥甘厚味对于减少输卵管病理损伤引起的不孕症至关重要。

不孕不育人群生殖道沙眼衣原体感染影响因素分析

目的了解不孕不育门诊人群生殖道沙眼衣原体(CT)感染现状及影响因素,为制定该人群的CT防治策略提供依据。方法2021年4—12月在深圳市宝安区4家开设有不孕不育门诊的医疗机构的常规就诊者中招募调查对象。在获得知情同意情况下,收集其社会人口学相关信息并采集尿液标本进行CT核酸检测。运用Logistic回归分析该人群CT感染的影响因素。结果共招募954例不孕不育患者,CT阳性率为3.56%。Logistic回归分析结果表明,年龄<25岁(OR=3.91,95%CI:1.58~9.67)、文化程度为大专(OR=4.33,95%CI:1.23~15.24)、最近1年性伴数量≥2个(OR=4.25,95%CI:1.72~10.55)是该人群感染CT的危险因素。在调查对象中,74.42%不了解CT感染的相关症状,73.90%既往未检测过CT。结论深圳市宝安区不孕不育人群CT感染率较高,性活跃年龄段、文化程度相对较低、有多个性伴是CT感染的危险因素,应在不孕不育专科门诊中针对以上人群开展CT筛查,同时开展健康宣传,提高人群生殖健康。

不孕症患者IVF-ET后不明原因反复种植失败的预测因素分析

目的分析不孕症患者体外受精-胚胎移植(IVF-ET)后不明原因反复种植失败(RIF)的预测因素。方法前瞻性纳入2020年6月至2022年6月无锡市妇幼保健院接诊的82例IVF-ET的不孕症患者作为研究对象,根据RIF发生原因将患者分为RIF组与不明原因RIF组。比较两组患者的基线资料、实验室指标,分析IVF-ET后不明原因RIF的影响因素;分析各项影响因素对不孕症患者IVF-ET后不明原因RIF的预测价值。结果82例患者中不明原因RIF 22例,占比为26.83%。Logistic回归分析结果显示,高水平CD4^(+)/CD8^(+)、纤维蛋白原(FIB)是不孕症患者IVF-ET后不明原因RIF的独立危险因素(OR>1,P<0.05),高水平抗米勒管激素(AMH)、血管内皮生长因子(VEGF)、粒细胞集落刺激因子(G-CSF)是其保护因素(OR<1,P<0.05)。绘制受试者工作特征(ROC)曲线结果显示,AMH、CD4^(+)/CD8^(+)、FIB、VEGF、G-CSF预测不孕症患者IVF-ET后不明原因RIF的曲线下面积(AUC)>0.70,均具有一定预测价值。结论AMH、CD4^(+)/CD8^(+)、FIB、VEGF、G-CSF对不孕症患者IVF-ET后不明原因RIF有一定预测价值。

四维超声子宫输卵管造影术对输卵管性不孕症患者术后妊娠影响

目的:探讨输卵管性不孕症患者行四维超声子宫输卵管造影(4D HyCoSy)结果及与术后自然妊娠关系。方法:收集2021年11月-2023年7月于本院生殖中心门诊疑为输卵管性不孕症,行4D-HyCoS检查显示至少有一侧输卵管通畅或双侧输卵管轻度通而不畅、年龄22~40岁并检查后积极备孕患者120例临床资料。收集患者一般临床资料及造影结果,随访患者造影术后6个月内自然妊娠情况并分为自然妊娠组(n=32)以及非自然妊娠组(n=88)。对比两组一般资料、输卵管通畅情况以及自然妊娠情况,采用多因素分析各因素对造影术后自然妊娠的影响。结果:术后6个月累计妊娠32例(26.7%),妊娠组年龄及不孕年限均小于非妊娠组,输卵管通畅度优于非妊娠组;logistic回归分析显示,年龄大、不孕时间长、输卵管通畅性不佳是和4D HyCoSy后6个月内自然妊娠的不利因素(均P<0.05)。结论:4D-HyCoSy技术能够在检查后短期内提升输卵管不孕症女性的自然妊娠几率;患者年龄大、不孕时间长及输卵管通畅度不佳影响4D-HyCoSy检查后自然妊娠。

输卵管阻塞性不孕患者血清TGF-β1、IL-2、MMP-9水平及临床意义

目的:分析输卵管阻塞性不孕患者血清转化生长因子-β1(TGF-β1)、白细胞介素-2(IL-2)、基质金属蛋白酶-9(MMP-9)水平变化及临床意义。方法:以本院2022年3月-2023年10月诊治的60例输卵管阻塞性不孕患者为病例组,正常妊娠分娩的女性50例为对照组。测定对比两组血清TGF-β1、IL-2、MMP-9水平,Pearson相关性分析血清指标间相关性,受试者工作特征(ROC)曲线分析血清指标诊断不孕效能,logistic多因素回归分析输卵管阻塞性不孕发生影响因素。结果:病例组术前血清TGF-β1(593.79±148.23 ng/L)、IL-2(3.90±0.75 ng/L)、MMP-9(384.88±86.87 ng/ml)水平均高于对照组(239.42±113.37 ng/L、3.09±0.84 ng/L、178.98±80.85 ng/ml),术后血清TGF-β1、IL-2、MMP-9水平较术前均下降,血清TGF-β1与IL-2、MMP-9,及IL-2与MMP-9均呈正相关(均P<0.05)。ROC曲线分析,诊断不孕TGF-β1曲线下面积(AUC)0.941、敏感度88.3%、特异度94.0%,IL-2 AUC 0.778、敏感度66.7%、特异度84.0%,MMP-9 AUC 0.946、敏感度88.3%、特异度86.0%,3指标联合诊断AUC为0.992,敏感度93.3%、特异度100.0%。logistic回归分析,血清TGF-β1、IL-2、MMP-9异常升高是输卵管阻塞性不孕发发生的危险因素(均P<0.05)。结论:输卵管阻塞性不孕患者血清TGF-β1、IL-2、MMP-9水平均高表达,且是不孕发生的危险因素,3者联合检测对输卵管阻塞性不孕有较高诊断价值。

9852例男性不育患者精液质量及其影响因素分析

目的分析9852例男性不育患者的精液参数,探讨男性不育患者精液质量及其影响因素。方法选取2018年1月至2022年12月就诊于温州市中医院的9852例男性不育患者,分析精液参数包括精液外观、精液量、黏稠度、凝集度、液化时间、pH值、精子浓度、精子总数、精子总活动率[前向运动精子(PR)+非前向运动精子(NP)]、PR和正常形态精子百分率。按检测年份、患者年龄、禁欲天数进行分组,分析精液常规指标,并与同期本院体检已生育男性673名(对照组)进行比较。采用多元线性回归分析患者感染状况、生活习惯和职业特点等因素对精液参数的影响。结果不育组精液异常率结果从高到低依次为:正常形态精子百分率、PR、黏稠度、pH值、液化时间、精子总活动率、精子浓度、精子总数、精液量和凝集度。不育组的pH值、液化时间、精子浓度、精子总数、精子总活动率、PR、正常形态精子百分率均低于对照组,差异均有统计学意义(均P<0.01)。2018—2022年不同检测年份的精子浓度、精子总数和正常精子形态百分率呈逐年下降趋势,差异均有统计学意义(均P<0.05);不同年龄分组中,随着患者年龄增长,精子总数、精子总活动率和PR随之降低,差异均有统计学意义(均P<0.001);不同禁欲天数分组中,患者精子浓度、精子总活动率、精子总数和PR的差异均有统计学意义(均P<0.05)。多元线性回归分析,前列腺炎、解脲脲原体感染、吸烟、饮酒、温热以及刺激气味环境与精子浓度、精子总数、精子总活动率、PR和正常精子形态百分率有关;久坐与精子总活动率、PR和正常精子形态百分率有关。结论2018—2022年男性不育患者精子浓度、精子总数和正常形态精子百分率呈逐年下降趋势;年龄、禁欲天数、泌尿生殖道感染(前列腺炎、解脲脲原体感染)、不良的生活习惯(吸烟、饮酒、久坐)和职业暴露(温热、刺激气味环境)可能是影响不育男性精液质量的因素。