Adverse Outcomes of IVF/ICSI Pregnancies Vary Depending on Aetiology of Infertility.
Adverse Outcomes of IVF/ICSI Pregnancies Vary Depending on Aetiology of Infertility.
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DOI：
10.5402/2012/451915
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发表时间：
2012-01-01
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影响因子：
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通讯作者：
Heinonen, Seppo
中科院分区：
文献类型：
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作者：
Kuivasaari-Pirinen, Paula;Raatikainen, Kaisa;Heinonen, Seppo
体外受精（IVF）是妊娠的一个危险因素，但很少有关于不孕症病因学影响的研究。因此，我们在一项回顾性队列研究中评估了病因学对IVF妊娠结局的作用，该研究比较了芬兰普通人群中IVF单胎妊娠与自发妊娠的结局。研究组由255名通过单胎IVF妊娠分娩的妇女组成。根据不孕的原因分为六个亚组：无排卵（27%），子宫内膜异位症（19%），男性因素（17%），输卵管因素（15%），多囊卵巢综合征（11%）和不明原因的不孕症（12%）。参考组由26，870名自然受孕的妇女组成。使用logistic回归分析估计年龄和产次等混杂因素的校正比值比（AOR）。患有子宫内膜异位症和无排卵的女性早产风险增加（AOR分别为3.25，95% CI 1.5-7.1和AOR 2.1，95% CI 1.0-4.2），而男性因素不孕夫妇中的女性有两倍的新生儿重症监护风险（AOR 2.5，95%CI 1.2-5.3）。研究结果表明，不孕症的病因影响产科结局，汇总结果可能掩盖了亚组中一些增加的风险。
In vitro fertilization (IVF) is a risk factor for pregnancy, but there have been few studies on the effect of infertility's aetiology. Thus, we have assessed the role of aetiology on IVF pregnancy outcomes in a retrospective cohort study comparing the outcomes of IVF singleton pregnancies with those of spontaneous pregnancies in the general Finnish population. The study group consisted of 255 women with births resulting from singleton IVF pregnancies. Six subgroups were formed according to the following causes of infertility: anovulation (27%), endometriosis (19%), male factor (17%), tubal factor (15%), polycystic ovary syndrome (11%), and unexplained infertility (12%). The reference group consisted of 26,870 naturally conceived women. Adjusted odds ratios (AORs), for confounding factors such as age and parity, were estimated using logistic regression analysis. Women with endometriosis and anovulation had increased risks of preterm birth (AOR 3.25, 95% CI 1.5-7.1 and AOR 2.1, and 95% CI 1.0-4.2, resp.), while women in couples with male factor infertility had a twofold risk of admission to neonatal intensive care (AOR 2.5, 95% CI 1.2-5.3). The findings show that the aetiology of infertility influenced the obstetrics outcome, and that pooling results may obscure some increased risks among subgroups.