POPULATION STUDY OF CAUSES, TREATMENT, AND OUTCOME OF INFERTILITY
POPULATION STUDY OF CAUSES, TREATMENT, AND OUTCOME OF INFERTILITY
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DOI：
10.1136/bmj.291.6510.1693
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发表时间：
1985-01-01
影响因子：
105.7
通讯作者：
DESAI, KM
中科院分区：
文献类型：
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作者：
HULL, MGR;GLAZENER, CMA;DESAI, KM
专家不孕不育的做法在英国一个卫生区的居民人口中的708对夫妇中进行了研究。它们代表了每年每1000人中有1-2对夫妇的发病率。至少六分之一的夫妇在一生中的某个时候需要专家的帮助，因为他们平均不孕不育的时间为2.5年，其中71%的夫妇正在努力想要第一个孩子。去妇科诊所就诊的人占新就诊人数的10%，占所有就诊人数的22%。21%的患者排卵失败(闭经或月经过少)，治疗成功(两年妊娠率分别为96%和78%)。尽管做了手术，输卵管损伤(14%)的前景不佳(19%)。子宫内膜异位症占不孕症的6%，尽管很少因为输卵管损伤，宫颈粘液缺陷或功能障碍占3%，性交失败高达6%。精子缺陷或功能障碍是最常见的不育原因(24%)，并导致在没有捐赠者授精的情况下怀孕的几率很低(0-27%)。梗阻性无精子症或原发生精障碍并不常见(2%)，男性不育的激素原因也很少见。28%的不孕不育原因不明，妊娠几率(总体72%)主要由不孕期长短决定。体外受精可以使80%的输卵管损伤病例和25%的不明原因不孕症病例受益，即占所有病例的18%，相当于每年每百万人中最多有216例新病例。
Specialist infertility practice was studied in a group of 708 couples within a population of residents of a single health district in England. They represented an annual incidence of 1-2 couples for every 1000 of the population. At least one in six couples needed specialist help at some time in their lives because of an average of infertility of 2.5 years, 71% of whom were trying for their first baby. Those attending gynaecology clinics made up 10% of new and 22% of all attendances. Failure of ovulation (amenorrhoea or oligomenorrhoea) occurred in 21% of cases and was successfully treated (two year conception rates of 96% and 78%). Tubal damage (14%) had a poor outlook (19%) despite surgery. Endometriosis accounted for infertility in 6%, although seldom because of tubal damage, cervical mucus defects or dysfunction in 3%, and coital failure in up to 6%. Sperm defects or dysfunction were the commonest defined cause of infertility (24%) and led to a poor chance of pregnancy (0-27%) without donor insemination. Obstructive azoospermia or primary spermatogenic failure was uncommon (2%) and hormonal causes of male infertility rare. Infertility was unexplained in 28% and the chance of pregnancy (overall 72%) was mainly determined by duration of infertility. In vitro fertilization could benefit 80% of cases of tubal damage and 25% of unexplained infertility-that is, 18% of all cases, representing up to 216 new cases each year per million of the total population.