"Research on Infertility: Definition Makes a Difference" Revisited
"Research on Infertility: Definition Makes a Difference" Revisited
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DOI：
10.1093/aje/kwx240
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发表时间：
2018-02-01
影响因子：
5
通讯作者：
Howards, Penelope P.
中科院分区：
文献类型：
--
作者：
Jacobson, Melanie H.;Chin, Helen B.;Howards, Penelope P.
在1989年的论文中，Marchbanks等人（AmJ Epidemiol.一九八九年; 130（2）：259-267）指出，在研究和临床实践中，不孕症的定义不一致，并检查了不同定义的患病率估计值的差异。自他们的研究以来，与女性生殖健康有关的社会、技术和临床实践发生了重大变化。作为回应，我们使用最近在育龄妇女中进行的一项研究的数据重新审视了原始论文。通过评估有多少女性和哪些女性被归类为不孕症、她们不孕时的年龄以及不孕症后自发怀孕的可能性，对不孕症的各种定义进行了内部比较。结果也与Marchbanks等人进行了比较。根据“12个月无保护性交”的定义，黑人妇女比白色妇女更容易被归类为不育。（40.1% vs. 33.7%），但“尝试怀孕12个月”的可能性较小（14.3%对21.8%）和“看医生帮助怀孕”（8.4%对19.7%）。在无保护的性交12个月后，36.1%的试图怀孕的妇女在6个月内自然受孕，而没有试图怀孕的妇女只有13.5%。虽然我们对大多数不孕症定义的结果与Marchbanks等人的结果相似，流行率估计数在定义上仍因人口群体而异。
In a 1989 paper, Marchbanks et al. (AmJ Epidemiol. 1989; 130(2): 259-267) noted inconsistent definitions of infertility across research and clinical practice and examined differences in prevalence estimates across definitions. Since their study, there have been substantial changes in society, technology, and clinical practice related to female reproductive health. In response, we revisited the original paper using data from a recent study among reproductive-aged women. Internal comparisons across various definitions of infertility were made by assessing how many and which women were classified as infertile, their age at infertility, and the probability of spontaneous pregnancy after infertility. Results were also compared with Marchbanks et al. Black women were more likely to be classified as infertile than white women based on the definition "12 months of unprotected intercourse" (40.1% vs. 33.7%) but less likely by "12 months of attempting pregnancy" (14.3% vs. 21.8%) and "visiting a doctor for help getting pregnant" (8.4% vs. 19.7%). After unprotected intercourse for 12 months, 36.1% of women who were attempting pregnancy spontaneously conceived by 6 months compared with 13.5% of women who were not attempting pregnancy. While our results for most infertility definitions were similar to those of Marchbanks et al., prevalence estimates continued to differ across demographic groups by definition.