生殖医学杂志

目的调查分析北京市和长治市三级妇幼专科医院女性不孕症患者的病因和特点,为不同级别城市的妇幼医疗保健机构开展更有针对性的不孕症诊治提供参考依据。方法选取2019年3～6月在首都医科大学附属北京妇产医院生殖医学科(A组,3 652例)和长治医学院附属长治市妇幼保健院妇科(B组,196例)就诊的不孕不育夫妇为调查对象,比较两组女性患者的一般情况、不孕症的病因构成及男女方不孕不育病因特点等。结果 A组女性患者的平均年龄和不孕年限显著高于B组(P<0.05)。不孕病因上,A组女性患者由盆腔因素和男方因素引起不孕的比例显著高于B组(分别为32.12%vs. 13.27%和51.23%vs. 21.94%,P<0.05);排卵障碍引起不孕的比例显著低于B组(42.61%vs. 77.55%,P<0.05)。两组女性患者均以卵巢性闭经或月经失调引起的不孕症为首位,A组显著低于B组(70.24%vs. 80.92%,P<0.05)。男方因素中两组患者均以弱精子症占首位,且A组显著高于B组(98.24%vs. 90.70%,P<0.05)。A组患者由2个病因引起不孕的比例显著高于B组(P<0.05)。A组患者由男方因素及男女双方因素引起不孕的比例均显著高于B组(P<0.05)。结论北京市和长治市三级妇幼专科医院的不孕症病因构成有显著差异,应在现有优势医疗资源的情况下,分别开展有侧重、有针对性的诊治。

Objective:To investigate the etiology and characteristics of female infertility in the third-level maternity and child specialist hospitals in Beijing and Changzhi city, in order to provide a reference for more targeted infertility diagnosis and treatment by maternal and child health care institutions in cities of different levels.Methods:The infertile couples had been investigated from March to June 2019 in the Department of Human Reproductive Medicine, Beijing Obstetrics & Gynecology Hospital, Capital Medical University(group A,n=3 652),and the Department of Gynecology, Changzhi Maternal and Child Health Care Hospital, Changzhi Medical College(group B,n=196). The general information and the etiology of infertile women, and the characteristics of female or male infertility were compared between the two groups.Results:The average age of infertile women was significantly older, and the infertile duration was significantly longer in group A than that in group B(P<0.05). The proportion of female infertility caused by pelvic(32.12% vs. 13.27%)or male factors(51.23% vs. 21.94%) in group A was significantly higher than that in group B(P<0.05),while the proportion of infertility caused by ovulation disorders in group A was significantly lower than that in group B(42.61% vs. 77.55%,P<0.05). The infertility caused by ovarian amenorrhea or menstrual disorders was the first in both groups, but the incidence of group A was significantly lower than that of group B(70.24% vs.80.92%,P<0.05). Asthenospermia was the first etiology for male infertility, and the incidence of group A was significantly higher than that of group B(98.24% vs. 90.70%,P<0.05). The proportion of infertility caused by two causes in group A was significantly higher than that in group B(P<0.05). The proportion of infertility caused by male factors, and both male and female factors in group A was higher than that in group B(P<0.05).Conclusions:There are significant differences in the etiology of infertility in the third-level maternity and child specialist hospitals in Beijing and Changzhi city. Under the condition of existing superior medical resources, the focused and targeted diagnosis and treatment respectively should be carried out.