含铜宫内节育器与继发不孕病因的相关性研究
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摘要
目的探讨使用含铜宫内节育器避孕与妇女继发不孕病因间的相关性。方法选取2015年8月至2016年8月来郑州大学第三附属医院生殖中心就诊的300例已婚妇女进行回顾性分析,根据既往是否使用含铜宫内节育器避孕将调查对象分为两组(研究组和对照组)。通过调查问卷的形式对所收集到的信息进行统计分析,并对两组育龄妇女的各项临床指标和不孕的原因进行比较。结果研究组放置含铜宫内节育器的时间平均为(54.91±3.02)个月,两组继发不孕原因相比,输卵管因素(分别为43.8%、39.8%)、男方因素(分别为20.2%、21.4%)、排卵障碍(分别为19.2%、22.4%)、卵巢储备下降(分别为9.9%、8.5%)等,差异无统计学意义(P>0.05)。结论输卵管因素是造成宫内节育器避孕后育龄妇女继发不孕的主要原因,其他还包括男方因素、排卵障碍、卵巢储备下降及不明原因不孕。通过本次大样本的研究表明,使用含铜宫内节育器避孕与育龄妇女继发不孕病因间无明显相关性,含铜宫内节育器不增加妇女继发不孕的发生,可作为我国育龄妇女的安全避孕方式。
Objective To study the relationship between Cu IUD and secondary infertility. Methods A retrospective cohort study was conducted from the reproductive medicine center in the Third Affiliated Hospital of Zhengzhou University from August 2015 to August 2016. A total of 300 married women were selected as participants. They were divided into two groups( case and control) based on previous history of using Cu T-380 A IUD. Data were gathered using a standard. Results Mean period of Cu IUD usage in the case group was( 54. 91 ± 3. 02) Months. There was no significant difference between the two groups in the causes of secondary infertility for tubal factor( 43. 8% and 39. 8%,respectively),male factor( 20. 2% and 21. 4%,respectively),ovulation dysfunction( 19. 2% and 22. 4%,respectively),and ovary funtion abates( 9. 9% and 8. 5%,respectively)( P > 0. 05). Conclusion Tubal factor is the main cause of infertility in the reproductive women after intrauterine contraceptive device. Other factors also included decreased ovarian reserve,decreased semen quality,etc. Given the relatively large sample size studied here,it is unlikely that Cu IUD results in secondary infertility and may be used by our country's women as a safe contraceptive method.
Objective To study the relationship between Cu IUD and secondary infertility. Methods A retrospective cohort study was conducted from the reproductive medicine center in the Third Affiliated Hospital of Zhengzhou University from August 2015 to August 2016. A total of 300 married women were selected as participants. They were divided into two groups( case and control) based on previous history of using Cu T-380 A IUD. Data were gathered using a standard. Results Mean period of Cu IUD usage in the case group was( 54. 91 ± 3. 02) Months. There was no significant difference between the two groups in the causes of secondary infertility for tubal factor( 43. 8% and 39. 8%,respectively),male factor( 20. 2% and 21. 4%,respectively),ovulation dysfunction( 19. 2% and 22. 4%,respectively),and ovary funtion abates( 9. 9% and 8. 5%,respectively)( P > 0. 05). Conclusion Tubal factor is the main cause of infertility in the reproductive women after intrauterine contraceptive device. Other factors also included decreased ovarian reserve,decreased semen quality,etc. Given the relatively large sample size studied here,it is unlikely that Cu IUD results in secondary infertility and may be used by our country's women as a safe contraceptive method.
引文
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[7]Shaw ST,Andrade AT,Paixao de Souza J,et al.Quantitative menstrual and intermenstrual blood loss in women using Lippes Loop and Copper T intrauterine devices[J].Contraception,1980,21(4):343-52.
[8]陈艳春,苏亮.500例女性继发不孕的病因分析[J].中国药物经济学,2013,2:463-364.
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[12]Hubacher D,Lara-Ricalde R,Taylor DJ,et al.Use of copper intrauterine devices and the risk of tubal infertility among nulligravid women[J].N Engl J Med.2001,345(8):561-567.
[13]张爱丹.放置宫内节育器对输卵管阻塞性不孕的影响[J].天津医药,2017,1(45):76-78.
[14]Swende TZ,Ocheke A,Mohammed H.Forgotten intrauterine contraceptive device:a rare cause of infertility[J].Niger Med J.2009,18(4):420-421.
[2]Hamerlynck JV,Knuist M.Modern intra-uterine contraception:a better option.Ned Tijdschr Geneeskd[J].2001,145(3):1621-1624.
[3]Gutin SA,Mlobeli R,Moss M,et al.Survey of knowledge,attitudes and practices surrounding the intrauterine device in South Africa.Contraception[J].2011,83(2):145-150.
[4]Aradhya K,Rahim Keita D,Mwebesa W.Repositioning of the intrauterine device continues[J].Africa Health.2010,2(32):36-37.
[5]Mansour D,Gemzell-Danielsson K,Inki P,et al.Fertility after discontinuation of contraception:a comprehensive review of the literature[J].Contraception.2011,84(5):465-477.
[6]张丽娜,席志敏,宋洁,等.803例城乡育龄妇女宫内节育器不良反应及影响因素分析[J].中国妇幼保健,2013,3(28):479-481.
[7]Shaw ST,Andrade AT,Paixao de Souza J,et al.Quantitative menstrual and intermenstrual blood loss in women using Lippes Loop and Copper T intrauterine devices[J].Contraception,1980,21(4):343-52.
[8]陈艳春,苏亮.500例女性继发不孕的病因分析[J].中国药物经济学,2013,2:463-364.
[9]Kelly-Weeder S.Cok D.The inpact of lifestyle risk factorson female infertility[J].Women Health,2006,44(4):1-23.
[10]MunnéS,Alikani M,Tomkin G,et a1.Embryo morphology,developmental rates,and maternal age are correlated with chromosome abnormalities[J].Fertil Steril,1995,64(2):382-391.
[11]MunnéS,Cohen J,Sable D.Preimplantation genetic diagnosis for advanced maternal age and other indications[J].Fertil Steril,2002,78(2):234-236.
[12]Hubacher D,Lara-Ricalde R,Taylor DJ,et al.Use of copper intrauterine devices and the risk of tubal infertility among nulligravid women[J].N Engl J Med.2001,345(8):561-567.
[13]张爱丹.放置宫内节育器对输卵管阻塞性不孕的影响[J].天津医药,2017,1(45):76-78.
[14]Swende TZ,Ocheke A,Mohammed H.Forgotten intrauterine contraceptive device:a rare cause of infertility[J].Niger Med J.2009,18(4):420-421.