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《工程(英文)》 >> 2021年 第7卷 第11期 doi: 10.1016/j.eng.2021.02.012

多囊卵巢综合征排卵障碍型患者经促排卵治疗后的生育力与配偶精液参数的关系

a College of Pharmacy, The Department of Medicine, Hangzhou Normal University, Hangzhou 311121, China
b First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin 150040, China
c Clinical Medical College, Heilongjiang University of Chinese Medicine, Harbin 150040, China
d Department of endocrinology, Xuzhou Central Hospital, Xuzhou 221009, China
e College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
f Department of Obstetrics and Gynecology, The Chinese University of Hong Kong, Hong Kong 999077, China
g Institute of Chinese Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China
h Heilongjiang Provincial Hospital, Harbin 150030, China

# These authors contributed equally to this work.

收稿日期: 2020-09-15 修回日期: 2021-01-21 录用日期: 2021-02-06 发布日期: 2021-04-14

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摘要

本研究中,精液参数的正常值是针对一般不孕不育夫妇设定的,其中大多数女性为正常排卵女性。而对于患有多囊卵巢综合征(PCOS)的女性,其配偶的精液质量,包括精子浓度、精子总活动力(活动精子计数)、向前运动精子计数和精子形态对其生殖结局的预测能力尚不清楚。本研究基于一项随机对照试验展开二次分析,研究对象为2011—2016 年1000 例患有PCOS 排卵障碍型不孕症的中国女性及其配偶。这些来自全国27 家医院的PCOS女性患者被随机分配到四组中的任意一组,均接受促排卵治疗,干预措施分别为针刺联合克罗米芬、对照针刺联合克罗米芬、针刺联合安慰剂或对照针刺联合安慰剂。根据世界卫生组织(WHO)的标准,对每位男性配偶进行精液参数分析。我们需要分析的结果包括受孕、临床妊娠和活产。用logistic 回归评估精液参数对有排卵女性的受孕、临床妊娠和活产的预测价值。在这1000对夫妇中,有排卵、受孕、临床妊娠和活产的夫妇分别为780、320、235 和205 对。将精液量和精子活力分别作为受孕[曲线下面积(AUC)为0.62,95%置信区间(CI)为0.55~0.69]、临床妊娠[AUC为0.67(95% CI:0.61~0.73)]和活产[AUC为0.57(95% CI:0.50~0.64)]的预测参数。在Hosmer-Lemeshow 测试中,这些模型没有出现较差的校准。精液参数分析对患有排卵功能障碍的PCOS女性的治疗结果的预测能力是有限的。

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