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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
Jingshu Gao, Yu Wang, Mubai Li, Mengyi Zhu, Xuekui Liu, Hongli Ma, Yijuan Cao, Lu Li, Xinming Yang, Xiaoke Wu
工程（英文） ›› 2021, Vol. 7 ›› Issue (11) : 1586-1591.
PDF(764 KB)
PDF(764 KB)
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
Semen Analysis and Fecundity Association Among Women with Polycystic Ovary Syndrome Experiencing Ovulatory Dysfunction Treated by Ovulation Induction
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。
In this study, normal values of semen analysis were set for a general infertile population of couples among which most women had normal ovulation. The predictive capacity values of sperm quality, including concentration, motile count, progressive motile count, and morphology, are unclear for women with polycystic ovary syndrome (PCOS). A secondary analysis was conducted based on a randomized controlled trial investigating infertility among women with PCOS experiencing ovulatory disorder between 2011 and 2016 in China. A total of 1000 women received ovulation induction (acupuncture and clomiphene). We randomized the women with PCOS in 27 hospitals in China who received one of four interventions (acupuncture plus clomiphene, sham acupuncture plus clomiphene, acupuncture plus placebo, or sham acupuncture plus placebo). Semen analysis was performed for every male partner according to the World Health Organization (WHO) criteria. The outcomes included conception, clinical pregnancy, and live birth. Logistic regression was used to evaluate the predictive value of semen analysis among ovulatory women for conception, clinical pregnancy, and live birth. Among the 1000 couples, the number of couples who attained ovulation, conception, clinical pregnancy, and live birth were 780, 320, 235, and 205, respectively. Semen volume and motility were applied and used as prediction parameters for conception (area under the curve (AUC) of 0.62 (95% confidence interval (CI), 0.55–0.69)), clinical pregnancy (AUC of 0.67 (95%CI: 0.61–0.73)), and live birth (AUC of 0.57 (95%CI: 0.50–0.64)). No poor calibration was shown for these models in Hosmer–Lemeshow tests. The predictive capacity of semen analysis for treatment outcome in PCOS women with PCOS experiencing with ovulatory dysfunction is limited.
Semen analysis / Fecundity / Ovulatory dysfunction / Predictive capacity
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