Sefa Arlıer, Sadık Kükrer, Fikriye Işıl Adıgüzel, Ahmet Zeki Nessar, Gülsüm Uysal, Cevdet Adıgüzel, Dilek Kaya Kaplanoğlu
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The study identified adenomyosis in 95 patients via 2D transvaginal Doppler ultrasonography and 3D transabdominal ultrasonography, whereas direct and indirect adenomyosis features were not detected in 279 patients. Both groups started ovulation induction on cycle day 2-3 using recombinant follicle stimulating hormone (rFSH) or letrozole combined with rFSH or rFSH combined with recombinant luteinizing hormone (rLH). Clinical and ultrasound findings were recorded systematically. IUI was performed 36 h post-human chorionic ggonadotropin (hCG) administration, with pregnancy defined as a positive β-hCG 12-14 days after IUI. Logistic regression models were used to analyze the independent effects of adenomyosis on clinical pregnancy rates, adjusting for potential confounders.</p><p><strong>Results: </strong>The cumulative pregnancy rate per cycle was significantly lower in women with adenomyosis (12.23%) compared to those without adenomyosis (20.81%). Adenomyosis was identified as a significant negative predictor of IUI success (OR 0.575, 95% CI: 0.335-0.998, p = 0.049).</p><p><strong>Conclusion: </strong>Adenomyosis negatively affects IUI outcomes, suggesting the need for tailored fertility treatment strategies in this population. 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引用次数: 0
摘要
背景:子宫腺肌症越来越被认为是影响生育的一个重要因素,特别是在辅助生殖技术(ART)的背景下。本研究旨在评估b子宫腺肌症对不明原因不孕妇女宫内人工授精成功率的独立影响。方法:本回顾性横断面研究包括在阿达纳市医院卫生科学大学辅助生殖技术中心接受治疗的374名不孕症妇女的533个IUI周期。本研究通过2D经阴道多普勒超声和3D经腹部超声检查发现95例子宫腺肌症,而279例患者未发现直接和间接子宫腺肌症特征。两组在第2-3天开始使用重组促卵泡激素(rFSH)或来曲唑联合rFSH或rFSH联合重组黄体生成素(rLH)诱导排卵。系统记录临床和超声检查结果。在人绒毛膜促性腺激素(hCG)给药后36小时进行IUI,在IUI后12-14天β-hCG阳性定义为妊娠。采用Logistic回归模型分析子宫腺肌症对临床妊娠率的独立影响,并对潜在混杂因素进行校正。结果:子宫腺肌症患者每周期累积妊娠率(12.23%)明显低于无子宫腺肌症患者(20.81%)。子宫腺肌症被认为是IUI成功的显著负向预测因子(OR 0.575, 95% CI: 0.335-0.998, p = 0.049)。结论:子宫腺肌症对IUI结果有负面影响,提示需要针对这一人群量身定制生育治疗策略。在不孕症评估中应考虑子宫腺肌症的常规评估,以优化临床管理和治疗成功。
The impact of adenomyosis on intrauterine insemination success in unexplained infertile women: a retrospective cross-sectional study.
Background: Adenomyosis is increasingly recognized as a significant factor affecting fertility, particularly in the context of assisted reproductive technologies (ART). This study aimed to assess the independent impact of adenomyosis on intrauterine insemination (IUI) success rates in women with unexplained infertility.
Methods: This retrospective cross-sectional study included 533 IUI cycles in 374 infertile women treated at the University of Health Science, assisted reproductive technologies center, Adana City Hospital. The study identified adenomyosis in 95 patients via 2D transvaginal Doppler ultrasonography and 3D transabdominal ultrasonography, whereas direct and indirect adenomyosis features were not detected in 279 patients. Both groups started ovulation induction on cycle day 2-3 using recombinant follicle stimulating hormone (rFSH) or letrozole combined with rFSH or rFSH combined with recombinant luteinizing hormone (rLH). Clinical and ultrasound findings were recorded systematically. IUI was performed 36 h post-human chorionic ggonadotropin (hCG) administration, with pregnancy defined as a positive β-hCG 12-14 days after IUI. Logistic regression models were used to analyze the independent effects of adenomyosis on clinical pregnancy rates, adjusting for potential confounders.
Results: The cumulative pregnancy rate per cycle was significantly lower in women with adenomyosis (12.23%) compared to those without adenomyosis (20.81%). Adenomyosis was identified as a significant negative predictor of IUI success (OR 0.575, 95% CI: 0.335-0.998, p = 0.049).
Conclusion: Adenomyosis negatively affects IUI outcomes, suggesting the need for tailored fertility treatment strategies in this population. Routine assessment of adenomyosis should be considered in infertility evaluations to optimize clinical management and treatment success.
期刊介绍:
BMC Pregnancy & Childbirth is an open access, peer-reviewed journal that considers articles on all aspects of pregnancy and childbirth. The journal welcomes submissions on the biomedical aspects of pregnancy, breastfeeding, labor, maternal health, maternity care, trends and sociological aspects of pregnancy and childbirth.