背景:中年工作妇女代表大多数在生育诊所接受体外受精(IVF)治疗的患者。在这项研究中,我们的目的是确定妇女的工作状态与IVF治疗后头三个月的临床妊娠和流产的关系。
方法:在哈萨克斯坦一家私人诊所的单中心横断面研究中,我们回顾了2018年1月至2019年12月所有采用卵胞浆内单精子注射(ICSI)和新鲜胚胎移植(ET)周期的IVF的电子病历(n=654).选择300个周期的卵巢储备正常患者和病历中女性伴侣的注册工作状态进行分析。该研究的主要结局指标是妊娠早期的临床妊娠率和临床流产率。
结果:204名妇女被雇用,而在治疗开始前没有使用96。所有患者的平均年龄为32.2±4.8岁,从23岁到46岁不等。三分之二的职业妇女从事的是医生,学校和大学教师,会计师,文员,和经理。三分之一的研究参与者从事体力劳动,包括服务岗位和工厂工人。女性的工作状态和临床妊娠率之间没有关联,调整为年龄,窦卵泡计数,盆腔粘连松解术史,胚胎移植的胚胎发育阶段。然而,与非工作女性相比,工作女性的妊娠早期流产风险几乎是非工作女性的5倍[校正比值比(aOR)4.56,95%置信区间(CI):0.52~4.96].
结论:在开始试管婴儿治疗之前工作的妇女可以放心,与非工作妇女相比,在治疗后有平等的受孕机会。观察到的职业妇女妊娠早期流产的风险需要进一步研究,然后才能从医疗和公共卫生方面得出任何结论。
BACKGROUND: Middle-aged working women represent most patients attending fertility clinics for in vitro fertilization (IVF) treatment. In this study, we aimed to identify the association of women\'s working status with clinical pregnancy and miscarriage in the first trimester after IVF treatment.
METHODS: In this single-centre cross-sectional study at a private clinic in Kazakhstan, we reviewed electronic medical records of all IVF with intracytoplasmic sperm injection (ICSI) and fresh embryo transfer (ET) cycles from January 2018 to December 2019 (n=654). 300 cycles in patients with normal ovarian reserve and registered working status of a female partner in the medical records were selected for the analysis. The study\'s primary outcome measures were clinical pregnancy rates and clinical miscarriage in the first trimester.
RESULTS: 204 women were employed, while 96 were not employed before the start of treatment. The mean age of all patients was 32.2 ± 4.8 years, ranging from 23 to 46 years. Two-thirds of working women had office-based occupations employed as doctors, school and university teachers, accountants, clerks, and managers. One-third of the study participants had manual labor jobs, including service positions and plant workers. There was no association between women\'s working status and clinical pregnancy rate adjusted for age, antral follicle count, history of pelvic adhesiolysis, and embryo development stage at embryo transfer. However, working women had almost five times the risk of the first trimester miscarriage compared to non-working women [adjusted odds ratio (aOR) 4.56, 95% confidence interval (CI): 0.52 to 4.96] adjusted for age and number of retrieved oocytes.
CONCLUSIONS: Women who work before commencing IVF treatment can be reassured of having equal chances of conception following the treatment compared to non-working women. The observed risk of first trimester miscarriage in working women necessitates further research before drawing any conclusions from medical and public health points.