盆腔输卵管因素不孕患者IVF/ICSI助孕结局的影响因素分析

Analysis of Influencing Factors of IVF/ICSI Assisted Pregnancy Outcomes in Patients with Pelvic Tubal Infertility

摘要: 目的：分析盆腔输卵管因素不孕患者首次体外受精/卵胞浆内单精子注射(IVF/ICSI)助孕结局的影响因素。方法：回顾性收集2024年1月至2025年12月于马鞍山市妇幼保健院生殖医学中心首次接受IVF/ICSI治疗的187例盆腔输卵管因素不孕患者的临床资料。根据移植后是否获得临床妊娠将患者分为妊娠组(n = 49)与未妊娠组(n = 138)，采用Mann-Whitney U检验比较两组间卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)、孕酮(P)、催乳素(PRL)以及抗苗勒管激素(AMH)的水平差异，并通过二元Logistic回归分析影响临床妊娠结局的相关因素。结果：单因素分析显示，妊娠组年龄、不孕年限及FSH水平均低于未妊娠组，AMH水平高于未妊娠组，差异均有统计学意义(P < 0.05)。多因素Logistic回归分析显示，年龄、FSH水平和AMH水平均为临床妊娠的独立影响因素，差异有统计学意义(P < 0.05)。结论：对于盆腔输卵管因素不孕患者，年龄、FSH水平是IVF/ICSI助孕结局的风险因素，AMH水平则是IVF/ICSI助孕结局的保护因素，临床可围绕上述指标开展个体化预后评估和治疗决策。

Abstract: Objective: To analyze the influencing factors on the outcome of first in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) assisted pregnancy in patients with pelvic tubal infertility. Methods: A retrospective collection of clinical data was conducted on 187 patients with pelvic tubal infertility who received IVF/ICSI treatment for the first time at the Reproductive Medicine Center of Ma’anshan Maternal and Child Health Hospital from January 2024 to December 2025. According to whether clinical pregnancy was obtained after transplantation, patients were divided into a pregnant group (n = 49) and a non-pregnant group (n = 138). Mann-Whitney U test was used to compare the differences in levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), progesterone (P), prolactin (PRL), and anti-Mullerian hormone (AMH) between the two groups, and binary logistic regression was used to analyze the relevant factors affecting clinical pregnancy outcomes. Results: Single factor analysis showed that the age, duration of infertility, and FSH levels in the pregnant group were lower than those in the non-pregnant group, while the AMH level was higher than that in the non-pregnant group, and the differences were statistically significant (P < 0.05). Multivariate logistic regression analysis showed that age, FSH level, and AMH level were independent influencing factors for clinical pregnancy, and the differences were statistically significant (P < 0.05). Conclusion: For patients with pelvic tubal infertility, age and FSH level are risk factors for IVF/ICSI assisted reproductive outcomes, while AMH level is a protective factor for IVF/ICSI assisted reproductive outcomes. Individualized prognosis assessment and treatment decisions can be made based on these indicators in clinical practice.