| The intrauterine device(IUD),is a long-acting,economical,safe and reversible contraceptive method,it has been strongly advocated for its high efficiency and practicality since the implementation of the family planning policy in China.At present,the intrauterine device has become one of the most effective contraceptive methods used by married women in China,despite high efficacy,the use rate of intrauterine device in China is declining in recent years.During the 1970 s and earlier the Dalkon Shield IUDs has brought a high risk of pelvic inflammatory disease(PID)and subsequent infertility to the users,which caused many women have been puzzled by the recovery of fertility after Intrauterine Device Removal,fear of subsequent infertility and PID following the use of IUD is considered as one of the main concerns in use of IUD among women and thought to be one of the most important factors for cessation of IUD use in our countrie.At present,there is lack of consistent results about the presence or absence of an association between IUD use and fertility.ObjectiveTo study the association between intrauterine device and secondary infertility.Material and methods1 Objects of researchThe 815 secondary infertility females after extracting intrauterine contraceptive device were selected as the case group(group A),from August 2015 to September 2017 visiting in the Third Affiliated Hospital of Zhengzhou University.In the same period,there was 937 women without the history of using IUD,and contraceptive methods for condoms,safe period contraception,in vitro ejaculation,or use of no contraceptive methods in the control group(group B).All patients underwent transvaginal ultrasound,ovulation monitoring,hystero-Salpingography or hysteroscopy and intubation,basic endocrine examination,chromosome examination and genital tract secretion examination,and the male side performed sperm quality examination.2 Methods of researchData were gathered by a standard structured,the patients,general condition,history of menstrual,histories of pregnancy,methods of contraception,the time of infertility,basal endocrine,hystero-Salpingography or hysteroscopy,the results of ovulation monitoring,the quality of the semen,the results of chromosome examination,and the factors of infertility are collected,and follow up the treatment outcome of the patients.The aim of this study was to analysis the main causes of infertility in women after extracting intrauterine contraceptive device and to examine the relationship between the use of intrauterine device and secondary infertility.3 Data sorting and statistical analysis The information were inputed to Excel date tables after checked.Using SPSS 17.0 software to statistics and analyze the data.All the test level was ?=0.05.Results1.Mean period of IUD usage in the case group was 7.86±4.72 years and mean time of infertility was 2(1,5)years,compared with the control group,the time of infertile years was statistically significant(P<0.05).The are no significant differences of age,body mass and basal endocrine between case and control groups(P>0.05).The degree of education was highter in control group,a significant statistical difference was observed in degree of education between case and control groups(P<0.05).2.The main causes of secondary infertility in case group was tubal factor,the proportion was 62.7%,the proportion of secondary infertility caused by male factors was 23.8%,the proportion of ovarian reserve decrease was 21.6%,ovulation dysfunction was 15.7%,intrauterine adhesions was 6.1%,abnormal uterine morphology was 2.1%,endometriossis was 2.0%,unexplained secondary infertility was 7.9% and other reasons was 2.3%.There was no significant difference in the proportion of the two groups of the cause of secondary infertility(P>0.05)?3.The mean anti-Mullerian hormone(AMH)in case group was2.27±1.79ng/L,the mean Antral follicle count(AFC)of both ovaries was 11.37±7.47,the differents of Luteinizing Hormone(LH),Follicle-stimulating Hormone(FSH),Estradiol(E2),Follicle-stimulating Hormone/Luteinizing Hormone(FSH/LH),AMH and AFC among the two groups were not statistically(P>0.05).4.The clinical pregnancy rate of the case group after assisted reproductive treatment was 30.6%,and in the control group was 29.1%,there was no statistical significance in the two groups(P>0.05).The live birth rate was 30% and the abortion rate was 57.6% in the case group,the control group's live birth rate was 66% and the abortion rate was 23.6%,the difference between the two groups of live rate and abortion rate was statistically significant(P<0.05).ConclusionsThe data showed that tubal factor was main factors of secondary infertility in women after extracting intrauterine contraceptive devicecaused,it is unlikely that IUD results in secondary infertility.In this study,intrauterine device contraception was not found to have an adverse effect on ovarian reserve function in women. |
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