| Objectives: 1.To study and compare the distribution of human papillomavirus(HPV)infection and its subtypes in infertile women and women of childbearing age;2.To explore the different aspects and types of HPV infection in pregnancy outcome and other aspects Correlation.3.To provide new evidence for the analysis of assisted reproductive technology to assist pregnancy outcome and the necessity of HPV infection intervention.Methods: From September 2017 to March 2019,1399 couples who volunteered for IVF /ICSI-ET in the Reproductive Medicine Center of the Affiliated Hospital of Inner Mongolia Medical University were enrolled.,Non-randomized control,using the same super ovulation promotion program(long program),the woman's age <45 years old,recording clinical information,collecting the woman's cervical exfoliated cells,endometrial tissue,follicular culture fluid and embryo culture fluid,and the specimens were aggregated Polymerase chain reaction(PCR)amplification method was used to detect HPV infection and subtype distribution in different parts.It was divided into HPV-positive group and HPV-negative group.Using statistical methods to study HPV infection in different parts and types And its impact on assisted reproductive technology to assist pregnancy outcomes.Results:(1)In general comparison,the age,infertility years,body mass index,basal endocrine hormone FSH,LH,estradiol(E2),There were no significant differences in testosterone(T),progesterone(P),endometrial thickness on trigger day,LH,E2,and P,and there were no significant differences in the cause of infertility(P> 0.05).(2)Of the 1399 women,1269(90.71%)were in the HPV-negative group and 130(9.29%).clinical pregnancy rate in the HPV negative group was53.51%(679/1269),live birth rate was 45.86%(582/1269),abortion rate was 13.25%(90/679),ectopic pregnancy The rate was 1.03%(7/679),the clinical pregnancy rate in the HPV-positive group was 43.08%(56/130),the live birth rate was 34.62%(45/130),the abortion rate was 19.64%(11/56),and the ectopic pregnancy rate was 0.00%(0/56).Therewere no significant differences in the number of eggs obtained,the number of transplantable embryos,the number of high-quality embryos,the clinical pregnancy rate,the miscarriage rate,and the ectopic pregnancy rate between the HPV-positive group and the HPV-negative group(P> 0.05).The difference in live birth rates was statistically significant(P = 0.009<0.05).(3)Among different parts of HPV infection,the HPV infection rate of the cervix was9.29%(130/1399),the HPV infection rate of the endometrium was 2.00%(28/1399),the HPV infection rate of the follicular culture solution was 1.00%(14/1399),and the HPV infection rate of the embryo culture solution was 0.00%.There were 90 cases of positive HPV infection in a single part of the cervix and 40 cases of positive infection in a multiple part of the cervix.Among them,24 cases were positive in the two parts of the cervix and endometrium.(Only 1 case had different HPV infection types in the two parts.)There were 11 cases in the two-site-positive group(only one case had two HPV infection types that were completely different),and one case in the two-site-positive group with positive endometrium and follicle culture solution.The infection types were the same,and three sites were cervical,endometrial,and follicle culture fluid.In the positive group,4 cases had the same HPV type as HPV infection.The detection rate of HPV infection type in endometrial tissue and follicle culture fluid was 95.00%(38/40)with cervical HPV infection.In the HPV single-site positive group,the clinical pregnancy rate was 40.00%(36/90),the live birth rate was 31.11%(28/90),and the abortion rate was 22.22%(8/36).The clinical pregnancy rate was 50.00%(20/40),the live birth rate was 40.00%(16/40),and the miscarriage rate was 15.00%(3/20)in the HPV-positive group.There was no significant difference in the number of eggs obtained,the number of transplantable embryos,the number of high-quality embryos,the clinical pregnancy rate,the live birth rate,and the abortion rate in the positive group(P> 0.05).(4)Among the different types of HPV infection,17 high-risk types and 5 low-risk types were detected.Type 82 was not detected.The highest detection rate of infection type was type 16(12.31%),and the remaining 42 types(12.31%)Type 52(16.15%)and type 58(11.54%).There were 102 cases of single type infection(78.46%),28 cases of composite type infection(21.54%),106 cases of high risk type(81.54%),24 cases of low type(18.46%),and clinical pregnancy rate in high-risk HPV infection group.44.34%(47/106),live birth rate 36.79%(39/106),abortion rate 17.02%(8/47);clinical pregnancy rate of low-risk HPV infection group was 37.50%(9/24),and delivery rate was 20.83 %(5/24),abortion rate 44.44%(4/9).There were no significant differences in the number of eggs obtained,the number of transplantable embryos,the number of high-quality embryos,the clinical pregnancy rate,the live birth rate,and the abortion rate between the high-risk group and the low-risk group in the HPV infection group(P> 0.05).Conclusions:(1)9.29% of cervical HPV infection is slightly lower than domestic studies ? The distribution of HPV infection subtypes is basically consistent with domestic studies,the highest detection rate of infection types is type 16(12.31%),the remaining 42 types(12.31%),52 types(16.15%),58 types(11.54%),HPV infection type detected in endometrial tissue and follicular culture fluid and cervical HPV infection coincided with 95.00%(38/40).(2)This study showed that HPV infection had no significant effect on the number of eggs retrieved,number of transplantable embryos,number of high-quality embryos,clinical pregnancy rate,abortion rate,and ectopic pregnancy rate of IVF / ICSI-ET.However,the live birth rate of HPV-positive group was significantly different from that of HPV-negative group.The live birth rate of HPV-positive women was 34.62%lower than that of HPV-negative women by 45.86%.(3)HPV infection in single and multiple sites had no significant effect on the number of eggs retrieved,the number of transplantable embryos,the number of superior embryos,the clinical pregnancy rate,the live birth rate,and the abortion rate for IVF / ICSI-ET.(4)HPV high-risk and low-risk infections have no significant effect on the number of eggs retrieved,the number of transplantable embryos,the number of high-quality embryos,the clinical pregnancy rate,the live birth rate,and the abortion rate of IVF / ICSI-ET.(5)For infertile women,HPV infection may only be used as a routine screening for cancer prevention,except for lower reproductive tract cancer and high-grade intraepithelial neoplasia before entering the cycle.Excessive treatment is not required,but the risk of HPV infection during pregnancy should be closely monitored.Reproductive tract lesions,reduce complications during pregnancy and increase live birth rate. |
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