Effect of inactive tuberculosis on pregnancy outcome of IVF/ICSI-ET in infertile patients
10.3760/cma.j.cn101441-20230106-00014
- VernacularTitle:非活动性结核对不孕患者IVF/ICSI-ET助孕结局的影响
- Author:
Qi LI
1
;
Zhiqin BU
1
;
Ziyao YANG
1
;
Linli HU
1
Author Information
1. 郑州大学第一附属医院生殖与遗传专科医院，郑州 450052
- Publication Type:Journal Article
- Keywords:
Infertility;
Fertilization in vitro;
Embryo transfer;
Inactive tuberculosis
- From:
Chinese Journal of Reproduction and Contraception
2023;43(8):784-791
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effect of inactive tuberculosis on the assisted reproductive outcome of the first in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) and embryo transfer (ET) in infertile patients. Methods:A retrospective cohort study was conducted to analyze the data of 15 412 infertile patients who underwent the first fresh-cycle embryo transfer in the Reproductive and Genetics Hospital of the First Affiliated Hospital of Zhengzhou University from January 2011 to December 2021. They were divided into inactive tuberculosis group (635 cases) and control group (1 270 cases) according to the ratio of 1∶2 by propensity score matching (PSM). The inactive tuberculosis group was divided into three subgroups: tuberculosis (group A, 378 cases), pelvic tuberculosis (group B, 214 cases) and other tuberculosis (group C, 43 cases) according to the location. The inactive tuberculosis group was also divided into the treatment subgroup (377 cases) and the non-treatment subgroup (258 cases) according to whether they had undergone treatment. The assisted reproductive outcomes were compared and the influencing factors were analyzed.Results:After PSM, the difference of the baseline data between the inactive tuberculosis group and control group was not statistically significant (all P>0.05). The fertilization rate [65.2% (5 207/7 991)] of patients in the inactive tuberculosis group was significantly higher than that of control group [63.7% (9 889/15 524), P=0.027], but the implantation rate [41.9% (483/1 152)], the clinical pregnancy rate [58.4% (371/635) ] and the live birth rate [46.5% (295/635)] were significantly lower than those of control group [48.8% (1 112/2 279), P<0.001; 67.2% (853/1 270), P<0.001; 57.9% (735/1 270), P<0.001], and the miscarriage rate [20.5% (76/371)] was significantly higher than that of control group [13.8% (118/853), P=0.003], and the endometrium thickness [(11.8±2.6) mm] was thinner than that of control group [(12.5±3.9) mm, P<0.001]. For subgroup analysis, the high-quality embryo rate in group B [62.3% (1 111/1 784)] was significantly lower than that in group A [66.5% (2 027/3 048), P=0.007] and control group [65.9% (6 516/9 889), P=0.007], and the difference was statistically significant. The implantation rate [46.6% (318/682)], the clinical pregnancy rate [64.5% (243/377)] and the live birth rate [51.7% (195/377)] in the treatment group were higher than those in the non-treatment group [35.1% (165/470), P<0.001;49.6% (128/258), P<0.001;38.8% (100/258), P=0.001]. In addition, logistic regression showed that inactive tuberculosis was an independent risk factor for clinical pregnancy, live birth, and miscarriage ( OR=0.71, 95% CI: 0.58-0.87, P=0.002; OR=0.65, 95% CI: 0.54-0.80, P<0.001; OR=1.58, 95% CI: 1.15-2.19, P=0.045). Conclusion:Inactive tuberculosis is an independent risk factor for adverse assisted reproductive outcomes. Compared with non-tuberculosis infertile patients, the pregnancy outcomes of inactive tuberculosis infertile patients who received IVF/ICSI-ET for the first time are poorer, especially the patients with pelvic tuberculosis in the past. Regular anti-tuberculosis treatment for tuberculosis patients can help to improve pregnancy outcomes.
