Statistics of the Diagnosis and Treatment of Infertile Patients

Journal of UOEH · 1986 · vol. 8(3) , pp. 381–390 · doi:10.7888/juoeh.8.381 · PMID:2945244 · W2415392453
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This study analyzed 1985 infertility patient data, finding primary infertility more common, ovarian-endocrine factors the leading cause, and open laparoscopy revealing previously undiagnosed tubal and endometriosis issues.

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The paper analyzed clinical statistics for 141 infertile patients who visited the obstetrics and gynecology infertility clinic at Industrial Medical University during one year (Showa 60), stratifying patients into primary (78) and secondary (63) infertility, and summarizing age, infertility duration, and infertility factors, with the majority attributed to ovarian/endocrine causes and fewer to tubal factors. Among 11 “intractable infertility” cases, “open laparoscopy” identified additional tubal patency disorders/adhesions and endometriosis in 8 cases that had not been detected by prior tests such as hysterosalpingography (HSG) or related procedures. By January 30 of the next year, 20 patients had achieved pregnancy, all of whom were age 35 or younger with infertility duration of 5 years or less, and 8 of these had undergone HSG in the pregnancy cycle or the prior cycle; depression-related measures in 42 patients largely remained within normal range. This paper is centrally about endometriosis — laparoscopic evaluation uncovered previously undetected endometriosis in infertile patients, linking infertility diagnostic workup to endometriosis findings.

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Abstract

Authors present the statistics of the diagnosis and treatment of infertile patients who visited the outpatient clinic of the Department of Obstetrics and Gynecology, School of Medicine, University of Occupational and Environmental Health, Japan throughout 1985. The number of primary infertility (78) was greater than that of secondary infertility (63). The average age and the duration of infertility were 30.5 y. old/3.86 y. (primary) and 31.6 y. old/3.59 y. (secondary), respectively. The most frequent cause of infertility was ovarian-endocrine factor both in primary and secondary infertilities. The second cause was the male factor in primary infertility in spite of the idiopathic factor in secondary infertility. Tubal disorder as a cause was relatively few in both infertilities. So-called open laparoscopy was performed on 11 patients, with little hope of cure. In eight of these patients, disorders of tubal patency and endometriosis, which were not found by hysterosalpingography and hydrotubation before laparoscopy, were discovered for the first time. In twenty pregnancies at the day of statistics, the number of secondary infertility (13) was greater than that of primary infertility (7). All pregnant cases were under 35 years of age and under 5-year of infertility duration at the initial visit to our outpatient clinic. The number 1 cause of infertility was ovarian-endocrine factor. In eight pregnant cases, hysterosalpingography was performed in the same or one cycle before the pregnant cycle. According to the summation of the questionnaire of 65 infertile patients, most of infertile patients were affirmative to in-vitro-fertilization and embryo transfer. Depressive and neurotic tendencies were not remarkable at that time by Self-Rating-Depression Scale (SDS) and Cornell Medical Index (CMI) in 42 infertile patients.
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不妊外来における診療統計, および不妊患者に対する心理検査とアンケート 1986 年 8 巻 3 号 p. 381-390 詳細 抄録 昭和60年の一年間に産業医科大学産婦人科外来を受診した不妊患者141名を対象に診療統計を行った. 原発性不妊78例, 続発性63例と原発性が多かった. 初診時年令・不妊期間は平均, 原発性30.5才, 3.86年;続発性31.6才, 3.59年であった. 不妊因子では原発・続発性ともに卵巣・内分泌因子が多く, 次いで原発性では男性因子, 続発性では特発性の順であり卵管因子は比較的少なかった. 難治性不妊11例にいわゆるopen laparo-scopyを行ったところ, 8例に術前の子宮卵管造影(HSG), 通水などで発見できなかった卵管疎通障害や癒着, 子宮内膜症を新たに認めた. 61年1月30日までの経過で妊娠例は20例, 内訳は原発性7例, 続発性13例と続発性の方が妊娠率が良かった. 妊娠例はすべて初診時年令35才以下, 不妊期間5年以下で不妊因子は卵巣・内分泌因子が最も多かった. 20例中8例は妊娠周期またはその一周期前にHSGを施行していた. 65名の患者のアンケートからは原発性不妊では体外受精に対しても肯定的な者が多かった. Self-Rating Depression ScaleとCMIを施行した42名の患者では特に鬱や神経症の傾向は高くなく正常域の者が大多数であった. © 1986 産業医科大学

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Condition tags

endometriosisinfertility

MeSH descriptors

Infertility, Female Adult Attitude Cornell Medical Index Embryo Transfer Female Fertilization in Vitro Humans Infertility, Female Infertility, Female Infertility, Female Laparoscopy

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